ʻO ka maʻi helminth i hoʻouna ʻia i ka lepo (STH) he pilikia olakino koʻikoʻi nui ma Philippines.
Ua hoʻokumu ʻia kahi papahana STH mass drug administration (MDA) i ka makahiki 2006, akā ʻo ka nui o ka nui o STH ma Philippines e mau ana ka kiʻekiʻe, mai ka 24.9% a hiki i ka 97.4%. me ka ʻike ʻole i ke koʻikoʻi o ka mālama mau ʻana, nā kuhi hewa ʻole e pili ana i nā hoʻolālā MDA, ka hilinaʻi ʻole i nā lāʻau i hoʻohana ʻia, ka makaʻu i nā hanana ʻino, a me ka hilinaʻi nui i nā papahana aupuni. wahi i nā kaiaulu [e laʻa, nā papahana hoʻomaʻemaʻe holoʻokoʻa holoʻokoʻa (CLTS) alakaʻi kaiaulu (CLTS) e hāʻawi ana i nā halepaku a me ke kākoʻo ʻana i ke kūkulu hale lua] a me nā kula [eg, school WASH (WINS) plan], akā pono ka hoʻokō mau ʻana e hoʻokō i nā hopena i makemake ʻia. ʻO ke aʻo ʻana o WASH ma nā kula, ʻo ka hoʻohui ʻana o STH ma ke ʻano he maʻi a me kahi pilikia kaiāulu i ka haʻawina kula haʻahaʻa lehulehu o kēia manawa ʻaʻole lawa.e koi 'ia ana no ka Integrated Helminth Control Program (IHCP) i kēia manawa ma ka'āina, e kālele ana i ka ho'omaika'i 'ana i ka ho'oma'ema'e a me ka ma'ema'e, ka ho'ona'auao olakino a me ka chemotherapy preventive. He pa'akikī ka ho'omau 'ana o ka papahana.
ʻOiai ʻo ka hoʻoikaika nui ʻana e hoʻopaʻa i ka maʻi STH ma Philippines i nā makahiki he ʻelua i hala iho nei, ua hōʻike ʻia ka nui o ka STH kiʻekiʻe ma waena o ka ʻāina, ma muli paha o ka uhi ʻana o ka MDA suboptimal a me nā palena o WASH a me nā papahana hoʻonaʻauao olakino..E hoʻomau ka hāʻawi ʻana i kahi ala hoʻokele hoʻohui i kahi kuleana nui i ka hoʻomalu a hoʻopau ʻana iā STH ma Philippines.
ʻO nā maʻi helminth i hoʻouna ʻia i ka lepo (STH) he pilikia koʻikoʻi koʻikoʻi no ke olakino lehulehu ma ka honua holoʻokoʻa, me kahi maʻi i manaʻo ʻia he ʻoi aku ma mua o 1.5 billion mau kānaka [1]. Hoʻopilikia ʻo STH i nā kaiāulu ʻilihune i hōʻike ʻia e ka hiki ʻole i ka wai kūpono, ka hoʻomaʻemaʻe a me ka maʻemaʻe (WASH) [2 , 3];a nui loa ia ma nā ʻāina haʻahaʻa loaʻa, me ka hapa nui o nā maʻi i loaʻa ma nā wahi o Asia, ʻApelika, a me Latin America [4]. ʻO ka mea maʻalahi loa, me ka nui o ka maʻi a me ka ikaika o ka maʻi. Loaʻa nā ʻikepili i ʻōlelo ʻia e ʻoi aku ma mua o 267.5 miliona PSAC a ʻoi aku ma mua o 568.7 miliona SAC e noho ana i nā wahi me ka hoʻoili STH koʻikoʻi a koi aku i ka chemotherapy preventive [5]. Ua manaʻo ʻia ke kaumaha honua o STH ʻo 19.7-3.3 miliona mau makahiki i hoʻoponopono ʻia i ke kino kīnā (DALYs) [6, 7].
Hiki i ka maʻi STH ke alakaʻi i ka hemahema o ka meaʻai a me ka hoʻomohala kino a me ka noʻonoʻo, ʻoi aku ka nui o nā keiki [8]. me ke kiʻekiʻe o ka make a me ka hoʻonui ʻana i ka maʻi i nā maʻi ʻē aʻe [10, 11]. ʻO nā hopena ʻino o kēia mau maʻi e hiki ke hoʻopili ʻaʻole i ke olakino wale nō akā i ka huahana waiwai [8, 12].
He ʻāina haʻahaʻa a haʻahaʻa ka ʻāina ʻo Pilipine. I ka makahiki 2015, ma kahi o 21.6% o ka 100.98 miliona mau kānaka Pilipino i noho ma lalo o ka laina ʻilihune aupuni [13]. Aia kekahi o ka prevalence kiʻekiʻe o STH ma Asia Hikina Hema [14] .2019 ʻikepili mai ka WHO Preventive Chemotherapy Database e hōʻike ana ma kahi o 45 miliona mau keiki i ka pilikia o ka maʻi e koi ana i ka lāʻau lapaʻau [15].
ʻOiai ua hoʻomakaʻia kekahi mau hana nui e hoʻomalu aiʻole e hoʻopau i ka hoʻounaʻana, ua hoʻomau nuiʻia ka STH ma Philippines [16] .e hōʻike i nā hana hoʻomalu i hala a me kēia manawa, e kākau i nā pilikia a me nā pilikia o ka hoʻokō ʻana i ka papahana, e loiloi i kona hopena i ka hōʻemi ʻana i ke kaumaha STH, a hāʻawi i nā manaʻo kūpono no ka mālama ʻana i nā ilo ʻōpū . polokalamu hoʻomalu STH hoʻomau ma ka ʻāina.
Ke nānā nei kēia loiloi i nā maʻi STH maʻamau ʻehā - roundworm, Trichuris trichiura, Necator americanus a me Ancylostoma duodenale. ʻOiai ke kū nei ʻo Ancylostoma ceylanicum ma ke ʻano he ʻano nui zoonotic hookworm ma Asia Hikina Hema, aia ka ʻike i kēia manawa ma Philippines a ʻaʻole e kūkākūkā ʻia. maanei.
ʻOiai ʻaʻole kēia he loiloi ʻōnaehana, ʻo ke ʻano i hoʻohana ʻia no ka loiloi puke e like me kēia. hoʻohana ʻia e like me nā huaʻōlelo ma ka ʻimi ʻana: (“Helminthiases” a i ʻole nā ilo lawe ʻia i ka lepo” a i ʻole “STH” a i ʻole “Ascaris lumbricoides” a i ʻole “Trichuris trichiura” a i ʻole “Ancylostoma spp.” a i ʻole “Necator americanus” a i ʻole “Roundworm” a i ʻole “Whichworm” a i ʻole “Hookworm”) a me (“Epidemiology”) a me (“Philippines”).ʻAʻohe palena o ka makahiki hoʻolaha.ʻO nā ʻatikala i ʻike ʻia e nā koina hulina i nānā mua ʻia e ke poʻo inoa a me ka ʻike kikoʻī, ʻaʻole i hoʻopaʻa ʻia no nā ʻatikala ʻekolu a i ʻole me ka laha a i ʻole ka ikaika o kekahi o nā STH.Hoʻokomo ʻia ka nānā ʻana i nā kikokikona piha i ka nānā ʻana (cross-sectional, case-control, longitudinal/cohort) a i ʻole nā hoʻāʻo hoʻomalu e hōʻike ana i ka prevalence baseline.ʻO ka unuhi ʻana o ka ʻikepili i loaʻa i kahi haʻawina, makahiki aʻo, makahiki o ka hoʻopuka noiʻi, ʻano haʻawina (cross-sectional, case-control, a longitudinal/cohort), ka nui o ka laʻana, ka heluna kanaka noiʻi, prevalence a me ka ikaika o kēlā me kēia STH, a me ke ʻano i hoʻohana ʻia no ka ʻike.
Ma muli o ka huli palapala, ua ʻike ʻia ka huina o 1421 mau moʻolelo e ka huli ʻikepili [PubMed (n = 322);Pākuʻi (n = 13);ProQuest (n = 151) a me Google Scholar (n = 935) ]. Ua nānā ʻia nā pepa he 48 ma muli o ka loiloi poʻo inoa, ua kāpae ʻia nā pepa 6, a ua hoʻokomo ʻia nā pepa he 42 i ka qualitative synthesis (Figure 1). ).
Mai ka 1970s, nui nā haʻawina i mālama ʻia ma Philippines e hoʻoholo ai i ka prevalence a me ka ikaika o ka maʻi STH. Hōʻike ka papa 1 i kahi hōʻuluʻulu o nā haʻawina i ʻike ʻia. Hoʻohana pinepine ʻia ke ʻano ether concentration (FEC) i nā lā mua (1970-1998). Akā naʻe, ua hoʻohana nui ʻia ka ʻenehana Kato-Katz (KK) i nā makahiki ma hope a ua hoʻohana ʻia ʻo ia ke ʻano diagnostic mua no ka nānā ʻana i nā kaʻina hana mana STH ma ka ʻāina. nā noiʻi.
ʻO ka maʻi STH he pilikia olakino koʻikoʻi nui ma Philippines, e like me ka hōʻike ʻana i nā haʻawina i hana ʻia mai nā makahiki 1970 a hiki i 2018. ʻO ke ʻano epidemiological o ka maʻi STH a me kona prevalence ua hoʻohālikelike ʻia me nā mea i hōʻike ʻia ma nā ʻāina endemic ʻē aʻe o ka honua, me ka kiʻekiʻe loa o ka maʻi maʻi i hoʻopaʻa ʻia ma PSAC a me SAC [17]. ʻOi aku ka pilikia o kēia mau makahiki no ka mea e ʻike pinepine ʻia kēia mau keiki i ka STH ma nā wahi waho.
Ma ka mōʻaukala, ma mua o ka hoʻokō ʻia ʻana o ka Polokalamu Hoʻomalu Helminth Integrated o ka 'Oihana Ola (IHCP), ʻo ka prevalence o kekahi maʻi STH a me nā maʻi koʻikoʻi i nā keiki o 1-12 mau makahiki mai ka 48.6-66.8% a i ka 9.9-67.4%, kēlā me kēia.
Hōʻike ka ʻikepili STH mai ka National Schistosomiasis Survey o nā makahiki āpau mai 2005 a i 2008 ua laha nui ka maʻi STH ma nā ʻāpana ʻāina nui ʻekolu o ka ʻāina, me ka A. lumbricoides a me T. trichiura i laha loa ma Visayas [16].
Ma 2009, ua mālama ʻia nā loiloi hope o ka 2004 [20] a me 2006 SAC [21] National STH Prevalence Surveys e loiloi i ka hopena o IHCP [26]. ʻO ka prevalence o kekahi STH he 43.7% ma PSAC (66% i 2004). survey) a me 44.7% ma SAC (54% ma 2006 survey) [26]. He haʻahaʻa loa kēia mau helu ma mua o nā mea i hōʻike ʻia ma nā noiʻi ʻelua ma mua. ka noiʻi 2004 no ka mea ʻaʻole i hōʻike ʻia ka nui o nā maʻi koʻikoʻi) a me 19.7% ma SAC (i hoʻohālikelike ʻia me 23.1% i ka noiʻi 2006), kahi hōʻemi 14% [26]. ʻAʻole i hoʻokō ʻo STH i ka heluna PSAC a me SAC i ka pahuhopu 2020 i wehewehe ʻia e WHO o kahi kumulative prevalence ma lalo o 20% a me kahi maʻi STH koʻikoʻi ma lalo o 1% e hōʻike ai i ka mana morbidity [27, 48].
ʻO nā haʻawina ʻē aʻe e hoʻohana ana i nā noiʻi parasitological i hana ʻia i nā manawa he nui (2006-2011) e nānā i ka hopena o ke kula MDA ma SAC i hōʻike i nā ʻano like [22, 28, 29]. Ua hōʻike nā hopena o kēia mau noiʻi ua emi ka nui o ka STH ma hope o kekahi mau pōʻai o MDA. ;akā naʻe, ua hōʻike ʻia kekahi STH (kahi, 44.3% a 47.7%) a me ka maʻi koʻikoʻi (kahi, 14.5% a 24.6%) i nā noiʻi hahai ʻana. ʻAʻole i hāʻule ka prevalence i ka pae i hoʻoholo ʻia e WHO-defined incidence control target level (Table 1).
ʻO nāʻikepili mai nā haʻawina'ē aʻe ma hope o ka hoʻokomoʻiaʻana o IHCP ma Philippines ma 2007-2018 i hōʻike i ka nui o ka STH ma PSAC a me SAC (Table 1) [30,31,32,33,34,35,36,37,38, 39. ].ʻO ka nui o nā STH i hōʻikeʻia ma kēia mau haʻawina mai ka 24.9% a hiki i ka 97.4% (e KK), aʻo ka nui o nā maʻi maʻamau a hiki i ka maʻi nui mai ka 5.9% a hiki i ka 82.6%.A.lumbricoides a me T. trichiura e noho mau ana ka nui o ka STH, me ka nui mai ka 15.8-84.1% a hiki i ka 7.4-94.4%, a o ka hookworms he haahaa ka nui, mai 1.2% a 25.3% [30,31, 32,33. ,34,35,36,37,38,39] (Table 1). Akā naʻe, ma 2011, he haʻawina e hoʻohana ana i ka molecular diagnostic quantitative real-time polymerase chain reaction (qPCR) i hōʻike i ka prevalence o hookworm (Ancylostoma spp.) o 48.1 % [45]. Ua ʻike pinepine ʻia ka co-infection o nā poʻe me A. lumbricoides a me T. trichiura ma kekahi mau haʻawina [26, 31, 33, 36, 45].
'Ōleloʻia keʻano KK e WHO no ka maʻalahi o ka hoʻohanaʻana i ke kula a me ke kumu kūʻai haʻahaʻa [46], no ka loiloiʻana i nā papa hana hoʻomalu aupuni no ka mana STH. he 2014 aʻo ma Laguna Province, kekahi maʻi STH (33.8% no KK vs 78.3% no qPCR), A. lumbricoides (20.5% KK vs 60.8% no qPCR) a me T. trichiura (KK 23.6% vs 38.8% no qPCR). Aia kekahi ma'i hookworm [6.8% prevalence;ʻO Ancylostoma spp.(4.6%) a me N. americana (2.2%)] ua ʻike ʻia me ka hoʻohana ʻana i ka qPCR a ua hoʻoholo ʻia ʻaʻole maikaʻi e KK [36]. ʻO ka prevalence maoli o ka maʻi hookworm hiki ke hoʻohaʻahaʻa ʻia no ka mea ʻo ka wikiwiki o ka lysis o nā hua hookworm pono e huli wikiwiki. no ka hoʻomākaukau ʻana a me ka heluhelu ʻana o ka KK slide [36,45,47], kahi kaʻina hana paʻakikī e hoʻokō ma lalo o nā kūlana kahua.
ʻO ka hoʻolālā nui no ka mana STH i kākoʻo ʻia e WHO e kālele ana i ka nui prophylactic chemotherapy mealbendazoleaiʻole mebendazole i nā pūʻulu pilikia nui, me ka pahuhopu o ka mālama ʻana i ka liʻiliʻi o 75% o PSAC a me SAC e 2020 [48]. Ma mua o ka hoʻomaka ʻana o ka Neglected Tropical Diseases (NTDs) Roadmap i 2030, WHO ʻōlelo ʻo PSAC, SAC a me ʻO nā wāhine o nā makahiki hānau (15-49 makahiki, me ka poʻe i loko o ka lua a me ke kolu o ka trimesters) loaʻa ka mālama maʻamau [49]. Eia kekahi, aia kēia alakaʻi i nā keiki liʻiliʻi (12-23 mahina) a me nā kaikamahine ʻōpio (10-19 mau makahiki) [ 49], akā kāpae ʻia nā ʻōlelo aʻoaʻo mua no ka mālama ʻana i nā poʻe ʻoihana kiʻekiʻe loa [50]. Hoʻolaha ʻo WHO i ka MDA makahiki no nā keiki liʻiliʻi, PSAC, SAC, nā kaikamahine ʻōpio, a me nā wahine o nā makahiki hānau keiki ma nā wahi me STH prevalence ma waena o 20% a me 50 %, a i ʻole hapalua makahiki inā ʻoi aku ka maʻi ma mua o 50%. 48, 49].
Ua hoʻokuʻu ʻia ka IHCP i ka makahiki 2006 e hāʻawi i ke alakaʻi kulekele no ka mālama ʻana i ka STH a me nā maʻi helminth ʻē aʻe [20, 51].albendazolea i ʻole mebendazole chemotherapy ma ke ʻano he hoʻolālā nui no ka mālama STH, e ʻimi ana i nā keiki i piha i ka makahiki 1-12 a me nā hui koʻikoʻi ʻē aʻe e like me nā wahine hāpai, nā wahine ʻōpio, nā mahiʻai, nā mea mālama meaʻai a me nā poʻe ʻōiwi. a me nā keʻena hoʻomaʻemaʻe e like me ka hoʻolaha olakino a me nā ʻano hoʻonaʻauao [20, 46].
Hoʻokō ʻia ka MDA semi-makahiki o PSAC e nā ʻāpana olakino o ka barangay (kaona) i hoʻomaʻamaʻa ʻia, nā limahana olakino a me nā limahana mālama lā ma nā wahi kaiāulu e like me Garantisadong Pambata a i ʻole "Healthy Children" (kahi pūʻolo e hāʻawi ana i ka papahana) o PSAC's Health Services) , ʻoiai ke kiaʻi ʻia a hoʻokō ʻia ka MDA o SAC e ka 'Oihana Hoʻonaʻauao (DepEd) [20]. ʻO MDA ma nā kula haʻahaʻa aupuni e lawelawe ʻia e nā kumu ma lalo o ke alakaʻi ʻana o nā limahana olakino i ka hapaha mua a me ke kolu o kēlā me kēia makahiki kula [20]. 2016, ua hoʻopuka ke Kuhina Ola i nā alakaʻi hou e hoʻokomo i ka deworming i nā kula kiʻekiʻe (keiki ma lalo o 18) [52].
Ua mālama ʻia ka MDA semiannual mua i nā keiki i piha i ka makahiki 1-12 i ka makahiki 2006 [20] a ua hōʻike ʻia ka uhi deworming o 82.8% o 6.9 miliona PSAC a me 31.5% o 6.3 miliona SAC [53]. Akā naʻe, ua emi nui ka uhi deworming MDA mai 2009 a hiki i ka 2014 (ma waena o 59.5% a 73.9%), he helu ma lalo o ka 75% i manaʻo ʻia e WHO. nā hoʻolālā [56, 57], nele i ka hilinaʻi i nā lāʻau lapaʻau i hoʻohana ʻia [58], a me ka makaʻu i nā hanana ʻino [55, 56, 58, 59, 60] . [61] Eia kekahi, ua ʻike ʻia nā pilikia hoʻolako a me nā logistical o nā lāʻau MDA ma ke ʻano he hemahema nui i loaʻa i ka hoʻokō ʻana o MDA ma ka ʻāina holoʻokoʻa [54].
I ka makahiki 2015, ua hui pū ka DOH me DepEd no ka hoʻolauna ʻana i ka National School Deworming Day (NSDD), kahi e manaʻo ai e kipaku aku i ka 16 miliona SAC (mau papa 1 a 6) i hoʻopaʻa ʻia ma nā kula haʻahaʻa aupuni āpau i ka lā hoʻokahi [62]. -based initiative ka hopena o ka heluna deworming puni honua o 81%, ʻoi aku ka kiʻekiʻe ma mua o nā makahiki i hala [54]. Akā naʻe, ʻo ka ʻike wahaheʻe e hoʻolaha nei i ke kaiāulu e pili ana i ka make ʻana o nā keiki deworming a me ka hoʻohana ʻana i nā lāʻau lapaʻau i hoʻopau i ka hysteria a me ka hopohopo, e alakaʻi ana i ka ua hoʻonuiʻia nā hōʻike o nā hananaʻino ma hope o MDA (AEFMDA) ma ka Zamboanga Peninsula, Mindanao [63] . Akā naʻe, ua hōʻikeʻia kahi noiʻi hoʻomalu i ka hihia AEFMDA i piliʻole me ka moʻolelo mua o ka deworming [63].
I ka makahiki 2017, ua hoʻokomo ke Kuhina Ola i kahi maʻi dengue hou a hāʻawi iā ia ma kahi o 800,000 mau keiki kula. Ma muli o ka hopena, ua emi ka uhi o nā pest mai 81% a me 73% o PSAC a me SAC i 2017 i 63% a me 52% i 2018, a i 60% a me 59% i 2019 [15].
Eia kekahi, i ka hoʻomaka ʻana o ka maʻi maʻi maʻi COVID-19 (coronavirus disease 2019) i kēia manawa, ua hoʻopuka ke Kuhina Ola i ka Memorandum Oihana No. 2020-0260 a i ʻole Interim Guidance for Integrated Helminth Control Plans a me Schistosomiasis Control and Elimination Plans i ka wā o ka COVID- 19 Pandemic 》” Iune 23, 2020, e hoʻokuʻu ʻia ka MDA a hiki i ka hoʻolaha hou.Ma muli o ka pani ʻana o ke kula, hoʻomaʻamaʻa mau ke kaiāulu i nā keiki i ka makahiki 1-18, ka hāʻawi ʻana i nā lāʻau lapaʻau ma o nā kipa ʻana i kēlā me kēia puka a i ʻole nā wahi paʻa, ʻoiai e mālama ana i ka hele kino a me ka huli ʻana i ka COVID-19 -19 kūpono i ka pale ʻana i ka maʻi a me nā hana hoʻomalu [66].Eia nō naʻe, ʻo nā kaohi i ka neʻe ʻana o ka poʻe a me ka hopohopo lehulehu ma muli o ka maʻi maʻi maʻi COVID-19 hiki ke alakaʻi i ka uhi mālama haʻahaʻa.
ʻO WASH kekahi o nā hana koʻikoʻi no ka mana STH i hōʻike ʻia e ka IHCP [20, 46]. He papahana kēia e pili ana i kekahi mau keʻena aupuni, me ka Ministry of Health, Ministry of Home Affairs and Local Government (DILG), Local Government Units ( LGU) a me ke Kuhina Hoʻonaʻauao. Aia ka papahana WASH o ke kaiāulu i ka hoʻolako ʻana i ka wai palekana, i alakaʻi ʻia e nā keʻena aupuni kūloko, me ke kākoʻo o DILG [67], a me nā hoʻomaikaʻi hoʻomaʻemaʻe i hoʻokō ʻia e DOH me ke kōkua o nā keʻena aupuni kūloko, hoʻolako i nā halepaku a nā kōkua no ke kūkulu halepaku [68, 69] ] ʻO ia hoʻi, mālama ʻia ka papahana WASH ma nā kula kumu aupuni e ke Kuhina Hoʻonaʻauao ma ka launa pū ʻana me ke Kuhina Ola.
Hōʻike ka ʻikepili hou loa mai ka Philippine Statistics Authority (PSA) 2017 National Population Health Survey he 95% o nā ʻohana Filipino e loaʻa i ka wai inu mai nā kumu wai i hoʻomaikaʻi ʻia, me ka hapa nui loa (43%) mai ka wai hue a me 26% wale nō mai nā kumu paipu. 70] loaʻa iā ia. Hoʻohana mau ka hapahā o nā hale Pilipino i nā hale hoʻomaʻemaʻe maikaʻi ʻole [70];ma kahi o 4.5% o ka heluna kanaka e hoʻomaʻemaʻe ma ke ākea, kahi hana ʻelua ʻoi aku ka kiʻekiʻe ma nā wahi kuaʻāina (6%) e like me nā wahi kūlanakauhale (3%) [70].
Hōʻike nā hōʻike ʻē aʻe ʻo ka hāʻawi ʻana i nā hale hoʻomaʻemaʻe wale nō ʻaʻole ia e hōʻoiaʻiʻo i ko lākou hoʻohana ʻana, ʻaʻole hoʻi e hoʻomaikaʻi i ka hoʻomaʻemaʻe a me nā hana maʻemaʻe [32, 68, 69] . ka nele o ka hakahaka o ka hale no ka halepaku a i ʻole ka pahu septic a puni ka hale, a me nā kumu ʻāina ʻē aʻe e like me ke ʻano o ka lepo a me ke kokoke i nā ala wai), ʻO ka ʻāina a me ka nele o ke kālā [71, 72].
I ka makahiki 2007, ua apono ka 'Oihana Ola o Pilipi i kahi ala ho'oma'ema'e holo'oko'a alaka'i kaiaulu (CLTS) ma o ka East Asia Sustainable Health Development Program [68, 73] . defecation, hōʻoia i nā mea a pau e hoʻohana i nā halepaku maʻemaʻe, holoi lima pinepine a kūpono, hoʻomaʻemaʻe i ka meaʻai a me ka wai, mālama pono i nā holoholona a me nā ʻōpala holoholona, a me ka hana ʻana a me ka mālama ʻana i kahi maʻemaʻe a palekana [68, 69]. ʻO ke ala o CLTS, pono e nānā mau ʻia ke kūlana ODF kauhale ʻoiai ma hope o ka pau ʻana o nā hana CLTS. Akā naʻe, ua hōʻike kekahi mau haʻawina i kahi kiʻekiʻe o ka STH i nā kaiāulu i loaʻa i ke kūlana ODF ma hope o ka hoʻokō ʻana o CLTS [32, 33]. i ka nele i ka hoʻohana ʻana i nā keʻena hoʻomaʻemaʻe, hiki ke hoʻomaka hou i ka wehe ʻana i ka defecation, a me ka uhi haʻahaʻa MDA [32].
ʻO nā polokalamu WASH i hoʻokō ʻia ma nā kula e hahai i nā kulekele i paʻi ʻia e ka DOH a me DepEd. I ka makahiki 1998, ua hoʻopuka ka 'Oihana Ola i ka Philippine Health Code School Health and Health Services Implementation Rules and Regulations (IRR) (PD No. 856) [74]. ʻO kēia IRR hoʻonohonoho i nā lula a me nā lula no ka hoʻomaʻemaʻe kula a me ka hoʻomaʻemaʻe maikaʻi ʻana, e like me nā halepaku, nā lako wai, a me ka mālama ʻana a me ka mālama ʻana i kēia mau hale [74]. ʻaʻole i hoʻokō pono ʻia a ʻaʻole lawa ke kākoʻo kālā [57, 75, 76, 77]. No laila, he mea koʻikoʻi ka nānā ʻana a me ka loiloi i ka hoʻomau ʻana o ka hoʻokō ʻana o ke Kuhina Hoʻonaʻauao i ka papahana WASH.
Eia kekahi, no ka hoʻokumu ʻana i nā maʻamau olakino maikaʻi no nā haumāna, ua hoʻopuka ke Kuhina Hoʻonaʻauao i ka 'Oihana Hoʻonaʻauao (DO) No. 56, Paukū 56.2009 i kapa ʻia "E hana koke i ka wai a me nā wahi holoi lima ma nā kula āpau e pale i ka Influenza A (H1N1)" a me DO ʻAʻole. 65, s.2009 i kapa ʻia ʻo "Essential Health Care Program (EHCP) for School Children" [78, 79] . ʻOiai ua hoʻolālā ʻia ka papahana mua e pale i ka hoʻolaha ʻana o ka H1N1, pili pū kēia me ka mana STH. ʻO ka hope e hahai i kahi ala kūpono kula a e kālele ana i ʻekolu mau hana olakino kula e pili ana i nā hōʻike: ka holoi lima me ke kopa, ka holoi ʻana me ka toothpaste fluoridated ma ke ʻano he hana hui i kēlā me kēia lā, a me ka MDA ʻelua makahiki o STH [78, 80]. .Ua hoʻonui ʻia ka hoʻolako ʻana i ka wai, ka hoʻomaʻemaʻe, ka mālama ʻana i ka meaʻai a me ka hoʻomākaukau ʻana, ka hoʻomaikaʻi ʻana i ka maʻemaʻe (e laʻa, ka mālama ʻana i ka maʻemaʻe menstrual), deworming, a me ka hoʻonaʻauao olakino [79].
ʻOiai ma keʻano holoʻokoʻa ua hoʻokomo ʻia ʻo WASH i loko o nā haʻawina kula haʻahaʻa [79], ʻo ka hoʻokomo ʻana o ka maʻi STH ma ke ʻano he maʻi a me ka pilikia olakino lehulehu. pili i nā haumāna āpau me ka nānā ʻole i ka pae papa a me ke ʻano kula, a ua hoʻohui pū ʻia i nā kumuhana he nui a hoʻohana nui ʻia.Hoʻolaha ʻia (ʻo ia hoʻi, hōʻike ʻia nā mea e hoʻolaha ana i ka hoʻonaʻauao olakino ma nā lumi papa, nā wahi WASH, a me ke kula holoʻokoʻa) [57]. E hoʻomaopopo i ka STH ma ke ʻano he pilikia olakino lehulehu, e like me: nā kumuhana e pili ana i ka hoʻouna ʻana o STH, ka pilikia o ka maʻi, ka pilikia o ka maʻi e alakaʻi i ka hoʻoheheʻe ʻana ma hope o ka ilo a ua hoʻokomo ʻia nā ʻano hoʻohālike i loko o ka papahana kula [57].
Ua hōʻike pū kekahi mau haʻawina ʻē aʻe i kahi pilina ma waena o ka hoʻonaʻauao olakino a me ka ʻae ʻana i ka mālama ʻana [56, 60] e hōʻike ana i ka hoʻonui ʻana i ka hoʻonaʻauao olakino a me ka hoʻolaha ʻana (e hoʻomaikaʻi i ka ʻike STH a hoʻoponopono i nā kuhi hewa MDA e pili ana i ka mālama ʻana a me nā pono) hiki ke hoʻonui i ka komo ʻana a me ka ʻae ʻana o MDA [56], 60].
Eia kekahi, uaʻikeʻia ke koʻikoʻi o ka hoʻonaʻauao olakino i ka hoʻouluʻana i nāʻano pili i ka maʻemaʻe maikaʻi e like me kekahi o nā mea nui o ka hoʻokō WASH [33, 60] . E like me nā haʻawina mua i hōʻikeʻia,ʻaʻole pono ka weheʻana i ka weheʻana ma muli o ka nele i ke komoʻana i ka halepaku. 32, 33]. ʻO nā mea e like me ka wehe ʻana i ka wehe ʻana a me ka hoʻohana ʻole ʻana i nā keʻena hoʻomaʻemaʻe hiki ke hoʻopili i nā hopena defecation wehe [68, 69]. 81]. No laila, pono e hoʻokomo i ka hoʻonaʻauao olakino a me nā hoʻolālā hoʻolaha e pili ana i ka hoʻomaikaʻi ʻana i nā ʻōpū a me ka maʻemaʻe, a me ka ʻae ʻana a me ka hoʻohana pono ʻana i kēia mau ʻōnaehana olakino, pono e hoʻopili ʻia no ka mālama ʻana i nā hana WASH.
Hōʻike ka ʻikepili i hōʻiliʻili ʻia i nā makahiki he ʻelua i hala aku nei ke kiʻekiʻe ka laha a me ka ikaika o ka maʻi STH ma waena o nā keiki ma lalo o ka makahiki 12 ma Philippines, ʻoiai nā hana like ʻole a ke aupuni Philippine. ʻike ʻia e hōʻoia i ka uhi MDA kiʻekiʻe. He mea kūpono hoʻi e noʻonoʻo i ka maikaʻi o nā lāʻau lapaʻau ʻelua i hoʻohana ʻia i kēia manawa i ka papahana STH control (albendazole a me mebendazole), no ka mea, ua hōʻike ʻia nā maʻi T. trichiura kiʻekiʻe loa i kekahi mau haʻawina hou ma Philippines [33, 34, 42]. Ua hōʻike ʻia nā lāʻau ʻelua i ka liʻiliʻi i ka T. trichiura, me ka hui pū ʻana o 30.7% a me 42.1% no kaalbendazolea me mebendazole, kēlā me kēia, a me 49.9% a me 66.0% ka emi ʻana o ka spawning [82]. No ka loaʻa ʻana o nā hopena therapeutic liʻiliʻi o nā lāʻau ʻelua, hiki i kēia ke loaʻa i nā hopena koʻikoʻi ma nā wahi kahi o Trichomonas e endemic. Helminth kaumaha i loko o nā kānaka maʻi ma lalo o ka paepae puka, akā ʻokoʻa ka maikaʻi ma waena o nā ʻano STH. ʻO ka mea nui, ʻaʻole hiki i nā lāʻau lapaʻau ke pale i ka reinfection, hiki ke hana koke ma hope o ka mālama ʻana. .
I kēia manawa, ʻaʻohe mālama MDA pono no nā mākua ma Philippines. ʻO ka IHCP wale nō ka nānā ʻana i nā keiki 1-18 mau makahiki, a me ka deworming koho o nā hui kiʻekiʻe e like me nā wahine hāpai, nā wahine ʻōpio, nā mahiʻai, nā meaʻai, a me ka heluna kanaka 'ōiwi [46]. Akā naʻe, ʻo nā hiʻohiʻona makemakika hou [84,85,86] a me nā loiloi ʻōnaehana a me nā meta-analyses [87] e hōʻike ana i ka hoʻonui ʻia ʻana o ke kaiāulu o nā papahana deworming e uhi i nā pūʻulu makahiki āpau e hōʻemi i ka prevalence o STH ma ka heluna kanaka pilikia nui.- Nā pūʻulu o nā keiki kula pilikia. Akā naʻe, ʻo ka hoʻonui ʻana i ka MDA mai ka lawelawe ʻana i ka lāʻau lapaʻau i kuhikuhi ʻia i ke kaiāulu a puni ka hopena waiwai nui no nā polokalamu hoʻomalu STH ma muli o ka pono o nā kumuwaiwai hoʻonui. ʻO ka hoʻolaha no ka lymphatic filariasis ma Philippines e hōʻike ana i ka hiki ke hoʻolako i ka lāʻau lapaʻau ākea ākea [52].
Manaʻo ʻia ke ala hou ʻana o nā maʻi STH ma muli o ka pau ʻana o nā hoʻolaha MDA e pili ana i ke kula e kūʻē iā STH a puni ka Philippines ma muli o ka maʻi maʻi COVID-19. ma ke ʻano he pilikia olakino lehulehu (EPHP) i ka makahiki 2030 (i wehewehe ʻia e like me ka loaʻa ʻana o <2% prevalence of moderate-to-high-intensity maʻi i SAC [88] ]) ʻaʻole hiki ke hoʻokō ʻia, ʻoiai nā hoʻolālā mitigation e hoʻoponopono i nā pōʻai MDA i hala ( ʻo ia hoʻi, ʻoi aku ka maikaʻi o ka uhi MDA kiʻekiʻe, >75%) [89]. No laila, makemake nui ʻia nā hoʻolālā hoʻomalu hoʻomau e hoʻonui ai i ka MDA no ka hakakā ʻana i ka maʻi STH ma Philippines.
Ma waho aʻe o MDA, pono ka hoʻololi ʻana i ka hoʻololi ʻana i nā ʻano maʻemaʻe, ke komo ʻana i ka wai palekana, a me ka hoʻomaʻemaʻe maikaʻi ʻana ma o nā polokalamu WASH a me CLTS. nā pilikia i ka hoʻokō WASH [68, 69, 71, 72]. Eia hou, ua hōʻikeʻia ka nui o ka STH i nā kaiaulu i loaʻa i ke kūlana ODF ma hope o ka hoʻokōʻana i ka CLTS ma muli o ka hoʻomaka houʻana o ka weheʻana i ka wehe a me ka haʻahaʻa o ka MDA [32] . ʻO ka hoʻomaopopo ʻana i ka STH a me ka hoʻomaikaʻi ʻana i nā hana maʻemaʻe he mau ala nui ia e hōʻemi ai i ka pilikia o ke kanaka i ka maʻi a he mau kumu kūʻai haʻahaʻa loa ia i nā polokalamu MDA a me WASH.
Hiki ke kōkua ka hoʻonaʻauao olakino i hoʻolako ʻia i nā kula i ka hoʻoikaika ʻana a me ka hoʻomaikaʻi ʻana i ka ʻike ākea a me ka ʻike o ka STH ma waena o nā haumāna a me nā mākua, me nā pōmaikaʻi i ʻike ʻia o ka deworming. He hana pōkole pōkole i hoʻolālā ʻia e hoʻonaʻauao i nā haumāna e pili ana i ka maʻi STH a me ka pale ʻana, e hāʻawi ana i ka hōʻoia o ke kumu e hiki ai i ka hoʻonaʻauao olakino ke hoʻomaikaʻi i ka ʻike a me ka hoʻoikaika ʻana i nā ʻano pili i ka maʻi STH [90]. ʻO ka mokuʻāina, a ua hoʻemi ʻia ka nui o ka maʻi STH e 50% i nā kula intervention i hoʻohālikelike ʻia me nā kula mana (odds ratio = 0.5, 95% confidence interval: 0.35-0.7, P <0.0001) .90]. ma Philippines [91] a me Vietnam;a ke kūkulu ʻia nei i kēia manawa no ka ʻāina ʻo Mekong haʻahaʻa, me kona hoʻololi ʻana i ka maʻi o ka maʻi ʻo Opisthorchis ate. ʻO kahi ʻāpana o nā hoʻolālā hoʻomalu aupuni, ma o nā ala kula a me ka hui triangular e hoʻopau i ka maʻi STH hiki ke hiki me nā hui, NGO a me nā loea ʻepekema [92,93,94].
Nui nā papahana ma Philippines e hoʻokomo i nā mana STH, e like me WASH/EHCP a i ʻole WINS i hoʻokō ʻia i nā kula, a me CLTS i hoʻokō ʻia i nā kaiāulu. ʻO nā hoʻolālā a me nā hana like ʻole e like me ka Philippines 'no ka mana STH hiki ke kūleʻa wale me ka lōʻihi o ka launa pū ʻana, ka launa pū ʻana a me ke kākoʻo o ke aupuni kūloko. Kākoʻo ke aupuni no ke kūʻai ʻana a me ka hāʻawi ʻana i nā lāʻau lapaʻau a me ka hoʻonohonoho mua ʻana i nā ʻāpana ʻē aʻe o nā hoʻolālā mana, e like me ma ke ʻano he mau hana e hoʻomaikaʻi ai i ka hoʻomaʻemaʻe a me ka hoʻonaʻauao olakino, pono e hoʻokō i nā pahuhopu 2030 EPHP [88]. I ke alo o nā pilikia o ka maʻi maʻi COVID-19, pono e hoʻomau a hoʻohui ʻia kēia mau hana me ka COVID-19 mau. nā hana pale. A i ʻole, ʻo ka hoʻololi ʻana i kahi papahana hoʻomalu STH i hoʻohālikelike ʻia e hiki ke loaʻa i ka maʻi lehulehu lōʻihi.lth hopena.
No ka aneane ʻelua mau makahiki, ua hoʻoikaika nui ka Philippines e hoʻomalu i ka maʻi STH. Eia naʻe, ua mau ka nui o ka STH i hōʻike ʻia ma ka ʻāina holoʻokoʻa, ma muli paha o ka suboptimal MDA uhi a me nā palena o WASH a me nā papahana hoʻonaʻauao olakino. Pono nā aupuni aupuni i kēia manawa e noʻonoʻo i ka hoʻoikaika ʻana i ke kula. -e pili ana i nā MDA a me ka hoʻonui ʻana i nā MDA ākea ākea;nānā pono i ka pono o ka lāʻau i ka wā MDA a me ka noiʻi ʻana i ka hoʻomohala ʻana a me ka hoʻohana ʻana i nā lāʻau antihelminthic hou a i ʻole nā hui lāʻau;a me ka hoʻolako mau ʻana o ka WASH a me ka hoʻonaʻauao olakino ma ke ʻano he ala hoʻouka kaua piha no ka mana STH e hiki mai ana ma Philippines.
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Ka manawa hoʻouna: Mar-15-2022