Matenda a helminth (STH) akhala akudziwika kwa nthawi yaitali ku Philippines.Mu ndemangayi, tikufotokoza momwe matenda a STH alili panopa ndikuwonetsa njira zoyendetsera kuchepetsa katundu wa STH.
Pulogalamu yapadziko lonse ya STH mass drug administration (MDA) inayambika ku 2006, koma kufalikira kwa STH ku Philippines kumakhalabe kwakukulu, kuyambira 24.9% mpaka 97.4% . kuphatikizapo kusazindikira kufunika kwa chithandizo chanthawi zonse, kusamvetsetsana pa njira za MDA, kusowa chidaliro pa mankhwala omwe amagwiritsidwa ntchito, kuopa zochitika zoipa, komanso kusakhulupirira kwambiri mapulogalamu a boma.Mapulogalamu omwe alipo kale a madzi, ukhondo ndi ukhondo (WASH) ali kale kuika m’madera [monga, mapologalamu a CLTS otsogozedwa ndi anthu opereka zimbudzi ndi kupereka ndalama zothandizira kumanga zimbudzi] ndi masukulu [monga dongosolo la WASH (WINS) kusukulu], koma kukhazikitsidwa kopitilira muyeso kumafunika kukwaniritsa zotsatira zomwe zikufunidwa. Kuphunzitsa kwa WASH m'sukulu, kuphatikiza kwa STH ngati matenda komanso nkhani ya anthu m'maphunziro a pulaimale yapagulu yapagulu sikukwanira.Kuwunika kopitiliration idzafunika pa Integrated Helminth Control Programme (IHCP) yomwe ikuchitika m'dzikoli, yomwe ikuyang'ana pa kukonza ukhondo ndi ukhondo, maphunziro a zaumoyo ndi njira zodzitetezera.
Ngakhale kuyesayesa kwakukulu kothana ndi matenda a STH ku Philippines pazaka makumi awiri zapitazi, kufalikira kwa ma STH kwakhala kukuchulukirachulukira m'dziko lonselo, mwina chifukwa cha kufalikira kwa MDA komanso kulepheretsa mapulogalamu a WASH ndi maphunziro azaumoyo..Kuperekedwa kosasunthika kwa njira yoyendetsera kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe kamwemwebundumwebundumwendundundundunkejojojojojojojojojojowukukhalambombowu pawu pawushoniwa pawushoni wo kutsi kuvaITwira nyimbothunzithunzithunzithunzithunzithunzithunzithunzithunzikuloyakuyayakundiRAyakugonandizozoelezakutizakutiSTHSTH ku Philippines.
Matenda opatsirana a helminth (STH) amakhalabe vuto lalikulu la thanzi la anthu padziko lonse lapansi, ndi matenda opitirira 1.5 biliyoni [1] .STH imakhudza anthu osauka omwe amadziwika kuti alibe madzi okwanira, ukhondo ndi ukhondo (WASH) [2 , 3];ndipo imapezeka kwambiri m'mayiko osauka, ndipo matenda ambiri amapezeka m'madera a Asia, Africa, ndi Latin America [4] . Zomwe zimakhudzidwa kwambiri, zomwe zimafala kwambiri komanso kuwonjezereka kwa matenda.Deta yomwe ilipo imasonyeza kuti oposa 267.5 miliyoni PSACs ndi oposa 568.7 miliyoni a SAC amakhala m'madera omwe ali ndi matenda opatsirana kwambiri a STH ndipo amafuna mankhwala oletsa mankhwala [5] . kukhala zaka 19.7-3.3 miliyoni za moyo wolemala (DALYs) [6, 7].
Matenda a STH angayambitse kuperewera kwa zakudya komanso kusokonezeka kwa thupi ndi chidziwitso, makamaka kwa ana [8] .Matenda a STH okwera kwambiri amawonjezera matenda [9,10,11]. ndi kufa kwakukulu komanso kuwonjezereka kwa matenda ena [10, 11] .Zotsatira zoipa za matendawa zingakhudze osati thanzi komanso zokolola zachuma [8, 12].
Dziko la Philippines ndi dziko lokhala ndi ndalama zochepa komanso zapakati.Mu 2015, pafupifupi 21.6% ya anthu a ku Philippines a 100.98 miliyoni amakhala pansi pa umphawi wa dziko lonse [13]. .2019 deta yochokera ku WHO Preventive Chemotherapy Database imasonyeza kuti pafupifupi ana 45 miliyoni ali pachiopsezo chotenga matenda ofunikira chithandizo chamankhwala [15].
Ngakhale kuti njira zingapo zazikulu zayambika kuti zithetse kapena kusokoneza kufalitsa, STH imakhalabe yofala kwambiri ku Philippines [16] .wonetsani khama loyang'anira zakale ndi zamakono zomwe zikuchitika, lembani zovuta ndi zovuta za kukhazikitsidwa kwa pulogalamu, kuwunika momwe zimakhudzira kuchepetsa katundu wa STH, ndikupereka malingaliro otheka kuti athe kulamulira mphutsi za m'mimba .Kupezeka kwa chidziwitsochi kungapereke maziko okonzekera ndi kukhazikitsa ndondomeko pulogalamu yokhazikika yowongolera ma STH mdziko muno.
Ndemangayi ikuyang'ana pa tizilombo tomwe timayambitsa matenda a STH - roundworm, Trichuris trichiura, Necator americanus ndi Ancylostoma duodenale. Pano.
Ngakhale uku sikungowunikira mwadongosolo, njira yomwe idagwiritsidwa ntchito powunikiranso mabuku ndi motere.Tidafufuza kafukufuku wokhudzana ndi kufalikira kwa STH ku Philippines pogwiritsa ntchito zida zapaintaneti za PubMed, Scopus, ProQuest, ndi Google Scholar.Mawu otsatirawa anali amagwiritsidwa ntchito ngati mawu osakira: (“Helminthiases” kapena nyongolotsi zonyamula nthaka” kapena “STH” kapena “Ascaris lumbricoides” kapena “Trichuris trichiura” kapena “Ancylostoma spp.” kapena “Necator americanus” kapena “Roundworm” kapena “Whichworm” kapena “Hookworm”) ndi (“Epidemiology”) ndi (“Philippines”).Palibe choletsa pa chaka chosindikizidwa.Zolemba zomwe zidadziwika ndi njira zofufuzira zidawonetsedwa koyamba ndi mutu ndi zomwe zili mwatsatanetsatane, zomwe sizinafufuzidwe pa Zolemba zosachepera zitatu zokhala ndi kuchuluka kapena kuchulukira kwa imodzi mwa ma STH sanaphatikizidwe.Kuwunika kwa mawu athunthu kumaphatikizapo maphunziro owonetsetsa (ozungulira, kuyang'anira milandu, nthawi yayitali / gulu) kapena mayesero oyendetsedwa akuwonetsa kufalikira koyambira.Kuchotsa deta kumaphatikizapo malo ophunzirira, chaka chophunzira, chaka chofalitsidwa chophunzira, mtundu wa phunziro (wodutsa, kuwongolera milandu, kapena kutalika / gulu), kukula kwachitsanzo, chiwerengero cha anthu ophunzirira, kufalikira ndi mphamvu ya STH iliyonse, ndi njira yomwe imagwiritsidwa ntchito pozindikira.
Kutengera kusaka kwa mabuku, zolemba zonse za 1421 zidadziwika ndi kusaka kwa database [PubMed (n = 322);Kuchuluka (n = 13);ProQuest (n = 151) ndi Google Scholar (n = 935)]. Mapepala onse a 48 adawonetsedwa poyang'ana mutuwo, mapepala a 6 sanaphatikizidwe, ndipo mapepala onse a 42 anaphatikizidwa potsirizira pake mu kaphatikizidwe kabwino (Chithunzi 1). ).
Kuyambira zaka za m'ma 1970, maphunziro ambiri achitika ku Philippines kuti adziwe kuchuluka kwa matenda a STH.Table 1 imasonyeza chidule cha maphunziro omwe anazindikiridwa.Kusiyana kwa njira zowonetsera matenda a STH pakati pa maphunzirowa kunawonekera pakapita nthawi, ndi formalin. Njira ya ether concentration (FEC) yomwe imagwiritsidwa ntchito kawirikawiri m'masiku oyambirira (1970-1998) . kafukufuku.
Matenda a STH akhala akudwala kwambiri ku Philippines ndipo akadali vuto lalikulu la thanzi la anthu ku Philippines, monga momwe kafukufuku wazaka za m'ma 1970 mpaka 2018 adachitira. kuchuluka kwambiri kwa matenda olembedwa mu PSAC ndi SAC [17] .
Zakale, asanayambe kukhazikitsidwa kwa Dipatimenti ya Health Integrated Helminth Control Program (IHCP), kufalikira kwa matenda aliwonse a STH ndi matenda aakulu kwa ana a zaka zapakati pa 1-12 kuyambira 48.6-66.8% mpaka 9.9-67.4%, motero.
Deta ya STH kuchokera ku National Schistosomiasis Survey yazaka zonse kuyambira 2005 mpaka 2008 inasonyeza kuti matenda a STH anali ofala m'madera atatu akuluakulu a dziko, ndi A. lumbricoides ndi T. trichiura makamaka ku Visayas [16].
Mu 2009, kafukufuku wotsatira wa 2004 [20] ndi 2006 SAC [21] National STH Prevalence Surveys anachitidwa kuti awone momwe IHCP imakhudzira [26] .Kuchuluka kwa STH iliyonse kunali 43.7% mu PSAC (66% mu 2004 kafukufuku) ndi 44.7% mu SAC (54% mu kafukufuku wa 2006) [26] .Ziwerengerozi ndizochepa kwambiri kusiyana ndi zomwe zinanenedwa m'mafukufuku awiri apitawo.Chiwopsezo chachikulu cha matenda a STH chinali 22.4% mu PSAC mu 2009 (osafanana ndi kafukufuku wa 2004 chifukwa chiwerengero cha matenda aakulu sananenedwe) ndi 19.7% mu SAC (poyerekeza ndi 23.1% mu kafukufuku wa 2006), kuchepetsa 14% [26]. Matenda a STH m'magulu a PSAC ndi SAC sanakwaniritse cholinga cha WHO cha 2020 cha kuchuluka kwa anthu osakwana 20% komanso chiwopsezo chachikulu cha matenda a STH osakwana 1% kuwonetsa kuwongolera matenda [27, 48].
Maphunziro ena ogwiritsira ntchito kafukufuku wa parasitological omwe amachitidwa nthawi zambiri (2006-2011) kuti ayang'ane zotsatira za MDA ya sukulu ku SAC adawonetsa zofanana [22, 28, 29]. ;Komabe, STH iliyonse (yosiyanasiyana, 44.3% mpaka 47.7%) ndi matenda aakulu (osiyanasiyana, 14.5% mpaka 24.6%) amalembedwa m'mafukufuku otsatiridwa. kufalikira sikunatsikebe pamlingo wowongolera zochitika zomwe zimafotokozedwa ndi WHO (Table 1).
Zambiri zochokera kumaphunziro ena pambuyo pa kukhazikitsidwa kwa IHCP ku Philippines mu 2007-2018 zikuwonetsa kuchulukirachulukira kwa STH ku PSAC ndi SAC (Table 1) [30,31,32,33,34,35,36,37,38, 39 ].Kuchuluka kwa STH iliyonse yomwe inafotokozedwa m'maphunzirowa inachokera ku 24.9% kufika ku 97.4% (mwa KK), ndipo kufalikira kwa matenda apakati mpaka aakulu kunachokera ku 5.9% mpaka 82.6%.lumbricoides ndi T. trichiura amakhalabe ma STH omwe amapezeka kwambiri, omwe amafala kwambiri kuyambira 15.8-84.1% mpaka 7.4-94.4%, motero, pamene hookworms amakhala ndi chiwerengero chochepa, kuyambira 1.2% mpaka 25.3% [30,31, 32,33] ,34,35,36,37,38,39] (Table 1) .Komabe, mu 2011, kafukufuku wogwiritsa ntchito molecular diagnostic quantitative real-time polymerase chain reaction (qPCR) anasonyeza kufalikira kwa hookworm (Ancylostoma spp.) ya 48.1 % [45] .Co-infection ya anthu omwe ali ndi A. lumbricoides ndi T. trichiura yawonetsedwanso kawirikawiri m'maphunziro angapo [26, 31, 33, 36, 45].
Njira ya KK ikulimbikitsidwa ndi WHO kuti ikhale yosavuta kugwiritsa ntchito m'munda ndi mtengo wotsika [46], makamaka poyesa ndondomeko zachipatala za boma za kulamulira kwa STH. kafukufuku wa 2014 ku Laguna Province, matenda aliwonse a STH (33.8% a KK vs 78.3% a qPCR), A. lumbricoides (20.5% KK vs 60.8% ya qPCR) ndi T. trichiura (KK 23.6% vs 38.8% ya qPCR). Palinso matenda a nyongolotsi [6.8% kuchuluka;zikuphatikizapo Ancylostoma spp. (4.6%) ndi N. americana (2.2%)] adadziwika pogwiritsa ntchito qPCR ndipo adaweruzidwa kuti ndi olakwika ndi KK [36]. kwa KK slide kukonzekera ndi kuwerenga [36,45,47], ndondomeko yomwe nthawi zambiri imakhala yovuta kukwaniritsa pansi pa zochitika za m'munda.Kuwonjezerapo, mazira a mitundu ya hookworm ndi morphologically osadziwika, zomwe zimapangitsa kuti zikhale zovuta kuti zidziwike bwino [45].
Njira yayikulu yowongolera matenda opatsirana pogonana yomwe imalimbikitsidwa ndi WHO imayang'ana kwambiri prophylactic chemotherapy ndialbendazolekapena mebendazole m'magulu omwe ali pachiopsezo chachikulu, ndi cholinga chochiza osachepera 75% a PSAC ndi SAC ndi 2020 [48] Azimayi a msinkhu wobereka (zaka 15-49, kuphatikizapo omwe ali mu trimester yachiwiri ndi yachitatu) amalandira chisamaliro chokhazikika [49]. Kuwonjezera apo, malangizowa akuphatikizapo ana aang'ono (miyezi 12-23) ndi atsikana achichepere (zaka 10-19) [ 49], koma osaphatikizapo malangizo am'mbuyomu ochizira akuluakulu omwe ali ndi chiopsezo chachikulu cha ntchito [50] .WHO imalimbikitsa MDA pachaka kwa ana aang'ono, PSAC, SAC, atsikana achichepere, ndi amayi a msinkhu wobereka m'madera omwe ali ndi matenda a STH pakati pa 20% ndi 50 %, kapena semiannual ngati kufalikira kuli pamwamba pa 50% .Kwa amayi apakati, nthawi za chithandizo sizinakhazikitsidwe [49].Kuphatikiza pa mankhwala oletsa tizilombo toyambitsa matenda, WHO yagogomezera madzi, ukhondo ndi ukhondo (WASH) monga chigawo chofunikira cha matenda opatsirana pogonana [ [Chithunzi pamasamba 48, 49].
IHCP inakhazikitsidwa mu 2006 kuti ipereke chitsogozo cha ndondomeko yoyendetsera STH ndi matenda ena a helminth [20, 51] .albendazolekapena mebendazole chemotherapy monga njira yaikulu ya matenda opatsirana pogonana, kutsata ana a zaka zapakati pa 1-12 ndi magulu ena omwe ali pachiopsezo chachikulu monga amayi apakati, amayi achichepere, alimi, osamalira zakudya ndi anthu amtundu wamba.Mapulogalamu owongolera amathandizidwanso ndi kuika madzi. ndi malo aukhondo komanso njira zolimbikitsira zaumoyo ndi maphunziro [20, 46].
MDA yapachaka ya PSAC imachitika makamaka ndi mabungwe azaumoyo aku barangay (mudzi), ogwira ntchito yazaumoyo ophunzitsidwa bwino komanso osamalira masana m'madera monga Garantisadong Pambata kapena "Ana Athanzi" (pulogalamu yopereka) ya PSAC's Health Services) , pamene MDA ya SAC ikuyang'aniridwa ndikugwiritsidwa ntchito ndi Dipatimenti ya Maphunziro (DepEd) [20].MDA m'masukulu apulaimale a boma imayendetsedwa ndi aphunzitsi motsogozedwa ndi ogwira ntchito zachipatala m'gawo loyamba ndi lachitatu la chaka chilichonse cha sukulu [20]. 2016, Unduna wa Zaumoyo udapereka malangizo atsopano ophatikizira mankhwala oletsa mphutsi m'masukulu a sekondale (ana osakwana zaka 18) [52].
MDA yoyamba yapachaka yapachaka inachitika mwa ana azaka zapakati pa 1-12 mu 2006 [20] ndipo inanena kuti 82.8% ya 6.9 miliyoni PSACs ndi 31.5% ya 6.3 miliyoni SACs [53]. ku 2014 (kusiyana kwa 59.5% mpaka 73.9%), chiwerengero chomwe chili pansi pa chiwerengero cha WHO chovomerezeka cha 75% [54] . njira [56, 57], kusowa chidaliro mu mankhwala ogwiritsidwa ntchito [58], ndi kuopa zochitika zoipa [55, 56, 58, 59, 60] . [61] .Kuonjezera apo, nkhani zoperekera ndi zogwirira ntchito za mankhwala a MDA zadziwika kuti ndi zofooka zazikulu zomwe zakhala zikuchitika pokwaniritsa MDA m'dziko lonse [54].
M’chaka cha 2015, bungwe la DOH linagwirizana ndi a DepEd kuchititsa mwambo wotsegulira Tsiku la National School Deworming Day (NSDD), lomwe cholinga chake ndi kuchotsa ma SAC pafupifupi 16 miliyoni (giredi 1 mpaka 6) omwe analembetsa m’sukulu zapulaimale zonse za boma tsiku limodzi [62]. -Kuyambira koyambira kunapangitsa kuti dziko lonse lapansi likhale ndi kachilombo ka 81%, kuposa zaka zam'mbuyo [54]. kuwonjezeka kwa malipoti a zochitika zovuta pambuyo pa MDA (AEFMDA) ku Peninsula ya Zamboanga, Mindanao [63] .
Mu 2017, Unduna wa Zaumoyo unayambitsa katemera watsopano wa dengue ndipo unapereka kwa ana asukulu pafupifupi 800,000. Kupezeka kwa katemerayu kwadzetsa nkhawa kwambiri za chitetezo ndipo kwachititsa kuti anthu ambiri asakhulupirire mapulogalamu a DOH, kuphatikizapo pulogalamu ya MDA [64, 65]. Zotsatira zake, kufalikira kwa tizilombo kudatsika kuchokera pa 81% ndi 73% ya PSAC ndi SAC mu 2017 mpaka 63% ndi 52% mu 2018, ndi kufika 60% ndi 59% mu 2019 [15].
Kuphatikiza apo, potengera mliri wapadziko lonse wa COVID-19 (matenda a coronavirus 2019), Unduna wa Zaumoyo wapereka Memorandum No. 2020-0260 kapena Interim Guidance for Integrated Helminth Control Plans and Schistosomiasis Control and Elimination Plans Munthawi ya COVID- 19 Pandemic 》” June 23, 2020, akupereka kuti MDA iyimitsidwe kaye mpaka padziwitsidwenso.Chifukwa chakutsekedwa kwa masukulu, anthu ammudzi amakhala akuchotsa ana azaka zapakati pa 1-18 pafupipafupi, kugawa mankhwala kudzera khomo ndi khomo kapena malo okhazikika, kwinaku akukhala kutali ndikuyang'ana COVID-19 -19 njira zoyenera zopewera komanso kupewa matenda [66].Komabe, zoletsa kuyenda kwa anthu komanso nkhawa zapagulu chifukwa cha mliri wa COVID-19 zitha kupangitsa kuti chithandizo chichepetse.
WASH ndi imodzi mwa njira zofunika kwambiri zothandizira matenda a STH zomwe zafotokozedwa ndi IHCP [20, 46] . LGU) ndi Unduna wa Maphunziro.Pulogalamu ya WASH ya anthu ammudzi ikuphatikizapo kupereka madzi abwino, motsogozedwa ndi madipatimenti a maboma ang'onoang'ono, mothandizidwa ndi DILG [67], ndi kukonza zaukhondo zomwe zakhazikitsidwa ndi DOH mothandizidwa ndi madipatimenti aboma, kupereka zimbudzi ndi ndalama zothandizira kumanga zimbudzi [68, 69] ].Panthawiyi, pulogalamu ya WASH m'masukulu apulaimale aboma imayang'aniridwa ndi Unduna wa Zamaphunziro mogwirizana ndi Unduna wa Zaumoyo.
Deta yaposachedwa kwambiri yochokera ku Philippine Statistics Authority (PSA) 2017 National Population Health Survey ikuwonetsa kuti 95% ya mabanja aku Philippines amapeza madzi akumwa kuchokera kumadzi owongolera, ndipo gawo lalikulu kwambiri (43%) kuchokera kumadzi am'mabotolo ndi 26% yokha kuchokera kumagwero a mipope[ 70] ipeze. Gawo limodzi mwa magawo anayi a mabanja a ku Philippines akugwiritsabe ntchito zimbudzi zosagwira ntchito [70];pafupifupi 4.5% ya anthu amachitira chimbudzi poyera, chizolowezi chowirikiza kawiri m'madera akumidzi (6%) monga m'midzi (3%) [70].
Malipoti ena akusonyeza kuti kupereka zipangizo zaukhondo kokha sikumatsimikizira kuti akugwiritsidwa ntchito, komanso sikupititsa patsogolo ukhondo ndi ukhondo [32, 68, 69]. Pakati pa mabanja opanda zimbudzi, zifukwa zomwe zimatchulidwa kawirikawiri zolepheretsa ukhondo zikuphatikizapo zolepheretsa luso (ie, kusowa kwa malo m'nyumba ya chimbudzi kapena thanki yamadzi pafupi ndi nyumba, ndi zinthu zina monga nthaka ndi kuyandikira kwa madzi), umwini wa nthaka ndi kusowa kwa ndalama [71, 72].
Mu 2007, Dipatimenti ya Zaumoyo ku Philippines inagwiritsa ntchito njira yoyendetsera bwino anthu (CLTS) kudzera mu East Asia Sustainable Health Development Programme [68, 73] .CLTS ndi lingaliro la ukhondo wathunthu womwe umaphatikizapo makhalidwe osiyanasiyana monga kusiya kutseguka. Kutaya chimbudzi, kuwonetsetsa kuti aliyense akugwiritsa ntchito zimbudzi zaukhondo, kusamba m'manja pafupipafupi komanso moyenera, ukhondo wa chakudya ndi madzi, kutaya nyama ndi zinyalala za ziweto motetezedwa, kupanga ndi kukonza malo Oyera ndi otetezeka [68, 69]. Njira ya CLTS, chikhalidwe cha ODF chamudzi chiyenera kuyang'aniridwa mosalekeza ngakhale ntchito za CLTS zitatha. kusowa kogwiritsa ntchito zimbudzi, kuyambiranso kwachimbudzi, komanso kutsika kwa MDA [32].
Mapulogalamu a WASH omwe akugwiritsidwa ntchito m'masukulu amatsatira ndondomeko zofalitsidwa ndi DOH ndi DepEd.Mu 1998, Dipatimenti ya Zaumoyo inapereka Malamulo ndi Malamulo a Zaumoyo ku Philippine Health Code School Health and Regulations (IRR) (PD No. 856) [74].Iyi IRR amakhazikitsa malamulo ndi malamulo okhudza ukhondo wa m’sukulu ndi ukhondo wokhutiritsa, kuphatikizapo zimbudzi, madzi, ndi kasamalidwe ndi kasamalidwe ka malowa [74]. osakhazikika mwamphamvu komanso thandizo la bajeti ndi losakwanira [57, 75, 76, 77] .Choncho, kuyang'anira ndi kuunika kumakhalabe kofunika kwambiri kuti atsimikizire kukhazikika kwa Unduna wa Zamaphunziro kukhazikitsidwa kwa pulogalamu ya WASH.
Komanso, kuti institutionalize makhalidwe abwino thanzi la ophunzira, Unduna wa Maphunziro wapereka Dipatimenti Order (DO) No. 56, Article 56.2009 mutu "Nthawi yomweyo kumanga malo madzi ndi kusamba m'manja m'masukulu onse kupewa Fuluwenza A (H1N1)" ndi DO No. 65,s.2009 yotchedwa "Programme Essential Health Care (EHCP) kwa Ana a Sukulu" [78, 79] .Ngakhale kuti pulogalamu yoyamba inakonzedwa kuti iteteze kufalikira kwa H1N1, izi zikugwirizananso ndi kulamulira kwa STH.Zotsatirazi zikutsatira njira yoyenera kusukulu imayang'ana kwambiri pazithandizo zitatu zokhudzana ndi thanzi la masukulu: kusamba m'manja ndi sopo, kutsuka ndi mankhwala otsukira mano a fluoridated monga gulu la tsiku ndi tsiku, ndi STH's biannual MDA [78, 80].Mu 2016, EHCP tsopano yaphatikizidwa mu pulogalamu ya WASH In Schools (WINS) .Inakula ndikuphatikizirapo kupereka madzi, ukhondo, kasamalidwe ndi kukonza chakudya, kukonza zaukhondo (monga, kusamalira ukhondo wa msambo), mankhwala ophera tizilombo toyambitsa matenda, ndi maphunziro a zaumoyo [79].
Ngakhale kuti WASH yakhala ikuphatikizidwa mu maphunziro a pulayimale [79], kuphatikizapo matenda a STH monga matenda ndi vuto la thanzi la anthu akadalibe. imagwira ntchito kwa ophunzira onse mosasamala kanthu za giredi ndi mtundu wa sukulu, ndipo imaphatikizidwanso m'maphunziro angapo ndikugwiritsidwa ntchito kwambiri.Kufikira anthu (ie, zipangizo zolimbikitsa maphunziro a zaumoyo zimaperekedwa mowonekera m'makalasi, madera a WASH, ndi pasukulu yonse) [57]. kumvetsetsa STH ngati nkhani yaumoyo wa anthu, kuphatikiza: mitu yokhudzana ndi kufala kwa ma STH, chiopsezo cha matenda, chiwopsezo chotenga kachilomboka chidzayendetsa chimbudzi chotseguka pambuyo pa nyongolotsi komanso njira zoyatsiranso kachilomboka zidayambika mu maphunziro asukulu [57].
Kafukufuku wina wasonyezanso mgwirizano pakati pa maphunziro a zaumoyo ndi kulandira chithandizo [56, 60] kutanthauza kuti maphunziro opititsa patsogolo thanzi labwino ndi kupititsa patsogolo (kupititsa patsogolo chidziwitso cha STH ndikuwongolera maganizo olakwika a MDA okhudza chithandizo ndi mapindu) akhoza kuwonjezera kutenga nawo mbali kwa chithandizo cha MDA ndi kuvomereza [56], 60].
Komanso, kufunikira kwa maphunziro a zaumoyo pakulimbikitsa makhalidwe abwino okhudzana ndi ukhondo wadziwika kuti ndi chimodzi mwa zigawo zikuluzikulu za WASH kukhazikitsa [33, 60] . 32, 33] .Zinthu monga zizolowezi zowonongeka momasuka komanso kusowa kwa kugwiritsa ntchito zipangizo zaukhondo zingakhudze zotsatira zowonongeka [68, 69]. 81] .Choncho, kuphatikizidwa kwa maphunziro a zaumoyo ndi njira zolimbikitsira zomwe cholinga chake ndi kupititsa patsogolo matumbo ndi ukhondo, komanso kuvomereza ndi kugwiritsira ntchito moyenera zipangizo zathanzizi, ziyenera kuphatikizidwa kuti zipitirize kutsata njira za WASH.
Deta yomwe yasonkhanitsidwa pazaka makumi awiri zapitazi ikuwonetsa kuti kufalikira ndi kuchulukira kwa matenda a STH pakati pa ana osakwana zaka 12 ku Philippines kumakhalabe kwakukulu, ngakhale kuti boma la Philippines likuyesetsa. Kuzindikiridwa kuti kuwonetsetsa kufalikira kwa MDA.Ndikoyeneranso kulingalira za mphamvu za mankhwala awiri omwe akugwiritsidwa ntchito panopa mu pulogalamu yolamulira matenda opatsirana pogonana (albendazole ndi mebendazole), monga momwe matenda ochititsa mantha a T. trichiura adanenedwa m'maphunziro aposachedwapa ku Philippines [33, 34, 42]. Mankhwala awiriwa adanenedwa kuti sakugwira ntchito kwambiri ndi T. trichiura, ndi machiritso ophatikizana a 30.7% ndi 42.1% kwaalbendazolendi mebendazole, motero, ndi 49.9% ndi 66.0% kuchepetsa kubereka [82].Popeza kuti mankhwala awiriwa ali ndi zotsatira zochepa zochiritsira, izi zikhoza kukhala ndi zofunikira kwambiri m'madera omwe Trichomonas ali ndi matenda.Chemotherapy inali yothandiza kuchepetsa matenda ndi kuchepetsa kulemedwa kwa helminth mwa anthu omwe ali ndi kachilomboka pansi pa chiwerengero cha zochitika, koma mphamvu zogwira mtima zimasiyanasiyana pakati pa mitundu ya STH.Zodziwika bwino, mankhwala omwe alipo saletsa kubwezeretsedwa, zomwe zingatheke mwamsanga pambuyo pa chithandizo.Chifukwa chake, mankhwala atsopano ndi njira zophatikizira mankhwala zingakhale zofunikira m'tsogolomu [83] .
Pakalipano, palibe chithandizo chovomerezeka cha MDA kwa akuluakulu ku Philippines.IHCP imangoyang'ana ana a zaka zapakati pa 1-18, komanso kusankha mankhwala ophera tizilombo toyambitsa matenda a magulu ena omwe ali pachiopsezo chachikulu monga amayi apakati, amayi achinyamata, alimi, ogulitsa chakudya, ndi anthu amtundu [46] . anthu omwe ali pachiwopsezo chachikulu.- Magulu a ana asukulu omwe ali pachiwopsezo.Komabe, kukulitsa MDA kuchokera ku kayendetsedwe ka mankhwala osokoneza bongo kupita kumadera onse kungakhale ndi zotsatira zofunikira pazachuma pa mapulogalamu owongolera matenda a STH chifukwa chosowa zinthu zowonjezera. kampeni ya lymphatic filariasis ku Philippines ikugogomezera kuthekera kopereka chithandizo chamagulu onse [52].
Kuyambiranso kwa matenda a STH kukuyembekezeka chifukwa kampeni ya MDA yolimbana ndi ma STH ku Philippines yatha chifukwa cha mliri womwe ukupitilira wa COVID-19. Mitundu yaposachedwa ya masamu ikuwonetsa kuti kuchedwa kwa MDA m'malo owopsa a STH kungatanthauze cholinga chothetsa matenda a STH. monga vuto la thanzi la anthu (EPHP) ndi 2030 (lomwe limatanthauzidwa kuti likukwaniritsa <2% kufalikira kwa matenda ochepetsetsa kwambiri ku SAC [88]]) sangakwaniritsidwe, ngakhale njira zochepetsera zopangira maulendo a MDA omwe anaphonya. ie kufalitsa kwapamwamba kwa MDA,> 75%) kungakhale kopindulitsa [89] .Choncho, njira zowonjezereka zowonjezereka zowonjezera MDA zikufunika mwamsanga kuti athetse matenda a STH ku Philippines.
Kuwonjezera pa MDA, kusokoneza kufalitsa kumafuna kusintha kwa makhalidwe aukhondo, kupeza madzi otetezeka, ndi kupititsa patsogolo ukhondo kupyolera mu mapulogalamu ogwira mtima a WASH ndi CLTS.Zomwe zimakhumudwitsa, komabe, pali malipoti a zimbudzi zosagwiritsidwa ntchito bwino zoperekedwa ndi maboma am'madera m'madera ena, kusonyeza zovuta pakugwiritsa ntchito WASH [68, 69, 71, 72] .Kuonjezera apo, kufalikira kwakukulu kwa STH kunanenedwa m'madera omwe adapeza udindo wa ODF pambuyo pa kukhazikitsidwa kwa CLTS chifukwa choyambiranso khalidwe lachimbudzi lotseguka komanso kutsika kwa MDA [32] . kuzindikira za matenda opatsirana pogonana komanso kuwongolera machitidwe aukhondo ndi njira zofunika zochepetsera chiopsezo cha munthu kutenga matenda ndipo ndizowonjezera zotsika mtengo zamapulogalamu a MDA ndi WASH.
Maphunziro a zaumoyo operekedwa m'masukulu angathandize kulimbikitsa ndi kupititsa patsogolo chidziwitso ndi chidziwitso cha STH pakati pa ophunzira ndi makolo, kuphatikizapo zomwe zimaganiziridwa phindu la deworming.Pulogalamu ya "Magic Glasses" ndi chitsanzo cha kulowererapo kopambana kwambiri kwa maphunziro a zaumoyo m'sukulu. ndi katuni kakang'ono kamene kamapanga kuti aphunzitse ophunzira za matenda a STH ndi kupewa, kupereka umboni wa mfundo yakuti maphunziro a zaumoyo angathe kupititsa patsogolo chidziwitso ndi kukhudza khalidwe lokhudzana ndi matenda a STH [90]. Chigawo, ndi chiwerengero cha matenda a STH chinachepetsedwa ndi 50% m'masukulu ochitapo kanthu poyerekeza ndi masukulu olamulira (osawerengeka = 0.5, 95% nthawi yodalirika: 0.35-0.7, P <0.0001) 90] .Izi zasinthidwa ndikuyesedwa mwamphamvu ku Philippines [91] ndi Vietnam;ndipo pakali pano ikupangidwira kudera laling'ono la Mekong, kuphatikizapo kusintha kwake ku matenda a khansa ya Opisthorchis.Zochitika m'mayiko angapo a ku Asia, makamaka Japan, Korea ndi Taiwan Province la China, zasonyeza kuti kupyolera mu MDA, maphunziro a ukhondo ndi ukhondo monga gawo la ndondomeko zoyendetsera dziko lonse, kudzera m'masukulu ophunzirira ndi kugwirizanitsa katatu kuthetsa matenda a STH ndizotheka ndi mabungwe, NGOs ndi akatswiri a sayansi [92,93,94].
Pali mapulojekiti angapo ku Philippines omwe amaphatikizapo zowongolera za STH, monga WASH / EHCP kapena WINS zomwe zimakhazikitsidwa m'masukulu, ndi CLTS zomwe zimakhazikitsidwa m'madera. mapulani ndi ntchito zamagulu ambiri monga Philippines 'kuwongolera kwa STH kungapambane ndi mgwirizano wautali, mgwirizano ndi chithandizo cha boma laderalo.Kuthandizira kwa boma pa kugula ndi kugawa mankhwala ndi kuika patsogolo mbali zina za ndondomeko zowongolera, monga monga ntchito zopititsa patsogolo zaukhondo ndi maphunziro a zaumoyo, ndizofunikira kuti zithandizire kukwaniritsa zolinga za EPHP za 2030 [88]. Poyang'anizana ndi zovuta za mliri wa COVID-19, izi ziyenera kupitiliza ndikuphatikizidwa ndi COVID-19 yomwe ikupitilira. Kupanda kutero, kusiya pulogalamu yolimbana ndi matenda a STH kumatha kukhala ndi vuto lalikulu kwa anthu kwanthawi yayitali.lth zotsatira.
Kwa zaka pafupifupi makumi awiri, dziko la Philippines lachita khama kwambiri kuti lithetse matenda a STH. Ngakhale zili choncho, kufalikira kwa matenda opatsirana pogonana kwakhalabe kwakukulu m'dziko lonselo, mwina chifukwa cha kufalikira kwa MDA ndi zolepheretsa za WASH ndi maphunziro a zaumoyo.Maboma a dziko ayenera tsopano kuganizira zolimbitsa sukulu -ma MDAs ndi kukulitsa MDAs m'madera onse;kuyang'anitsitsa mphamvu ya mankhwala pazochitika za MDA ndikufufuza chitukuko ndi kugwiritsa ntchito mankhwala atsopano a antihelminthic kapena kuphatikiza mankhwala;ndi kuperekedwa kokhazikika kwa WASH ndi maphunziro azaumoyo ngati njira yowukira yamtsogolo ya STH ku Philippines.
Who.Soil-borne helminth infection.https://www.who.int/news-room/fact-sheets/detail/soil-transmitted-helminth-infections.Accessed Epulo 4, 2021.
Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC.Water, ukhondo, ukhondo, ndi matenda a helminth opangidwa ndi nthaka: ndondomeko yowonongeka ndi meta-analysis.PLoS Medicine.2014;11(3):e1001620 .
Hotez PJ, Fenwick A, Savioli L, Molyneux DH.Sungani mabiliyoni otsikirapo pothana ndi matenda onyalanyazidwa a m'madera otentha.Lancet.2009;373(9674):1570-5.
Plan RL, Smith JL, Jasrasaria R, Brooke SJ.Global matenda manambala ndi kulemedwa kwa matenda a helminth opatsirana nthaka, 2010.Parasite vector.2014; 7:37.
Who.2016 Chidule cha Global Preventive Chemotherapy Implementation: Kuphwanya Biliyoni imodzi.Weekly epidemiological records.2017;40(92):589-608.
DALYs GBD, wothandizira H. Padziko lonse, m'madera, ndi zaka za moyo wolemala (DALYs) ndi moyo wathanzi (HALE) wa matenda a 315 ndi kuvulala, 1990-2015: Kusanthula mwadongosolo la 2015 Global Burden of Disease Study.Lancet .2016;388(10053):1603-58.
Matenda a GBD, kuvulala C.Global kulemedwa kwa matenda a 369 ndi kuvulala m'mayiko ndi madera 204, 1990-2019: Kusanthula mwadongosolo kwa 2019 Global Burden of Disease Study.Lancet.2020;396(10258):1204-22.
Jourdan PM, Lamberton PHL, Fenwick A, Addiss DG.Soil-borne helminth infection.Lancet.2018;391(10117):252-65.
Gibson AK, Raverty S, Lambourn DM, Huggins J, Magargal SL, Grigg ME.Polyparasitism imagwirizanitsidwa ndi kuwonjezereka kwa matenda amtundu wa toxoplasma-infected marine sentinel.PLoS Negl Trop Dis.2011;5(5):e1142.
Nthawi yotumiza: Mar-15-2022