Indwara yandurira mu butaka (STH) imaze igihe kinini ari ikibazo cy’ubuzima rusange muri Filipine. Muri iri suzuma, turasobanura aho indwara zandurira muri iki gihe kandi tunagaragaza ingamba zo kugenzura kugabanya imitwaro ya STH.
Gahunda yo kurwanya ibiyobyabwenge rusange mu gihugu hose (MDA) yatangijwe mu 2006, ariko muri rusange abantu banduye indwara zandurira mu mibonano mpuzabitsina muri Filipine baracyari hejuru, kuva kuri 24.9% kugeza kuri 97.4% .Komeza kwiyongera kwanduye bishobora guterwa n’ibibazo bifitanye isano no gushyira mu bikorwa MDA, harimo no kutamenya akamaro ko kuvurwa buri gihe, kutumva neza ingamba za MDA, kutizera imiti ikoreshwa, gutinya ibintu bibi, no kutizera muri rusange gahunda za leta. Gahunda zamazi, isuku nisuku (WASH) zirahari shyira mu baturage [urugero, gahunda y’isuku iyobowe n’abaturage itanga ubwiherero kandi igatera inkunga iyubakwa ry’ubwiherero] hamwe n’ishuri [urugero, gahunda ya WASH y’ishuri (WINS)], ariko gushyira mu bikorwa birakenewe kugira ngo tugere ku bisubizo byifuzwa. imyigishirize ya WASH mumashuri, guhuza STH nkindwara nikibazo cyabaturage muri gahunda rusange yubuyobozi rusange ikomeje kuba idahagije.Isuzuma rikomejehazakenerwa gahunda ya “Integrated Helminth Control Programme” (IHCP) iriho ubu mu gihugu, yibanda ku kunoza isuku n’isuku, uburezi bw’ubuzima ndetse na chimiotherapie ikumira. Gukomeza gahunda biracyari ikibazo.
Nubwo hashyizweho ingufu nyinshi mu kurwanya ubwandu bwa STH muri Filipine mu myaka 20 ishize, mu gihugu hose hagaragaye ubwandu bukabije bw’indwara zandurira mu mibonano mpuzabitsina, bikaba bishoboka ko biterwa na MDA itagabanijwe ndetse n’ubushobozi bwa WASH na gahunda z’ubuzima..Gutanga uburyo burambye bwo kugenzura ibikorwa bizakomeza kugira uruhare runini mugucunga no gukuraho STH muri Philippines.
Indwara zandurira mu butaka (STH) zikomeje kuba ikibazo gikomeye cy’ubuzima rusange ku isi, aho bivugwa ko banduye abantu barenga miliyari 1.5 [1] .STH yibasira abaturage bakennye barangwa no kubona amazi adahagije, isuku n’isuku (WASH) [2 , 3];kandi yiganje cyane mu bihugu bikennye, aho usanga indwara nyinshi zibera mu bice bya Aziya, Afurika, na Amerika y'Epfo [4] .Abana bato mbere y’ishuri bafite hagati y’imyaka 2 na 4 (PSAC) hamwe n’abana biga kuva ku myaka 5 kugeza 12 (SAC) bari abantu bakunze kwibasirwa cyane, hamwe n’ubwinshi bw’ubwandu n’ubwandu. Amakuru aboneka yerekana ko PSAC zirenga miliyoni 267.5 na SAC zirenga miliyoni 568.7 ziba mu turere twanduye cyane kandi bisaba imiti ivura indwara [5]. kuba miliyoni 19.7-3.3 yubumuga bwahinduwe nubuzima (DALYs) [6, 7].
Indwara ya STH irashobora gutuma habaho kubura imirire no kubangamira iterambere ryumubiri nubwenge, cyane cyane kubana [8] .Uburemere bukabije bwanduye STH bwongera uburwayi [9,10,11] .Poliparasitism (kwandura parasite nyinshi) nayo yerekanwe ko ifitanye isano. hamwe n’impfu nyinshi no kongera kwandura izindi ndwara [10, 11] .Ingaruka mbi z’izi ndwara ntizishobora kugira ingaruka ku buzima gusa ahubwo no ku musaruro w’ubukungu [8, 12].
Abanyafilipine ni igihugu giciriritse kandi giciriritse.Mu mwaka wa 2015, hafi 21,6% by'abaturage ba miliyoni 100.98 bo muri Filipine babaga munsi y'umurongo w'ubukene [13] .Bufite kandi bimwe mu byorezo bya STH mu majyepfo y'uburasirazuba bwa Aziya [14] .2019 imibare yavuye muri OMS ishinzwe gukumira imiti ivura imiti igaragaza ko abana bagera kuri miliyoni 45 bafite ibyago byo kwandura bisaba kwivuza [15].
Nubwo ibikorwa byinshi binini byatangijwe kugenzura cyangwa guhagarika kwanduza, STH ikomeje kugaragara cyane muri Philippines [16] .Muri iyi ngingo, turatanga incamake yerekana uko indwara zanduye zanduye muri Philippines;garagaza imbaraga zashize nubu zirimo gukorwa, wandike imbogamizi ningorane zo gushyira mubikorwa gahunda, gusuzuma ingaruka zabyo mukugabanya umutwaro wa STH, no gutanga icyerekezo gishoboka cyo kurwanya inyo zo munda .Kuboneka kwaya makuru birashobora gutanga ishingiro ryo gutegura no gushyira mubikorwa a gahunda ihamye yo kugenzura STH mugihugu.
Iri suzuma ryibanda kuri parasite enye zikunze kugaragara - inzoka, Trichuris trichiura, Necator americanus na Ancylostoma duodenale.Nubwo Ancylostoma ceylanicum igaragara nkubwoko bukomeye bwa zoonotic zo mu majyepfo yuburasirazuba bwa Aziya, amakuru make arahari muri Philippines kandi ntabwo azaganirwaho. hano.
Nubwo iyi atari isubiramo rifatika, uburyo bukoreshwa mugusubiramo ubuvanganzo nuburyo bukurikira. Twashakishije ubushakashatsi bujyanye no kwerekana ubwandu bwa STH muri Philippines dukoresheje ububiko bwa interineti bwa PubMed, Scopus, ProQuest, na Google Scholar. Amagambo akurikira yari ikoreshwa nkijambo ryibanze mugushakisha: (“Helminthiase” cyangwa inyo zanduzwa nubutaka ”cyangwa“ STH ”cyangwa“ Ascaris lumbricoides ”cyangwa“ Trichuris trichiura ”cyangwa“ Ancylostoma spp. ”cyangwa“ Necator americanus ”cyangwa“ Roundworm ”cyangwa“ Nindeworm ”. cyangwa “Hookworm”) na (“Epidemiologiya”) na (“Philippines”).Nta mbogamizi ku mwaka yatangajwe.Ingingo zagaragajwe nubushakashatsi bwabanje kugenzurwa nizina hamwe nibisobanuro bidafatika, bitakorewe iperereza byibuze ingingo eshatu zifite ubwinshi cyangwa ubukana bwa imwe muri STH zarashizwemo.Kugenzura inyandiko yuzuye harimo kwitegereza (guhuza ibice, kugenzura-kugenzura, birebire / cohort) ubushakashatsi cyangwa ibigeragezo bigenzura raporo yibanze.Gukuramo amakuru byari bikubiyemo ahantu ho kwigwa, umwaka wiga, umwaka watangarijweho kwiga, ubwoko bwinyigisho (guhuza ibice, kugenzura, cyangwa birebire / cohort), ingano yicyitegererezo, umubare wabaturage, ubwinshi nimbaraga za buri STH, nuburyo bukoreshwa mugupima.
Hashingiwe ku gushakisha ubuvanganzo, inyandiko 1421 zamenyekanye no gushakisha amakuru [PubMed (n = 322);Ibipimo (n = 13);ProQuest (n = 151) na Google Scholar (n = 935)]. Impapuro 48 zose zapimwe hashingiwe ku isubiramo ry'umutwe, impapuro 6 zaraciwe, kandi impapuro 42 zose zashyizwe muri synthesis yujuje ubuziranenge (Ishusho 1 ).
Kuva mu myaka ya za 70, ubushakashatsi bwinshi bwakorewe muri Filipine kugirango hamenyekane ubwinshi nimbaraga zandura zanduye. Imbonerahamwe ya 1 irerekana incamake y’ubushakashatsi bwamenyekanye. uburyo bwa ether concentration (FEC) bwakunze gukoreshwa muminsi yambere (1970-1998) .Nyamara, tekinike ya Kato-Katz (KK) yakoreshejwe cyane mumyaka yakurikiyeho kandi ikoreshwa nkuburyo bwibanze bwo gusuzuma mugukurikirana uburyo bwo kugenzura STH mugihugu ubushakashatsi.
Indwara ya STH yabaye kandi ikomeje kuba ikibazo cy’ubuzima rusange muri Filipine, nkuko bigaragazwa n’ubushakashatsi bwakozwe kuva mu myaka ya za 70 kugeza 2018.Icyorezo cya epidemiologi y’ubwandu bwa STH n’ubwiyongere bwacyo kiragereranywa n’ibivugwa mu bindi bihugu byanduye ku isi, hamwe na ubwinshi bwubwandu bwanditse muri PSAC na SAC [17] .Iyi matsinda yimyaka ifite ibyago byinshi kuko aba bana bakunze guhura na STH mumwanya wo hanze.
Mu mateka, mbere y’ishyirwa mu bikorwa rya Minisiteri y’ubuzima ishinzwe gahunda yo kurwanya indwara ya Helminth (IHCP), ubwandu bwa virusi itera SIDA n’ubwandu bukabije ku bana bafite hagati y’imyaka 1-12 kuva kuri 48.6-66.8% kugeza kuri 9.9-67.4%.
Ubushakashatsi bwakozwe na STH bwo mu bushakashatsi bwakozwe na Schistosomiasis ku myaka yose kuva 2005 kugeza 2008 bwerekanye ko kwandura indwara ya STH byakwirakwiriye mu turere dutatu tw’ibanze tw’igihugu, aho A. lumbricoides na T. trichiura byiganje cyane muri Visayas [16].
Muri 2009, ubushakashatsi bwakorewe muri 2004 [20] na 2006 SAC [21] Ubushakashatsi bwakozwe ku rwego rw’igihugu bwanduye STH hagamijwe gusuzuma ingaruka za IHCP [26] .Ubwandu bwa STH bwari 43.7% muri PSAC (66% muri 2004) ubushakashatsi) na 44.7% muri SAC (54% mu bushakashatsi bwakozwe mu 2006) ubushakashatsi bwakozwe mu 2004 kubera ko muri rusange ubwandu bw’indwara zikomeye zitigeze zivugwa) na 19.7% muri SAC (ugereranije na 23.1% mu bushakashatsi bwakozwe mu 2006), kugabanukaho 14% STH mu baturage ba PSAC na SAC ntabwo yujuje intego ya OMS yasobanuwe na 2020 yo kwanduza abantu bari munsi ya 20% ndetse n’ubwandu bukabije bw’indwara ya STH iri munsi ya 1% kugira ngo bagaragaze ko barwaye indwara [27, 48].
Ubundi bushakashatsi ukoresheje ubushakashatsi bwa parasitologiya bwakozwe ku masaha menshi (2006-2011) kugira ngo ukurikirane ingaruka z’ishuri MDA muri SAC bwerekanye ibintu bisa [22, 28, 29] .Ibyavuye muri ubwo bushakashatsi byagaragaje ko ubwandu bwa STH bwagabanutse nyuma y’ibice byinshi bya MDA ;icyakora, indwara zose zandurira mu mibonano mpuzabitsina (intera, 44.3% kugeza kuri 47.7%) hamwe n'ubwandu bukabije (intera, 14.5% kugeza 24,6%) byavuzwe mubushakashatsi bwakurikiranye Muri rusange ubwiyongere bw'indwara bukomeje kuba bwinshi [22, 28, 29], byongeye kwerekana ko ubwiyongere ntiburagwa kuri OMS yasobanuye urwego rwo kugenzura indwara (Imbonerahamwe 1).
Imibare yavuye muyindi nyigo ikurikira itangizwa rya IHCP muri Philippines muri 2007-2018 yerekanaga ubwandu bwa STH muri PSAC na SAC (Imbonerahamwe 1) [30,31,32,33,34,35,36,37,38, 39 ] .Indwara ya STH iyo ari yo yose ivugwa muri ubu bushakashatsi yavuye kuri 24.9% igera kuri 97.4% (na KK), naho ubwandu bw'indwara zoroheje kandi zikomeye kuva kuri 5.9% kugeza kuri 82,6% .A.lumbricoides na T. trichiura bikomeza kuba indwara zandurira mu mibonano mpuzabitsina, aho ubwandu buri hagati ya 15.8-84.1% na 7.4-94.4%, mu gihe inzoka zo mu bwoko bw'inzoka zikunda kuba nkeya, kuva kuri 1.2% kugeza kuri 25.3% [30,31, 32,33 , 34,35,36,37,38,39]. % 45.
Uburyo bwa KK burasabwa na OMS kubworohereza imikoreshereze yumurima kandi bidahenze [46], cyane cyane mugusuzuma gahunda yo kuvura leta yo kugenzura indwara zandurira mu mibonano mpuzabitsina.Nyamara, itandukaniro riri hagati y’indwara ya STH ryagaragaye hagati ya KK n’abandi bapima indwara.In ubushakashatsi bwakozwe muri 2014 mu Ntara ya Laguna, kwandura indwara zose (33.8% kuri KK vs 78.3% kuri qPCR), A. lumbricoides (20.5% KK vs 60.8% kuri qPCR) na T. trichiura (KK 23,6% vs 38.8% kuri qPCR). Hariho kandi kwandura inzoka [6.8%;Harimo Ancylostoma spp. kubijyanye no gutegura amashusho ya KK no gusoma [36,45,47], inzira ikunze kugorana kuyigeraho mubihe byumurima.Ikindi kandi, amagi yubwoko bwinzoka ntaho atandukaniye na morphologique, ibyo bikaba bitera ikindi kibazo cyo kumenya neza [45].
Ingamba nyamukuru zo kugenzura indwara zandurira mu mibonano mpuzabitsina zunganiwe na OMS yibanda kuri chimiotherapie ya rusangealbendazolecyangwa mebendazole mu matsinda afite ibyago byinshi, hagamijwe kuvura byibuze 75% bya PSAC na SAC muri 2020 [48] .Mbere yuko hashyirwaho igishushanyo mbonera cy’indwara zo mu turere dushyuha (NTDs) kugeza 2030, Ninde wasabye PSAC, SAC na abategarugori bafite imyaka yimyororokere (imyaka 15-49, harimo nabari mugihembwe cya kabiri nicyagatatu) bahabwa ubuvuzi busanzwe [49]. Byongeye kandi, aya mabwiriza akubiyemo abana bato (amezi 12-23) nabakobwa b'ingimbi (10-19) [ 49], ariko ukuyemo ibyifuzo byabanjirije kuvura abantu bakuze bafite akazi gakomeye [50] .Ninde usaba MDA ngarukamwaka kubana bato, PSAC, SAC, abakobwa b'ingimbi, n'abagore bafite imyaka yo kubyara mubice byanduye STH hagati ya 20% na 50 %, cyangwa buri mwaka niba ubwiyongere buri hejuru ya 50% .Ku bagore batwite, hashyizweho intera yo kuvura [49]. Usibye imiti ivura imiti, OMS yashimangiye amazi, isuku nisuku (WASH) nkigice cyingenzi cyo kurwanya indwara zandurira mu mibonano mpuzabitsina [WASH] 48, 49].
IHCP yatangijwe mu 2006 kugirango itange umurongo ngenderwaho wa politiki yo kurwanya indwara zandurira mu mibonano mpuzabitsina ndetse n’izindi ndwara zandurira mu mitsi [20, 51] .Uyu mushinga ukurikiza ingamba zemewe na OMS zemewe na OMS, hamwealbendazolecyangwa chimiotherapie ya mebendazole nkingamba nyamukuru yo kurwanya indwara zandurira mu mibonano mpuzabitsina, yibasira abana bafite hagati yimyaka 1-12 nandi matsinda afite ibyago byinshi nkabagore batwite, abagore bingimbi, abahinzi, abashinzwe ibiryo hamwe nabasangwabutaka. Gahunda zo kugenzura nazo zuzuzwa no gushyiraho amazi n'ibikoresho by'isuku kimwe no guteza imbere ubuzima n'uburere [20, 46].
Buri mwaka MDA ya PSAC ikorwa cyane cyane n’ibigo nderabuzima bya barangay (umudugudu), abahugura abashinzwe ubuzima bwa barangay hamwe n’abakozi bashinzwe kwita ku bana aho batuye nka Garantisadong Pambata cyangwa “Abana bafite ubuzima bwiza” (paki itanga umushinga) wa serivisi z'ubuzima za PSAC) , mugihe MDA ya SAC ikurikiranwa kandi igashyirwa mubikorwa nishami ryuburezi (DepEd) 2016, Minisiteri y’Ubuzima yasohoye amabwiriza mashya yo gushyira inzoka mu mashuri yisumbuye (abana bari munsi y’imyaka 18) [52].
Igihembwe cya mbere cy’igihugu cya MDA cyakorewe mu bana bafite hagati y’imyaka 1-12 mu 2006 [20] kandi kivuga ko indwara y’inzoka igera kuri 82.8% ya miliyoni 6.9 za PSAC na 31.5% bya miliyoni 6.3 za SACs. kugeza 2014 (intera iri hagati ya 59.5% na 73.9%), imibare ihora munsi yikigereranyo cya OMS cyagenwe na 75% ngamba .
Muri 2015, DOH yafatanije na DepEd kwakira umunsi wo gutangiza ishuri ry’igihugu ry’imyororokere (NSDD), rigamije kwirukana SACs zigera kuri miliyoni 16 (icyiciro cya 1 kugeza ku cya 6) zanditswe mu mashuri abanza ya Leta mu munsi umwe [62] .Iyi shuri -Igikorwa gishingiye ku bikorwa byatumye abantu bangana na 81% bangiza ibyorezo by’igihugu, biruta ibyo mu myaka yashize. kwiyongera kwa raporo z’ibintu bibi nyuma ya MDA (AEFMDA) mu gace ka Zamboanga, Mindanao [63] .Nyamara, ubushakashatsi bwakozwe mu manza bwerekanye ko kuba urubanza rwa AEFMDA ntaho bihuriye n'amateka yabanjirije iyangirika [63].
Muri 2017, Minisiteri y’ubuzima yashyizeho urukingo rushya rwa dengue maze ruha abanyeshuri bagera ku 800.000. Uru rukingo rwabonetse rwateye impungenge zikomeye z’umutekano kandi bituma abantu batizerana muri gahunda za DOH, harimo na gahunda ya MDA [64, 65]. Kubera iyo mpamvu, ibyorezo by’udukoko byagabanutse kuva kuri 81% na 73% bya PSAC na SAC muri 2017 bigera kuri 63% na 52% muri 2018, na 60% na 59% muri 2019 [15].
Byongeye kandi, ukurikije icyorezo cya COVID-19 ku isi (indwara ya coronavirus 2019), Minisiteri y’ubuzima yashyize ahagaragara Memorandum ishami rya 2020-0260 cyangwa Ubuyobozi bw’agateganyo bwa gahunda yo kurwanya Helminth hamwe na gahunda yo kurwanya no kurandura Schistosomiasis no gukuraho gahunda ya COVID- 19 Icyorezo》 ”Ku ya 23 Kamena 2020, giteganya ko MDA ihagarikwa kugeza igihe ibimenyeshejwe.Bitewe no gufunga amashuri, abaturage bakunze kwangiza abana bafite imyaka 1-18, bagatanga imiti binyuze munzu ku nzu cyangwa ahantu hateganijwe, mugihe bakomeza intera yumubiri no kurwanya COVID-19 -19 ingamba zikwiye zo gukumira no kurwanya indwara [66].Ariko, kubuza urujya n'uruza rw'abantu no guhangayikishwa n'abaturage kubera icyorezo cya COVID-19 bishobora gutuma abantu bavurwa nabi.
WASH ni kimwe mu bintu by'ingenzi bigamije kurwanya indwara zandurira mu mibonano mpuzabitsina zagaragajwe na IHCP [20, 46] .Iyi ni gahunda irimo ibigo byinshi bya Leta, birimo Minisiteri y'Ubuzima, Minisiteri y'Ubutegetsi bw'igihugu ndetse n'inzego z'ibanze (DILG), Inzego z'ibanze ( LGU) na Minisiteri y'Uburezi. Gahunda ya WASH y'abaturage ikubiyemo gutanga amazi meza, iyobowe n'inzego z'ibanze, ku nkunga ya DILG [67], no kunoza isuku yashyizwe mu bikorwa na DOH ibifashijwemo n'inzego z'ibanze, gutanga ubwiherero na inkunga yo kubaka ubwiherero [68, 69]] .Mu gihe, gahunda ya WASH mumashuri abanza ya leta ikurikiranwa na minisiteri yuburezi ku bufatanye na minisiteri yubuzima.
Ubushakashatsi buheruka gukorwa n’ikigo cy’igihugu gishinzwe ibarurishamibare cya Filipine (PSA) 2017 Ubushakashatsi bw’ubuzima bw’abaturage ku baturage bugaragaza ko 95% by’ingo zo muri Filipine zibona amazi yo kunywa aturuka ku masoko meza y’amazi, aho umubare munini (43%) uva mu icupa na 26% gusa biva mu miyoboro [ 70] kubibona. Kimwe cya kane cy'ingo z'Abanyafilipine baracyakoresha ibikoresho by'isuku bidashimishije [70];hafi 4.5% by'abaturage biyuhagira ku mugaragaro, imyitozo ikubye kabiri mu cyaro (6%) nko mu mijyi (3%) [70].
Izindi raporo zerekana ko gutanga ibikoresho by’isuku byonyine bidasobanura ko bikoreshwa, cyangwa ngo bitezimbere imikorere y’isuku n’isuku [32, 68, 69] .Imiryango myinshi idafite ubwiherero, impamvu zikunze kuvugwa mu kudateza imbere isuku harimo inzitizi za tekiniki (ni ukuvuga, kubura umwanya munzu yubwiherero cyangwa ikigega cya septique gikikije urugo, nibindi bintu nk’imiterere nk’ubutaka ndetse no kuba hafi y’amazi), gutunga ubutaka no kubura inkunga [71, 72].
Mu 2007, Ishami ry’Ubuzima rya Filipine ryemeje abaturage bayobowe n’isuku rusange (CLTS) binyuze muri gahunda y’iterambere ry’ubuzima burambye bwa Aziya y’iburasirazuba [68, 73] .CLTS ni igitekerezo cy’isuku yuzuye ikubiyemo imyitwarire itandukanye nko guhagarika gufungura kwiyuhagira, kwemeza ko buri wese akoresha ubwiherero bw’isuku, gukaraba intoki kenshi kandi neza, gusukura ibiryo n’amazi, guta neza amatungo n’imyanda y’amatungo, no gushyiraho no kubungabunga ibidukikije bisukuye kandi bifite umutekano [68, 69] .Kugirango habeho iterambere rirambye rya Uburyo bwa CLTS, imidugudu ya ODF igomba guhora ikurikiranwa na nyuma yibikorwa bya CLTS birangiye.Nyamara, ubushakashatsi bwinshi bwerekanye ubwiyongere bukabije bwa STH mubaturage bageze kuri status ya ODF nyuma yo gushyira mu bikorwa CLTS [32, 33] .Ibi birashobora kuba biterwa kubura imikoreshereze y’isuku, birashoboka ko hasubukurwa umwanda, hamwe na MDA nkeya [32].
Gahunda za WASH zashyizwe mu bikorwa zikurikiza politiki yatangajwe na DOH na DepEd.Mu 1998, Ishami ry’Ubuzima ryasohoye Amategeko n’amabwiriza yo gushyira mu bikorwa serivisi z’ubuzima n’ubuzima bwa Philippine (IRR) (PD No 856) [74] .Iyi IRR ishyiraho amategeko n'amabwiriza agenga isuku y'ishuri n'isuku ishimishije, harimo ubwiherero, ibikoresho by'amazi, no kubungabunga no kubungabunga ibyo bigo [74] .Nyamara, isuzuma rya minisiteri y'uburezi ryashyize mu bikorwa gahunda mu ntara zatoranijwe ryerekana ko umurongo ngenderwaho ari ntabwo byubahirizwa cyane kandi inkunga yingengo yimari ntabwo ihagije [57, 75, 76, 77] .Nuko rero, kugenzura no gusuzuma bikomeje kuba ingenzi kugirango gahunda ya minisiteri yuburezi ishyire mu bikorwa gahunda ya WASH.
Byongeye kandi, kugirango hashyizweho uburyo bwiza bwubuzima bwabanyeshuri, Minisiteri yuburezi yasohoye iteka ry’ishami (DO) No 56, ingingo ya 56.2009 ryiswe “Ako kanya kubaka amazi no gukaraba intoki mumashuri yose kugirango wirinde ibicurane A (H1N1)” na DO No . 65, s.2009 yiswe “Gahunda Yingenzi Yita ku Buzima (EHCP) ku Bana bo mu Ishuri” [78, 79] .Mu gihe gahunda ya mbere yari igamije gukumira ikwirakwizwa rya H1N1, iyi nayo ifitanye isano no kugenzura indwara ya STH. Iyanyuma ikurikiza uburyo bukwiye bw’ishuri kandi yibanze ku bimenyetso bitatu bishingiye ku buzima bw’ishuri: gukaraba intoki hamwe nisabune, kwoza amenyo ya fluoride nkigikorwa cyitsinda rya buri munsi, hamwe na MDA ya kabiri ya MDA [78, 80] .Mu 2016, EHCP ubu yinjiye muri gahunda ya WASH Mumashuri (WINS) .Yagutse ikubiyemo gutanga amazi, isuku, gufata neza ibiryo no gutegura, kunoza isuku (urugero, gucunga isuku yimihango), kurwara, no kwigisha ubuzima [79].
Nubwo muri rusange WASH yashyizwe mu nteganyanyigisho z'amashuri abanza [79], kwanduza indwara ya STH nk'indwara n'ikibazo cy'ubuzima rusange biracyabura. Ubushakashatsi buherutse gukorwa mu mashuri abanza ya Leta yatoranijwe yo mu ntara ya Cagayan bwatangaje ko inyigisho z'ubuzima zijyanye na WASH ari bikurikizwa kubanyeshuri bose utitaye kurwego rwamanota nubwoko bwishuri, kandi nayo ihuriweho mumasomo menshi kandi ikoreshwa cyane.Kwegera (ni ukuvuga, ibikoresho biteza imbere uburezi bwubuzima bigaragarira mubyumba by’ishuri, mu gace ka WASH, ndetse no mu ishuri ryose) gusobanukirwa indwara zandurira mu mibonano mpuzabitsina nk'ikibazo cy’ubuzima rusange, harimo: ingingo zijyanye no kwandura indwara zandurira mu mibonano mpuzabitsina, ibyago byo kwandura, ibyago byo kwandura bizatera Post-worm gufungura umwanda ndetse n’uburyo bwo kongera kwinjizwa mu ishuri ry’ishuri [57].
Ubundi bushakashatsi bwerekanye kandi isano iri hagati yubuzima bwubuzima no kwemerwa kwivuza [56, 60] byerekana ko guteza imbere uburezi bwubuzima no kuzamura iterambere (kunoza ubumenyi bwa STH no gukosora imyumvire mibi ya MDA kubyerekeye kwivuza nibyiza) bishobora kongera uruhare rwa mDA no kwemerwa [56], 60].
Byongeye kandi, akamaro k’inyigisho z’ubuzima mu guhindura imyitwarire myiza ijyanye n’isuku byagaragaye ko ari kimwe mu bintu byingenzi bigize ishyirwa mu bikorwa rya WASH [33, 60] .Nkuko ubushakashatsi bwibanze bwabigaragaje, kwanduza ku mugaragaro ntabwo byanze bikunze biterwa no kubura ubwiherero [ ., 33 ]
Amakuru yakusanyijwe mu myaka 20 ishize yerekana ko ubwinshi bw’indwara zandurira mu mibonano mpuzabitsina ku bana bari munsi y’imyaka 12 muri Filipine bikomeje kuba byinshi, nubwo guverinoma ya Filipine yashyizeho ingufu zitandukanye. Inzitizi n’imbogamizi ku ruhare rwa MDA no kubahiriza imiti bigomba kuba yamenyekanye kugirango MDA ikwirakwira cyane. Birakwiye kandi ko harebwa akamaro k'ibiyobyabwenge bibiri bikoreshwa muri gahunda yo kurwanya STH (albendazole na mebendazole), kuko indwara zanduye T. trichiura zagaragaye mu bushakashatsi bwakozwe vuba aha muri Philippines [33, 34, 42] .Imiti yombi yavuzwe ko idakora neza kuri T. trichiura, hamwe no gukira kwa 30.7% na 42.1% kurialbendazolena mebendazole, hamwe na 49.9% na 66.0% kugabanuka kwintanga [82] .Gutanga ko imiti yombi igira ingaruka nke zo kuvura, ibi bishobora kugira ingaruka zikomeye mubice Trichomonas yanduye.Chemotherapie yagize akamaro mukugabanya urwego rwanduye no kugabanya umutwaro wa helminth kubantu banduye uri munsi yurugero rwanduye, ariko efficacy yari itandukanye mubwoko bwa STH.Ntabwo bivuze ko imiti iriho itabuza kongera kwandura, ishobora guhita ivurwa. Kubera iyo mpamvu, hashobora gukenerwa imiti mishya hamwe ningamba zo guhuza ibiyobyabwenge. .
Kugeza ubu, nta miti ya MDA iteganijwe ku bantu bakuru muri Philippines.IHCP yibanda gusa ku bana bafite hagati y’imyaka 1-18, ndetse no kwanduza indwara y’andi matsinda afite ibyago byinshi nk'abagore batwite, abagore b'ingimbi, abahinzi, abacuruza ibiryo, n'abaturage b'abasangwabutaka [46] .Nyamara, imibare iheruka y'imibare [84,85,86] hamwe nisuzuma rifatika hamwe na meta-isesengura [87] byerekana ko kwaguka kwabaturage muri gahunda zose zangiza ibyatsi kugirango bigabanye ibyiciro byose bishobora kugabanya ubwandu bwa STH muri abaturage bafite ibyago byinshi. ubukangurambaga kuri lymphatic filariasis muri Filipine bishimangira uburyo bwo gutanga ubuvuzi rusange [52].
Biteganijwe ko hongera kubaho ubwandu bwa STH mu gihe ubukangurambaga bwa MDA bushingiye ku ishuri kurwanya STH hirya no hino muri Filipine bwahagaritswe kubera icyorezo cya COVID-19. Icyitegererezo cy’imibare cyerekana ko gutinda kwa MDA ahantu hahanamye cyane bishobora kwerekana intego yo gukuraho STH nkikibazo cyubuzima rusange (EPHP) mumwaka wa 2030 (bisobanurwa nkugera ku <2% byanduye byanduye-by-ubukana muri SAC [88]]) ntibishobora kugerwaho, nubwo ingamba zo kugabanya ibyiciro bya MDA zabuze ( ni ukuvuga ubwinshi bwa MDA,> 75%) byagira akamaro [89] .Nuko rero, ingamba zihamye zo kugenzura MDA zirakenewe byihutirwa kurwanya ubwandu bwa STH muri Philippines.
Usibye MDA, guhagarika kwanduza bisaba guhindura imyitwarire yisuku, kubona amazi meza, no kunoza isuku binyuze muri gahunda nziza za WASH na CLTS. Biteye agahinda ariko, hari raporo z’ibikorwa by’isuku bidakoreshwa neza byatanzwe n’inzego z’ibanze mu baturage bamwe, bikagaragaza imbogamizi mu ishyirwa mu bikorwa rya WASH [68, 69, 71, 72] .Ikindi kandi, ubwandu bwa STH bwagaragaye mu baturage bageze kuri status ya ODF nyuma yo gushyira mu bikorwa CLTS bitewe no kongera imyitwarire yo kwanduza no gukwirakwiza MDA [32] .Kubaka ubumenyi na Kumenya indwara zandurira mu mibonano mpuzabitsina no kunoza imikorere y’isuku ninzira zingenzi zo kugabanya ibyago byumuntu ku giti cye kandi ni inyongera zihenze kuri gahunda za MDA na WASH.
Inyigisho zubuzima zitangwa mumashuri zirashobora gufasha gushimangira no guteza imbere ubumenyi rusange nubukangurambaga kuri STH mubanyeshuri ndetse nababyeyi, harimo ninyungu zigaragara ziterwa no kurwara.Ibikorwa bya "Magic Glasses" ni urugero rwibikorwa byubuzima byatsinze cyane mumashuri.Ibi ni interineti ngufi igamije kwigisha abanyeshuri kwandura no kwirinda indwara ya STH, itanga ibimenyetso-byerekana ko uburezi bwubuzima bushobora guteza imbere ubumenyi no guhindura imyitwarire ijyanye no kwandura indwara zandurira mu mibonano mpuzabitsina [90] .Ubwo buryo bwakoreshejwe bwa mbere mu banyeshuri bo mu mashuri abanza y’Abashinwa muri Hunan. Intara, kandi indwara zandurira mu mibonano mpuzabitsina zagabanutseho 50% mu mashuri yitabiriwe ugereranije n’ishuri rishinzwe kugenzura (intera ratio = 0.5, 95% intera intera: 0.35-0.7, P <0.0001) .90] .Ibi byahinduwe kandi birageragezwa cyane muri Philippines [91] na Vietnam;kuri ubu irimo gutezwa imbere mu karere ka Mekong yo hepfo, harimo no kurwanya indwara ya kanseri ya Opisthorchis yanduye umwijima. Uburambe mu bihugu byinshi byo muri Aziya, cyane cyane Ubuyapani, Koreya n'Intara ya Tayiwani mu Bushinwa, bwerekanye ko binyuze muri MDA, uburezi bukwiye bw'isuku n'isuku nk'uko igice cya gahunda yo kugenzura igihugu, binyuze muburyo bushingiye kumashuri hamwe nubufatanye bwa mpandeshatu kurandura indwara zandurira mu mibonano mpuzabitsina birashoboka mubigo, imiryango itegamiye kuri leta ninzobere mubumenyi [92,93,94].
Hano hari imishinga myinshi muri Philippines ikubiyemo ubugenzuzi bwa STH, nka WASH / EHCP cyangwa WINS yashyizwe mubikorwa mumashuri, na CLTS ishyirwa mubikorwa mubaturage.Nyamara, kugirango amahirwe menshi arambye, habeho guhuza ibikorwa mumiryango ishyira mubikorwa gahunda.Niyo mpamvu, kwegereza ubuyobozi abaturage gahunda nimbaraga zamashyaka menshi nka Philippines 'kugenzura STH birashobora gutsinda gusa mubufatanye bwigihe kirekire, ubufatanye ninkunga yinzego zibanze. Inkunga ya leta mugutanga no gukwirakwiza imiti no gushyira imbere ibindi bice bigize gahunda yo kugenzura, nkibi nkibikorwa byo kunoza isuku nuburezi bwubuzima, birakenewe kugirango twihutishe kugera ku ntego za 2030 za EPHP [88] .Mu guhangana n’ibibazo by’icyorezo cya COVID-19, ibyo bikorwa bigomba gukomeza kandi bigahuzwa na COVID-19 ikomeje. imbaraga zo gukumira. Ubundi, guteshuka kuri gahunda yo kugenzura STH isanzwe igoye bishobora kugira igihe kirekire cya rubandaIngaruka.
Mu myaka igera hafi kuri makumyabiri, Filipine yashyizeho ingufu nyinshi mu kurwanya indwara zandurira mu mibonano mpuzabitsina.Nyamara, amakuru avuga ko ubwandu bwa STH bwakomeje kuba mwinshi mu gihugu hose, bishoboka ko biterwa na MDA itagabanijwe kandi bigarukira kuri gahunda za WASH na gahunda z’uburezi bw’ubuzima. Guverinoma z’ibihugu zikwiye gutekereza ku gushimangira ishuri. -Bishingiye kuri MDA no kwagura umuryango-MDAs;gukurikiranira hafi imikorere yibiyobyabwenge mugihe cya MDA no gukora iperereza ku iterambere no gukoresha imiti mishya ya antihelminthique cyangwa ibiyobyabwenge;no gutanga amakuru arambye ya WASH nuburezi bwubuzima nkuburyo bwuzuye bwo gutera STH muri Philippines.
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Igihe cyo kohereza: Werurwe-15-2022