Ivhu-inotapurirwa helminth (STH) chirwere chakagara chiri dambudziko rinokosha rehutano hwevanhu muPhilippine.Mukuongorora uku, tinotsanangura mamiriro ezvinhu ehutano hweSTH ikoko uye tinosimbisa matanho ekudzora kuderedza STH mutoro.
Chirongwa chenyika yose cheSTH mass drug administration (MDA) chakatangwa mu2006, asi kuwanda kweSTH muPhilippines kunoramba kwakakwirira, kubva ku24.9% kusvika ku97.4%. kusanganisira kusaziva kukosha kwekurapwa nguva dzose, kusanzwisisana pamusoro pemazano eMDA, kusavimbika nemishonga inoshandiswa, kutya kwezviitiko zvakashata, uye kusavimba zvachose kwezvirongwa zvehurumende.Mapurogiramu aripo emvura, utsanana uye utsanana (WASH) atova mukati. nzvimbo munharaunda [somuenzaniso, zvirongwa zvenharaunda zvinotungamirirwa nenharaunda (CLTS) zvinopa zvimbuzi nekupa mari yekuvaka zvimbuzi] uye zvikoro [somuenzaniso, chirongwa cheWASH yechikoro (WINS)], asi kushandiswa kunopfuurira kunodiwa kuti zvibereko zviitwe. kudzidzisa kweWASH muzvikoro, kubatanidzwa kweSTH sechirwere uye nyaya yenharaunda mugwaro redzidzo rekutanga reveruzhinji rinoramba risina kukwana.Ongoing ongororotion ichadiwa kune Integrated Helminth Control Program (IHCP) iripo munyika, iyo inotarisa kuvandudza hutsanana nehutsanana, dzidzo yehutano uye kudzivirira chemotherapy.Kugara kwechirongwa kunoramba kuchinetsa.
Pasinei nekuedza kukuru kudzora hutachiona hweSTH muPhilippine mumakore makumi maviri apfuura, kuenderera mberi kweSTH kupararira kwave kuchishumwa munyika yose, zvichida nekuda kwekuvharirwa kweMDA uye kurambidzwa kweWASH uye zvirongwa zvehutano hwehutano..Kuendesa kwakasimba kwehutano hwakabatanidzwa hucharamba huchiita basa rinokosha mukutonga uye kubvisa STH muPhilippine.
Zvirwere zveSoil-transmitted helminth (STH) zvinoramba zviri dambudziko guru rehutano hwevanhu munyika yose, uye chirwere chinofungidzirwa chevanhu vanopfuura mabhiriyoni 1.5 [1]. , 3];uye inonyanya kupararira munyika dzine mari shoma, uye zvirwere zvakawanda zvinowanzoitika kune dzimwe nzvimbo dzeAsia, Africa, uye Latin America [4] . iyo inonyanya kubatwa, ine huwandu hwepamusoro uye hutachiwana hwehutachiona.Data iripo inoratidza kuti anopfuura mamiriyoni 267.5 ePSAC uye anopfuura mamiriyoni 568.7 maSAC anogara munzvimbo dzine chirwere chakanyanya cheSTH uye zvinoda kudzivirira chemotherapy [5].Mutoro wepasi rose weSTH unofungidzirwa. kuva 19.7-3.3 mamiriyoni akaremara-akagadziriswa makore ehupenyu (DALYs) [6, 7].
Utachiona hweSTH hunogona kutungamirira kukushaya zvokudya zvinovaka muviri uye kukanganisa kwemuviri uye kukura kwepfungwa, kunyanya muvana [8] .Kunyanya hutachiona hweSTH hunowedzera kuwedzera kwehutano [9,10,11].Polyparasitism (kutapukirwa nemaparasite akawanda) yakaratidzawo kuti inobatanidzwa. nekufa kwepamusoro uye kuwedzera kwehutachiwana kune zvimwe zvirwere [10, 11] .Zvakaipa zvezvirwere izvi zvinogona kukanganisa kwete hutano chete asiwo kubudirira kwehupfumi [8, 12].
IPhilippines inyika ine mari yakaderera uye yepakati.Mu 2015, inenge 21.6% yevanhu vane mamiriyoni e100.98 vePhilippine vaigara pasi pehurombo hwenyika yose [13]. .2019 data kubva kuWHO Preventive Chemotherapy Database inoratidza kuti vana vanosvika mamiriyoni makumi mana neshanu vari panjodzi yekutapukirwa inoda kurapwa [15].
Kunyange zvazvo zvirongwa zvakakura zvakatangwa kutonga kana kukanganisa kutapurirwa, STH inoramba ichinyanya kupararira muPhilippine [16].ratidza kuedza kwekare uye ikozvino kuenderera mberi kwekutonga, kunyora zvipingamupinyi uye kuoma kwekushandiswa kwepurogiramu, kuongorora kukanganisa kwayo pakuderedza mutoro weSTH, uye kupa maonero anogoneka ekutonga kwehonye dzematumbo. chirongwa cheSTH chinodzora munyika.
Ongororo iyi inotarisa kune mana anonyanya kuzivikanwa eSTH parasites - roundworm, Trichuris trichiura, Necator americanus uye Ancylostoma duodenale.Kunyange zvazvo Ancylostoma ceylanicum iri kubuda semhando yakakosha yezoonotic hookworm muSoutheast Asia, ruzivo rushoma parizvino rwuripo muPhilippine uye haruzokurukurwa. here.
Kunyange zvazvo iyi isiri ongororo yakarongeka, nzira inoshandiswa pakuongorora mabhuku ndeiyi inotevera.Takatsvaga zvidzidzo zvakakodzera zvinoshuma kupararira kweSTH kuPhilippines tichishandisa dura repamhepo rePubMed, Scopus, ProQuest, neGoogle Scholar.Mazwi anotevera anoshandiswa semazwi akakosha pakutsvaga: (“Helminthiases” kana makonye anobatwa nevhu” kana “STH” kana “Ascaris lumbricoides” kana “Trichuris trichiura” kana “Ancylostoma spp.” kana “Necator americanus” kana “Roundworm” kana “Whichworm” kana kuti “Hookworm”) uye (“Epidemiology”) uye (“Philippines”).Hapana kurambidzwa pagore rekuburitswa.Zvinyorwa zvakaonekwa nemaitiro ekutsvaga zvakatanga kuongororwa nemusoro uye abstract content, izvo zvisina kuferefetwa kweinenge matatu Zvinyorwa zvine kuwanda kana kusimba kweimwe yeSTHs hazvina kuverengerwa.Kuongororwa-kwakazara-mavara kwaisanganisira kutarisa (kuyambuka-chikamu, kesi-kutonga, kureba/cohort) zvidzidzo kana inodzorwa miedzo inoshuma kuwanda kwekutanga.Kutorwa kwedata kwaisanganisira nzvimbo yekudzidza, gore rekudzidza, gore rekudhindwa kwechidzidzo, rudzi rwekufunda (muchinjika-chikamu, kesi-control, kana longitudinal / cohort), saizi yemuenzaniso, huwandu hwekudzidza, kuwanda uye kusimba kweSTH yega yega, uye nzira inoshandiswa kuongororwa.
Kubva pakutsvaga mabhuku, zvinyorwa zve1421 zvakaonekwa nekutsvaga kwepa database [PubMed (n = 322);Zvikamu (n = 13);ProQuest (n = 151) uye Google Scholar (n = 935)]. Mapepa e48 akaongororwa zvichienderana nekuongorora kwemusoro, mapepa matanhatu akaiswa kunze, uye mapepa e42 akapedzisira aiswa muhutano hwekugadzirisa (Mufananidzo 1). )
Kubva ku1970s, zvidzidzo zvakawanda zvakaitwa muPhilippine kuti zvione kuwanda uye kusimba kwehutachiona hweSTH.Tafura 1 inoratidza chidimbu chezvidzidzo zvakaonekwa.Kusiyana kwemaitiro ekuongorora kweSTH pakati pezvidzidzo izvi kwakaonekwa nekufamba kwenguva, neiyo formalin. ether concentration (FEC) nzira inowanzoshandiswa mumazuva ekutanga (1970-1998) .Zvisinei, nzira yeKato-Katz (KK) yakashandiswa zvakanyanya mumakore anotevera uye inoshandiswa senzira yekutanga yekuongorora nzira yekuongorora maitiro ekutonga kweSTH munyika yose. ongororo.
Utachiona hweSTH hwakanga huri uye hunoramba huri dambudziko guru rehutano hwevanhu muPhilippine, sezvakaratidzwa nezvidzidzo zvakaitwa kubva kuma1970 kusvika muna 2018. kuwanda kwepamusoro kwehutachiona hwakanyorwa muPSAC neSAC [17].Mazera emazera aya ari panjodzi huru nekuti vana ava vanowanzosangana neSTH munzvimbo dzekunze.
Nhoroondo, kusati kwaitwa kweDhipatimendi rehutano Integrated Helminth Control Program (IHCP), kuwanda kwehutachiwana hweSTH uye hutachiona hwakanyanya muvana vane makore 1-12 kubva pa48.6-66.8% kusvika 9.9-67.4%, maererano.
STH data kubva kuNational Schistosomiasis Survey yemakore ose kubva ku2005 kusvika ku2008 yakaratidza kuti chirwere cheSTH chakanga chakapararira munzvimbo nhatu huru dzenyika, neA. lumbricoides uye T. trichiura zvakanyanya kunyanya kuVisayas [16].
Muna 2009, kuongororwa kwekutevera kwe2004 [20] uye 2006 SAC [21] National STH Prevalence Surveys yakaitwa kuti iongorore kukanganisa kweIHCP [26] . ongororo) uye 44.7% muSAC (54% muongororo ye2006) [26].Nhamba idzi dzakanyanya kuderera kune dzakataurwa muongororo mbiri dzakapfuura.Iyo yepamusoro-yakanyanya STH hutachiona hwehutachiona hwaive 22.4% muPSAC mu2009 (isina kuenzaniswa ne tsvakurudzo ye2004 nokuti kuwanda kwehuwandu hwehutachiona hwakanyanya hakuna kutaurwa) uye 19.7% muSAC (ichienzaniswa ne23.1% muongororo ye2006), kuderedzwa kwe14% [26]. STH muPSAC neSAC vanhu havasati vasangana neWHO-yakatsanangurwa 2020 chinangwa chekuwedzera kuwanda kwepasi pe20% uye yakanyanya STH hutachiona hwehuwandu hweisingasviki 1% kuratidza hurwere hwekudzora [27, 48].
Zvimwe zvidzidzo zvinoshandisa parasitological surveys zvakaitwa panguva dzakawanda (2006-2011) kutarisa kukanganisa kweMDA yechikoro muSAC yakaratidza maitiro akafanana [22, 28, 29] . ;zvisinei, chero STH (range, 44.3% kusvika 47.7%) uye utachiona hwakanyanya (range, 14.5% kusvika 24.6%) yakashumwa mukuongororwa kwekutevera Kupararira kwezvirwere kunoramba kwakakwirira [22, 28, 29], zvakare zvichiratidza kuti kuwanda hakusati kwawira kune WHO-inotsanangurwa chiitiko chekudzora chinangwa chenhanho (Table 1).
Dhata kubva kune zvimwe zvidzidzo zvichitevera kuunzwa kweIHCP muPhilippine muna 2007-2018 yakaratidza kuramba kwakakwira kweSTH muPSAC uye SAC (Tafura 1) [30,31,32,33,34,35,36,37,38,39. ].Kuwanda kweSTH chero ipi zvayo yakataurwa mune zvidzidzo izvi yakabva ku24.9% kusvika ku97.4% (neKK), uye kuwanda kwehutachiona hwepakati kusvika kune hwakanyanya kubva ku5.9% kusvika ku82.6%.lumbricoides uye T. trichiura zvinoramba zvichinyanya kupararira maSTHs, nehuwandu hunobva ku15.8-84.1% kusvika 7.4-94.4%, zvichienderana, nepo hookworms inowanzove ine huwandu hushoma, kubva pa1.2% kusvika ku25.3% [30,31, 32,33 ,34,35,36,37,38,39] (Table 1) .Zvisinei, mu2011, chidzidzo chinoshandisa molecular diagnostic quantitative real-time polymerase chain reaction (qPCR) yakaratidza kuwanda kwehookworm (Ancylostoma spp.) ye48.1 % [45] .Co-infection yevanhu vane A. lumbricoides uye T. trichiura zvakare yakaonekwa kakawanda mune zvidzidzo zvakawanda [26, 31, 33, 36, 45].
Nzira yeKK inokurudzirwa neWHO kuitira nyore kushandiswa mumunda uye kudhura kwakaderera [46], kunyanya kuongorora zvirongwa zvehurumende zvekurapa kweSTH control.Zvisinei, kusiyana kwehuwandu hweSTH zvakataurwa pakati peKK nedzimwe diagnostics.In chidzidzo che2014 muProvince yeLaguna, chero chirwere cheSTH (33.8% yeKK vs 78.3% yeqPCR), A. lumbricoides (20.5% KK vs 60.8% yeqPCR) uye T. trichiura (KK 23.6% vs 38.8% yeqPCR). Kunewo hookworm chirwere [6.8% kupararira;inosanganisira Ancylostoma spp.(4.6%) uye N. americana (2.2%)] vakaonekwa vachishandisa qPCR uye vakatongwa zvisina kunaka neKK [36].Kupararira kwechokwadi kwehutachiwana hwehutachiwana hunogona kuderedzwa zvikuru nokuti kukurumidza lysis yehookworm mazai inoda kukurumidza kuchinja. nokuda kweKK slide kugadzirira uye kuverenga [36,45,47], nzira inowanzova yakaoma kubudirira pasi pemamiriro emunda.Uyezve, mazai ehookworm marudzi ane morphologically asinganzwisisiki, ayo anokonzera imwe dambudziko rekuzivikanwa kwakarurama [45].
Iyo huru zano reSTH kudzora rinotsigirwa neWHO rinotarisa pane mass prophylactic chemotherapy nealbendazolekana mebendazole mumapoka ane ngozi yakawanda, nechinangwa chekurapa zvishoma 75% yePSAC neSAC ne2020 [48] . vakadzi vezera rekubereka (15-49 makore, kusanganisira avo vari muchipiri uye chechitatu trimesters) vanowana kutarisirwa nguva dzose [49]. Uyezve, iyi nhungamiro inosanganisira vana vaduku (mwedzi 12-23) uye vasikana vechidiki (makore gumi-19) [ 49], asi isingabatanidzi mazano ekare ekurapa kwevakuru vane ngozi yepamusoro yebasa [50] .WHO inokurudzira gore negore MDA yevana vaduku, PSAC, SAC, vasikana vechidiki, uye vakadzi vezera rekubereka munzvimbo dzine STH kupararira pakati pe20% ne50 %, kana semiannually kana kuwanda kuri pamusoro pe50%.Kuvakadzi vane pamuviri, nguva dzekurapa hadzina kusimbiswa [49].Kuwedzera kune chemotherapy yekudzivirira, WHO yakasimbisa mvura, tsvina uye utsanana (WASH) sechikamu chinokosha cheSTH control [ 48, 49].
IHCP yakatangwa muna 2006 kuti ipe hutungamiri hwemitemo yekutonga kweSTH uye mamwe zvirwere zvehelminth [20, 51].albendazolekana kuti mebendazole chemotherapy senzira huru yeSTH control, inotarisa vana vane makore 1-12 uye mamwe mapoka ane ngozi akadai semadzimai ane pamuviri, madzimai achiri kuyaruka, varimi, vachengeti vezvokudya uye vanhu veko.Zvirongwa zvekutonga zvinowedzerwawo nekuiswa kwemvura. uye nzvimbo dzehutsanana pamwe nekusimudzira hutano uye nzira dzedzidzo [20, 46].
Iyo semi-pagore MDA yePSAC inoitwa zvakanyanya nevemunharaunda barangay (mumusha) vehutano, vakadzidziswa barangay vashandi vehutano uye vanochengeta masikati munzvimbo dzenharaunda seGarantisadong Pambata kana "Vana Vane Utano" (pasuru inopa chirongwa) chePSAC's Health Services) , nepo MDA yeSAC inotariswa uye inoshandiswa neDhipatimendi reDzidzo (DepEd) [20].MDA muzvikoro zvepuraimari zvehurumende inotungamirirwa nevadzidzisi vachitungamirirwa nevashandi vehutano mukati mechikamu chekutanga nechetatu chegore rega rega rechikoro [20]. 2016, Ministry of Health yakapa nhungamiro mitsva yekubatanidza deworming muzvikoro zvesekondari (vana vari pasi pe18) [52].
Yekutanga yenyika semiannual MDA yakaitwa muvana vane makore 1-12 emakore muna 2006 [20] uye yakashuma kuvharwa kwedeworming ye82.8% ye6.9 miriyoni PSACs uye 31.5% ye6.3 miriyoni maSACs [53].Zvisinei, kuvharwa kwechirwere cheMDA kwakadzikira kubva pa209. kusvika ku2014 (range 59.5% kusvika 73.9%), nhamba inogara iri pasi peiyo WHO-yakakurudzirwa chiyero che75% [54] . mazano [56, 57], kusava nechivimbo mumishonga inoshandiswa [58], uye kutya kwezviitiko zvakashata [55, 56, 58, 59, 60]. [61] .Mukuwedzera, kupa uye kugadzirisa nyaya dzeMDA zvinodhaka zvakaonekwa sekukanganisa kukuru kwakasangana mukushandiswa kweMDA munyika yose [54].
Muna 2015, DOH yakabatana neDepEd kuita zuva rekutanga reNational School Deworming Day (NSDD), iro rine chinangwa chekudzinga maSAC anosvika miriyoni gumi nematanhatu (giredhi 1 kusvika 6) akanyoresa muzvikoro zvese zvepuraimari zvehurumende nezuva rimwe [62]. -based initiative yakaguma nehuwandu hwehuwandu hwehuwandu hwehuwandu hwe81%, huri pamusoro pemakore apfuura [54].Zvisinei, ruzivo rwenhema runopararira munharaunda pamusoro pekufa kwevana uye kushandiswa kwemishonga yakapera kwakakonzera hysteria huru uye kutya, zvichiita kuti yakawedzera mishumo yezviitiko zvakashata mushure meMDA (AEFMDA) muZamboanga Peninsula, Mindanao [63] .Zvisinei, kuongorora kwekuongorora kwakaratidza kuti kuva nyaya yeAEFMDA yakabatanidzwa pasina nhoroondo yekare ye deworming [63].
Muna 2017, Ministry of Health yakaunza mushonga mutsva we dengue ndokupa vana vechikoro vanenge 800 000. Kuvapo kwejekiseni iri kwakakonzera kushushikana kukuru kwekuchengetedza uye kwakonzera kusavimbana muzvirongwa zveDOH, kusanganisira chirongwa cheMDA [64, 65]. Nekuda kweizvozvo, kufukidzwa kwezvipembenene kwakadzikira kubva pa81% uye 73% yePSAC neSAC muna 2017 kusvika 63% uye 52% muna 2018, uye kusvika 60% uye 59% muna 2019 [15].
Pamusoro pezvo, maererano nedenda repasi rose reCOVID-19 (coronavirus disease 2019) denda, Ministry of Health yakapa departmental Memorandum No. 2020-0260 kana Interim Guidance for Integrated Helminth Control Plans uye Schistosomiasis Control and Elimination Plans Panguva yeCOVID- 19 Pandemic 》” Chikumi 23, 2020, inopa kuti MDA imiswe kusvika yaziviswa.Nekuda kwekuvharwa kwezvikoro, nharaunda iri kugara ichirapa vana vane makore 1-18, vachigovera mishonga kuburikidza nekushanya paimba neimba kana nzvimbo dzakatarwa, uku vachichengetedza kureba nekunangana neCCIDID-19 -19 nzira dzekudzivirira nekudzora hutachiona [66].Nekudaro, zvirambidzo pakufamba kwevanhu uye kushushikana kweveruzhinji nekuda kweCOVID-19 denda zvinogona kutungamira kudzikira kurapwa.
WASH ndiyo imwe yenzira dzakakosha dzekupindira kweSTH kudzora kunotsanangurwa neIHCP [20, 46].Ichi chirongwa chinosanganisira masangano ehurumende akawanda, kusanganisira Ministry of Health, Ministry of Home Affairs and Local Government (DILG), Local Government Units ( LGU) nebazi rezvedzidzo.Chirongwa chenharaunda cheWASH chinosanganisira kuwaniswa kwemvura yakachena, inotungamirwa nemapazi ehurumende yenzvimbo, nerutsigiro rweDILG [67], uye kuvandudzwa kwehutsanana kunoitwa neDOH vachibatsirwa nemapazi ehurumende, kuwanisa zvimbuzi uye rubatsiro rwekuvaka zvimbuzi [68, 69] ].Zvichakadaro, chirongwa cheWASH muzvikoro zvepuraimari zvehurumende chinotariswa nebazi rezvedzidzo richibatsirana nebazi rezvehutano.
Iyo yazvino data kubva kuPhilippine Statistics Authority (PSA) 2017 National Population Health Survey inoratidza kuti 95% yemhuri dzePhilippines dzinowana mvura yekunwa kubva kune yakagadziridzwa matsime emvura, ine chikamu chikuru (43%) kubva mumvura yemubhodhoro uye chete 26% kubva kune pombi zvitubu [ 70] zviwane. Chikamu chechina chemhuri dzemuPhilippines dzichiri kushandisa zvimbuzi zvisingagutsi [70];inenge 4.5% yevanhu vanoita tsvina pachena, tsika yakapetwa kaviri kumaruwa (6%) semumaguta (3%) [70].
Mimwe mishumo inoratidza kuti kupa zvivako zvehutsanana chete hazvivimbisi kushandiswa kwavo, uye hazvigadzirisi maitiro ehutsanana uye utsanana [32, 68, 69].Pakati pedzimba dzisina zvimbuzi, zvikonzero zvinowanzotaurwa zvekusavandudza hutsanana zvinosanganisira zvipingamupinyi zveunyanzvi (kureva,, kushaikwa kwenzvimbo mumba yechimbuzi kana septic tank yakatenderedza imba, nezvimwe zvinhu zvakaita semamiriro evhu uye padyo nenzira dzemvura), muridzi wevhu uye kushaikwa kwemari [71, 72].
Muna 2007, Dhipatimendi reHutano rePhilippine rakagamuchira nzira inotungamirirwa nenharaunda (CLTS) nzira kuburikidza neEast Asia Sustainable Health Development Programme [68, 73] .CLTS ipfungwa yehutsanana hwose hunosanganisira mararamiro akasiyana-siyana akadai sekumisa kuvhurika. kuita tsvina, kuona kuti munhu wese anoshandisa zvimbuzi zvehutsanana, kugeza maoko nguva nenguva uye kwakaringana, kucheneswa kwechikafu nemvura, kuraswa kwakachengeteka kwemhuka nemarara ezvipfuyo, uye kusikwa nekuchengetedza Kwakachena uye kwakachengeteka nharaunda [68, 69]. CLTS nzira, nzvimbo yeODF yemumusha inofanira kuramba ichitariswa kunyange mushure mokunge mabasa eCLTS apera.Zvisinei, zvidzidzo zvakawanda zvakaratidza kupararira kwakanyanya kweSTH munharaunda dzakawana mamiriro eODF mushure mekushandiswa kweCLTS [32, 33].Izvi zvingave zvakakonzerwa kushaikwa kwekushandiswa kwenzvimbo dzehutsanana, zvichibvira kutangwazve kwekubuda pachena, uye kuderera kweMDA kufukidzwa [32].
WASH mapurogiramu anoitwa muzvikoro anotevera mitemo yakabudiswa neDOH neDepEd.Muna 1998, Dhipatimendi rehutano rakapa Philippine Health Code School Health and Health Services Implementation Rules and Regulations (IRR) (PD No. 856) [74].Iyi IRR inotara mitemo nemirau yehutsanana hwechikoro nehutsanana hunogutsa, zvinosanganisira zvimbuzi, pombi yemvura, uye kuchengetedzwa nekuchengetwa kwezvivakwa izvi [74].Zvisinei, ongororo yeBazi rezvedzidzo yekushandiswa kwechirongwa ichi mumapurovhinzi akasarudzwa inoratidza kuti nhungamiro kwete kunyatsotevedzwa uye rubatsiro rwebhajeti haruna kukwana [57, 75, 76, 77]. Nokudaro, kutarisa uye kuongorora kunoramba kuchikosha kuti kuve nechokwadi chekuchengetedza kweBazi reDzidzo kushandiswa kwechirongwa cheWASH.
Mukuwedzera, kugadza tsika dzakanaka dzehutano hwevadzidzi, Ministry of Education yakapa Dhipatimendi Order (DO) No. 65, p.2009 ine musoro unoti "Essential Health Care Program (EHCP) yeVana Vechikoro" [78, 79] .Kunyange zvazvo chirongwa chekutanga chakagadzirirwa kudzivirira kupararira kweH1N1, izvi zvakare zvine chokuita neSTH control.Iyo yekupedzisira inotevera nzira yakakodzera yechikoro uye inotarisisa pane hutatu hunoratidza kupindira kwehutano hwechikoro: kugeza maoko nesipo, kukwesha nefluoridated toothpaste sechiitiko cheboka remazuva ese, uye STH's biannual MDA [78, 80].Muna 2016, EHCP ikozvino yabatanidzwa muchirongwa cheWASH In Schools (WINS) .Yakawedzera kuti ibatanidze kupihwa kwemvura, hutsanana, kubata chikafu nekugadzirira, kuvandudzwa kwehutsanana (semuenzaniso, kumwedzi kwehutsanana kutarisira), deworming, uye dzidzo yehutano [79].
Kunyange zvazvo kazhinji WASH yakabatanidzwa muchikoro chepuraimari [79], kubatanidzwa kwehutachiona hweSTH sechirwere uye dambudziko rehutano hwevanhu huchiri kushayikwa.Ongororo ichangobva kuitika muzvikoro zvepuraimari zvakasarudzwa munharaunda yeCagayan yakashuma kuti dzidzo yehutano ine chokuita neWASH ndeye inoshanda kuvadzidzi vese zvisinei negiredhi giredhi uye rudzi rwechikoro, uye inosanganiswa muzvidzidzo zvakawanda uye inoshandiswa zvakanyanya.Kusvikira vanhu (kureva, zvinhu zvinokurudzira dzidzo yehutano zvinoratidzwa zvinoonekwa mumakirasi, nzvimbo dzeWASH, uye muchikoro chese) [57] .Zvisinei, chidzidzo chimwechete chakaratidza kuti vadzidzisi vanofanira kudzidziswa muSTH uye deworming kuti vawedzere kunzwisisa kwavo maparasite uye zviri nani. kunzwisisa STH senyaya yehutano hweveruzhinji, kusanganisira: misoro ine chekuita neSTH kutapurirana, njodzi yekutapukirwa, njodzi yekutapukirwa inotyaira Post-worm yakavhurika defecation uye maitiro ekutapurirana akaunzwa mukirasi yechikoro [57].
Zvimwe zvidzidzo zvakaratidzawo hukama pakati pedzidzo yehutano uye kugamuchirwa kwekurapa [56, 60] zvichiratidza kuti dzidzo yehutano yakasimbiswa uye kukurudzirwa (kuvandudza ruzivo rweSTH uye kugadzirisa MDA kusanzwisisa pamusoro pekurapa uye kubatsirwa) kunogona kuwedzera MDA kutora chikamu uye kugamuchirwa [56], 60].
Uyezve, kukosha kwedzidzo yehutano mukupesvedzera maitiro akanaka ane chokuita nehutsanana kwakaonekwa sechimwe chezvikamu zvakakosha zveWASH kushandiswa [33, 60] .Sezvo zvidzidzo zvekare zvakaratidza, kusvibiswa kwakazaruka hakusi chikonzero chekushayikwa kwechimbuzi [33, 60]. 32, 33] .Zvinhu zvakadai semaitiro akazaruka ehutsvina uye kushayikwa kwekushandiswa kwezvivakwa zvehutsanana zvinogona kukanganisa migumisiro yakazaruka yetsvina [68, 69].Mune imwe ongororo, hutsanana husina kunaka hwakabatana nehuwandu hwehuwandu hwekusagona kuverenga nekunyora pakati peSACs muVisayas [ 81] .Saka, kubatanidzwa kwezvidzidzo zvehutano uye nzira dzekusimudzira chinangwa chekuvandudza marara uye hutsanana hutsika, pamwe nekugamuchirwa uye kushandiswa kwakakodzera kwezvivakwa zvehutano izvi, zvinoda kuiswa kuitira kuchengetedza kupindira kweWASH.
Dhiyabhorosi yakaunganidzwa mumakore makumi maviri adarika inoratidza kuti kuwanda uye kusimba kwehutachiona hweSTH pakati pevana vari pasi pemakore gumi nemaviri muPhilippines hunoramba huri pamusoro, pasinei nekuedza kwakasiyana-siyana kwehurumende yePhilippine. yakaonekwa kuti ive nechokwadi chekuvharidzirwa kweMDA.Inofanirwawo kufunga nezvekushanda kwemishonga miviri ikozvino inoshandiswa muchirongwa chekutonga cheSTH (albendazole uye mebendazole), sezvinotyisa zvakanyanya T. trichiura zvirwere zvakataurwa mune zvimwe zvidzidzo zvenguva pfupi muPhilippine [33, 34, 42]. Mishonga miviri iyi yakanzi yakanga isinganyanyi kushanda pakurwisa T. trichiura, nemishonga yakabatanidzwa ye30.7% uye 42.1% yealbendazoleuye mebendazole, pamwe chete, uye 49.9% uye 66.0% kuderedza mukubereka [82]. Zvichipa kuti mishonga miviri ine zvishoma zvekurapa, izvi zvinogona kuva nemigumisiro inokosha munzvimbo dzine Trichomonas endemic.Chemotherapy yakanga inobudirira mukuderedza hutachiona hwehutachiona uye kuderedza helminth mutoro muvanhu vane utachiona pasi pechikumbaridzo chechiitiko, asi kushanda kwakasiyana-siyana pakati pemarudzi eSTH.Zvinonzwisisika, mishonga iripo haidziviriri kuberekwazve, iyo inogona kuitika pakarepo mushure mekurapa.Saka, mishonga mitsva uye nzira dzekubatanidza zvinodhaka zvinogona kudiwa mune ramangwana [83] .
Parizvino, hapana chinosungirwa kurapwa kweMDA kune vanhu vakuru muPhilippine.IHCP inongotarisa kuvana vane makore 1-18 ekuzvarwa, pamwe nekusarudza deworming yemamwe mapoka ane njodzi akadai sevakadzi vane nhumbu, vakadzi vachiri kuyaruka, varimi, vanobata chikafu, uye vanhu vomunharaunda [46] .Zvisinei, masvomhu achangobva kuitika [84,85,86] uye kuongororwa kwakarongeka uye meta-analyses [87] inoratidza kuti kuwedzera kwenharaunda-yakawanda yezvirongwa zvekudzivirira hove kuvhara mapoka ose ezera zvinogona kuderedza kupararira kweSTH mu. vanhu vakawanda vane ngozi.- Mapoka evana vechikoro vari panjodzi.Zvisinei, kuwedzera MDA kubva kune inotarirwa kushandiswa kwezvinodhaka kusvika munharaunda yose inogona kuva nemigumisiro inokosha yehupfumi yezvirongwa zvekutonga kweSTH nekuda kwekudiwa kwekuwedzera zviwanikwa.Kunyange zvakadaro, kurapwa kwevanhu vakawanda kunobudirira. mushandirapamwe we lymphatic filariasis muPhilippine inosimbisa kugona kwekupa nharaunda-yakawanda kurapwa [52].
Kutangazve kwezvirwere zveSTH kunotarisirwa sezvo danidziro dzeMDA dzekuchikoro dzichipokana neSTH muPhilippine dzakamira nekuda kwedenda ririkuenderera mberi reCCIDID-19. Zvichangoburwa masvomhu mhando dzinoratidza kuti kunonoka muMDA munzvimbo dzakakwirira dzeSTH-endemic zvinogona kureva chinangwa chekubvisa STH. sedambudziko rehutano hweveruzhinji (EPHP) ne2030 (inotsanangurwa sekuwana <2% kuwanda kwepakati-kusvika-yakanyanya-yakanyanya hutachiona muSAC [88]]) inogona kunge isingagoneki, kunyangwe nzira dzekudzikisa kuita kupotsa MDA kutenderera ( kureva huwandu hweMDA hwepamusoro,> 75%) hungave hunobatsira [89] .Saka, mamwe maitiro ekugadzirisa akasimba ekuwedzera MDA anodiwa nokukurumidza kurwisa chirwere cheSTH muPhilippine.
Mukuwedzera kune MDA, kukanganiswa kwekutapurirana kunoda kuchinjwa kwemaitiro ehutsanana, kuwana mvura yakachengeteka, uye kuvandudzwa kwehutsanana kuburikidza nehurongwa hunobudirira hweWASH neCLTS.Zvimwe zvinogumbura, zvisinei, kune mishumo yezvivako zvehutsanana zvisingashandisi zvakapiwa nehurumende dzenharaunda mune dzimwe nharaunda, zvichiratidza matambudziko mukushandiswa kweWASH [68, 69, 71, 72].Mukuwedzera, kupararira kweSTH kwakakwirira kwakashumwa munharaunda dzakawana mamiriro eODF mushure mekushandiswa kweCLTS nekuda kwekutangazve kwemaitiro ekushambidzika akazaruka uye kuvhara kweMDA kwakaderera [32].Kuvaka ruzivo uye kuziva nezveSTH uye kunatsiridza hutsanana inzira dzakakosha dzekudzikisa njodzi yemunhu yekutapukirwa uye zvinonyanya mutengo wakaderera wekuwedzera kune MDA neWASH zvirongwa.
Dzidzo yehutano inopiwa muzvikoro inogona kubatsira kusimbisa nekuvandudza ruzivo rwese uye kuziva kweSTH pakati pevadzidzi nevabereki, kusanganisira zvinofungidzirwa kubatsira kwedeworming.Purogiramu ye "Magic Glasses" muenzaniso wekupindira kwedzidzo yehutano munguva pfupi yapfuura yakabudirira zvikuru muzvikoro.Izvi. ipfupi yekatuni inopindira yakagadzirirwa kudzidzisa vadzidzi nezveSTH utachiona nekudzivirira, ichipa humbowo-hwe-musimboti kuti dzidzo yehutano inogona kuvandudza ruzivo uye kukanganisa maitiro ane chekuita neSTH utachiona [90].Iyo nzira yakatanga kushandiswa muChina chepuraimari vadzidzi muHunan. Purovhinzi, uye chiitiko chechirwere cheSTH chakaderedzwa ne50% muzvikoro zvekupindira zvichienzaniswa nezvikoro zvekutonga (zvisingabvumirwi = 0.5, 95% nguva yekuvimba: 0.35-0.7, P <0.0001) .90] .Izvi zvakagadziriswa uye zvakaedzwa zvakasimba muPhilippines [91] neVietnam;uye parizvino iri kugadzirwa kunharaunda yepasi yeMekong, kusanganisira kuchinjika kwayo kucarcinogenic Opisthorchis chiropa fluke infection.Zvakaitika munyika dzakawanda dzeAsia, kunyanya Japan, Korea neTaiwan Province yeChina, zvakaratidza kuti kuburikidza neMDA, hutsanana hwakakodzera uye dzidzo yehutsanana se chikamu chezvirongwa zvekutonga kwenyika, kuburikidza nechikoro-based approaches uye triangular Kubatana kubvisa chirwere cheSTH chinogoneka nemasangano, NGOs uye nyanzvi dzezvesayenzi [92,93,94].
Kune mapurojekiti akati wandei muPhilippine anosanganisira maSTH controls, akadai seWASH/EHCP kana WINS anoitwa muzvikoro, uye CLTS anoitwa munharaunda.Zvisinei, kuitira kuti mikana irambe iripo, kudyidzana kukuru pakati pemasangano ari kuita chirongwa kunodiwa. zvirongwa uye kuedza kwemapato akawanda sePhilippine' yekutonga kweSTH kunogona kubudirira chete nekushandira pamwe kwenguva refu, kushandira pamwe nerutsigiro rwehurumende yenzvimbo.Rutsigiro rweHurumende pakutenga nekugoverwa kwemishonga uye kuisa pamberi pezvimwe zvikamu zvezvirongwa zvekutonga, zvakadai. sezviitwa zvekuvandudza hutsanana nedzidzo yezvehutano, zviri kudiwa kukurumidza kuzadzikiswa kwezvinangwa zve2030 EPHP [88].Pakatarisana nematambudziko eCOVID-19 denda, zviitiko izvi zvinofanirwa kuenderera mberi uye kubatanidzwa neCOVID-19 irikuenderera mberi. Kuedza kudzivirira. Zvikasadaro, kukanganisa chirongwa cheSTH chave chakapikiswa kunogona kuve kwakakomba kwenguva refu yeruzhinji kupisa.lth mhedzisiro.
Kwemakore anoda kusvika makumi maviri, Philippines yakaita nhamburiko huru yekudzora hutachiona hweSTH.Zvisinei, kupararira kweSTH kwakaramba kwakakwira munyika yose, zvichida nekuda kwehuwandu hweMDA kuvharwa uye kuganhurirwa kweWASH uye zvirongwa zvedzidzo yehutano.Hurumende dzenyika dzinofanira kufunga zvino kusimbisa chikoro. -yakavakirwa MDAs uye kuwedzera nharaunda-yakawanda MDAs;kunyatsotarisa kushanda kwezvinodhaka panguva yezviitiko zveMDA uye kuongorora kukura uye kushandiswa kwemishonga mitsva ye antihelminthic kana kusanganiswa kwezvinodhaka;uye kupihwa kwakasimba kweWASH uye dzidzo yehutano senzira yakazara yekurwisa yeramangwana STH kutonga muPhilippine.
Who.Soil-borne helminth infection.https://www.who.int/news-room/fact-sheets/detail/soil-transmitted-helminth-infections.Yakasvika Kubvumbi 4, 2021.
Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC.Mvura, hutsanana, utsanana, uye zvirwere zvehelminth zvinotakura ivhu: kuongorora kwakarongeka uye meta-analysis.PLoS Medicine.2014;11(3):e1001620 .
Hotez PJ, Fenwick A, Savioli L, Molyneux DH. Chengetedza bhiriyoni iri pasi nekudzora zvirwere zvinogara pasi zvinopisa.Lancet.2009;373(9674):1570-5.
Ronga RL, Smith JL, Jasrasaria R, Brooke SJ.Global utachiona nhamba uye mutoro wechirwere chevhu-inotapurirwa helminth infections, 2010.Parasite vector.2014;7:37.
Who.2016 Summary yeGlobal Preventive Chemotherapy Implementation: Kuputsa Mabhirioni.Weekly epidemiological records.2017;40(92):589-608.
DALYs GBD, mushandirwi H. Global, nharaunda, uye nyika yakagadziriswa makore ehupenyu (DALYs) uye hutano hunotarisirwa hupenyu (HALE) kune zvirwere zve315 nekukuvara, 1990-2015: Kuongororwa kwakarongeka kwe2015 Global Burden of Disease Study.Lancet .2016;388(10053):1603-58.
Chirwere GBD, kukuvadzwa C.Global mutoro we369 zvirwere uye kukuvara munyika 204 nematunhu, 1990-2019: Kuongororwa kwakarongeka kwe2019 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 inobatanidza nekuwedzera kwechirwere chechirwere muToxoplasma-infected marine sentinel species.PLoS Negl Trop Dis.2011;5(5):e1142.
Nguva yekutumira: Mar-15-2022