Usulelo lwe-helminth oludluliselwa ngumhlaba (STH) luye lwaba yingxaki ebalulekileyo yempilo yoluntu kwiiPhilippines.Kolu hlaziyo, sichaza imeko yangoku yosulelo lwe-STH apho kwaye sigxininisa amanyathelo okulawula ukunciphisa umthwalo we-STH.
Inkqubo yelizwe lonke ye-STH yolawulo lweziyobisi (MDA) yasungulwa kwi-2006, kodwa ukuxhaphaka ngokubanzi kwe-STH kwiiPhilippines kuhlala kuphezulu, ukusuka kwi-24.9% ukuya kwi-97.4%. kubandakanywa nokungabikho kokuqonda ukubaluleka konyango oluqhelekileyo, ukungaqondi malunga nezicwangciso ze-MDA, ukungabikho kokuzithemba kumayeza asetyenziswayo, ukwesaba iziganeko ezimbi, kunye nokungathembeki ngokubanzi kweenkqubo zikarhulumente.Iinkqubo ezikhoyo zamanzi, ucoceko kunye nococeko (WASH) indawo ekuhlaleni [umz., iinkqubo zogutyulo olubanzi olukhokelwa luluntu (CLTS) ezibonelela ngezindlu zangasese kunye nokuxhasa ngemali ulwakhiwo lwezindlu zangasese] kunye nezikolo [umz., isicwangciso sokuHLAnjwa kwezikolo (WINS)], kodwa ukuphunyezwa okuqhubekayo kuyafuneka ukuze kufikelelwe kwiziphumo ezinqwenelekayo. ukufundiswa kwe-WASH ezikolweni, ukudityaniswa kwe-STH njengesifo kunye nomba wasekuhlaleni kwikharityhulam yangoku karhulumente yamabanga aphantsi kuhlala kunganelanga.Uvandlakanyo oluqhubekayokuya kufuneka kwiNkqubo yoLawulo lweHelminth eDityanisiweyo (IHCP) ekhoyo ngoku kweli lizwe, egxile ekuphuculeni ucoceko kunye nococeko, imfundo yezempilo kunye nokuthintela ichemotherapy. Ukuzinza kwenkqubo kuhlala kungumngeni.
Ngaphandle kwemigudu emikhulu yokulawula usulelo lwe-STH kwiiPhilippines kule minyaka ingamashumi amabini idlulileyo, ukuxhaphaka okuthe gqolo kwe-STH kuye kwaxelwa kwilizwe lonke, mhlawumbi ngenxa yokhuseleko lwe-MDA olungeyomfuneko kunye nemida ye-WASH kunye neenkqubo zemfundo yezempilo..Ukuhanjiswa okuzinzileyo kwendlela yokulawula edibeneyo kuya kuqhubeka nokudlala indima ebalulekileyo ekulawuleni nasekupheliseni i-STH kwiiPhilippines.
Usulelo lwe-helminth esasazwa ngumhlaba (STH) luhlala luyingxaki enkulu yempilo yoluntu kwihlabathi jikelele, kunye nosulelo oluqikelelwayo lwabantu abangaphezu kwe-1.5 yezigidigidi [1]. , 3];kwaye ixhaphake kakhulu kumazwe anengeniso ephantsi, kunye nosulelo oluninzi lwenzeka kwiindawo zaseAsia, eAfrika, naseLatin America [4] .Abantwana basesikolweni abaneminyaka eyi-2 ukuya kwe-4 (PSAC) kunye nabantwana besikolo abaneminyaka emi-5 ukuya kwe-12 (SAC) eyona nto ichaphazeleka kakhulu, kunye nokuxhaphaka okuphezulu kunye nobukhulu bosulelo.Idatha ekhoyo ibonisa ukuba ngaphezu kwe-267.5 yezigidi ze-PSACs kunye ne-568.7 yezigidi ze-SACs zihlala kwiindawo ezinosulelo olunzima lwe-STH kwaye zifuna i-chemotherapy yokukhusela [5].Umthwalo wehlabathi jikelele we-STH uqikelelwa. ukuba yi-19.7-3.3 yezigidi zeminyaka yokuphila yokukhubazeka (DALYs) [6, 7].
Ukusuleleka kwe-STH kunokukhokelela ekunqongopheni kwesondlo kunye nokukhubazeka komzimba kunye nokuphuhliswa kwengqondo, ngakumbi kubantwana [8].Ukusuleleka kwi-STH ephezulu kakhulu kwandisa ukugula [9,10,11]. ngokufa okuphezulu kunye nokunyuka kokuchaphazeleka kwezinye izifo [10, 11] .Imiphumo emibi yolu sulelo ayinakuchaphazela impilo kuphela kodwa kunye nemveliso yezoqoqosho [8, 12].
IiPhilippines lilizwe elinengeniso ephantsi kunye nephakathi.Ku-2015, malunga ne-21.6% ye-100.98 yezigidi zabantu basePhilippine bahlala ngaphantsi komgca wentlupheko kazwelonke [13]. .2019 idatha evela kwi-WHO Preventive Chemotherapy Database ibonisa ukuba malunga ne-45 yezigidi zabantwana basemngciphekweni wosulelo olufuna unyango lwezonyango [15].
Nangona amanyathelo amaninzi amakhulu aqaliswe ukulawula okanye ukuphazamisa usulelo, i-STH ihlala ixhaphake kakhulu kwiiPhilippines [16] .Kule nqaku, sinika umboniso wemeko yangoku yosulelo lwe-STH kwiiPhilippines;gqamisa iinzame zolawulo eziqhubekayo kunye nezangoku, bhala imingeni kunye nobunzima bokuphunyezwa kwenkqubo, ukuvavanya impembelelo yayo ekunciphiseni umthwalo we-STH, kunye nokubonelela ngeembono ezinokwenzeka zokulawula iintshulube zamathumbu. inkqubo yolawulo lwe-STH ezinzileyo elizweni.
Olu phononongo lujolise kwiintsholongwane ezine ze-STH eziqhelekileyo - i-roundworm, i-Trichuris trichiura, i-Necator americanus kunye ne-Ancylostoma duodenale.Nangona i-Ancylostoma ceylanicum ivela njengeentlobo ezibalulekileyo ze-zoonotic hookworm kwi-Southeast Asia, ulwazi olulinganiselwe lukhoyo ngoku kwiiPhilippines kwaye aluyi kuxoxwa. Apha.
Nangona oku ingekuko uphononongo olucwangcisiweyo, indlela yokusebenza esetyenzisiweyo kuphononongo loncwadi ngolu hlobo lulandelayo.Sikhangele izifundo ezifanelekileyo ezixela ukuxhaphaka kwe-STH kwiiPhilippines kusetyenziswa oovimba beenkcukacha ze-intanethi ze-PubMed, Scopus, ProQuest, kunye ne-Google Scholar.La magama alandelayo aye isetyenziswe njengamagama angundoqo kuphando: (“Helminthiases” okanye iintshulube ezithwalwa ngumhlaba” okanye “STH” okanye “Ascaris lumbricoides” okanye “Trichuris trichiura” okanye “Ancylostoma spp.” okanye “Necator americanus” okanye “Roundworm” okanye “Whichworm” okanye “Hookworm”) kunye (“Epidemiology”) kunye (“Philippines”).Akukho sithintelo kunyaka wopapasho.Amanqaku achongwe ngemilinganiselo yokukhangela ekuqaleni ahlolwe ngesihloko kunye nomxholo ongabonakaliyo, ezo zingaphandwanga ubuncinane amaNqaku amathathu kunye nokuxhaphaka okanye ukuqina kwenye ye-STHs yayingabandakanywanga.Ukuhlolwa okugcweleyo okubhaliweyo kuqukwa ukuqwalaselwa (kwecandelo elinqamlezayo, ulawulo lwamatyala, ubude/iqela) izifundo okanye iimvavanyo ezilawulwayo ezixela ukuxhaphaka kwesiseko.Ukukhutshwa kwedatha kubandakanya indawo yokufunda, unyaka wokufunda, unyaka wokupapashwa kokufunda, uhlobo lokufunda (i-cross-sectional, i-case-control, okanye i-longitudinal / cohort), ubungakanani besampula, inani labantu abafundayo, ukuxhaphaka kunye nokuqina kwe-STH nganye, kunye nendlela esetyenziselwa ukuxilongwa.
Ngokusekelwe kuphando loncwadi, iirekhodi ze-1421 zizonke zichongiwe ngophando lwedatha [PubMed (n = 322);Imida (n = 13);I-ProQuest (n = 151) kunye ne-Google Scholar (n = 935)]. Amaphepha e-48 ewonke ahlolwe ngokusekelwe kuphononongo lwesihloko, amaphepha e-6 ayengabandakanywa, kwaye amaphepha angama-42 ekugqibeleni afakwe kwi-qualitative synthesis (Umfanekiso 1). ).
Ukususela kwi-1970s, uphando oluninzi luye lwaqhutyelwa kwiiPhilippines ukumisela ukuxhaphaka kunye nokuqina kosulelo lwe-STH.Itheyibhile 1 ibonisa isishwankathelo sezifundo ezichongiweyo.Ukwahlukana kwiindlela zokuxilonga ze-STH phakathi kwezi zifundo kwabonakala ngokuhamba kwexesha, kunye ne-formalin. I-ether concentration (FEC) indlela esetyenziswa rhoqo kwiintsuku zokuqala (1970-1998) .Nangona kunjalo, indlela ye-Kato-Katz (KK) isetyenziswe ngokunyukayo kwiminyaka elandelayo kwaye isetyenziswe njengendlela yokuqala yokuxilonga yokubeka iliso kwiinkqubo zokulawula i-STH kwilizwe lonke. uphando.
Usulelo lwe-STH luye lwaba kwaye luhlala luyingxaki ebalulekileyo yempilo yoluntu kwiiPhilippines, njengoko kubonisiwe kwizifundo eziqhutywe ukususela ngo-1970 ukuya ku-2018. ukuxhaphaka okuphezulu kosulelo olurekhodiweyo kwi-PSAC kunye ne-SAC [17]. La maqela obudala asemngciphekweni omkhulu kuba aba bantwana bahlala bechanabeke kwi-STH kwiindawo zangaphandle.
Ngokomlando, ngaphambi kokuphunyezwa kweNkqubo yoLawulo lwe-Helminth yeSebe lezeMpilo (IHCP), ukuxhaphaka kwaluphi na usulelo lwe-STH kunye nosulelo olunzima kubantwana abaneminyaka eyi-1-12 ubudala ukusuka kwi-48.6-66.8% ukuya kwi-9.9-67.4%, ngokulandelanayo.
Idatha ye-STH evela kwi-National Schistosomiasis Survey yeminyaka yonke ukusuka kwi-2005 ukuya kwi-2008 ibonise ukuba ukusuleleka kwe-STH kwakuxhaphake kwiindawo ezintathu eziphambili zelizwe, kunye ne-A. lumbricoides kunye ne-T. trichiura ngokukodwa kwi-Visayas [16].
Kwi-2009, uvavanyo olulandelayo lwe-2004 [20] kunye ne-2006 ye-SAC [21] i-National STH Prevalence Surveys yenziwa ukuvavanya impembelelo ye-IHCP [26] .Ukuxhaphaka kwayo nayiphi na i-STH kwakuyi-43.7% kwi-PSAC (66% ngo-2004) uphando) kunye ne-44.7% kwi-SAC (i-54% kwi-survey ka-2006) [26] . uphando luka-2004 ngenxa yokuba ukuxhaphaka kosulelo olubi aluzange luxelwe) kunye ne-19.7% kwi-SAC (xa kuthelekiswa ne-23.1% kwi-survey ka-2006), ukuncipha kwe-14% I-STH kwi-PSAC kunye ne-SAC yabemi ayizange ihlangabezane ne-WHO-echazwe kwi-target ye-2020 ye-cumulative prevalence engaphantsi kwe-20% kunye neqondo elibi losulelo lwe-STH olungaphantsi kwe-1% ukubonisa ulawulo lokugula [27, 48].
Olunye uphando olusebenzisa uphando lwe-parasitological olwenziwe ngamaxesha amaninzi (2006-2011) ukubeka iliso kwimpembelelo ye-MDA yesikolo kwi-SAC ibonise iindlela ezifanayo [22, 28, 29]. ;nangona kunjalo, nayiphi na i-STH (uluhlu, i-44.3% ukuya kwi-47.7%) kunye nosulelo olunzima (uluhlu, i-14.5% ukuya kwi-24.6%) luxelwe kwiimvavanyo ezilandelwayo Ukuxhaphaka kwezifo kuhlala kuphezulu [22, 28, 29], kwakhona kubonisa ukuba ukuxhaphaka ayikaweli kwinqanaba elichazwe yi-WHO yolawulo lwezehlo (Itheyibhile 1).
Idatha evela kwezinye izifundo emva kokuqaliswa kwe-IHCP kwiiPhilippines kwi-2007-2018 ibonise ukuxhaphaka okuphezulu okuqhubekayo kwe-STH kwi-PSAC kunye ne-SAC (Itheyibhile 1) [30,31,32,33,34,35,36,37,38,39]. ].Ukuxhaphaka kwayo nayiphi na i-STH echazwe kwezi zifundo zivela kwi-24.9% ukuya kwi-97.4% (nge-KK), kunye nokuxhaphaka kwezifo eziphakathi ukuya kwi-5.9% ukuya kwi-82.6%.I-lumbricoides kunye ne-T. trichiura zihlala ziyi-STH ezixhaphakileyo, kunye nokuxhaphaka ukusuka kwi-15.8-84.1% ukuya kwi-7.4-94.4%, ngokulandelanayo, ngelixa i-hookworms ivame ukuba ne-1.2% ukuya kwi-25.3% [30,31, 32,33 ,34,35,36,37,38,39] (Itheyibhile 1). Nangona kunjalo, kwi-2011, uphando olusebenzisa i-molecular diagnostic quantitative real-time polymerase chain reaction (qPCR) ibonise ukuxhaphaka kwe-hookworm (Ancylostoma spp.) ye-48.1 I-% [45] .I-Co-infection yabantu abane-A. lumbricoides kunye ne-T. trichiura nayo ibonwe rhoqo kwizifundo ezininzi [26, 31, 33, 36, 45].
Indlela ye-KK inconywa yi-WHO ngokukhululeka kwayo ekusebenziseni kwintsimi kunye neendleko eziphantsi [46], ngokukodwa ukuvavanya izicwangciso zonyango zikaRhulumente zokulawula i-STH.Nangona kunjalo, ukungafani kokuxhaphaka kwe-STH kuye kwabikwa phakathi kwe-KK kunye nezinye i-diagnostics.In isifundo sika-2014 kwiPhondo laseLaguna, naluphi na usulelo lwe-STH (33.8% ye-KK vs 78.3% ye-qPCR), A. lumbricoides (20.5% KK vs 60.8% ye-qPCR) kunye ne-T. trichiura (KK 23.6% vs 38.8% ye-qPCR). Kukwakho nosulelo lwe-hookworm [6.8% yobukho jikelele;ibandakanya i-Ancylostoma spp.(4.6%) kunye ne-N. americana (2.2%)] zaye zafunyaniswa zisebenzisa i-qPCR kwaye zagwetywa ngokungalunganga yi-KK [36].Ukuxhaphaka kokwenyani kosulelo lwe-hookworm kunokuncitshiswa kakhulu kuba i-lysis ekhawulezayo yamaqanda e-hookworm ifuna ukuguqulwa ngokukhawuleza ukulungiselela i-KK isilayidi sokulungiselela kunye nokufunda [36,45,47], inkqubo edla ngokuba nzima ukuyifeza phantsi kweemeko zentsimi.Ngaphezu koko, amaqanda eentlobo ze-hookworm azibonakali ngokwe-morphologically, ebangela umngeni owongezelelweyo wokuchongwa okuchanekileyo [45].
Isicwangciso esiphambili solawulo lwe-STH esikhuthazwa yi-WHO sigxile kwi-mass prophylactic chemotherapy ngealbendazoleokanye i-mebendazole kumaqela anobungozi obuphezulu, ngenjongo yokuphatha ubuncinane i-75% ye-PSAC kunye ne-SAC ngo-2020 [48]. abafazi abaneminyaka yobudala yokuzala (iminyaka eyi-15-49, kubandakanywa nabo kwi-trimester yesibini neyesithathu) bafumana unonophelo oluqhelekileyo [49].Ukongezelela, esi sikhokelo siquka abantwana abancinci (iinyanga eziyi-12-23) kunye namantombazana afikisayo (iminyaka eyi-10-19) [ I-49], kodwa ingabandakanyi iingcebiso zangaphambili zonyango lwabantu abadala abasengozini enkulu [50] .I-WHO incoma i-MDA yonyaka kubantwana abancinci, i-PSAC, i-SAC, amantombazana afikisayo, kunye nabasetyhini abaneminyaka yobudala bokuzala kwiindawo ezine-STH phakathi kwe-20% kunye ne-50 I-%, okanye i-semiannually ukuba ukuxhaphaka kungaphezulu kwe-50%. Kwabasetyhini abakhulelweyo, amaxesha onyango awazange asungulwe [49].Ukongezelela kwi-chemotherapy yokukhusela, i-WHO igxininise amanzi, ucoceko kunye nococeko (WASH) njengenxalenye ebalulekileyo yokulawula i-STH [ 48, 49].
I-IHCP yasungulwa ngo-2006 ukubonelela ngesikhokelo somgaqo-nkqubo wokulawula i-STH kunye nezinye izifo ze-helminth [20, 51].albendazoleokanye i-mebendazole chemotherapy njengeyona ndlela iphambili yokulawula i-STH, ejolise kubantwana abaneminyaka eyi-1-12 kunye namanye amaqela asemngciphekweni afana nabasetyhini abakhulelweyo, abafazi abafikisayo, amafama, abaphathi bokutya kunye nabantu bomthonyama.Iinkqubo zokulawula nazo zincediswa ngokufakela amanzi. kunye neendawo zococeko kunye nokukhuthazwa kwezempilo kunye neendlela zemfundo [20, 46].
I-MDA yesiqingatha sonyaka ye-PSAC iqhutywa ikakhulu ngamacandelo ezempilo e-barangay (kwilali), abasebenzi bezempilo abaqeqeshiweyo be-barangay kunye nabasebenzi bokhathalelo lwemini kwiindawo zoluntu njengeGarantisadong Pambata okanye “Abantwana abasempilweni” (iprojekthi yokubonelela ngephakheji) yeeNkonzo zezeMpilo zePSAC) , ngelixa i-MDA ye-SAC yonganyelwe kwaye iphunyezwe liSebe leMfundo (DepEd) [20].I-MDA kwizikolo zamabanga aphantsi zikarhulumente ilawulwa ngootitshala phantsi kwesikhokelo sabasebenzi bezempilo kwikota yokuqala neyesithathu kunyaka wesikolo ngamnye [20]. Ngo-2016, i-Ofisi yoMphathiswa wezeMpilo ikhuphe izikhokelo ezitsha ezibandakanya ukutshabalalisa iintshulube kwizikolo zasesekondari (abantwana abangaphantsi kwe-18) [52].
I-MDA yokuqala yesizwe yesiqingatha sonyaka yaqhutywa kubantwana ababudala buphakathi kwe-1-12 leminyaka ngo-2006 [20] kwaye ingxelo yothintelo lweentshulube lufikelele kwi-82.8% ye-6.9 yezigidi ze-PSACs kunye ne-31.5% ye-6.3 yezigidi ze-SACs [53]. Nangona kunjalo, ukhuselo lwe-MDA lokubulala iintshulube lwehle kakhulu ukusuka kwi-2099. ukuya ku-2014 (uluhlu lwe-59.5% ukuya kwi-73.9%), inani elihlala lingaphantsi kwe-benchmark ecetyiswayo ye-WHO ye-75% [54].I-Low deworming coverage ingaba ngenxa yokungabikho kolwazi ngokubaluleka konyango lwesiqhelo [55], ukungaqondi kakuhle kwe-MDA. izicwangciso [56, 57], ukungabikho kokuzithemba kwiziyobisi ezisetyenziswayo [58], kunye noloyiko lweziganeko ezimbi [55, 56, 58, 59, 60] .Uloyiko lweziphene zokuzalwa kuye kwabikwa njengesizathu esinye sokuba abafazi abakhulelweyo banqabe unyango lwe-STH [61] .Ukongezelela, imiba yokubonelela kunye neyokulungiselela iziyobisi ze-MDA zichongiwe njengentsilelo enkulu efunyenwe ekuphunyezweni kwe-MDA kwilizwe lonke [54].
Ngo-2015, i-DOH ibambisene ne-DepEd ukuba isingathe uSuku lweSizwe lokuTsha iintshulube (NSDD), olujolise ekugxothweni malunga ne-16 yezigidi zee-SACs (amabanga 1 ukuya ku-6) ababhalise kuzo zonke izikolo zamabanga aphantsi zikarhulumente ngosuku olunye [62]. -inyathelo elisekelwe kwisiphumo senqanaba lesizwe le-deworming rate ye-81%, ephezulu kuneminyaka edlulileyo [54].Nangona kunjalo, ulwazi lobuxoki olujikelezayo kuluntu malunga nokufa kwabantwana be-deworming kunye nokusetyenziswa kweziyobisi eziphelelwe yisikhathi kubangele i-hysteria enkulu kunye noloyiko, olukhokelela ekubeni ukwanda kweengxelo zeziganeko ezimbi emva kwe-MDA (AEFMDA) kwi-Peninsula yaseZamboanga, eMindanao [63] .Nangona kunjalo, uphando lwe-case-control control lubonisa ukuba ukuba yimeko ye-AEFMDA yayinxulumene nembali yangaphambili ye-deworming [63].
Kwi-2017, i-Ofisi yoMphathiswa wezeMpilo yazisa isitofu esitsha se-dengue kwaye yanikezela malunga ne-800,000 yabantwana besikolo. Ukufumaneka kwesi sitofu kuye kwaphakamisa iinkxalabo ezikhuselekileyo zokhuseleko kwaye kuye kwakhokelela ekukhuliseni ukungathembani kwiinkqubo ze-DOH, kubandakanywa neprogram ye-MDA [64, 65]. Ngenxa yoko, ukugqunywa kwezinambuzane zehle ukusuka kwi-81% kunye ne-73% ye-PSAC kunye ne-SAC ngo-2017 ukuya kwi-63% kunye ne-52% ngo-2018, kunye ne-60% kunye ne-59% ngo-2019 [15].
Ukongeza, ngenxa yobhubhani wehlabathi jikelele we-COVID-19 (isifo se-coronavirus ngo-2019), iSebe lezeMpilo likhuphe iMemorandam yeSebe enguNombolo 2020-0260 okanye isiKhokelo seThutyana sokuCwangciswa kweHelminth eziDityanisiweyo kunye neziCwangciso zoLawulo lweSchistosomiasis kunye nokuPhelisa Ngexesha le-COVID- 19 Pandemic 》” Ngomhla wama-23 kuJuni, 2020, ibonelela nge-MDA ukuba inqunyanyiswe de kube kuphinde kunikwe esinye isaziso.Ngenxa yokuvalwa kwezikolo, uluntu luhlala lubulala iintshulube kubantwana abaneminyaka eyi-1-18, besasaza amayeza ngokundwendwela indlu ngendlu okanye kwiindawo ezimisiweyo, ngelixa kugcinwa umgama obonakalayo kunye nokujolisa kwi-COVID-19 -19 efanelekileyo yothintelo kunye nolawulo losulelo [66].Nangona kunjalo, izithintelo ekuhambeni kwabantu kunye nokuxhalaba koluntu ngenxa yobhubhani we-COVID-19 kunokukhokelela kunyango oluphantsi.
I-WASH yenye yeendlela zokungenelela eziphambili zokulawulwa kwe-STH echazwe yi-IHCP [20, 46].Le yinkqubo ebandakanya ii-arhente ezininzi zikarhulumente, kubandakanywa uMphathiswa wezeMpilo, uMphathiswa weMicimbi yezeKhaya kunye noRhulumente weNgingqi (DILG), iiYunithi zoRhulumente weNgingqi ( LGU) kunye noMphathiswa wezeMfundo.Inkqubo ye-WASH yoluntu ibandakanya ukunikezelwa kwamanzi akhuselekileyo, ekhokelwa ngamasebe karhulumente wendawo, ngenkxaso yeDILG [67], kunye nokuphuculwa kogutyulo oluphunyezwe yi-DOH ngoncedo lwamasebe karhulumente wendawo, ukubonelela ngezindlu zangasese kunye uncediso-mali lokwakhiwa kwezindlu zangasese [68, 69] ].Ngeli xesha, inkqubo ye-WASH kwizikolo zaseprayimari zikarhulumente ijongwe nguMphathiswa wezeMfundo ngokubambisana noMphathiswa wezeMpilo.
Idatha yakutshanje evela kwi-Philippine Statistics Authority (PSA) 2017 National Population Health Survey ibonisa ukuba i-95% yamakhaya asePhilippines afumana amanzi okusela kwimithombo yamanzi aphuculweyo, kunye neyona nxalenye inkulu (43%) yamanzi asebhotileni kunye ne-26% kuphela kwimithombo yepayipi [ 70] ukuyifumana.Ikota yemizi yakwiiPhilippines isasebenzisa izixhobo zogutyulo ezinganelisiyo [70];malunga ne-4.5% yabemi bazithuma ngokuphandle, isenzo esiphindwe kabini kwiindawo zasemaphandleni (6%) njengasezidolophini (3%) [70].
Ezinye iingxelo zibonisa ukuba ukubonelela ngeendawo zococeko zodwa akuqinisekisi ukusetyenziswa kwazo, kwaye akuphuculi iindlela zococeko kunye nococeko [32, 68, 69] .Phakathi kwezindlu ezingenazo izindlu zangasese, izizathu ezichazwe rhoqo zokungaphuculi ucoceko ziquka imiqobo yobugcisa (okt, ukungabikho kwendawo kwindlu yangasese okanye itanki ye-septic ejikeleze ikhaya, kunye nezinye izinto zejografi ezifana neemeko zomhlaba kunye nokuba kufuphi nemijelo yamanzi), ubunini bomhlaba kunye nokungabikho kwenkxaso-mali [71, 72].
Kwi-2007, iSebe lezeMpilo lasePhilippine lamkela indlela yococeko olukhokelwa luluntu (CLTS) ngeNkqubo yoPhuhliso lwezeMpilo eZinzileyo e-East Asia [68, 73] .CLTS ingcamango yococeko olupheleleyo olubandakanya uluhlu lweendlela zokuziphatha ezifana nokuyeka ukuvula. ukuhlamba, ukuqinisekisa ukuba wonke umntu usebenzisa izindlu zangasese zococeko, ukuhlamba izandla rhoqo nangokufanelekileyo, ucoceko lokutya namanzi, ukulahlwa ngokukhuselekileyo kwezilwanyana nenkunkuma yemfuyo, kunye nokudalwa nokugcinwa kokucoceka nokusingqongileyo okukhuselekileyo [68, 69]. Indlela ye-CLTS, isimo se-ODF sedolophana kufuneka sibekwe esweni ngokuqhubekayo nasemva kokuba imisebenzi ye-CLTS iphelile.Nangona kunjalo, izifundo ezininzi zibonise ukuxhaphaka okuphezulu kwe-STH kwiindawo eziye zafumana isimo se-ODF emva kokuphunyezwa kwe-CLTS [32, 33]. ukungabikho kokusetyenziswa kweendawo zococeko, ukuqaliswa kwakhona kokukhutshwa kwe-defecation evulekileyo, kunye nokukhutshwa kwe-MDA ephantsi [32].
Iinkqubo ze-WASH eziphunyeziweyo ezikolweni zilandela imigaqo-nkqubo epapashwe yi-DOH kunye ne-DepEd.Ngo-1998, iSebe lezeMpilo likhuphe iKhowudi yezeMpilo yasePhilippine yeSikolo seMpilo kunye neMithetho yokuPhunyezwa kweeNkonzo zezeMpilo (IRR) (PD No. 856) [74] .Le IRR imisela imithetho nemigaqo yococeko ezikolweni kunye nogutyulo olwanelisayo, kuquka izindlu zangasese, izixhobo zamanzi, nokugcinwa nokugcinwa kwazo zisemgangathweni kwezi zixhobo [74] .Noko ke, uvandlakanyo lokuphunyezwa kwenkqubo yoMphathiswa weMfundo kumaphondo akhethiweyo lubonisa ukuba imigaqo akunyanzeliswa ngqongqo kwaye inkxaso yebhajethi ayonelanga [57, 75, 76, 77]. Ngoko ke, ukubeka iliso novavanyo luhlala lubalulekile ekuqinisekiseni ukuzinza koMphathiswa wezeMfundo ukuphunyezwa kwenkqubo ye-WASH.
Ukongeza, ukwenza iziko lemikhwa emihle yempilo kubafundi, iSebe leMfundo likhuphe uMyalelo weSebe (DO) Nombolo 56, iSiqendu 56.2009 esinesihloko esithi "Kwakha kwangoku kwakha izibonelelo zamanzi kunye nokuhlamba izandla kuzo zonke izikolo ukuthintela i-Influenza A (H1N1)" kunye ne-DO No. 65, isigabaI-2009 enesihloko esithi "INkqubo yokuNakekelwa kweMpilo ebalulekileyo (i-EHCP) yaBantwana beSikolo" [78, 79] .Nangona inkqubo yokuqala yenzelwe ukuthintela ukusasazeka kwe-H1N1, oku kukwanxulumene nolawulo lwe-STH. Le yokugqibela ilandela indlela efanelekileyo yesikolo kwaye igxile kumanyathelo amathathu ezempilo ezikolo ezisekelwe kubungqina: ukuhlamba izandla ngesepha, ukuxubha ngentlama yamazinyo ene-fluoridated njengomsebenzi weqela lemihla ngemihla, kunye ne-STH's biannual MDA [78, 80] .Ngo-2016, i-EHCP ngoku idityaniswe kwinkqubo ye-WASH In Schools (WINS) .Yandiswa ukuze iquke ubonelelo lwamanzi, ugutyulo, ukuphathwa kunye nokulungiswa kokutya, ukuphuculwa kococeko (umzekelo, ulawulo lococeko lokuya exesheni), ukunyanga iintshulube, kunye nemfundo yezempilo [79].
Nangona ngokubanzi i-WASH ifakwe kwiikharityhulam zesikolo esiprayimari [79], ukufakwa kwe-STH isifo njengesifo kunye nengxaki yempilo yoluntu kusekhona. iyasebenza kubo bonke abafundi kungakhathaliseki inqanaba lebanga kunye nohlobo lwesikolo, kwaye ikwadityaniswe kwizifundo ezininzi kwaye isetyenziswa ngokubanzi.Ukufikelela eluntwini (okt, imathiriyeli ekhuthaza imfundo yezempilo iboniswa ngokubonakalayo kumagumbi okufundela, kwiindawo ze-WASH, nakwisikolo sonke) [57] .Nangona kunjalo, kwa olu phononongo lunye lucebise ukuba ootitshala kufuneka baqeqeshwe kwi-STH kunye neyeza lokunyanga iintshulube ukuze baziqonde ngakumbi izifunxi-gazi kwaye ngcono. ukuqonda i-STH njengomcimbi wezempilo yoluntu, kubandakanywa: izihloko ezinxulumene nokudluliselwa kwe-STH, umngcipheko wosulelo, umngcipheko wosulelo uya kuqhuba ukukhutshwa kwe-Post-worm evulekileyo kunye neepatheni zokuphinda zifakwe kwikharityhulam yesikolo [57].
Olunye uphando luye lwabonisa ubudlelwane phakathi kwemfundo yezempilo kunye nokwamkelwa konyango [56, 60] ebonisa ukuba imfundo yezempilo ephuculweyo kunye nokukhuthaza (ukuphucula ulwazi lwe-STH kunye nokulungisa iimbono eziphosakeleyo ze-MDA malunga nonyango kunye neenzuzo) kunokunyusa ukuthatha inxaxheba kunyango lwe-MDA kunye nokwamkelwa [56], 60].
Ngaphezu koko, ukubaluleka kwemfundo yezempilo ekuphembeleleni ukuziphatha okulungileyo okuhambelana nokucoceka kuye kwachongwa njengenye yezinto eziphambili zokuphunyezwa kwe-WASH [33, 60]. 32, 33].Izinto ezifana nemikhuba yokuhlambalaza evulekileyo kunye nokungabikho kokusetyenziswa kwezixhobo zokucoceka kunokuchaphazela iziphumo ezivulekileyo zokungcola [68, 69].Kwesinye isifundo, ucoceko olubi lunxulunyaniswa nomngcipheko ophezulu wokungakwazi ukufunda nokubhala phakathi kwe-SACs kwi-Visayas [ I-81] .Ngoko ke, ukubandakanywa kwemfundo yezempilo kunye nezicwangciso zokukhuthaza ezijolise ekuphuculeni izibilini kunye nemikhwa yokucoceka, kunye nokwamkelwa kunye nokusetyenziswa ngokufanelekileyo kwezi ziseko zempilo, kufuneka zifakwe ukuze kugcinwe ukungenelela kwe-WASH.
Idatha eqokelelwe kwiminyaka engamashumi amabini edlulileyo ibonisa ukuba ukuxhaphaka kunye nokuqina kosulelo lwe-STH phakathi kwabantwana abangaphantsi kweminyaka eyi-12 kwiiPhilippines zihlala ziphakamileyo, nangona iinzame ezahlukeneyo zikaRhulumente wase-Philippine. ichongiwe ukuze kuqinisekiswe ukhuseleko lwe-MDA ephezulu.Kukwafanelekile ukuqwalasela ukusebenza kwamachiza amabini asetyenziswa ngoku kwinkqubo yokulawula i-STH (i-albendazole kunye ne-mebendazole), njengoko i-T. trichiura ephezulu eyoyikisayo iye yachazwa kwizifundo zamva nje kwiiPhilippines [33, 34, 42].Amachiza amabini achazwe njengangasebenziyo kangako kwi-T. trichiura, kunye namazinga okunyanga adityanisiweyo angama-30.7% kunye nama-42.1%albendazolekunye ne-mebendazole, ngokulandelanayo, kunye ne-49.9% kunye ne-66.0% yokunciphisa ukuzala [82].Ngenxa yokuba amachiza amabini aneempembelelo zonyango ezincinci, oku kunokuba nefuthe elibalulekileyo kwiindawo apho i-Trichomonas i-endemic.I-Chemotherapy yayisebenza kakuhle ekunciphiseni amanqanaba okusuleleka kunye nokunciphisa i Umthwalo we-helminth kubantu abosulelekileyo ngaphantsi komlinganiselo wesiganeko, kodwa ukuphumelela kwahluka phakathi kweentlobo ze-STH.Ngokucacileyo, amachiza akhoyo awathinteli ukuphinda aphinde aphinde aphinde aphinde aphinde aphinde aphinde aphinde abuyele, anokuthi avele ngokukhawuleza emva kokunyanga.Ngoko ke, amayeza amatsha kunye nezicwangciso zokudibanisa izidakamizwa zingafuneka kwixesha elizayo [83] .
Okwangoku, akukho unyango lwe-MDA olusisinyanzelo kubantu abadala kwiiPhilippines.IHCP igxile kuphela kubantwana abaneminyaka eyi-1-18 ubudala, kunye nokukhethwa kweentshulube kwamanye amaqela asemngciphekweni afana nabasetyhini abakhulelweyo, abafazi abafikisayo, amafama, abaphathi bokutya, kunye nabemi bomthonyama [46] .Nangona kunjalo, iimodeli zemathematika zakutsha nje [84,85,86] kunye nophononongo olucwangcisiweyo kunye nohlalutyo lweemeta [87] lucebisa ukuba ukwandiswa koluntu ngokubanzi kweenkqubo zokubulala iintshulube ukugubungela onke amaqela eminyaka kunokunciphisa ukuxhaphaka kwe-STH kwi. abantu abasengozini enkulu.- Amaqela abantwana besikolo abasengozini.Nangona kunjalo, ukunyusa i-MDA ekulawuleni iziyobisi ezijoliswe kuluntu ngokubanzi kunokuba nefuthe elibalulekileyo kwezoqoqosho kwiinkqubo zokulawula i-STH ngenxa yesidingo sokwanda kwezibonelelo.Nangona kunjalo, unyango oluninzi olusebenzayo iphulo le-lymphatic filariasis kwiiPhilippines ligxininisa ukuba nokwenzeka kokubonelela ngonyango olubanzi kuluntu [52].
Ukubuya kwakhona kosulelo lwe-STH kulindeleke njengoko amaphulo e-MDA asekwe esikolweni ngokuchasene ne-STH kulo lonke elakwiiPhilippines ayekile ngenxa yobhubhane oqhubekayo we-COVID-19. Iimodeli zamva nje zemathematika zibonisa ukuba ukulibaziseka kwe-MDA kwiindawo eziphezulu ze-STH-endemic kungathetha injongo yokuphelisa i-STH. njengengxaki yezempilo yoluntu (EPHP) ngo-2030 (echazwe njengokuphumeza <2% ukuxhaphaka kwe-moderate-to-high-intensity infections kwi-SAC [88]]) ayinakufezekiswa, nangona izicwangciso zokunciphisa ukwenza imijikelezo ye-MDA elahlekileyo ( oko kukuthi, ukukhutshwa kwe-MDA ephezulu,> 75%) kuya kuba luncedo [89] .Ngoko ke, izicwangciso zokulawula ezizinzileyo zokwandisa i-MDA zifuneka ngokukhawuleza ukulwa nokusuleleka kwe-STH kwiiPhilippines.
Ukongeza kwi-MDA, ukuphazamiseka kokuhanjiswa kufuna utshintsho kwindlela yokuziphatha ecocekileyo, ukufikelela kumanzi akhuselekileyo, kunye nokuphuculwa kococeko oluphuculweyo ngokusebenzisa iinkqubo ezisebenzayo ze-WASH kunye ne-CLTS. Noko ke, ngokukrakra, kukho iingxelo zeendawo zokucoceka ezingasetyenziswanga ezinikezelwa ngoorhulumente basekhaya kwiindawo ezithile, ezibonisa imingeni ekuphunyezweni kwe-WASH [68, 69, 71, 72]. Ukongezelela, ukuxhaphaka okuphezulu kwe-STH kwaxelwa kuluntu olufumene isimo se-ODF emva kokuphunyezwa kwe-CLTS ngenxa yokuqaliswa kokuziphatha okuvulekileyo kunye ne-MDA ephantsi [32]. ukuqonda nge-STH kunye nokuphucula izenzo zococeko ziindlela ezibalulekileyo zokunciphisa umngcipheko womntu wokosuleleka kwaye zisisiseko seendleko eziphantsi zokongeza kwiinkqubo ze-MDA kunye ne-WASH.
Imfundo yezempilo enikezelwa ezikolweni inokunceda ukuqinisa nokuphucula ulwazi jikelele kunye nokwazisa nge-STH phakathi kwabafundi kunye nabazali, kubandakanywa neenzuzo ezibonwayo ze-deworming.Inkqubo "yeMilingo yeeglasi" ngumzekelo wongenelelo olusandul 'ukuphumelela kakhulu lwemfundo yezempilo ezikolweni.Oku lungenelelo olufutshane lwekhathuni eyenzelwe ukufundisa abafundi malunga nokusuleleka kwe-STH kunye nokuthintela, ukubonelela ubungqina bomgaqo-siseko wokuba imfundo yezempilo inokuphucula ulwazi kunye nefuthe lokuziphatha okunxulumene nosulelo lwe-STH [90] .Inkqubo yaqala ukusetyenziswa kubafundi bezikolo zaseprayimari zaseTshayina eHunan. Iphondo, kunye nezehlo zosulelo lwe-STH zancitshiswa nge-50% kwizikolo zongenelelo ngoncedo xa kuthelekiswa nezikolo zolawulo (odd ratio = 0.5, 95% interval yokuzithemba: 0.35-0.7, P <0.0001).90].Oku kuye kwahlengahlengiswa kwaye kwavavanywa ngokungqongqo. kwiiPhilippines [91] naseVietnam;kwaye okwangoku iphuhliselwa ummandla osezantsi weMekong, kubandakanywa ukuziqhelanisa nentsholongwane ye-carcinogenic Opisthorchis yesibindi.Amava kumazwe amaninzi aseAsia, ngokukodwa iJapan, iKorea kunye nePhondo laseTaiwan laseChina, libonise ukuba nge-MDA, ucoceko olufanelekileyo kunye nemfundo yococeko njengoko inxalenye yezicwangciso zolawulo lwesizwe, ngeendlela ezisekelwe esikolweni kunye ne-triangular Ukusebenzisana ukuphelisa usulelo lwe-STH lunokwenzeka ngamaziko, ii-NGOs kunye neengcali zesayensi [92,93,94].
Kukho iiprojekthi ezininzi kwiiPhilippines ezibandakanya ulawulo lwe-STH, njenge-WASH / EHCP okanye i-WINS ephunyezwe ezikolweni, kwaye i-CLTS iphunyezwe kwiindawo zokuhlala.Nangona kunjalo, ngenxa yamathuba amakhulu okuzinzisa, ulungelelwaniso olukhulu phakathi kwemibutho esebenzisa inkqubo iyafuneka. izicwangciso kunye neenzame zamaqela amaninzi afana nePhilippines 'ulawulo lwe-STH lunokuphumelela kuphela ngentsebenziswano yexesha elide, intsebenziswano kunye nenkxaso karhulumente wendawo.Inkxaso karhulumente ekuthengeni nasekuhanjisweni kwamayeza kunye nokubekwa phambili kwamanye amacandelo ezicwangciso zokulawula, ezifana njengemisebenzi yokuphucula ucoceko kunye nemfundo yezempilo, ziyafuneka ukukhawulezisa ukufezekiswa kweethagethi ze-EPHP zika-2030 [88]. Xa sijongene nemingeni yobhubhane we-COVID-19, le misebenzi kufuneka iqhube kwaye ihlanganiswe ne-COVID-19 eqhubekayo. Kungenjalo, ukubeka esichengeni inkqubo yolawulo lwe-STH esele ingumngeni kunokuba nefuthe elibi kuluntu ixesha elide.iziphumo.
Phantse iminyaka engamashumi amabini, iiPhilippines zenze iinzame ezinkulu zokulawula ukusuleleka kwe-STH.Nonetheless, ukuxhaphaka okuxeliweyo kwe-STH kuye kwahlala kuphakamileyo kwilizwe lonke, mhlawumbi ngenxa ye-MDA ephantsi kunye nokulinganiselwa kwe-WASH kunye neenkqubo zemfundo yezempilo.Oorhulumente besizwe kufuneka ngoku baqwalasele ukomeleza isikolo. ii-MDA ezisekelwe kuluntu ngokubanzi kunye nokwandisa ii-MDA kuluntu ngokubanzi;ukubeka iliso ngokusondeleyo ukusebenza kweziyobisi ngexesha leziganeko ze-MDA kunye nokuphanda ngophuhliso kunye nokusetyenziswa kwamachiza amatsha e-antihelminthic okanye indibaniselwano yamachiza;kunye nokubonelela okuzinzileyo kwe-WASH kunye nemfundo yezempilo njengendlela yokuhlasela ebanzi yokulawula i-STH kwixesha elizayo kwiiPhilippines.
Ngubani.Usulelo lwe-helminth olubangelwa ngumhlaba.https://www.who.int/news-room/fact-sheets/detail/soil-transmitted-helminth-infections.Ifikeleleke ngo-Aprili 4, 2021.
I-Strunz EC, i-Addiss DG, i-Stocks ME, i-Ogden S, i-Utzinger J, i-Freeman MC.Amanzi, ucoceko, ucoceko, kunye nosulelo lwe-helminth olubangelwa ngumhlaba: ukuphononongwa okucwangcisiweyo kunye nohlalutyo lwe-meta.PLoS Medicine.2014;11 (3):e1001620 .
Hotez PJ, Fenwick A, Savioli L, Molyneux DH.Gcina ibhiliyoni esezantsi ngokulawula izifo zetropiki ezingahoywanga.Lancet.2009;373(9674):1570-5.
Isicwangciso seRL, uSmith JL, uJasrasaria R, uBrooke SJ.Amanani osulelo lwehlabathi jikelele kunye nomthwalo wezifo zentsholongwane ye-helminth edluliselwa ngumhlaba, i-2010.Parasite vector.2014; 7:37.
Ngubani.2016 Isishwankathelo se-Global Preventive Chemotherapy Implementation: Ukuqhawula iBhiliyoni enye. Iirekhodi ze-epidemiological zeveki.2017; 40 (92): 589-608.
I-DALYs GBD, umququzeleli H. I-Global, ingingqi, kunye nelizwe-iminyaka yokuphila yokukhubazeka (DALYs) kunye nexesha lokuphila elinempilo (HALE) kwi-315 izifo kunye nokulimala, i-1990-2015: Uhlalutyo olucwangcisiweyo lwe-2015 Global Burden of Disease Study.Lancet .2016;388(10053):1603-58.
Isifo se-GBD, ukulimala kwe-C.Global umthwalo wezifo ze-369 kunye nokulimala kumazwe angama-204 kunye nemimandla, i-1990-2019: Uhlalutyo olucwangcisiweyo lwe-2019 Global Burden of Disease Study.Lancet.2020;396 (10258): 1204-22.
I-Jourdan PM, i-Lamberton PHL, i-Fenwick A, i-Addiss DG.Usulelo lwe-helminth olubangelwa ngumhlaba.Lancet.2018;391 (10117): 252-65.
I-Gibson AK, i-Raverty S, i-Lambourn DM, i-Huggins J, i-Magargal SL, i-Grigg ME.I-Polyparasitism ihambelana nokunyuka kobunzima besifo kwiintlobo ze-sentinel ezisulelekileyo ze-Toxoplasma.PLoS Negl Trop Dis.2011; 5 (5): e1142.
Ixesha lokuposa: Mar-15-2022