Schistosomiasis adds to poverty burden (3)

Sta. Fe town in Leyte forms part of a vast plain of contiguous towns in the central part of Leyte that is considered the rice granary of Eastern Visayas. The province also prides itself as among the top 10 rice-producing provinces in the country.

But behind the pride of rice sufficiency lies the thousands of farmers who face the daily risk of the debilitating effect of schistosomiasis infection. The parasite thrives in wet areas such as rice paddies and irrigation canals which are essential in rice farming.

Spreading on

Since 1906 when Schistosoma japonicum, the host snail of schistosomiasis in the Philippines, was discovered in Palo town in Leyte, hundreds of researches and studies have been done to control the spread and find treatment against infection.

Laboratories for parasitological research of Bayer AG and Merck KGaA in Germany developed in the mid-1970s the drug Praziquantel as a treatment for parasitic worm infections including schistosomiasis giving a glimpse of hope for the farmers to finally free themselves from the parasitic scourge.

The drug was approved for medical use in the United States in 1982 and since then the World Health Organization has included it in the List of Essential Medicines.

The international community, likewise, has pledged through the Sustainable Development Goals to eliminate neglected tropical diseases by 2030. In 2021, the eradication of Neglected Tropical Diseases such as schistosomiasis was included in the WHO roadmap 2021-2030.

Despite the international efforts to end the spread of the parasitic infection, conditions on the ground however do not look optimistic.

Conducive environment

Schistosomiasis thrives in Eastern Visayas due to its favorable environments such as lack of access to safe water among the rural folk, the practice of open defecation, low sanitary toilet coverage, the high population density of carabao and other farm animals, the perennial problem of flooding in many areas and the relatively low participation in the mass drug administration.

Emelda Legaspi, a zoologist at the Schistosomiasis Research and Training Center, said addressing the problem of schistosomiasis spread is “complicated” as it would entail an all-out participation of the general public, national government agencies, the local government units and private institutions to break the cycle of infection.

Legaspi cited the problem of open defecation to illustrate her point. “It is a common practice ingrained in many poor communities. We can educate the people regarding the ill-effects of open defecation but even if we convince them where will they do it when there are no available toilets?” she said.

She added that open defecation is the biggest contributory in the spread of the parasite. “Humans contribute 75 percent of the spread while 25 percent are by farm animals such as carabao,” she said.

Records from the Department of Health regional office shows that out of 136 municipalities in Eastern Visayas, only 36 have been certified as zero open defecation — 12 in Leyte, nine in Southern Leyte, five in Eastern Samar, six in Samar and two in Northern Samar.

Legaspi said an individual who is not taking the praziquantel can be a carrier and has a potential to spread the infection even to places where schistosomiasis is not considered endemic.

“People who are not seeking treatment are the ones spreading the parasite. We can only pity those who religiously take medicines. When flooding comes, the cercaria spread because of them,” she said.

Some municipalities have adopted creative approaches to address the problem of open defecation.

(To be continued)

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