In 2015, the World Health Organization, in partnership with the Department of Agriculture and the Department of Health proposed to pilot a program for the elimination of schistosomiasis among carabaos in Leyte. The LGUs however are clueless about what happened to it as no such program is felt on the ground.

Agnes Cuayzon, program manager of DoH's Schistosomiasis Control and Elimination Program, said LGUs should be more proactive in looking for solutions that will control the spread of the parasite in their respective localities.

She said small projects like the provision of a level 2 water system, the construction of sanitary toilets, and the putting up of bridges in shallow waterways are within the capability of the LGUs to implement.

"When the river is shallow, there is the tendency of a person to wade on the river to cross. But if there is a bridge it lessens the chances of them getting to the water and less chances of getting infected," she said.

Mass drug administration

Cuayzon said the DoH has adopted a four-pronged approach to control the spread of schistosomiasis. These are through preventive chemotherapy through mass drug administration, case finding and management, environmental management, and promotion of safe water and sanitation.

The municipal health offices of schistosomiasis endemic areas conduct MDA using praziquantel to all residents from five to 65 years old regardless of whether they are positive for infection or not.
A dose of 40mg per kilogram of body weight is given to participants who have no advanced symptoms of infection while 60 mg per kilogram of body weight is administered to those showing symptoms including convulsive individuals.

The dosage is normally divided into two — the first half is to be taken in the morning and the remaining half in the afternoon. However, DoH allows the medicines, sometimes amounting to up to four tablets, to be taken in one sitting as some people would no longer take the remaining half due to side effects.

"It is considered a treatment failure if the full dosage is not taken," Cuayzon said.

The DoH aims to administer the drug to 85 percent of the target population but over the years the outcome had ranged between 50 to 65 percent.

Cuayzon said while some of the target participants fail to join the MDA due to prior commitments, many are reluctant due to the discomforts that they experience after taking the medicine. Among the more common side effects are headache, dizziness, stomach pain, nausea and fever.

Cuayzon said MDA is done under the supervision of a doctor, usually the municipal health officer, or at least a nurse so that health issues that may arise are readily addressed.

In the last two years, though, MDA participation went down further due to health protocols imposed concerning the Covid-19 pandemic.

She said the LGUs were also focused on the Covid-19 vaccination and the personnel that were supposed to conduct the treatment were assigned to it.

(This story is part of the journalism fellowship of the Philippine Press Institute under the auspices of the Hanns Seidel Foundation.)