DOCUMENTING THE SUCCESSFUL CONTROL AND ELIMINATION OF SCHISTOSOMIASIS IN BOHOL,

PHILIPPINESNATIONAL SCHISTOSOMIASIS CONTROL AND ELIMINATION PROGRAM

DEPARTMENT OF HEALTHOCTOBER 9, 2015

TEAMTEAM LEADER: DR. WINSTON A. PALASI, NSCEP

TEAM MEMBERS FROM THE PHILIPPINESDR. JOANRI T. RIVERAL AND STAFF, REGIONAL HEALTH OFFICE, REGION VII

DR. REYMOSES A. CABAGNOT AND STAFF, PROVINCIAL HEALTH OFFICE, BOHOLDR. FRANCISCO NGOBOC AND STAFF, MUNICIPAL HEALTH OFFICE, TALIBON

DR. ANALITA N. AUZA AND STAFF, MUNICIPAL HEALTH OFFICE, TRINIDADNURSES FROM TALIBON AND TRINIDAD (20)

DEPARTMENT OF EDUCATION REPRESENTATIVESDEPARTMENT OF AGRICULTURE

WHOCLARENCE DE GUZMAN, WHO INTERN, GEORGETOWN UNIVERSITY (USA)

DR. ZAIXING ZHANG, WHO COUNTRY OFFICE

VOLUNTEERSRAGINE VALENTE, MUNICIPAL NURSE, CAVINTI, LAGUNA

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OVERVIEW

BACKGROUND KEY OBJECTIVES APPROACH

NATIONAL BURDEN OF DISEASE• "A DISEASE OF POVERTY THAT LEADS TO CHRONIC

ILL-HEALTH." (WHO)

• ~240 MILLION AFFECTED WORLDWIDE• PHILIPPINES (S. japonicum)

• 12 REGIONS• 28 PROVINCES• 14 CITIES• 203 MUNICIPALITIES• 1,593 BARANGAYS

THE CASE OF BOHOL• ENDEMIC IN 2 MUNICIPALITIES

• TALIBON• TRINIDAD

• 2009-2014 SSR• PREVALENCE RATES OF <1%

• KATO KATZ• UNDERESTIMATION OF RATES

• UP MANILA NTDSG 2014 ASSESSMENT• 414 SAMPLES IN BOHOL

• KK = 0%• ELISA ANTIGEN = 15.7%• ELISA ANTIBODY = 5.1%

Residual Infections

OVERVIEW

BACKGROUND KEY OBJECTIVES APPROACH

OBJECTIVES(1)DESCRIBE THE CURRENT PUBLIC HEALTH

INTERVENTION PROGRAMS FOR SCHISTOSOMIASIS CONTROL IN BOHOL, PHILIPPINES.

(2) EXAMINE THE POTENTIAL RISK/PROTECTIVE FACTORS ASSOCIATED WITH RESIDUAL INFECTIONS OF SCHISTOSOMIASIS IN THE MUNICIPALITIES OF TALIBON AND TRINIDAD.

OVERVIEW

BACKGROUND KEY OBJECTIVES APPROACH

Design

Data & Informatio

n Collection• Collection

of routine data

• Cross-Sectional Survey

Data & Information

Analysis

Report Write-up

Dissemination

TIMELINE

ACTIVITIESCASE STUDY REPORT

• DOCUMENT STRATEGIES AND CONTRIBUTING FACTORS TO BOHOL'S SUCCESS STORY

• COLLECT & ANALYZE HEALTH INDICATORS

• EXTRACT KEY LESSONS• PROVIDE RECOMMENDATIONS AND

FUTURE DIRECTIONS

CROSS-SECTIONAL SURVEY• EXPLORE THE POTENTIAL RISK/PROTECTIVE

FACTORS FOR RESIDUAL INFECTIONS • PART OF DOH'S M&E IN THE REGION• FOLLOW-UP ASSESSMENT OF DR. BELIZARIO’S

STUDY• 414 SUBJECTS FROM BOHOL

• 9-15 SCHOOL-AGED CHILDREN • KAP SURVEYS

• QUESTIONNAIRES (MAGPI) • MAPPING OF SAMPLES IF POSSIBLE (GIS)

ROUTINE DATA COLLECTION DATA FORMS

HEALTH INDICATORS MDA WATER SANITATION SNAIL SURVEILLANCE ADVOCACY IRRIGATION SYSTEM FARMING PRACTICES HUMAN RESOURCES FINANCIAL RESOURCES ORGANIZATIONAL STRUCTURE

(COMMITTEES)

PHO

MHO

Department of

Agriculture, Bohol

CROSS-SECTIONAL SURVEYMEETING WITH ALL

KEY TEAM MEMBERS

• INFORM (METHODOLOGY, ETC.)• MOBILIZATION OF

INTERVIEWERS• DISCUSS BEST IMPLEMENTATION

STRATEGIES AND PRACTICES• INPUT & FEEDBACK FROM TEAM

MEMBERS• FEASIBILITY OF SCHEDULE

• INTRO TO MAGPI

TRAINING OF INTERVIEWERS

• PROTOCOLS & SURVEY APPROACH

• QUESTIONNAIRES• TECHNICAL COMPONENTS• DEMO GPS (GIS APPLICATIONS)

CONDUCTING THE SURVEYS

• 5 DAYS• 10 TEAMS = 16-20 INTERVIEWS/ DAY• VENUE

• 4 BARANGAYS• HOUSEHOLDS (414, IF POSSIBLE)

• INTERVIEWEES• STUDENTS (ALREADY RANDOMLY

SELECTED) • HEAD OF HOUSEHOLDS

• SUBMISSION OF DATA COLLECTED • UPLOAD, WI-FI LOCATION, FEEDBACK

LIMITATIONS

TIME CONSTRAINT ROUTINE DATA:

AVAILABILITY, COMPLETENESS, ACCURACY, INTEGRITY, RECORD-KEEPING TECHNIQUES

CROSS-SECTIONAL SURVEY: OBSERVATION BIAS, RECALL BIAS,

RECORDER BIAS & ERRORS

HOW TO OVERCOME SOME OF THESE CHALLENGES:

PREPARATION COORDINATION COMMUNICATION TRAINING & FEEDBACK

DAGHANG SALAMAT!