WHO backs Bukidnon fight vs. schistosomiasis

MALAYBALAY CITY –  The World Health Organization positively responded to the request of the Bukidnon Sangguniang Panlalawigan for help in the control of schistosomiasis in the province, according to the letter of Dr. Soe Nyunt-U, WHO country director, to the provincial board, dated July 15.

The WHO official stopped short of saying they approved the request but hinted possibility for funding support.

Ngunt-U requested the provincial board to nominate a provincial non-government organization “who will be responsible for the management of WHO funds.

He said they will work with the NGO, the Provincial Health Office, and the Department of Health to develop a technical proposal to meet the provincial board’s request.

But the WHO required the NGO contractor to have at least 10 years experience in communicable disease control, primary health care, mass drug treatment, training of trainers, field supervision, monitoring and evaluation, public relations, events organizing, reporting, project and financial management.

They also cited that the NGO must have good working relationship with the concerned health authorities and local government units.

“Satisfactory completion of similar works with LGU, DOH, or WHO is an advantage,” the WHO added.

The Bukidnon Provincial Board has passed a resolution requesting the World Health Organization (WHO) to intervene and provide financial assistance for the rehabilitation of the Matin-ao Spring Resort in Bangcud, Malaybalay City to “contain and eliminate schistosomiasis.”

The resolution sponsored by lawyer Nemesio Beltran Jr. in May 2011 sought the assistance of WHO to declare the spring as a pilot area where they can pour scientific, medical, and financial resources to prevent schistosomiasis.

Beltran welcomed the WHO response and filed a resolution expressing elation and gratitude of the provincial board to the WHO for “responding positively.”

But he cited that the search for the NGO is the thing to hurdle. He has requested referrals as to whom to nominate.

Beltran said in May that  the problem is too complicated that WHO intervention is needed.

“The provincial government does not have the money and technical expertise to solve the schistosomiasis problem,” he told Bukidnon News then.

Matin-ao resort, a favorite destination of both foreign and local tourists, has reportedly been contaminated and infected with schistosomiasis in the last 10 years.

The provincial government has prohibited bathing in the resort inside its seven-hectare property, but visitors manage to sneak in and bathe in the spring resort’s cool waters. (Walter I. Balane)

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Next headache after floods – leptospirosis – DOH Sec. Ona

MALAYBALAY CITY – The next headache communities might face after flooding is leptospiroris, Health Sec. Enrique Ona said.

Ona told Bukidnon News the communities should be prepared also of the disease brought by rats in flooded areas.

He cited the flooded areas in Mindanao such as Cotabato, Davao, and other cities as prone to the disease especially those with high population of rats.

He stressed the DOH’s advice for the people to prevent leptospirosis by avoiding to wade in floodwaters, and to wear protective wear if unavoidable.

Leptospirosis, an infection usually transmitted to humans from water contaminated by animal urine commonly rats, comes in contact with cuts in the skin, eyes, or with the mucous membranes.

Among the symptoms include fever, chills, intense headache. Complications could be meningitis, renal failure, respiratory distress, may arise and lead to death.

The Department of Health put this year’s nationwide cases of leptospirosis as 65.4-percent higher compared to the same period last year, wherein 315 cases were reported with 38 deaths.

Ona was in town to visit the Provincial Government of Bukidnon’s health systems, including provincial hospitals and the Provincial Indigency Health Program, which he said, were “very impressive”. He accompanied Dr. Shin Young Soo, the Western Pacific Regional Director of the World Health Organization to the Bukidnon Provincial Medical
Center.

The two officials attended the Universal Health Care Conference for Northern and Western Mindanao in Cagayan de Oro City this week. (Walter I. Balane)

 

Find this story in: www.mindanews.com

Bukidnon to combat low TB detection with multi-sector alliance

MALAYBALAY CITY– The Bukidnon Provincial Health Office is spearheading the formation of a Bukidnon multi-sectoral alliance for the control of tuberculosis in the province.

Dr. Teresita G. Damasco, provincial health officer has announced that they are holding consultations in line with the move to create the alliance, a measure prescribed by the Department of Health to control TB.

“The alarming condition of TB cases in Bukidnon needs special attention from the local officials in every municipality or city,” she added.

In 2010, Bukidnon reported 131 deaths attributed to TB. But only 43, or 33 percent of the cases, were reported from the Rural Health Units or health stations, Barrera said. She said 88 of the patients, or 67 percent, died without even getting treatments.

The LGUs and all stakeholders’ commitment, she added, (are needed) to strengthen implementation of measures to improve TB detection rate in the province.

She said a joint provincial government, DOH, and stakeholders consultation should be

held.

Damasco scheduled a consultation meeting on June 14, a date set after Bukidnon Vice Gov. Jose Ma. R. Zubiri Jr. flared up upon hearing Bukidnon has the lowest detection rate for tuberculosis in Region 10.

Bukidnon News reported earlier that the Province of Bukidnon has a lackluster record in detecting tuberculosis cases. It is, in fact, at the bottom in Northern Mindanao with only a 55-percent case detection rate (CDR) compared to the national cut-off of 70 percent. The rate is alarming situation that deserves “full attention” considering that the province has been at the bottom at least since 2004, said Marilou Gecosala, Northern Mindanao regional nurse TB coordinator.

Gecosala told Bukidnon News at the end of a forum on Program Implementation Review On Tuberculosis Control and other concerns at the Folk Arts Theater last month that the low performance could be attributed to the province’s geography and also the commitment of health workers and the patients’ “health-seeking” behavior.

Tuberculosis is an infectious disease that primarily affects the lungs with condition known as pulmonary tuberculosis; it also has effect on other portions of the body, like the bones joints, intestines, liver, kidneys, and the heart, according to the Health Promotion Handbook distributed during the event.

Bukidnon’s cure rate, or the number of patients cured among those detected with TB, is 82 percent. Still it falls short of the national cut-off of 85 percent, said Emmanuelita R. Barrera, Bukidnon’s nurse TB coordinator.

Misamis Occidental, the best in the region for both detection and cure rates, has 104 percent and 94 percent, respectively. The detection and cure rates are based on performances of the province’s 24 TB directly observed treatment (DOT) facilities. Only four of Bukidnon’s 20 towns and two cities have passed the national standards in cure rates: Maramag (104 percent), Don Carlos (100 percent), Malitbog (79.17 percent), and Damulog (70.86 percent).

The municipality of Don Carlos was listed in the areas with TB DOTS that has “high cure rates”. Barrera said the 2010 figures at least show an improvement compared to the 2007 figures. Four years ago Bukidnon’s detection rate was only 43 percent while its cure rate was at 60 percent.

Based on estimates from a detection formula, if Bukidnon has 1.06 million population, it must have at least 1,006 cases in 2010. But only 975 cases were reported in the province, Barrera said.

“Where did they go? Most of these people are ashamed of their conditions, are self medicating or have poor health-seeking behavior,” she added.

Barrera warned that each patient has the possibility of infecting 10 to 15 other people so they must not self medicate.

She said those who take medicines without going through the protocol in recognized treatment centers stand the risk of acquiring multiple-drug resistant TB cases. She added that many TB patients are ashamed and afraid to come out when there is nothing to be ashamed or be afraid of.

TB drugs are free in rural health units in the province’s 24 TB treatment facilities. TB is the eight biggest cause of deaths in Bukidnon in 2010. Nationwide, TB is the sixth leading cause of deaths and illnesses and accounts for 7 percent of the total deaths. About 75 Filipinos die of TB everyday.

Barrera said there is no alternative to going through the province’s 24 TB DOT facilities. Barrera said the review is one of the initiatives to address the province’s poor performance in TB detection and cure. She added that the problem in TB detection and cure is not drugs and facilities. “One major concern we are addressing is the information and education drive,” she said. (Walter I. Balane)

 

Note: This story also appears on www.mindanews.com

 

DOH reveals 53 schisto endemic barangays in Bukidnon

MALAYBALAY CITY – About 53 of Bukidnon’s 464 barangays are endemic to schistosomiasis with five of these villages considered “highly endemic” or with 10 percent and above infection rate, according to a report released by the Department of Health Bukidnon Schistosomiasis Control Office.

This number is 13.2 more barangays than it was 2006’s 46 villages, when Bukidnon had the lowest infection rate, 2.63 percent, in a span of 10 years.

Bukidnon had an infection rate of 3.5 percent in 2010, down from 15.81 percent in 1981, a record high in the province.

The five barangays were identified from the top as San Isidro, Valencia City; San Jose, San Fernando; San Martin, Malaybalay City; Can-ayan, Malaybalay City; and Dagatkidavao, Valencia City.

About 13 barangays were listed in the “moderately endemic” or those with 5 to 9.99 percent infection rate.

A barangay can be included in the “endemic areas” when the DOH verifies the presence of infected snails or a confirmed schistosomiasis case, according to Dr. Vincent Raguro, who heads DOH’s schistosomiasis control office, based in Malaybalay City.

Bangcud, home of the controversial schistosomiasis-infected spring resort in Malaybalay City, is among the 35 barangays considered as “low endemic“ with below 5 percent infection rate.

Only two of the resort’s 11 springs are infected as of March 2011. But Raguro said it means the whole resort is still infected and cannot be cleared from schistosomiasis. He said it is dangerous that it has become a tourist attraction despite its declaration as “infected” spring.

“Even if the visitors just wade in the water, they stand the risk of infection,” he added.

Raguro said the higher number of endemic barangays is a sign of the effort to treat the disease. He added that they conduct, upon request of the endemic barangays, a once a year mass treatment.

Raguro said all of the 53 endemic barangays have requested mass treatment even if he cited difficulty in an earlier interview about some sort of resistance in Bangcud. He said all barangays have cooperated, at difference level of cooperation.

But he said the DOH target for the province of cutting the infection rate down to 1 percent is “difficult to achieve.”

Raguro said Schistosoma japonicum parasite-carrying snails dwells in “clear, clean, cool” waters like Matin-ao springs.

Her said humans and animals can get the Schistosoma japonicum parasite through simple washing of hands and feet, bath or just passing by the infested streams.

But he said schistosomiasis is a curable tropical disease. He dded that the disease does not kill, but its complications does.
In 2010, Raguro’s team examined 13,877 stool samples and found 495 to be positive of schistosomiasis. About 330 or 67 percent of the positive cases were males.

Valencia and Malaybalay cities own up more than half of the barangays with endemic cases, 17 and 16 barangays respectively.
In 2010, the barangays with the most number of cases from the endemic areas are San Jose, San Fernando (54), Mapolo, Malaybalay City (41), and Kahaponan, Valencia City (37).

The DOH did not disclose Bukidnon’s ranking in Mindanao as of Wednesday last week. But he said Mindanao owns 80 percent of schistosomiasis in the Philippines, 5 percent in the Visayas, and 15 in Luzon.

He attributed the big number of cases to the amount of rainfall in Mindanao and the fact that it is the biggest island in the country. (Walter I. Balane)

With community support, Bukidnon can control schistosomiasis – DOH official

MALAYBALAY CITY – The Department of Health can control schistosomiasis in Bukidnon with the help of the community using a mix of ways, primarily mass treatment, Dr. Ricardo Reyes, DOH provincial health team leader said.

He said there is a need to focus on mass treatment as an intervention to address schistosomiasis in the province where there are 53 out of its 464 barangays considered to be endemic or where there are observed prevalence of cases.

Reyes gave his reaction when asked about a provincial board resolution requesting the World Health Organization (WHO) to intervene and provide financial assistance for the rehabilitation of the Matin-ao Spring Resort in Bangcud, Malaybalay City to “contain and eliminate schistosomiasis.”

The resolution sponsored by lawyer Nemesio Beltran Jr., seeks the assistance of WHO to declare the spring as a pilot area where they can pour scientific, medical, and financial resources to prevent schistosomiasis.

“The problem is too complicated that we have to ask them to intervene. The provincial government does not have the money and technical expertise to solve the schistosomiasis problem,” he told MindaNews last week.

But Reyes said schistosomiasis in Bukidnon has dropped to 3.5 percent prevalence rate in 2010 compared to the 4.72 percent rate in 2.72. This is far from the 15.81 percent in 1981, the year when the highest number of infections in the province was recorded.

In 2010, DOH reported a total of 495 schistosomiasis cases out of 13, 877 stool samples they tested in Bukidnon. The top four of the seven towns and two cities where the cases are located  were traced to Valencia City (104), San Fernando town (98), Malaybalay City (61), and Quezon town (28).

Among the 53 endemic barangays, the most numbers are traced to Valencia and Malaybalay cities.

But the barangay with the highest number of positive cases in 2010 is San Jose in San Fernando town with 54 positive cases of the 340 examined.

Of the 53, five were considered to be “highly endemic” areas (10 percent above, prevalence rate), and 18 “moderately endemic” (5 to 9.99 percent rate). The rest, th3 30 barangays have below 5 percent rates or are “low endemic” barangays.

He said the DOH and the local government, with the help of the community and other stakeholders can control schistosomiasis in Bukidnon.

Matin-ao resort, a favorite destination of both foreign and local tourists, has reportedly been contaminated and infected with schistosomiasis in the last 10 years.

The provincial government has prohibited bathing in the resort inside its seven-hectare property, but visitors manage to sneak in and bathe in the spring resort’s cool waters.

He added he will also file another resolution to include in the piloting the Atugan Resort pool in Manolo Fortich.  “It is also contaminated,” he said, a statement refuted by the DOH schistosomiasis control team. The DOH said the municipal government of Impasug-ong has assumed responsibility after a DOH team inspected the area, found snails in the area, but cleared it of schistosomiasis at the moment.

Both resorts have remained open to the public.

Dr. Vincent Raguro, DOH Bukidnon schistosomiasis control team leader, said the DOH marked the Matin-ao spring site as infected since 2005 warning the public against bathing in the resort. But he said reports point to vendors who allegedly removed the concrete signage.

He said only two of the 11 springs in the area where there are colonies of schistosomiasis carrying snails have remained infected.

But he said it has not yet been cleared from infection.

As early 2005, he said, they have pushed that the spring resort be closed from public use because of the infection. But he said barangay officials invoked a resolution declaring the resort a tourist destination in their opposition. BukidnonNews is yet to reach barangay officials of Bangcud for comments.

Dr. Jose Tiongco, chief executive officer of the Medical Mission Group Hospitals and Health Services Cooperative-Philippines Federation, told MindaNews a major aspect to consider is open defecation in infected areas.

He said other areas have considered building public toilets. But in most cases the public has to pay to use the toilets. He said in some areas it is the government who pay the users because the human waste are used to produce biomass energy.

According to the WHO, schistosomiasis, or bilharzia, is a parasitic disease caused by trematode flatworms of the genus Schistosoma.  Larval forms of the parasites, which are released by freshwater snails, penetrate the skin of people in the water.

“In the body, the larvae develop into adult schistosomes, which live in the blood vessels. The females release eggs, some of which are passed out of the body in the urine or faeces. Others are trapped in body tissues, causing an immune reaction,” it said.

“In urinary schistosomiasis, there is progressive damage to the bladder, ureters and kidneys. In intestinal schistosomiasis, there is progressive enlargement of the liver and spleen, intestinal damage, and hypertension of the abdominal blood vessels,” the WHO website said.

Control of schistosomiasis is based on “drug treatment, snail control, improved sanitation and health education.” (Walter I. Balane)

Bukidnon seeks WHO help on schistosomiasis

MALAYBALAY CITY – The Bukidnon Provincial Board passed a resolution Wednesday urging and requesting the World Health Organization to intervene and provide financial assistance for the rehabilitation of the Matin-ao Spring Resort in Bangcud, Malaybalay City.

In a resolution sponsored by lawyer Nemesio Beltran Jr, the province board is asking the WHO to declare the spring as a pilot area where they can pour scientific, medical, and financial resources to contain and eliminate schistosomiasis. Continue reading

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