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Marianette T Inobaya,1 Remigio M Olveda,1 Thao NP Chau,3 David U Olveda,2 Allen GP Ross21Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Philippines; 2Griffith Health Institute, School of Medical Sciences, Gold Coast Campus, Griffith University, Southport, Australia; 3Discipline of Public Health, Flinders University, Adelaide, AustraliaAbstract: Schistosomiasis is a neglected tropical disease that ranks second only to malaria in terms of human suffering in the tropics and subtropics. Five species are known to infect man and there are currently over 240 million people infected worldwide. The cornerstone of control to date has been mass drug administration with 40 mg/kg of praziquantel but there are problems with this approach. Human and bovine vaccines are in various stages of development. Integrated control, targeting the life cycle, is the only approach that will lead to sustainability and future elimination.Keywords: schistosomiais, morbidity, treatment and control, mass drug administration

Objective In the year 2000, the Philippines' Department of Health adopted mass chemotherapy using praziquantel to eliminate schistosomiasis. Mass treatment was offered to an eligible population of 30 187 residents of 50 villages in Western Samar, the Philippines, in 2004 as part of an ongoing epidemiological study, Schistosomiasis Transmission and Ecology in the Philippines (STEP), aimed at measuring the effect of irrigation on infection with schistosomiasis. This paper describes the mass-treatment activities and factors associated with participation. Methods Advocacy, information dissemination and social mobilization activities were conducted before mass chemotherapy. Village leaders were primarily responsible for community mobilization. Mass treatment was offered in village meeting halls and schools. Participation proportions were estimated based on the 2002DS2003 census. Community involvement was measured using a participation index. A Bayesian hierarchical logistic regression model was fitted to estimate the association between sociodemographic factors and residents coming to the treatment site. Findings A village-level average of 53.1% of residents (range: 21.1DS85.3) came to the treatment site, leading to a mass-treatment coverage with an average of 48.3% (range: 15.8DS80.7). At the individual level, participation proportions were higher among males, preschool and school-age children, non-STEP participants and among those who provided a stool sample. At the village-level, better community involvement was associated with increased participation whereas a larger census was associated with decreased participation. Conclusion The conduct of mass treatment in the 50 villages resulted in far lower participation than expected. This raises concern for the ongoing mass-treatment initiatives now taking place in developing countries. Copyright © 2008 World Health Organization [ABSTRACT FROM AUTHOR]