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BackgroundRepeated mass drug administration (MDA) of antihelminthics to at-risk populations is still the main strategy for the control of soil-transmitted helminth (STH) infections. However, MDA, as a stand-alone intervention, does not prevent reinfection. Accordingly, complementary measures to prevent STH reinfection, such as health education and improved sanitation, as part of an integrated control approach, are required to augment the effectiveness of MDA for optimal efficiency and sustainability. ObjectiveThe aim of this study is to determine the impact and generalizability of a school-based health education package entitled The Magic Glasses for STH prevention in the Philippines. MethodsWe conducted a cluster randomized controlled intervention trial, involving 2020 schoolchildren aged 9-10 years, in 40 schools in Laguna Province, Philippines, to evaluate the impact of the school-based health education package for the prevention of STHs. The trial was conducted over the course of 1 year (June 2016 to July 2017). A total of 20 schools were randomly assigned to the intervention arm, in which The Magic Glasses Philippines health education package was delivered with the standard health education activities endorsed by the Philippines Department of Health (DOH) and the Department of Education (DepEd). The other 20 schools comprised the control arm of the study, where the DOH/DepEd’s standard health education activities were done. At baseline, parasitological assessments and a knowledge, attitude, and practice survey were carried out in all schools. In addition, height, weight, and hemoglobin levels were obtained from each child (after parental consent), and their school attendance and academic performance in English and mathematics were accessed from the school records. The baseline and 2 follow-up surveys were completed using the same study measurements and quality-control assessments. ResultsKey results from this cluster randomized intervention trial will shed light on the impact that The Magic Glasses health education package will have against STH infections in schoolchildren in the province of Laguna, located on the Island of Luzon, in the Calabarzon Region of the Philippines. ConclusionsThe results of the trial will be used to assess the generalizability of the impact of The Magic Glasses health education package in different epidemiological and cultural settings, providing evidence for translation of this health education package into public health policy and practice in the Asian region and beyond. Trial RegistrationAustralian New Zealand Clinical Trials Registry number ACTRN12616000508471; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368849 International Registered Report Identifier (IRRID)DERR1-10.2196/18419

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 descdbes 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 2002-2003 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: 21.1-85.3) came to the treatment site, leading to a mass-treatment coverage with an average of 48.3% (range: 15.8-80.7). 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. Une traduction en francais de ce resume figure a la fin de l'article. Al final del articulo se facilita una traduccion al espanol. Objectif En 2000, le ministere de la sante philippin a adopte la chimiotherapie de masse par le praziquantel pour eliminer la schistosomiase. Le traitement de masse a ete propose a une population justiciable de ce traitement, composee de 30 187 habitants de 50 villages du Samar occidental, aux Philippines, en 2004, dans le cadre d'une etude epidemiologique en cours, le projet STEP sur la transmission et l'ecologie de la schistosomiase aux Philippines. Ce projet STEP vise a mesurer l'impact de l'irrigation sur l'infection par la schistosomiase. Le present article decrit les operations de traitement de masse et ies facteurs lies a la participation a ce traitement. Methodes Des operations de sensibilisation, de diffusion de l'information et de mobilisation sociale ont ete menees avant la chimiotherapie de masse. Ce sont principalement les chefs de village qui ont assure la mobilisation communautaire. Le traitement a ete propose dans les salles de reunion et les ecoles des villages. Les taux de participation ont ete estimes sur la base du recensement de 2002-2003. L'implication de la communaute a ete mesuree par un indice de participation. Un modele de regression logistique hierarchique bayesien a ete applique pour estimer l'association entre des facteurs sociodemographiques et la venue des habitants sur le site de traitement. Resultats En moyenne dans les villages, 53,1% des habitants (plage de variation : 21,1--85,3) se sont rendus sur le site de traitement, ce qui donne un taux de couverture moyen de 48,3 % (plage de variation : 15,8--80,7). Au niveau individuel, le taux de participation etait plus eleve chez les hommes, les enfants d'age prescolaire et scolaire, les personnes ne participant pas au projet STEP et ceux ayant fourni un echantillon de selles. A l'echelle des villages, une plus grande implication de la communaute etait associee a une plus forte participation, tandis qu'un recensement plus large etait associe a une faible participation. Conclusion Le traitement de masse realise dans 50 villages a donne lieu a une participation bien plus reduite que prevu. Cette observation est preoccupante pour les initiatives de traitement de masse en cours actuellement dans les pays en developpement. Objetivo En el ano 2000, el Ministerio de Salud de Filipinas adopto la antibioticoterapia masiva con prazicuantel como medio de eliminacion de la esquistosomiasis. En 2004 se ofrecio tratamiento masivo a una poblacion idonea de 30 187 residentes en 50 aldeas de Samar occidental, Filipinas, como parte de un estudio epidemiologico en curso--Transmision y Ecologia de la Esquistosomiasis en Filipinas (STEP)--concebido para medir el efecto del riego en la infeccion por esquistosoma. En este articulo se describen las actividades de tratamiento masivo y los factores asociados a la participacion. Metodos Antes de la antibioticoterapia masiva se llevaron a cabo actividades de promocion, difusion de informacion y movilizacion social. Los lideres de aldea fueron los principales responsables de la movilizacion comunitaria. Se ofrecio tratamiento masivo en las salas de reunion y las escuelas de las aldeas. Los porcentajes de participacion se estimaron a partir dei censo de 2002-2003, y la implicacion de la comunidad se midio empieando un indice de participacion. Se aplico un modelo jerarquico bayesiano de regresion logistica para estimar la relacion entre los factores sociodemograficos y la visita de los residentes al centro de tratamiento. Resultados A nivel de aldea, acudieron al centro de tratamiento una media dei 53,1% de los residentes (intervalo: 21,1-85,3), lo que se tradujo en una cobertura de tratamiento masivo del 48,3% (intervalo: 15,8-80,7). A nivel individual, los porcentajes de participacion fueron mayores entre los hombres, los ninos en edad preescolar y escolar, los participantes ajenos a STEP y las personas que proporcionaron una muestra de heces. A nivel de aldea, una mayor implicacion de la comunidad se asocio a una mayor participacion; esta disminuia en cambio cuanto mayor era el censo. Conclusion La practica del tratamiento masivo en las 50 aldeas estudiadas se asocio a una participacion muy inferior a la prevista. Esto Suscita preocupacion en relacion con las iniciativas de tratamiento masivo que se estan Ilevando a cabo en los paises en desarrollo., Introduction Schistosomiasis remains a major public health problem in the Philippines. Some 6.7 million people distributed in 1212 villages (barangays), predominantly in the islands of Leyte, Samar and areas of [...]

Abstract Background Few studies have described heterogeneity in Schistosoma japonicum infection intensity, and none were done in Philippines. The purpose of this report is to describe the village-to-village variation in the prevalence of two levels of infection intensity across 50 villages of Samar Province, the Philippines. Methods This cross-sectional study was conducted in 25 rain-fed and 25 irrigated villages endemic for S. japonicum between August 2003 and November 2004. Villages were selected based on irrigation and farming criteria. A maximum of 35 eligible households were selected per village. Each participant was asked to provide stool samples on three consecutive days. All those who provided at least one stool sample were included in the analysis. A Bayesian three category outcome hierarchical cumulative logit regression model with adjustment for age, sex, occupation and measurement error of the Kato-Katz technique was used for analysis. Results A total of 1427 households and 6917 individuals agreed to participate in the study. A total of 5624 (81.3%) participants provided at least one stool sample. The prevalences of those lightly and at least moderately infected varied from 0% (95% Bayesian credible interval (BCI): 0%–3.1%) to 45.2% (95% BCI: 36.5%–53.9%) and 0% to 23.0% (95% BCI: 16.4%–31.2%) from village-to-village, respectively. Using the 0–7 year old group as a reference category, the highest odds ratio (OR) among males and females were that of being aged 17–40-year old (OR = 8.76; 95% BCI: 6.03–12.47) and 11–16-year old (OR = 8.59; 95% BCI: 4.74–14.28), respectively. People who did not work on a rice farm had a lower prevalence of infection than those working full time on a rice farm. The OR for irrigated villages compared to rain-fed villages was 1.41 (95% BCI: 0.50–3.21). Discussion We found very important village-to-village variation in prevalence of infection intensity. This variation is probably due to village-level variables other than that explained by a crude classification of villages into the irrigated and non-irrigated categories. We are planning to capture this spatial heterogeneity by updating our initial transmission dynamics model with the data reported here combined with 1-year post-treatment follow-up of study participants.

Background and objectives Despite a substantial reduction in the mortality rate of children under 5 years in the past 25 years, pneumonia remains the single-largest infectious cause of child deaths worldwide. This study explored the chronological order of visited healthcare facilities and practitioners, and the factors affecting mothers’ intention to seek care before the hospitalisation of children with pneumonia. Methods and analysis A qualitative research design was employed using theory of planned behaviour as a framework for the analysis. Using purposive sampling technique, 11 mothers, whose children under 5 years old were hospitalised with severe pneumonia, were recruited for individual semi-structured interviews. Their sociodemographic information was analysed using descriptive statistics. Results Mothers brought their sick children to multiple facilities, and 1 to 19 days had passed before hospitalisation. We identified four major factors determining mothers’ intentions: (1) doing something useful for the sick child, (2) expecting the child to receive the necessary assessment and treatment, (3) accepting advice to visit a healthcare facility and be referred to a hospital and (4) considering issues and benefits associated with hospitalisation. Mothers noticed their children’s unusual symptoms and monitored them while applying home remedies. They also took their children to traditional healers despite knowing that the treatments were not necessarily effective. Mothers expected children to be checked by health professionals and listened to advice from family members regarding the facilities to visit, and from healthcare staff to be referred to a hospital. Financial issues and the double burden of housework and caring for the hospitalised child were mothers’ major concerns about hospitalisation. Conclusion Children were hospitalised after several days because they visited multiple healthcare facilities, including traditional healers. Improving care quality at healthcare facilities and reducing financial and mothers’ burden may reduce the hospitalisation delay for children with pneumonia. [ABSTRACT FROM AUTHOR]

Background: Respiratory syncytial virus (RSV) is one of the main viral causes of lower respiratory tract illness (LRTI), especially in young children. RSV vaccines, including maternal and infant vaccines, are under development; however, more epidemiological studies are needed to develop effective vaccination strategies. Objectives: To estimate detailed age‐specific incidence rates and severity of RSV‐associated LRTI (RSV‐LRTI) using data from a community‐based prospective cohort study in the Philippines. Patients/Methods: Cohort children who visited health facilities due to acute respiratory symptoms were identified, and nasopharyngeal swabs were collected to detect RSV. The severity of RSV‐LRTI was assessed using the severity definition proposed by the World Health Organization. Risk factors for developing RSV‐LRTI and contribution of SpO2 measurement were also evaluated. Results: A total of 395 RSV episodes which occurred in children aged 2‐59 months were categorised as 183 RSV‐LRTI, 72 as severe RSV‐LRTI and 29 as very severe RSV‐LRTI. Children aged 3‐5 months had the highest incidence rate of RSV‐LRTI, at 207.4 per 1000 child‐years (95% CI: 149.0‐279.5). Younger age group, place of living and low educational level of caregivers were associated with developing RSV‐LRTI. Clinical manifestations had low levels of agreement with hypoxaemia as measured by pulse oximeter. Conclusion: The highest burden of RSV was observed in young infants aged 3‐5 months, whereas the burden was also high in those aged 12‐20 months. Future vaccination strategies should consider the protection of older children, especially those aged one year, as well as young infants. [ABSTRACT FROM AUTHOR]