Central Philippine University

Jaro, Iloilo City, 5000 Iloilo

College of Medicine
Department of Preventive Community and Family Medicine
2nd Semester

DOH PROGRAMS
FOOD AND WATER BORNE AND HELMINTH CONTROL
PROGRAMS

In partial fulfilment of the Requirements in Preventive Community and Family Medicine

Submitted by: 

Artates, Michael Josan Libo-on, Anna Andrea
Codillo, Alexis Job Mendez, Joher, Jr.
Emmanuel, Randel Padilla, Cheska Norane
Hinguillo, Mariah Penaflorida, Megan
Jimenez, Ruffa Dawn Tirante, Junien

Leysa, Meldeline

Submitted to:

THE FACULTY, DEPARTMENT OF FAMILY MEDICINE

CENTRAL PHILIPPINE UNIVERSITY, COLLEGE OF MEDICINE

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 FOOD AND WATERBORNE DISEASES
PREVENTION AND CONTROL PROGRAM

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 FOOD AND WATERBORNE DISEASES PREVENTION AND CONTROL PROGRAM

BRIEF HISTORY

• The program covers diseases of a parasitic, fungal, viral, and bacteria in nature, usually acquired
through the ingestion of contaminated drinking water or food.

• The more common of these diseases are bacterial in nature, the most common of which are
typhoid fever and cholera

• Parasitic organisms are also an important factor, among Capillariasis, Heterophydiasis,

Paragonimiasis, which are endemic in Luzon, Visayas, and Mindanao. Cysticercosis is also a major
problem since it has a neurologic component to the illness

• Also, outbreaks from FWBDs can be very passive and catastrophic. Since most of these diseases
have no specific treatment modalities, the best approach to limit economic losses dueto FWBDs is
prevention through health education and strict food and water sanitation.

DISEASE OVERVIEW

Hepatitis A
It is spread through consumption of food or water contaminated with fecal matter, principally
in areas of poor sanitation.

Signs and symptoms:

fever
jaundice
diarrhea

Hepatitis E
It is most commonly spread through fecal contamination of drinking water

Signs and symptoms:

jaundice
fatigue
abdominal pain
dark colored urine.

Typhoid Fever
It is bacterial disease spread through contact with food or water contaminated by fecal matter
or sewage. Victims exhibit sustained high fevers.

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 Bacterial Gastroenteritis
It typically manifests with symptoms of vomiting, diarrhea, and abdominal discomfort. It is
usually self-limited, but improper management of an acute infection can lead to a protracted
course.

Diarrhea is defined as daily stools with a mass greater than 15 g/kg for children younger than
2 years and greater than 200 g for children 2 years or older. Adult stool patterns vary from 1
stool every 3 days to 3 stools per day; therefore, consider individual stool patterns.

Bacilliary Dysentery
It is a type of food poisoning caused by infection with the Shigella species in fecal-oral
transmission and follows a self-limited course ranging from 3 days to 1 week. It rarely lasts as
long as a month.

Amoebiasis
It is caused by Entamoeba histolytica

Cholera
It is a disease caused by bacteria that produce a watery diarrhea that can rapidly lead to
dehydration. Symptoms and signs include a rapid onset of copious, smelly diarrhea that
resembles rice water and may lead to signs ofdehydration (for example,vomiting, wrinkled
skin, low blood pressure, dry mouth, rapid heart rate). Most frequently transmitted by water
sources contaminated with the causative bacterium Vibrio cholerae, although contaminated
foods, especially raw shellfish, may also transmit the cholera-causing bacteria.

DESCRIPTION
FWBDs refer to the limited group of illnesses characterized by diarrhea, nausea, vomiting with
or without fever, abdominal pain, headache and/or body malaise. These are spread or acquired
through the ingestion of food or water contaminated by disease-causing microorganisms (bacterial or
its toxins, parasitic, viral).

VISION
Zero Mortality from FWBDs

MISSION
To reduce morbidity and mortality due to FWBDs

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 OBJECTIVES
• To guarantee universal access to quality FWBD-PCP intervention and services at all stages of
the life
• To guarantee financial risk protection of clients availing diagnosis, management and treatment
for FWBDs
• To guarantee a responsive service delivery network for the prevention and control of FWBDs

PROGRAM COMPONENTS

Policy, Plans and Organizational Support.

• This component ensures that supportive policies, directional and annual plans are
developed and updated to govern the design and implementation of the FWBD-PCP.

Diagnosis, Management and Treatment.

• This component ascertains the proper diagnosis as well as prompt management and
treatment of patients suffering from FWBDs. Focus will be given to the development of
clinical practice guidelines (CPGs) on FWBD diagnosis, management and treatment.

Quality Assurance System.

• This component ensures the quality of diagnostic services of FWBD cases. This requires
regular test, validation and follow-up of laboratory capacities and competencies of medical
technologists as well as provision of the necessary laboratory supplies and equipment.

Logistic Management.
• This component guarantees that essential drugs/medicines, supplies and equipment are in
place and available at the point of service. While the LGUs are mainly responsible for
placing-in these commodities and other logistics at their level.

Health Promotion and Advocacy.

• This component ensures the prevention of FWBDs which hinges on the promotion of
proper practices on water, sanitation and personal hygiene.

Monitoring and Evaluation, Research, Surveillance and Response.

• Under this component, necessary system and tools will be developed to ensure that
quality and timely data are generated as basis for decision-making, prioritization of
resources and appropriate and immediate response to any outbreak.

Outbreak Response/Disaster Management.

• This component ensures that any outbreak due to FWBD in any area is properly monitored and
immediately responded to especially during disaster or emergency situations where the
affected population became most prone to these infections as in evacuation centers or flooded
areas.

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 TARGET POPULATION/ CLIENT
FWBD by Sex
Based on EB’s data in 2016, there were slightly more males generally experiencing FWBDs (cholera,
typhoid, Hepa A, rotavirus and paralytic shellfish poisoning) than females. However, for acute bloody
diarrhea, there were more females than males reported experiencing the disease in the same year.

FWBDs by Age Group

Majority of the reported
• acute bloody diarrhea in 2016 were among the 1-4 year old children.
• Rotavirus as characterized occurs mainly among the same age group and those below 1 year
old.
• Hepa A, mostly affected are the 15 to 39 year olds and also notable among the younger age
group (5-14 years old).
• typhoid, cholera and paralytic shellfish poisoning, highest number of cases reported was
among the 5-14 years old.

FWBDs by Geographical Areas

• Regions 7 and 8 came out as hosts of the highest incidence of FWBDs in the country.
• Incidence of acute bloody diarrhea is highest in Region 7 and also the host of the highest
number of reported Hepa A and Typhoid cases in 2016.
• Region 8 on the other hand had the highest incidence of cholera and paralytic shellfish
poisoning. Region 1 came out highest in the incidence of rotavirus in the same year.

PARTNER INSTITUTIONS
The management and implementation of the FWBD-PCP are shared responsibility among the following
offices:

Department of Health – Central Office

1. Infectious Disease Office (IDO) - Disease Prevention and Control Bureau (DPCPB)
• Formulate and disseminate national policies, standards and guidelines governing the
management and implementation of the FWBD-PCP
• Develop strategic plans and cascade this to the regional offices for adoption
• Ensure the provision/delivery of quality diagnosis, management and treatment
services of FWBDs

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2. Environmental Health and Sanitation
• Provide technical assistance to the regions and LGUs to comply with the provisions
and requirements of the Sanitation Code in the Philippines;
• Develop and promote guidelines on healthy wash, sanitation and hygiene practices
among food handlers, and other concerned institutions
3. Epidemiology Bureau (EB)
• Establish, operate and sustain FWBD surveillance nationwide
• Support LGUs in case investigation of reported FWBD cases and in providing
immediate and proper response
4. Health Emergency Management Bureau (HEMB)
• Provide technical assistance in developing plans in times of emergencies and
disasters.
• Mobilize WASH resources through Regional DRRM-H Manager to ensure adequate
and safe water through water quality surveillance, disinfection / treatment
5. Health Promotion and Communication Services (HPCS)
• Formulate and design a communication plan to address the poor health seeking
behavior of the community and their unhealthy food and water practices including
personal hygiene
• Design appropriate media channels and materials to communicate the key FWBD
prevention and control messages
6. Research Institute for Tropical Medicine (RITM) and National Reference Laboratories
(Parasitology, Bacterial Enterics and Viral Enterics)
• Perform laboratory testing for samples referred for the FWBD surveillance and
outbreak investigation
• Provides laboratory technical support, training and quality assurance to the
subnational, regional and other laboratories
• Evaluate test kits and reagents in coordination with FDA
7. Food and Drug Administration (FDA)
• Perform microbiologic tests on food samples submitted to the laboratory
• Monitor the safety of pre-packaged food in the market and issue Public Advisory /
Warning to prevent consumption of contaminated food

Other Government Agencies

1. Department of Interior and Local Government (DILG)
• Support the DOH and DA in the collection and documentation of food-borne illness
data, monitoring and research
2. Department of Education
• Integrate messages on proper water, food and sanitary practices including personal
hygiene in the school curriculum

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 3. Department of Agriculture
• Develop and transfer technologies that will improve and sustain the development of
the livestock industry which ensure food security and competitiveness of the local
produce in the global market
4. Department of Social Welfare and Development
• Proper water, food and sanitary practices including personal hygiene of DSWD
residential centers, canteen, caterers
5. Department of Environment and Natural Resources
• Control the construction and maintenance of waterworks, sewerage, and sanitation
systems and other public utilities
• Prohibiting dumping of waste products detrimental to the plants and animals or
inhabitants therein

POLICIES AND LAWS

• Sanitation Code of the Philippines

1975 PD No. 856
Intensifying the Program on Food Handlers and Water Quality Surveillance to Curb Outbreaks
of water and sanitation related diseases

• 1996 DOH DC No. 110

Creation of the Food and Water-Borne Disease Prevention and Control Program

• 1997 DOH AO No. 29-A

Issuance of the Philippines National Standards for Drinking Water

• 2007 AO No. 0012

Food Safety Act to strengthen the food safety regulatory system in the country to protect
consumer health and facilitate market access of local foods and food product

STRATEGIES, ACTION POINTS, AND TIMELINE

Strategy 1. Regulate and monitor food and water sanitation practices at the local level through
enforcement of national and local legislations, application of appropriate technical
standards and participation of non-government agencies.
Implementation Status
• There is a robust set of laws and policies that support food and water sanitation practices in
the country; the extent of compliance and adherence however to these laws and policies
cannot be fully ascertained given the absence of data relative to such practices:
◦ 2012. RA 10611 on Food Safety Act to strengthen the food safety regulatory system in
the country to protect consumer health and facilitate market access of local foods and
food product

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 ◦ 2000 RA Act 9003. 200 providing for an ecological solid waste management
program, creating the necessary institutional mechanisms and incentives
declaring certain acts prohibited and providing penalties, appropriating
funds therefor and for other purpose
◦ 1975 PD No. 856 Code of Sanitation of the Philippines

Strategy 2. Sustain inter-agency collaboration to fast-track sanitation infrastructure development in

poor urban areas and in rural areas with low access to safe water and sanitation
facilities.
Implementation Status
• Interagency Committee on Environmental Health with sub-task forces on Water, Solid Waste,
Toxic Chemicals and Occupational Health

Strategy 3. Promote personal hygiene, food and water sanitation practices and the principles
of environmental health.
Implementation Status
• 90% of HHs have access to safe water (2015)
• 86.7% of HHs with sanitary toilets (2015)
• No data available to establish extent of personal hygiene practices

Strategy 4. Promote the use of ORS in the management of diarrhea to prevent dehydration,
especially among infants and children.
Implementation Status
• ORS continues to be the primary intervention of children with diarrhea as shown by the 2015
FHSIS Reports that 100% of diarrhea cases were given ORS.
• However, facilities visited are already without ORT Corners
• Likewise, some health facilities have inadequate supply of zinc

Strategy 5. Promote breastfeeding and other good feeding practices for infants and children.
Implementation Status
• WHO discourages use of bottles with nipples for feeding during early infancy as it is usually
associated with malnutrition and increased risk of infection, especially diarrheal disease,
through unhygienic procedures in the preparation of the liquid or the feeding bottle and use of
unsafe water. The 2013 NDHS showed that bottle-feeding is relatively still common in the
Philippines with 27% of infants under age two months being fed using a bottle with a nipple.

Strategy 6. Continue training of health personnel in the early diagnosis and treatment of food-borne
and waterborne diseases.
Implementation Status
• No training has been conducted on the early diagnosis and treatment of FWBDs; the clinic
practice guidelines are still currently being finalized which will be packaged into a Training
Module for both hospital and public health facility staff

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Strategy 7. Continue nationwide information campaign for the prevention and control of food-
borne and waterborne diseases.
Implementation Status
• No nationwide information campaign has been designed and mounted on the prevention and
control of FWBDs in the past 6 years

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 INTEGRATED HELMINTH
CONTROL PROGRAM

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 SOIL-TRANSMITTED HELMINTHIASIS

Soil-transmitted infections persist in areas where personal hygiene and environmental

sanitation practices are poorly carried out and where cases remain untreated and become continuing
sources of infection. A high prevalence of helminthiasis is also generally associated with areas that are
basically agricultural and low in the economic and human development scale.

The three major intestinal parasitism in the Philippines are:
o ascariasis or roundworm infection
o trichuriasis or whipworm infection, and
o hookworm infection.


Other parasitism that continue to affect some areas are:

o paragonimiasis
o capillariasis
o echinostomiasis
o taeniasis or tapeworm infection.
Source: National Objectives for Health, Philippines, 2005-2001, Department of Health, Manila,
Philippines.

DISEASE OVERVIEW

Ascaris lumbricoides
Ascaris lumbricoides, known as the “roundworm of man”, is the largest of the intestinal
nematodes parasitizing humans. It is the most common worm found in human. It is worldwide in
distribution and most prevalent throughout the tropics, sub-tropics and more prevalent in the
countryside than in the city

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Trichuris trichiura

The nematode (roundworm) Trichuris trichiura, also called the human whipworm. Whipworm is
a soil-transmitted helminth (STH) and is the third most common roundworm of humans. Whipworm
causes an infection called trichuriasis and often occurs in areas where human feces is used as fertilizer
or where defecation onto soil happens. The worms are spread from person to person by fecal-oral
transmission or through feces-contaminated food.
People infected with whipworm can suffer light or heavy infections. People with light infections
usually have no symptoms. People with heavy symptoms can experience frequent, painful passage of
stool that contains a mixture of mucus, water, and blood. Rectal prolapse can also occur. Heavy
infection in children can lead to severe anemia, growth retardation, and impaired cognitive
development.

Hookworm
Includes:
a. Ancylostoma duodenale
b. Necator americanus
- Blood-sucking nematodesPrevalence rate is 5-45 %
- 96% infection caused by N. americanus
- 2% infection caused by A. duodenale
- 2% mixed infection
- Adult worms are identified based on the presence of cutting plates or teeth
- Infective stage is 3rd stage larva
- Lives in the large intestine
- Modified Kato Katz technique

EPIDEMIOLOGY

Global distribution and prevalence

More than 1.5 billion people, or 24% of the world’s population, are infected with soil-
transmitted helminth infections worldwide. Infections are widely distributed in tropical and
subtropical areas, with the greatest numbers occurring in sub-Saharan Africa, the Americas, China
and East Asia.
Over 270 million preschool-age children and over 600 million school-age children live in
areas where these parasites are intensively transmitted, and are in need of treatment and
preventive interventions (World Health Organization, 2015).
Of the 4.98 million years lived with disability (YLDs) attributable to STH, 65% were attributable
to hookworm, 22% to A. lumbricoides and the remaining 13% to T. trichiura. The vast majority of STH
infection (67%) and YLDs (68%) occurred in Asia (Pullan et.al., 2014).
Soil-transmitted helminths refer to the intestinal worms infecting humans that are transmitted
through contaminated soil ("helminth" means parasitic worm): Ascaris lumbricoides (sometimes called
just "Ascaris"), whipworm (Trichuris trichiura), and hookworm (Anclostoma duodenale and Necator

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americanus). A large part of the world's population is infected with one or more of these soil-
transmitted helminths:
• approximately 807-1,121 million with Ascaris
• approximately 604-795 million with whipworm
• approximately 576-740 million with hookworm
(Center for Disease Control Data (Updated last January 10, 2013)

PREVALENCE OF SOIL TRANSMITTED HELMINTHS

In the Philippines, intestinal helminthiasis remains a major public health concern. In a study
involving elementary school children in selected sites in Luzon, Visayas and Mindanao, the cumulative
prevalence, which is the positivity for at least one type of STH infection, was 67% (Belizario et al.,
2005). A nationwide study also revealed that 66% of preschool children were infected with STH (de
Leon and Lumampao, 2005), while a much recent study that served as a baseline for the Integrated
Helminth Control Program (IHCP) of Department of Health (DOH) noted an overall cumulative
prevalence of 54.0% and prevalence of heavy intensity infections of 23.1% (Belizario et al., 2009).
Belizario said that statistics of the 2009 survey of four demographic groups—A.
Preschoolchildren, B. School-age children, C. Adolescent women, D. Pregnant women. Data are way
above the less-than-20-percent mark by the World Health Organization. The gravest statistics came
from Leyte. It recorded (A) 67 percent, (B) 61 percent, (C) 62 percent and (D) 76 percent,
respectively. Concluded that about 14 million of 30 million children have STHs.
Source: Philippines one of Asia’s ‘wormiest’ countries by Vaughn Alviar. Philippine Daily
Inquirer. July 27, 2013
Soil-transmitted helminth infection is found mainly in areas with warm and moist climates
where sanitation and hygiene are poor, including in temperate zones during warmer months. These
STHs are considered Neglected Tropical Diseases (NTDs) because they inflict tremendous disability
and suffering yet can be controlled or eliminated.
Soil-transmitted helminths live in the intestine and their eggs are passed in the feces of
infected persons. If an infected person defecates outside (near bushes, in a garden, or field) or if the
feces of an infected person are used as fertilizer, eggs are deposited on soil. Ascaris and hookworm
eggs become infective as they mature in soil. People are infected with Ascaris and whipworm when
eggs are ingested. This can happen when hands or fingers that have contaminated dirt on them are
put in the mouth or by consuming vegetables and fruits that have not been carefully cooked, washed
or peeled. Hookworm eggs are not infective. They hatch in soil, releasing larvae (immature worms)
that mature into a form that can penetrate the skin of humans. Hookworm infection is transmitted
primarily by walking barefoot on contaminated soil. One kind of hookworm (Anclostoma duodenale)
can also be transmitted through the ingestion of larvae (Center for Disease Control and Prevention,
2013)

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 THE INTEGRATED HELMINTH CONTROL PROGRAM (IHCP)

Vision:
Healthy & productive Filipinos in the 21st century

Goal:
To reduce morbidity & mortality due to soil transmitted helminthiasis

General Objectives:
To reduce the prevalence of STH to below 30 % among 1-12 y/o by 2016 & lower STH infection
among the adolescent females, pregnant women & special population groups of food handlers/
operators, farmers, sodiers & indigenous people.

Indicators:
• STH prevalence of 1-5 y/o children reduced to less than 30 % from 43.7 % (2010)
• STH prevalence of 6-12y/o children reduced to less than 30 % from 44.7 % (2010)
• Risk to STH infection among special population groups reduced to less than 10 % from 36.9 %
(2010)

Specific Objectives:
• To increase the coverage of deworming of target population groups at risk to STH infection
• To expand coverage of water, sanitation & hygiene
• To increase proportion of households aware of proper STH prevention & control

Why deworm?
• Short-term goal – treatment is intended to prevent & control morbidity by reducing worm
burden
• Long-term goal – treatment is to prevent healthy people from becoming infected by reducing
the source of infection

Treatment Guidelines
A. Target population
• Children 1-5 y/o (preschoolers)
• Children 6-12 y/o (schoolchildren)
B. Schedule of Mass Deworming
• Children 1-5 y/o (preschooler)
GP – April & October
RHU, BHS, day care centers

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 • Children 6-12 y/o (schoolchildren)
July & January
School nurses & teachers
- Out of school youth
RHU, BHS
• Filariasis endemic areas (2 y/o & above)
1st dose will be given on :
-1-5 y/o - April by GP
-6-12 y/o – July by DepEd
nd
2 dose will be given in Oct.-Nov by FEP

C. Approach to deworming
• Facility – based or fixed post
-deworming children in RHUs, BHS, day care centers, schools, etc.
• Door to door
-deworming children house to house especially in under-served, remote areas o r
poorest segment of the community

D. Duration of Deworming
• Mass treatment should be done every 6 months or 2x a year for 3 consecutive years then
once a year thereafter

E. DOH recommended drugs for mass treatment

• Albendazole 400 mg, single dose
• Mebendazole 500 mg, single dose

F. DRUG DOSAGE BY TARGET GROUPS (NEXT PAGE)

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 DRUG DOSAGE BY TARGET GROUPS

Target Groups Drug Dosage

12-24 months children Albendazole, 200 mg, single dose or
Mebendazole, 500 mg, single dose

more than 2-12 years old children Albendazole, 400 mg, sigle dose or
Mebendazole 500 mg, single dose

Note: If Vitamin A and deworming drug are

given simultaneously during the GP
activity, either drug can be given first. 

Adolescent females
 Albendazole 400 mg once a year


It is recommended that all adolescent Mebendazole 500 mg once a year
females who consult the health be given

Pregnant women

It is recommended that all pregnant In areas where hookworm is endemic:

women who consult the health be given Where hookworm prevalence is 20 – 30%

anthelminthic drug once in the 2nd Albendazole 400 mg once in the 2nd
trimester of pregnancy.
 trimester

Mebendazole 500 mg once in the 2nd
trimester

Where hookworm prevalence is > 50%,
repeat treatment in the 3rd trimester

4. Special groups, e.g., food handlers
and operators, soldiers, farmers and
indigenous people


Selective deworming is the giving of
anthelminthic drug to an individual based
on the diagnosis of current infection.
However, certain groups of people should
be given deworming drugs regardless of
their status once they consult the health
center.



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Side effects of Anthelminthic drugs
• Rare & generally a reaction to the degeneration of worms that have been killed
• Only S/E that needs intervention is allergic skin reaction which can be treated with histamine
antagonist
• Mild abdominal pain is most frequently reported S/E – does not need treatment
• Erratic worm migration

Disposal of the worms

• Worms expelled as a result of deworming should be flushed thru the toilet
• If no toilets are available, it should be burned
• Worms should not be buried in the soil

Stakeholders/Beneficiaries
The DOH is the lead agency in the deworming of children while the Department of Education
(DepEd) is in charge of deworming all children aged 6-12 years old enrolled in public schools (Grade
1-VI). Deworming is done by teachers under the supervision of school nurses or any health personnel.

Program Strategies
1. Improve governance through:

a. Policies/resolutions;
b. Securing budget for STH prevention and control;
c. Mobilization and coordination of sectoral support.


2. Improve service quality and scale-up coverage.

a. Capacity building


3. Areas for training

· Epidemiology, life cycle etc.

· Proficiency training on lab diagnosis for med techs/lab techs

· Annual/biannual updates on current technology in lab diagnosis

· Training on drug administration, side effects, etc


4. Target participants


5. Training mechanisms

a. Development and issuance of protocols and guidelines

b. Expansion of service delivery points

c. Availability and affordability of deworming drugs


6. Institute financing reforms

a. Efficiency in program implementation

b. Mobilization of resources

c. Strengthening LGU financing schemes


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 7. Strengthen regulations

8. Installation of management support systems

a. Drug procurement

b. Research

c. Surveillance Guidelines/Administrative Orders AO No. 2010-0023 – guidelines
on deworming drug administration and the management of adverse events
following deworming (AEFD)


Organizations/Agencies: 

• World Health Organization (WHO)
• University of the Philippines-National Institutes
of Health (UP-NIH)
• United Nations Children’s Fund (UNICEF)
• World Vision
• Feed the Children International
• Helen Keller International (HKI) 

• Council for the Welfare of Children
• Department of Science and Technology-Food
and Nutrition Institute (DOST -FNRI)
• Department of Education (DepEd)
• Plan International
• Save the Children

DEPARTMENT OF HEALTH DEWORMING PROGRAM

DOH Administrative Order No. 90 FS 1999

– DOH established the STH Control Program (STHCP) in 1999

DOH Administrative Order No. 2006-0028

– Every January & July is the deworming schedule for Strategic and operational framework for
establishing integrated helminth control program (IHCP) Status of the program Deworming of target
population during:


1-5 years old – during Garantisadong Pambata (GP) April and October

6-12 years old (school children Grade 1-6 enrolled in public schools) every January and July
Partner

DOH Administrative Order No. 2006-0228

– Strategic & Operational Framework for Establishing Integrated Helminth Control Program (IHCP)

DOH Administrative Order No. 2010- 0023

– Guidelines on Deworming Drug Administration & the Management of Adverse Event Following
Deworming (AEFD)

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Department of Education Deworming Program

DepEd Memorandum # 28 S. 2007

– Implementation of the Mass Deworming Program In All Public Elem. School Nationwide.

DepEd Order #65 S. 2009

- Implementation of Essential Health Care Program (EHCP) for the School Children ( Bi-annual
Deworming of school children)

Regional Memorandum #60 S. 2011

- Implementation of Essential Health Care Program (EHCP) for the School Children (a record of
deworming activities per class should be kept by the Classroom Adviser for easy monitoring)

WHO’S STRATEGY - PREVENTIVE CHEMOTHERAPHY IN HUMAN HELMINTHIASIS

The strategy for control of soil-transmitted helminth infections is to prevent and control morbidity
through the periodic treatment of at-risk population living in endemic areas. People at risk are:
end:
• preschool-aged children;
• school-aged children;
• women of childbearing age (including pregnant women in the second and third
trimesters and breastfeeding women)

WHO recommends periodic treatment with anthelminthic (deworming) medicines, without previous
individual diagnosis to all at-risk people living in endemic areas. Treatment should be given once a
year when the prevalence of soil-transmitted helminth infections in the community is over 20%, and
twice a year when the prevalence of soil-transmitted helminth infections in the community exceeds
50%. This intervention reduces morbidity by reducing the worm burden. In addition:
• education on health and hygiene reduces transmission and reinfection by encouraging healthy
behaviours;
• provision of adequate sanitation is also important but not always possible in resource-
constrained settings.

Periodic deworming can be easily integrated with child health days or vitamin A
supplementation programmes for preschool-aged children, or integrated with school-based health
programmes.
Schools provide an important entry point for deworming activities, as they provide easy access
to health and hygiene education components, such as the promotion of hand washing and improved
sanitation.

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Aim
The aim of periodic administration of anthelminthics is to control morbidity from soil-transmitted
helminthiases by reducing and maintaining low the intensity of infection.

Access to anthelminthic medicines

Donations of anthelminthic medicines are available through WHO to ministries of health in all endemic
countries for the treatment of all children of school age.

Eligible population
Preschool and school-age children, women of childbearing age (including pregnant women in the 2nd
and 3rd trimesters and lactating women), and adults at high risk in certain occupations (e.g. tea-
pickers and miners).

Ineligible population
Children in the 1st year of life; pregnant women in the 1st trimester of pregnancy.

Global target
The global target is to eliminate morbidity due to from soil-transmitted helminthiases in children by
2020. This will be obtained by regularly treating at least 75% of the children in endemic areas
(estimated total number 873 million).

Ancillary benefits and advantages of preventive chemotherapy

Preventive chemotherapy targeted at lymphatic filariasis, onchocerciasis, schistosomiasis and
soil-transmitted helminthiasis not only reduces the morbidity caused by those diseases but also yields
a number of ancillary benefits and advantages.
Community compliance within other health-care programmes will be increased and school attendance
improved
Epidemiological evidence strongly suggests that
• the establishment of HIV infection and acceleration to AIDS will be reduced when
schistosomiasis and soil-transmitted helminth infections are treated
• treatment of soil-transmitted helminth infections will help to lessen the burden of malaria
• treatment of helminth infections may help to lessen the burden of tuberculosis
Sustained, large-scale preventive chemotherapy against helminthic infections is a cost-effective
intervention that contributes to the achievement of several Millennium Development Goals
including:
1.eradicating extreme poverty and hunger
2.achieving universal primary education
3.promoting gender equality

4. reducing child mortality
5.improving maternal health and

6. combating HIV/AIDS, malaria and tuberculosis

IN FOCUS: DOH PROGRAMS 21 of 21 FOOD & WATER BORNE II STH