Feature: Moving in for filariasis elimination in Aklan
by Venus G. Villanueva
Kalibo, Aklan (18 June) -- Health workers call it the disease of the poor. It is also the 2nd leading cause of permanent long term disability, with 83 of the world's poorest countries affected. 1.1 billion people are at risk.
Having it causes psychological, social and economic problem in the afflicted individuals, families and communities. This is the Lymphatic Filariasis (LF) disease, and according to local health officials, the province of Aklan has been found in 2009 to be moderately endemic for LF with a Microfilaria Rate (MF) of 6.2%.
Lymphatic Filariasis is a parasitic disease caused by microscopic, thread-like worms that live in the human lymph system.
These parasites live for 5-15 years in the body of an infected person. When the parasites die, they block the bloodstream, causing swelling in arms, legs (elephantiasis), scrotum in the males and breasts in women (hydrocoele).
The disease is not usually life threatening, according to health officials, but it can permanently damage the lymph system and kidneys. Because the lymph system does not work right, fluid collects and causes swelling in the arms, breasts and legs.
LF is transmitted through bites of infected female mosquito. Aedes Poecilus is the primary vector which lives in the leaf axils of abaca, banana, pandanus, pakil, gabi and other axilled plants. Its peak biting time is between 10 p.m. and 12 midnight.
Health officials here said that World Health Organization guidelines state that Microfilaria rate of 1% and above makes Aklan a candidate for Mass Drug Administration (MDA).
In Aklan, municipalities found to have endemic cases of filariasis are Libacao and Madalag. These are abaca-producing towns.
According to Provincial; Health Officer II Dr. Emma T. Cortes, tests conducted to 500 Libacao residents particularly in abaca-producing barangays through nocturnal blood screening yieldled 46 persons positive for filariasis. Madalag, on the other hand, had 15 residents positive for filariasis out of the 500 tested.
Some residents tested in Valderrama, Antique in November 2009 were also found positive for filariasis.
In Western Visayas, Iloilo was found to be moderately endemic in 2007 with a 5.18% MF (26/501) and 13.7% Antigen Rate (66/501 while in 2008, Capiz was found to have low endemicity with an MF Rate of 2.4% (33/532) and Antoigen Rate of 19.1% (35/183).
Presently, the Department of Health (DOH) and the Provincial Government of Aklan through the Provincial Health Office (PHO) are moving in for the total elimination of filariasis.
Just this week, the DOH and the PHO conducted a series of Orientations and Seminars to Aklan's health, education, and other sectors to inform them about this government move, as well as to plan for strategies in the conduct of the Mass Drug Administration here.
Ana Luz I. Hibionada of DOH-CHD-WV said that even as tests showed that some Libacao and Madalag residents, mostly abaca strippers carry the infection, it is a must that the whole population of Aklan will undergo mass treatment for the disease.
The only component of the population exempted from the treatment, according to her, are the pregnant women whose treatment are deferred until delivery; individuals with cardiac and kidney diseases, while individuals with asthma, seizure disorders and severe malnutirition should be given with caution.
Children below two years old are also exempted from the treatment.
For mass treatment, people will be given two kinds of drugs, the DEC and Albendazole once a year for five years.
Hibionada said children with ages from 2-5 will be given 1 each of DEC 50 mg tablet and 400mg. tablet of albendazole, while those from ages 6-12 will given 2 DEC and 1 Allbendazole; 13-20 - 4 DEC and 1 Albendazole and 21 and above - 5 DEC and 1 Albendazole.
The mass treatment of filariasis is supported by the government through Executive Order No. 369 issued by President Gloria Macapagal Arroyo on October 5, 2004 establishing the National Program for Eliminating Lymphatic Filariasis and declaring the month of November of every year as Mass Treatment for Filariasis in established endemic areas.
According to her EO, the main strategy to eliminate filariasis is through Mass Treatment using a combination of Dietheylcarbamazine Citrate (DEC) and Albendazole annually for five years which has been pilot-tested in 2000 and formally started in 2001 in selected municipalities and provinces.
The EO also stated that to facilitate program management, social mobilization, drug reapplication, distribution, and to epidemiologically control the disease, the global experts in consultation with regional coordinators, LGUs and other stakeholders recommended that a month each year will be concentrated for Mass Treatment for filariasis.
Government agencies cited in the EO with respective roles include the DOH as the lead agency in the implementation of mass treatment; the DILG, DepEd, DSWD, DND, DENR and the PIA, while the LGUs shall lead the local implementation of the mass treatment campaign. The LGUs are expected to exert special effort to encourage every family member aged 2 years and above to take the filariasis mass treatment drugs to ensure the success of the campaign.
Drugs to be used in the mass treatment are free, the DOH and the PHO stressed.
Aklan is aiming to hold the mass treatment in time with the observation of Garantisadong Pambata in October of this year.
This early, local health officials, led by Dr. Cortes are airing their appeal to all Aklanons to join the Mass Drug Administration.
Hibionada said the DOH is targeting to reach 95% of the population for the MDA, and appealed to partners in government service, health workers, local officials and other sectors to help in the advocacy of the program.
"The PHO and the DOH cannot do it alone to bring down or eliminate filariasis. We appeal for your support," was Dr. Cortes' appeal to participants of the various orientation and seminars conducted on MDA.
Although many provinces in the Philippines are affected by filariasis, DOH officials said some countries have already eliminated the disease through MDA like China, Japan, Egypt, Suriname, Trinidad and Tobago and Costa Rica. (PIA) [top]