chronic tropical disease Bloodfluke called Schistosoma Japonicum

Transmitted through the intermediary host of a tiny snail known as Oncomelania Quadrazi.asi.

SCHISTOSOMIASIS:SCHISTOSOMIASIS:

- - is one of the most widespread parasitic infection afflicting mankind for a long time (118 years in the Philippines)

- second to malaria in Prevalence

- rank first in prevalence among water-borne diseases

Mode of infection:SKIN PENETRATIONOF CERCARIAE

Intermediate host:Oncomelania snails

Schistosoma eggspass out with feces and hatch in fresh Water into miracidia.

Adult wormslive in portal andmesenteric veins

Life Cycle of Schistosomiasis

An area is endemic:

1.Presence of Positive cases

2.Presence of Infected Snails ( Oncomelania quadrasi )

WASHING OF CLOTHES

LAUNDERING IN SCHISTO ENDEMIC AREAS

DEFECATING ON SCHISTO INFESTED AREA.

Transmission

Adult Worm of Schistosoma Japonicum in the Portal Vein

AVERAGE LIFE SPAN IS 3-5 YEARS BUT CAN SURVIVE UP TO 30 YEARS OR MORE

LIVE IN THE BLOOD VESSEL CONNECTING THE LIVER WITH THE INTESTINE.

SCHISTOSOMA EGG PRODUCED/ EGGLAYING

500 – 2000 EGGS / DAY /FEMALE

WORM

MIRACIDIUMLife span is 48 hrsInfective up to 24 Hrs.

CERCARIAECERCARIAEWill survive for a maximum of 3 days, & Will survive for a maximum of 3 days, & infective for 36 hrs.infective for 36 hrs.

Symptomatology :Symptomatology : Study showed that :Study showed that : 37.8 % = 37.8 % = symptomaticsymptomatic 62.2 % = 62.2 % = asymptomaticasymptomatic

Symptoms Early Stage: epigastric or abdominal pain bloody-mucoid stool dysenteric attacks fever Advance Stage: enlargement of the abdomen enlargement of the liver and

spleen epileptic seizures of the

Jacsonian type Cor-pulmonale

Soil-transmitted Helminth Infections(ascariasis, trichuriasis, hookworm infection)Caused by:

ingestion of eggs from contaminated soil (Ascaris and Trichuris) or

skin penetration by larvae from the soil (hookworms)

Poor environmental sanitation (open defecation) and poor personal hygiene (dirty hands) are major factors for exposure

People dirtying the environmentinfect other people…Open defecation!

EFFECTS OF STHEFFECTS OF STH

-Human ‘pinworm”

•Frequently asymptomatic•Perianal pruritis•Anorexia•Irritability•Abdominal pain

Mebendazole,Abendazole

•Frequently asymptomatic•Abdominal pain•Diarrhea•Pulmonary symptoms

•DFS –follow-up stool exams 2-4 weeks after treatment to confirm clearance of infection.•FECT

Identification of larvae (rhabditiform form) through:

•Ivermectin•Albendazole

CASE FINDING

Case Finding:

1.1 clinical diagnosis * history of exposure * symptoms 1.2 Laboratory diagnosis * stool examination ( K/K method)

* blood exam (COPT )

Use of sanitary toilets and safe water supply reduction in the transmission of schisto by 75 % can be achieved.

Use of Sanitary Facilities

2. ENVIRONMENTAL SANITATION

Use of Foot bridges

Control of Stray Animals

25 % reduction of transmission can be achieved

environmental sanitation environmental sanitation through the use of latrines can through the use of latrines can prevent contamination of the prevent contamination of the environment with eggs of STH, environment with eggs of STH, schistosomes and food-borne schistosomes and food-borne helminthes thus arresting the life helminthes thus arresting the life cycle.cycle.

Health Education Objective: - change undesirable knowledge, attitudes & practices for the improvement of their personal & community health. Health education is needed Health education is needed to convince people to use to convince people to use toilets and to participate in toilets and to participate in other control and prevention other control and prevention activities of the Government activities of the Government

The impact: is measured in terms of health enhancing behaviors; the outcome is reduction in morbidity & mortality

Preventive chemotherapy can prevent Preventive chemotherapy can prevent development of serious morbidity as well development of serious morbidity as well as transmission. 85% coverage should be as transmission. 85% coverage should be achieved in this intervention. achieved in this intervention.

2. Water , Sanitation And Hygiene ( WASH)

Water , Sanitation And Hygiene ( WASH)

> serves as the cornerstone in the reduction of diseases specially those related to intestinal parasitism.> is formulated in line with the UNICEF’s water, sanitation, and hygiene strategies for 2006 – 2015.

Control of Schistosomiasis

Mode of infection:SKIN PENETRATION

OF CERCARIAEPERSONAL

PROTECTION Intermediate host:Oncomelania snails

SNAIL CONTROL

Adult worms live in portal andmesenteric veinsCHEMOTHERAPY

Schistosoma eggspass out with fecesand hatch in fresh Water

ENVIRONMENTALSANITATION

x

xx

x

SUBMIT FOR EXAMINATION & TREATMENT

PARTICIPATE IN SNAIL CONTROL MEASURES

USE OF SANITARY FACILITIES

USE OF FOOTBRIDGES, CONTROL OF STRAY ANIMALS

DESIRED BEHAVIOUR CHANGE

Schistosomiasis is still a public health problem. Helminthiasis affect people of all ages and cause profound effects esp. on childrenKato-Katz is use to diagnose Schistosomiasis and STH An integrated control program can be used for Schisto and STHThe DISEASE is influenced by the 3P’s people,parasite,poverty

Summary:

Disposal of excreta containing Schistosome eggs into fresh water

SCHISTOSOMIASIS IS SPREAD BY PEOPLE AND NOT BY SNAILS

HUMAN PARASITES ARE A REASONABLE INDICATION OF LACK OF PERSONAL CLEANLINESS AND HYGIENE

THANK YOU..

SONIA G. MARGALLO, RMTSchisto/STH/ FWBDAssistant Program Manager