STRATEGIES/PROGRAMS TO PROMOTE HEALTH OF THE VULENRABLE SECTORS OF THE POPULATION

1. SCHISTOSONUASIAS CONTROL PROGRAM
• POLICIES FOR SCHISTOSOMIASIS CONTROL
• PROGRAM (SCP): CHES
• C ase Finding
• H ealth Education
• E nvironmental Sanitation
• S nail Eradication
• CASE FINDING:
• Disease: Schistosomiasis
• Another name: Bilhariasis or Snail Fever
• Causative agent: Schistosoma-a blood fluke (parasite)
• 3 Types of Species:
• Schistosoma japonicum-endemic in the Philippines & affecting Indonesia, China, Japan, Korea Vector: Oncomelania quadrasi
• Schistosoma mansoni
• Schistosoma haematobium
• Laboratory Procedures to rule out Schistosomiasis:
• Blood Examination: ↑ eosinophil level indicates parasitism
• Fecalysis: Kato Katz (plain stool exam that uses a special apparatus resembling a feeding bottle sterilizer)
• Procedure:
• Collect specimen
• Have the test tube undergo centrifugation for 20 minutes
• Get specimen from precipitate & swab it on glass slide
• Observe it on microscope
• Signs & Symptoms
• CNS: High grade fever→ cerebral convulsion
• GIT: Nausea & vomiting, Diarrhea→ Chronic dysentery(prolonged diarrhea of more than 2 weeks & consistency is mucoid & bloody (with streaks of blood)
• Liver: Presence of infection manifested by jaundice & hepatomegaly
• Spleen: Infection of spleen→ inflammation→ enlargement of organ (Splenomegaly)→ abdominal distension→ abdominal pain on the right upper quadrant
• Blood: Anemia & weakness
• Treatment: Drug of Choice-Praziquantel (Biltricide) 60 mg/KBW/day
• Example: If patient is 50 kg, 50 kg x 60 mg/KBW/day=3000 mg/day
• Initial treatment: 1st 2 weeks=3000 mg/day, then do stool exam after 2 weeks→ if still (+), extend treatment for another 2 weeks. Repeat stool exam, if still (+) after the extended week, continue treatment for 2 weeks again. No adverse effect or over dosage even if extended for a year.
• Length of Treatment takes months to a year
• Health Education: It affects mostly farmers so educate them to wear rubber boots
• Environmental Sanitation:
• Snail is the 1st concern
• Water where snail thrives is the 2nd concern
• Toilet=3rd concern
• Food
• Garbage
• Snail Eradication: Use molluscicides treat the entire suspected soil with chemical solution that kills snails.
2. MALARIA CONTROL PROGRAM
• CASE FINDING:
• Disease: Malaria
• Another name: Ague
• Causative agent: Plasmodium-a protozoa
• 4 Types of Species:
• Plasmodium falciparum-more fatal that affects the Philippine Vector: Female Anopheles Mosquito (FAM)
• Plasmodium vivax
• Plasmodium ovale
• Plasmodium malariaeSchistosoma mansoni
• Laboratory Procedures
• Malarial smear-extract blood at the height of fever because plasmodium is very active & ruptures at this period.
• Signs & Symptoms
• 1st Stage=Cold: Chilling sensation for 1-2 hours
• 2nd Stage=Hot: High grade fever lasting for 3-4 hours
• 3rd Stage=Wet: Diaphoresis (excessive sweating/perspiration)
• Treatment: Drug of Choice-Quinine
• 2 Forms:
1. Chloroquine (Aralen)
2. Primaquine
• If Quinine is not available, may use Sulfadoxime-an antibacterial drug paired with pyrinthamine

PERSONAL PROTECTION:

• Sleep under a mosquito net
• Sleep in a screened room
• sleep with long sleeve attire
• Use repellents that contains DET (diethyl toluamide or toluene which has a pungent odor that drives away mosquitoes & an irritant to mucous membrane of respiratory tract when inhaled
• Plant a Neem Tree using the leaves

CLEAN:

• Chemical Method=insecticide spraying at night
• Larvae eating fish=Tilapia
• Environmental Sanitation & Health Education=insect, water, trash
• Anti-mosquito soap=basil citronelli
• Neem tree=banana, banaba, gabi, eucalyptus provide repellent effect