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Filariasis

Ruzgal, Celeste Irah


Saluta, Maria Divina

The World Health Organization clearly states


that lymphatic filariasis is infection with the
filarial worms, Wuchereria bancrofti, Brugia
malayi or B. timori.
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These parasites are transmitted to humans through


the bite of an infected mosquito and develop into
adult worms in the lymphatic vessels, causing
severe damage and swelling (lymphoedema)
Elephantiasis painful, disfiguring swelling of the
legs and genital organs is a classic sign of latestage disease.

The infection can be treated with drugs.


However, chronic conditions may not be
curable by anti-filarial drugs and require
other measures, eg. surgery for hydrocele,
care of the skin and exercise to increase
lymphatic drainage in lymphoedema.

Filariasis continues to be a public health problem in the


Philippines.
It was first discovered in the Philippines in 1907 by
foreign workers.
Consolidated field reports showed a prevalence rate of
9.7% per 1000 population in 1998.
It is the second leading cause of permanent and longterm disability.
The disease affects mostly the poorest municipalities in
the country about 71% of the case live in the 4th-6th
class type of municipalities.

The World Health Assembly in 1997 declared Filariasis Elimination as


a priority and followed by WHOs call for global elimination. A sign of
the DOHs commitment to eliminate the disease, the programs official
shift from control to elimination strategies was evident in an
Administrative Order #25-A,s 1998 disseminated to endemic regions. A
major strategy of the Elimination Plan was the Mass Annual Treatment
using the combination drug, Diethylcarbamazine Citrate and
Albendazole for a minimum of 2 years & above living in established
endemic areas after the issuance from WHO of the safety data on the
use of the drugs. The Philippine Plan was approved by WHO which
gave the government free supply of the Albendazole (donated b y GSK
thru WHO) for filariasis elimination. In support to the program, an
Administrative Order declaring November as Filariasis Mass
Treatment Month was signed by the Secretary of Health last July 2004
and was disseminated to all endemic regions.

The goal is to eliminate Lymphatic Filariasis as a public health problem in the


Philippines by year 2017 and the general objective is to decrease Prevalence
Rate of filariasis in endemic municipalities to <1/1000 population.

This is endemic in 44 provinces however, 7 provinces have


reached elimination level namely: Southern Leyte, Sorsogon, Biliran,
Bukidnon, Romblon, Agusan del Sur & Dinagat Island.
The National Filariasis Elimination Program specifically aims to:
1. Reduce the Prevalence Rate to elimination level of <1%;
2. Perform Mass treatment in all established endemic areas;
3. Develop a Filariasis disability prevention program in established
endemic areas; and
4. Continue surveillance of established endemic areas 5 years after
mass treatment.

INTERVENTION OF DOH
Vision: Healthy and productive individuals and
families for Filariasis-free Philippines
Mission: Elimination of Filariasis as a public
health problem thru a comprehensive approach
and universal access to quality health services.

MANAGEMENT BEING USED


1. Selective Treatment- treating individuals found to be positive for
microfilariae in nocturnal blood examination
Drug: Diethylcarbamazine Citrate
Dosage: 6mg/kg body weight in 3 divided doses for 12 consecutive days
(usually given after meals)

2. Mass Treatment- giving the drugs to all population from aged 12


years and above in all established endemic areas

Drug: Diethylcarbamazine Citrate (single dose based on 6mg/kg body


weight plus Albendazole 400 mg given single dose once
annually to
people 12 years and above living in established endemic areas.

3. Disablility Prevention- thru home-based or community-based care


for lymphedema & elephanthiasis cases. Surgical management for
hydrocele patients.

FUTURE PLANS
1. Assist low performing areas to increase the MDA
coverage in order to interrupt the transmission of the LF.
2. Assist implementing Units to reach the goal of
elimination.
3. Strengthen integration with other NTD programs.
4. Strengthen the disability prevention strategy thru
community-based or home based care & thru
integration with leprosy.
5. Implement an integrated vector management
6. Implement a sustainability plan for provinces that have
reached elimination level.

SOURCES
http://www.who.int/schistosomiasis/en/
http://www.doh.gov.ph/content/schistosomiasis-controlprogram.html
http://www.who.int/topics/filariasis/en/
http://www.doh.gov.ph/content/filariasis-controlprogram.html
http://www.doh.gov.ph/content/national-filariasiselimination-program.html