Community help key to containing schisto in Bukidnon

MALAYBALAY CITY (MindaNews/24 May) – The Department of Health can control schistosomiasis in Bukidnon with the help of the community using a mix of ways with emphasis on mass treatment, Dr. Ricardo Reyes, DOH provincial health team leader said.

He said there is a need to focus on mass treatment as an intervention to address schistosomiasis in the province where it is considered endemic or prevalent in 53 of its 464 barangays.

Reyes was reacting to a provincial board resolution requesting the World Health Organization (WHO) to intervene and provide financial assistance for the rehabilitation of the Matin-ao Spring Resort in Bangcud, Malaybalay City to “contain and eliminate schistosomiasis.”

The resolution sponsored by lawyer Nemesio Beltran Jr. asks the WHO to declare the spring as a pilot area where they can pour in scientific, medical, and financial resources to prevent schistosomiasis.

“The problem is too complicated that we have to ask them to intervene. The provincial government does not have the money and technical expertise to solve the schistosomiasis problem,” he told MindaNews last week.

But Reyes said schistosomiasis in Bukidnon has dropped to 3.5 percent prevalence rate in 2010 compared to the 4.72-percent rate in 2009. This is far from the 15.81 percent in 1981, the year when the highest number of infections in the province was recorded.

In 2010, DOH reported a total of 495 schistosomiasis cases out of 13, 877 stool samples they tested in seven towns and in the cities of Valencia and Malaybalay. Valencia had the most number of cases at 104, followed by San Fernando (98), Malaybalay City (61), and Quezon town (28).

Most of the 53 barangays where the disease was reported to be endemic belong to the two cities. Of this number, five were considered to be “highly endemic” areas (10 percent and above prevalence rate), and 18 were “moderately endemic” (5- to 9.99-percent rate). The remaining 30 barangays had less than 5-percent prevalence rates and were considered “low endemic”.

But the barangay with the highest number of positive cases last year was San Jose in San Fernando town where 54 of the 340 stool samples examined tested positive.

Matin-ao resort, a favorite destination of both foreign and local tourists, has reportedly been contaminated with schistosomiasis in the last 10 years.

The provincial government has prohibited bathing in the resort inside its seven-hectare property, but visitors would manage to sneak inside the resort to enjoy its cool spring waters.

Beltran added he will file another resolution to include in the piloting the Atugan Resort pool in Impasugong.  “It is also contaminated,” he said, a statement refuted by the DOH schistosomiasis control team.

The DOH said the municipal government of Impasugong has assumed responsibility after a DOH inspection team found snails in the area but declared it negative of schistosomiasis at the moment.

Both resorts have remained open to the public.

Dr. Vincent Raguro, DOH Bukidnon schistosomiasis control team leader, said the DOH has marked the Matin-ao spring site as infected since 2005 and warned the public against bathing in the resort. But he said that vendors allegedly removed the concrete signage which bore the warning.

He said only two of the 11 springs in the area have remained infected with schistosomiasis, although all of these still host the snails that carry the disease.

As early 2005, he said, they have pushed for the closure of the spring resort to the public because of the infection. But he said barangay officials opposed the move and invoked a resolution declaring the resort a tourist destination. MindaNews is yet to reach the barangay officials for comments.

Dr. Jose Tiongco, chief executive officer of the Medical Mission Group Hospitals and Health Services Cooperative-Philippines Federation, told MindaNews a major aspect to consider is open defecation in infected areas.

He said other areas have considered building public toilets. But in most cases the public has to pay to use them. He said in some areas it is the government that pays the users because human waste is being used to produce biomass energy.

According to the WHO, schistosomiasis, or bilharzia, is a parasitic disease caused by trematode flatworms of the genus Schistosoma.  Larval forms of the parasites, which are released by freshwater snails, penetrate the skin of people in the water.

“In the body, the larvae develop into adult schistosomes, which live in the blood vessels. The females release eggs, some of which are passed out of the body in the urine or faeces. Others are trapped in body tissues, causing an immune reaction,” the United Nations’ health body said.

“In urinary schistosomiasis, there is progressive damage to the bladder, ureters and kidneys. In intestinal schistosomiasis, there is progressive enlargement of the liver and spleen, intestinal damage, and hypertension of the abdominal blood vessels,” the WHO website said.

Control of schistosomiasis is based on “drug treatment, snail control, improved sanitation and health education.” (Walter I. Balane/MindaNews)