Introduction and Situationer Parasitism is one of the frequently ignored infection in the Philippines and even misconceived as a part of a child’s normal development. Soil Transmitted Helminthiasis, although prevalent among under 14 years old, have the greatest impact among those 2-5 years old as this may cause malnutrition, anemia, stunted growth in height and size, decreased physical activity, impaired mental development and school performance. Based on national surveys, the prevalence of STH in the Philippines has persisted at high levels above 50%. Mass deworming of children aged 2-14 years old at least 2x/year for 3 consecutive years is required to immediately halt the impact of the disease on children and the community. In Dagupan City, the latest prevalence survey conducted in 2004 by UNICEF/DOH showed 78% prevalence of parasitism in 2 barangays ( 1 island, 1 river barangay). OBJECTIVE: To reduce the incidence of Soil Transmitted Helminthiasis (Intestinal Parasitism) by 50% at the end of 2010. METHODOLOGY

REDUCING THE INCIDENCE OF SOIL TRANSMITTED HELMINTHIASIS (excluding 8,300 secondary school elementary school children THROUGH SUSTAINABLE SANITATION children) Leonard L. Carbonell M.D., Dagupan City Health Office
Comparative Stool Exam Results of 5 schools November 2008


Improved STH disease surveillance implemented since 2008 o Improvements in school and public water points (50% of school water supply systems improved) LESSONS LEARNED 1. Baseline data defines planned and integrated activities and interventions to address Parasitism 2. Participatory consultation and community engagement are essential to the programs success and sustainability 3. Low cost sanitation technologies should be better emphasized and explored

Severity of Infestation Per Type of Parasite


Baseline Information, including results of stool surveys (Kato Katz) of Grade IV student in 3 public schools, 2 private schools and control group household survey, sanitation mapping, focus group discussions and key informant interviews 2. Data Analysis 3. Pre-testing of IEC materials from upstream and downstream stakeholders in the formulation of a communication plan

KEY SANITATION PROBLEMS/ISSUES o Problem of Open Defacation o Lack of sanitary toilets/facilities o Lack of Septage Management Policy o Lack of awareness and low priority among community residents on the importance of sanitation. Specific Interventions: o Development of comprehensive action and communication plans (Local Sustainable Sanitation Plan, Sanitation Communication Plan and Open Defecation Prevention Plan) o Completion of seven (7) “instant” community toilets in priority barangays (using a rapid, low-cost local design) o Two (2) deworming campaigns covered all enrolled

Focus hygiene promotion on behavior change. 5. Strong political commitment and recognition and awareness of policy makers of this previously hidden incidences of disease


OUTCOME The results showed a prevalence rate of 48. 85%, showing that one half of the study population are exposed to at least one of the STH. It ranged from 10.6% in Creative Montessori and 100% in Pugaro. WHO considers a prevalence rate of 50% and above as high, the overall prevalence rate is a little below 50%, the figure obtained in this study of subjects are “with moderate to heavy intensities of infection.”


The special studies conducted (STH stool sample tests) helped to clarify the priorities in Dagupan City, and have convinced the city officials that the bulk of the immediate sanitation problems are in concentrated pockets that can be tackled with targeted interventions.

Create Barangay Sanitation Brigades and School Sanitation Brigades with specific duties and tasks with multi-sectoral composition 2. Institutionalize a septage management program to address sanitation related diseases like Parasitism and diarrhea 3. Implement Community Led Total Sanitation (CLTS) strategy to achieve open defecation free status


With limited financing, there is a need to source funds from national, international and private sectors.