Evarle, Maria Jeaness B. Mr.

Monchito Avila

A59 – Science, Technology and Society December 3, 2021

MODULE EXAMINATION 1

Vector-borne infections are a significant strain in our society. According to Elizabeth

Zeibig (2013), malaria refers to pathological conditions caused by parasitic infestation of the
phylum Apicomplexa. Plasmodium is the genus to which they fall. Plasmodium spp. was probably
introduced to England. Intriguingly, most of those from West Africa who have been introduced to
America during the time of slavery effectively did not contract malaria. It was later discovered that
they had been genotypically resistant from some species of Plasmodium spp. Even during
Revolutionary War, malaria is deemed widespread in most of the territories, particularly in areas
with major water supplies where mosquitos flourished and troops frequently tented. Moving on to
the Philippine context, malaria has been recorded in the Philippines as more than just a public
security crisis from 1521. The structuring of the malaria elimination program, as well as the start
of data gathering, started in 1902. Throughout 1956 to 1960, the National Malaria Control Program
(NMCP) collaborated with that of the WHO-led Global Malaria Eradication Programme (GMEP),
with funding from the US government (Global Malaria Programme-WHO, 2020). Currently, the
Department of Health (DOH) and its collaborators have appealed for continued assistance for the
National Malaria Control and Elimination Program (NMCEP), that aims to make the Philippines
malaria-free by 2030. With malaria still remaining prevalent in several regions of the country, the
DOH must maintain effective vector control, deploy skilled microscopists along with laboratory
technology to these regions, and ensure sufficient awareness and education amongst indigenous
groups most impacted by the endemic.

According to Berg et al. (2012), vector reduction does have the capacity to play a key role
in lowering disease propagation and achieving critical low amounts of vectorial capability needed
for infection eradication. According to the Epidemiology Bureau Public Health Surveillance
Division of the Department of Health (2016), the largest (79%) of parasites discovered were P.
Falciparum, then P. Vivax (12%), with a modest number of mixed parasites (4%) and P. malariae
accounted for 2% of the total, with the remaining 2% remaining unidentified. Parasite prevalence
differed between Palawan and non-Palawan regions. P. falciparum accounted for a significant
fraction (83.7%) of parasites found in Palawan whereas P. palciparum is (28.8%). The majority of
parasites in non-Palawan regions are P. vivax (23.4%). Vector control should therefore be focused
within those regions.

Image from 2015 & 2016 Cases-Philippine Integrated Disease Surveillance and Response & Phil.
Malaria Information System Database

Vector control measures must be customized to the habitat, behavior, and pesticide resistance of
vector species in order to be efficient, while human protective solutions must be suited to people's
patterns and lifestyle. Vector control must be focused wherever and whenever individuals are the
most vulnerable. A fully planned and customed vector eradication strategies can guarantee the
effective use of funds and greatly contribute to the solution of the disease spread. In most endemic
locations of malaria, WHO presently advises using either insecticide-treated netting (ITNs) and
indoor residual sprays (IRS) to reduce malaria vectors.

Furthermore, as per the DOH's Epidemiology Bureau Public Health Surveillance Division
(2016), the fact that the majority (53.8%) of malaria diagnostic tests were conducted using Rapid
Diagnostic Test (RDT), with a lower number (39.8%) using microscopic examination.
 Image from 2015 & 2016 Cases-Philippine Integrated Disease Surveillance and Response & Phil.
Malaria Information System Database

Even though microscopy is still the gold standard for the diagnosis of malaria, the use of RDT as
an initial evaluation was advantageous, particularly in provinces where qualified microscopists
were no longer existent. Without a microscope, there seems to be little to accomplish in a
microbiology laboratory since the subjects of our interest are too minuscule to view. Microscopes
are optical equipment that allow us to see the microorganisms. Microscopy is a well-established,
very easy method that most lab technicians are knowledgeable with. A thin and thick malaria
screening can be performed in any facility that can perform regular hematological testing. The
microscopy examination can reveal useful information within a few hours of obtaining the blood.
Furthermore, according to the study conducted by Takahashi et al. (2016), the availability of an
adequate number of microscopists obviously improved the viability of early identification and
treatment all across the region of Palawan.

Lastly, according to the DOH's Epidemiology Bureau Public Health Surveillance Division
(2016), the great majority (86%) of malaria deaths occurred among Palawan's indigenous
populations in the districts of Bataraza, Brooke's Point, Quezon, and Marcos. Large percentage
(67%) of the confirmed incidents have been indigenous people (IP).

Image from 2015 & 2016 Cases-Philippine Integrated Disease Surveillance and Response & Phil.
Malaria Information System Database

According to the research, the highest incidence (76%) and deaths from malaria (86%) were among
indigenous population, indicating that the confirmed susceptibility of these populations warrants
specialized action within them. Because of the isolation of their settlements, a language obstacle,
the poor education, consistently low physical and nutritional status, and, more crucially, cultural
separation from existing public service delivery, those native population were prone to malaria
infections. These persons should be prioritized by the authorities.

The Department of Health and the State must establish a vector control reinforcement
strategy, strongly prioritized additional strategies for indigenous groups, including issuing a fund
for the salaries of microbiologist. The Republic Act 7305: Magna Carta of Public Health Workers
must apply to microscopists. This encompasses their security, compensation, and work
assignments. Using this technique, a suitable number of microscopists can be distributed all
throughout the Philippines' regions. On the other hand, comprehensive and dependable malaria
vector control continues to be a significant challenge. Lately, it was discovered that the very first
vaccination for Plasmodium falciparum malaria, RTSS/AS01, provided only temporary immunity,
especially in newborns, and also that accelerated resistance to artemisinin-based medicines has
already been emerging. As a result, focus is being placed on the eradication of malaria mosquito
vectors through integrated vector management (IVM) tactics. A broad range of novel mosquito
operational tools have already been evaluated thus should be applied, including appealing
corrosive sugar lures, eave ducts, nano-synthesized pesticide residues packed with microbial- and
plant-borne substances, biocontrol agents with minimal non-target side effects, novel adult
biocontrol agents, oviposition repellents, and perhaps even acoustic larvicides. Finally, the
Department of Education, in collaboration with the Department of Health, should prioritize the
issue of extending out to indigenous tribes. As according to Takahashi et al. (2016), understanding
of malaria manifestations increased indigenous individual's awareness of their ailments and
advanced illnesses. Reinforcing this responsiveness to one’s body as well as actually making
citizens informed of neighboring medical technologists can be the answer and key factors to
advancing public access to quality malaria treatment in the province. Microscopists have been
specializing in malaria detection since 1999, and the practicality of early identification and
treatment has been improved throughout the region. Good healthcare seeking attitude must be
promoted when malaria infection is anticipated in order to speed accessibility of infected
individuals to testing and treatment in Palawan and other areas of malaria endemics.
References

Department of Health. (2016). Malaria Cases. Epidemiology Bureau Public Health Surveillance
Division. -Philippine Integrated Disease Surveillance and Response & Phil. Malaria
Information System Database

Newby, G. et al. (2013). Determinants of Malaria Program Expenditures during Elimination:

Case Study Evidence from Select Provinces in the Philippines.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0073352

Russell, P. (1936). Epidemiology of Malaria in the Philippines.

https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.26.1.1

Takahashi, Emilie., Kano Shigeyuki. (2016). Evaluating active roles of community health workers
in accelerating universal access to health services for malaria in Palawan, the Philippines.
https://tropmedhealth.biomedcentral.com/articles/10.1186/s41182-016-0008-7

Takahashi, E. et al. (2015). Patient Knowledge on Malaria Symptoms Is a Key to Promoting

Universal Access of Patients to Effective Malaria Treatment in Palawan, the Philippines.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127858

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Zeibig, E. (2013). Clinical Parasitology: A Practical Approach. 2nd edition. Chapter 6, page 132