A Reading on

SCHISTOSOMIASIS

A Journal Reading Presented to the Faculty of San Pedro College

In Partial Fulfillment of the Requirements in NCM 207 - RLE

COMMUNITY HEALTH ROTATION

Submitted to:

Ma’am Florence Puno, RN, MN

Clinical Instructor

Submitted by:

Immanuel John G. Jurilla, St. N

BSN 2L – GROUP 1

November 18, 2022

Title: Schistosomiasis in the Philippines: Innovative Control Approach is Needed
if Elimination is the Goal

Bibliography:
Olveda, R. M., & Gray, D. J. (2019). Schistosomiasis in the Philippines:
Innovative Control Approach is Needed if Elimination is the Goal. Tropical
Medicine and Infectious Disease, 4(2), 66.
https://doi.org/10.3390/tropicalmed4020066

‌Summary:
In the Philippines, schistosomiasis remains present and active in endemic
areas with approximately 12 million people residing in 28 endemic provinces
located across 12 different geographical zones at risk for infection. In Japan
however, eradication of schistosomiasis was achieved way back in 1996 led by
comprehensive multidisciplinary campaigns. The integrated measures however,
cannot be duplicated in the Philippines due to lack of resources and complicated
topography, that is why an innovative approach is needed if elimination is the
goal.

Long-term infection with schistosoma japonicum can lead to two types of

morbidities, clear end-organ complications and subtle manifestations. Clear end-
organ complications are granuloma or fibrosis in internal tissues caused by the
parasite eggs. Subtle manifestations are due to inflammatory cytokines induced
by eggs or worm products of the parasite. In pregnant women, infection has led
to negative pregnancy outcomes namely, decreased birth weight, small for
gestational age, and prematurity.

Praziquantel (PZQ), a highly effective anti-schistosome drug was

introduced in the Philippines during the 1980s and was administered to
communities at a large scale to eliminate parasite-associated morbidity which
became the backbone of schistosomiasis control. Other measures were health
education, behavioral modification, better sanitation, and snail control were
continued but limited to a smaller scale. After decades of implementation,
problems started to arise and schistosomiasis is still present in hard to reach
areas. That is why an innovated approach is needed, the authors suggest to treat
not only humans to having resistance to schistosomiasis, but also the bovines
which are a relevant factor in the spreading of the infection. Another suggestion
is to limit or remove the use of carabaos for farming and to replace these with
tractors, not only will this lessen the spread of the infection, but also increase the
income of the farmers.

Reaction:
Overall, I agree with the article since it was a well done research by the
authors and their suggestions were clear and backed up by studies. Although
some of their suggestions were pretty difficult to achieve but with enough
attention and help from the government or the people, it may be achievable in the
future. During my read, I have realized how poor our sanitary situation is in the
Philippines which I assume to be due to poverty or lack of resources, but this is
when compared to Japan which I also believe is way ahead of us in terms of
sanitation. There have been measures such as mass medication but that is not
enough if the people’s way of living still put them at risk for infection.

Also throughout my read, I have learned the effects of the disease in the
long-term as conveniently written by the authors in its own section to further give
knowledge to their readers since prior to this reading, I have only known the
short-term effects. The authors have also included its effects to pregnant women
which gave me insight and is relevant to our current rotation since we are
recommended to asses a family with a pregnant member. It was stated in the
article the effects of the disease to the quality of pregnancy, and the health of the
mother which is significant knowledge which we can use throughout our duty.

Which leads me to my related experience with the topic which as a person

who has been staying in the urban areas of Davao city for the majority of my life
have little to none encounters with this disease. Since the infecting factors such
as the snails and carabaos which spread the disease are not prevalent in my
area I have only read about this disease so far. So rather, I would like to share
that during my research of this topic, I have found out that there is zero
prevalence of this disease in Davao city based on a study that I have read which
further proves that this is mostly a problem in rural and out of reach areas.

The impact of this article is I would say mostly positive if the suggestions
of the authors would be implemented, otherwise the same old procedures will be
done and eradication of schistosomiasis will be far ahead of us. But the
knowledge given by the article is a positive though, especially for us nurses since
this is a relevant topic in our area of profession. So the nursing implications I can
form from this journal are the gaining of valuable knowledge to be used in the
future regarding the disease and the current situations of Filipino rural
communities also regarding this matter. With the proper information given,
nurses can provide much better care with the better understanding that they
have.