Discussion

Schistosomiasis and soil-transmitted helminthiasis (STH) remain as major public health concerns in developing countries. In the Philippines, interventions recommended by the World Health Organization for their control have been implemented through national control programs. This study, carried out as part of the ZooTRIP project, aimed to determine the prevalence and intensity of schistosomiasis and STH in selected communities in co-endemic provinces of Agusan del Sur and Surigao del Norte, Caraga region, the Philippines. Stool samples, collected from 663 participants ages 10 to 60 years old, were processed by Kato-Katz technique and examined microscopically for the presence of intestinal helminth ova. Results revealed high prevalence and moderate heavy intensity (HI) schistosomiasis, as well as moderate prevalence and HI STH. Remaining pockets of moderate to high prevalence and intensity of schistosomiasis and STH were still observed after more than a decade of program implementation. The results indicate considerable morbidity despite high reported mass drug administration coverage, suggesting the need to revisit the reported coverage rates as well as to identify and address the factors underlying possible low coverage. Challenges in safe water, sanitation, and hygiene (WASH), such as continuing open defecation and lack of access to WASH facilities, promote considerable continuing transmission in the area. Lack of available sensitive laboratory diagnostic techniques and a robust surveillance scheme are likely to have contributed to underdiagnosis, lack of access to treatment, and continuing transmission amidst co-existing challenges in WASH. For schistosomiasis, complementary measures such as promotion of veterinary public health and vector ecology management, will help accelerate its control and elimination.