Philippines

Country operational research priorities pending.

Studies

To identify the sampling strategy for positive case follow-up after TAS 2 and TAS 3 that optimizes the chances of correctly identifying evidence of ongoing transmission, while saving program resources.

To determine if there is evidence of ongoing transmission of lymphatic filariasis in Mindoro Oriental, following a TAS 2 failure.

To determine the feasibility and best practices of using the Supervisor's Coverage Tool to monitor community and school-based distribution and integrated MDA.

The Supervisor’s Coverage Tool (SCT) is a rapid, simple, and inexpensive tool designed for use in Neglected Tropical Diseases (NTD) programs mass drug administration (MDA) to monitor drug coverage and compliance, to supervise community drug distributors (CDD), and to identify areas that may need mop-up. After successfully piloting the SCT in Ethiopia and Nigeria in 2015, additional testing of the tool was suggested to assess the feasibility of the tool in different regions and new settings. Therefore, the SCT was implemented in the Philippines in July 2016.

After the completion of training, the field work was conducted in two provinces, in six Supervision Areas (SA) consisting of one or more puroks (subdivisions) per barangay (village). Two survey populations were represented in the SCT implementation covering a community-based distribution for Lymphatic Filariasis (LF), excluding children aged 5-18 years and a school-based distribution for LF for all children aged 5-18 years. 

Findings and lessons learned:

  • The most common reasons for not swallowing drugs were fear of side effects, not feeling well, forgetting, being too busy, and the taste of the medicine.
  • When an accurate register of all the households in the SA exists, it is possible to complete the SCT in each SA in less than a day because the registers greatly aid the random selection process.
  • Implementing the SCT during the last week or two of the MDA was advantageous as it enabled the program to implement the action plan to improve the current MDA using the personnel, budget, and infrastructure that was already in place for the MDA.
  • It is important to consider whether or not Community Drug Distributors (CDD) should accompany the SCT teams during interviews, as their presence may influence the answers of the respondents.
  • It is strongly recommended that when possible, CDDs use directly observed treatment (DOT). If DOT is not possible, CDDs should remind participants that there is no advantage in delaying swallowing the drugs, and that it is actually better when everyone swallows the drugs at the same time.
  • Overall, the Philippines SCT pilot was a success, as it was the first time it was implemented in the Western Pacific region, and it was also used to monitor multiple distributions (both school- and community-based). 

Measure the solidarity and ethics of care to strengthen the sustainability of community-based healthcare in controlling hookworm infection among adults

Districts:

A comparison study of ICT cards and the new Filariasis Test Strip in Albay district, Philippines. Make recommendations for the new LF diagnostic test for the broader community.

Study Findings:

  • A total of 60 primary schools were surveyed using ICT tests, while a total of 46 primary schools were surveyed using FTS. In some instances, additional blood was not collected for FTS due to parental refusal.

  • Of the 2,944 children examined via ICT, 1 (0.034%) tested positive. No FTS was done on this child.

  • Of the 1,885 children examined via FTS, 1 (0.05%) tested positive. That same child tested negative via ICT and via repeat FTS.

  • FTS resulted in 57 invalid results due to: 1) test strips having no reaction, 2) detached sample pad on test strips, or 3) blood failing to travel upward after being absorbed by the test strips. In addition, some FTS foil pouches were empty.

  • Wb123 antibody levels appear to be relatively low among younger age groups and increase with age.

  • There was little observed change in antibody levels from Phase 1 (Oct 2014) to Phase 2 (Feb 2016).
Districts: Albay