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SOIL TRANSMITTEDHELMINTHIASIS

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Ascaris lumbricoides

Trichuris trichiura

Hookworm

Soil-transmitted

Helminths• intestinal parasitic worms whichcause

soil-transmitted helminthiasis (STH)

• develop in the soil

• man is the only host

• enter the body through the mouth

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3 most common helminths3 most common helminths

Ascaris lumbricoides

Trichuris trichiura

Hookworm

HOOKWORM

TRICHURIS

TRICHIURA

ASCARIS

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ASCARIS LUMBRICOIDES

Or ROUNDWORMS

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EGG O ASCARIS LUMBRICOIDES

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• Lays about 240,000 eggs/day

• 1 fea!e "o# $#odu%es

a$$#o&'ate!y (),000,000 eggs '*

+ o*ts• I*fe%t'-e stage 's eb#yo*ated

egg

• D& . DS o# ato at

e%*'3ue

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Most con!itions "re mil! "n! o#ten sho$

little or no s%m&toms

He"'% in#ections c"(sin) se'ere intestin"l

*loc+")e "n! im&"ir )ro$th in chil!ren, "re

most in#ecte!- $ith the most common ")e)ro(& *ein) 3 to . %e"r ol!s- $ith "n "nn("l

!e"th o# "*o(t /0-000,

M"ln(trition

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In)estion1e)) enter the *loo! stre"m1 re"chthe l(n)s "#ter 214 !"%s "#ter in#ection1

m"t(res 5tr"'el to sm"ll intestine "n!!e'elo& into "n "!(lt1 /13 month h&ro!('ee))s

The% !o not s(c+ *loo! or !"m")e them(cos" *(t #ee! in intestin"l contents

E))s li'e in the soil #or %e"rs 6/%e"rs

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TRICHURIS

TRICHIURA

OR WHI7WORM

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• , The #em"le T. trichiura *e)in to l"% e))s"#ter three months o# m"t(rit%,

• Worms c"n li'e (& to #i'e %e"rs• l"% (& to /0-000 e))s &er !"%,

• No mi)r"tion &h"se in the l(n)s- li'er or

he"rt• 7osterior en! is thic+ )i'in) " 8$hi&li+e9

sh"&e

• Mo!i#ie! K"to K"t: techni;(e

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• 7eo&le $ith li)ht in#ections (s("ll% h"'eno s%m&toms, 7eo&le $ith he"'%

s%m&toms c"n e

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EGG O TRICHURIS TRICHIURA

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HOOKWORM

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oo5"o# eggs e&a'*ed o* "et ou*t 6eggs of

Ancylostoma duodenale a*d Necator americanus

%a**ot be d'st'*gu'sed o#$o!og'%a!!y78 D'ag*ost'%%a#a%te#'st'%s9

S'e ): to :( ; by

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A*%y!ostoa duode*a!e

• Mout !o%ated o* do#sa! s'de of

a*te#'o# e*d• Bu%%a! %a$su!es "'t 2 $a'#s of

-e*t#a! teet

a*d 1 $a'# of a%%esso#y teet

• Body %o*tou# fo!!o"s te ge*e#a!

%u#-atu#e of body . !ette# =C>• Lays 20,000 to

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• The% c"n then m"t(re "n! h"tch-rele"sin) l"r'"e 6imm"t(re $orms=, The

l"r'"e m"t(re into " #orm th"t c"n&enetr"te the s+in o# h(m"ns,

• Hoo+$orm in#ection is m"inl% "c;(ire! *%

$"l+in) *"re#oot on cont"min"te! soil,One +in! o# hoo+$orm c"n "lso *etr"nsmitte! thro()h the in)estion o#l"r'"e,

• Most common in $omen es&eci"ll% in&re)n"nt $omen

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• Mil! in#ections &ro!(ce !i"rhe" "n!"*!omin"l &"in,

• More se'ere in#ections c"n cre"te serio(she"lth &ro*lems #or ne$*orns- chil!ren-&re)n"nt $omen- "n! m"lno(rishe!

"!(lts, In #"ct it is the le"!in) c"(se o#"n"emi" "n! &rotein !e#icienc%

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Coo* @ae S%'e*t'f'% @ae Lo%at'o* of

a#as't's

eog#a$'%a!

D'st#'but'o*Rou*d"o# As%a#'s

!ub#'%o'd'sI*test'*e !oba!

'$"o# #'%u#'s t#'%u#'a I*test'*e !oba!

oo5"o# A*%y!ostoaduode*a!e

@e%ato#ae#'%a*us

I*test'*e !oba!

COMMO@ SOIL RA@SMIED ELMI@S

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Life stages

2. Larval stage

3. Adult stage

1. Egg stage

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Life Cycle

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Worm Cycle

C , e o t , e # a $ y

S a *

' t a

t ' o *

Sa*'tat'o*

He"lth

E!(c"tion

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Si)ns > s%m&toms o# STHSi)ns > s%m&toms o# STH

A*!omin"l &"in "n! enl"r)ement A*!omin"l &"in "n! enl"r)ement

Wei)ht lossWei)ht loss Anemi" Anemi"

M"ln(tritionM"ln(trition

Loss o# "&&etiteLoss o# "&&etite

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Effe%ts of SEffe%ts of S

I$a'#ed %og*'t'-eI$a'#ed %og*'t'-e

$#o%esses$#o%esses

oo# $ys'%a! de-e!o$e*too# $ys'%a! de-e!o$e*t

De%#eased $ys'%a! a%t'-'tyDe%#eased $ys'%a! a%t'-'ty

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Complications of scariasis

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!ntestinal

perforation

"hoto courtesy of #r$ %# Cabrera

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"hoto courtesy of #r$ %# Cabrera

Ascarisin the

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Photo courtesy of Dr. BD Cabrera

Ascari

s in

the

brain

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RICURIS RICIURA

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&ectal

Photo courtesy of Dr. BD Cabrera

Complications of Trichiuriasis

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Complications of Trichiuriasis

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Comlication of Hoo!"orm

a!!o# a*da%'a! Edea

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The most serio(s conse;(ence

o# hoo+$orm in#ectionis chronic *loo! loss

#rom the sm"ll intestinele"!in) to the !e'elo&ment o#

iron !e#icienc% "nemi"

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#'H recommended drugs formass treatment

? lbendaole ** mg+ single+standardied dose in chewable tabletform

? ,ebendaole ** mg+ single+standardied dose in chewable tabletform

Treatment .uidelines / Treatment .uidelines /

"rocedures"rocedures

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Treatment .uidelines /Treatment .uidelines /

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Side-efects o anthelminthicSide-efects o anthelminthic

drugsdrugsRare and generally a reactionRare and generally a reaction

to the degeneration of wormsto the degeneration of worms

that have been killedthat have been killedOnly S/E that needsOnly S/E that needs

intervention is allergic skinintervention is allergic skin

reaction which can be treatedreaction which can be treated with histamine antagonist with histamine antagonist

Mild abdominal pain is mostMild abdominal pain is most

frequently reported S/E – doesfrequently reported S/E – does



Treatment .uidelines /Treatment .uidelines /

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Dis&os"l o# the $orms

• worms e0pelled as a result ofdeworming should be 1ushed

thru the toilet• if no toilets are available+ it

should be burned• worms should not be buried inthe soil



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HOW TO 7RE@ENT STH INECTION

#lbenda$ole %&& m'(sin'le( standardi$ed dose

in che"able tablet form

Mebenda$ole )&& m'(sin'le( standardi$ed

dose in che"able tabletform

1. Through regular deworming

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2. Personal hygiene

H"n! $"shin) Use o# #oot$e"r

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3. Sanitation

7ro&er $"ste !is&os"l

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THANK OU

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M")nit(!e o# STHM")nit(!e o# STH

/ *illion &eo&le "re "##ecte! $orl!$i!e/ *illion &eo&le "re "##ecte! $orl!$i!e

300 million s(##er se'ere mor*i!it%300 million s(##er se'ere mor*i!it%

-000 !e"ths re&orte! "nn("ll%-000 !e"ths re&orte! "nn("ll%Chil!ren 5 2 %rs ol! h"s the hi)hestChil!ren 5 2 %rs ol! h"s the hi)hest

$orm *(r!en$orm *(r!en

Chil!ren / 5 %rs ol! s(##er the )re"testChil!ren / 5 %rs ol! s(##er the )re"testmor*i!it%mor*i!it%

B d f S ' f ' d

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Bu#de* of S '*fe%t'o*s a*d

o#b'd'ty %o*t#o!

5 Base!'*e *at'o*"'de su#-ey 620047 so"ed((80 of $#es%oo!age %'!d#e* '*fe%ted "'t

S 6UNICEDOH- !e Leon "n! L(m"m&"o- /00=

? Se*t'*e! su#-ey 6200(7 #e-ea!ed )480 ofs%oo!age %'!d#e* '*fe%ted "'t S, 2

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"ccor!in) to re)ion- /002"ccor!in) to re)ion- /002

Cumulati*e Pre*alence of S+H amon' children , /,

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'months old( &&%

R#0K R#0K R123O0R123O0 44

,, )) 5.)5.)

,&,& 6767

88 66 6.86.8

%% % - B% - B //.7//.7

)) ,, //.%//.%

77 ,, /7.)/7.)

// #RMM#RMM /%.6/%.6

66 77 /.6/.6

55 88 76.576.5

,&,& ,,,, 78.)78.)

,,,, 55 )6.6)6.6

,, % - #% - # )%)%

,8,8 0CR0CR ).)).)

,%,% C#R#2#C#R#2# ),.5),.5

,),) %5.6%5.6

,7,7 C#RC#R %5.)%5.)

,/,/ // %/.)%/.)

C9M9:#+3;1 PR1;#:10C1C9M9:#+3;1 PR1;#:10C1 7777

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I*teg#ated e!'*t Co*t#o! #og#a

5 Inte)r"te! Helminth Control

7ro)r"m 6IHC7= l"(nche! *%

the DOH in /004 "s "

res&onse to the contin(in)ch"llen)e &ose! *% STH

in#ections

5 T"r)etsF? C(m(l"ti'e &re'"lence0

? He"'% intensit% in#ections 0

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MDA '* te '!'$$'*es

5 M"ss !r() "!ministr"tion 6MDA= "srecommen!e! *% the IHC7 !eli'ere! thro()h

the #ollo$in) &ro)r"msF

Res$o*s'b!eAge*%y

#og#a a#get S%edu!e

DOHDe&E! He"lth "n!N(trition 7ro)r"m

School chil!ren641/ %e"rs ol!=

"n("r% "n! (l%

DOH- !"% c"re$or+ers- NGOs

GarantisadongPambata 6G7=

7reschoolchil!ren61 %e"rs ol!=

A&ril "n! Octo*er

DOH1NE7 "n!ICH7

N"tion"l ili"ri"sisElimin"tion7ro)r"m 6NE7=

il"ri"sis1en!emic "re"s6/14 %e"rs ol!=

No'em*er

6DOH- /004=

i i$ i I i

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Drug treatment - MDA

Improvements in sanitation – CLTS/ZOD

Improvements in personal hygiene - handashing!ealth edu"ation# advo"a"y

$asi" Interventions$asi" Interventions

%or &edu"ing !elminth In%e"tions%or &edu"ing !elminth In%e"tions

(WAR ON WORMS)(WAR ON WORMS)

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Wh% #oc(s thro()h schoolsJ

? S%oo!s $#o-'de te ost effe%t'-e a*deff'%'e*t "ay9 5 to #ea% !a#ge $o#t'o*s of te $o$u!at'o*

5 o #edu%e '*fe%t'o*s a*d $#e-e*t #e'*fe%t'o*s

? S%oo!%'!d#e* a#e ofte* te g#ou$ tat

as te 'gest '*fe%t'o* #ate as "e!! aste 'gest "o# bu#de* "'%%o*t#'butes g#eat!y to te%o*ta'*at'o* of te e*-'#o*e*t

7 ti ! ! i h l i th

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7re'entin) "n! re!(cin) helminth

in#ections thro()h schools

? I* ost %ou*'t'es te#e a#e o#e s%oo!s

ta* ea!t %e*te#s a*d o#e tea%e#s ta*

*u#ses

? ea%e#s %a* $!ay a* '$o#ta*t #o!e as ea!t

edu%ato#s a*d as fa%'!'tato#s of %ou*'ty

a%t'o*s to '$#o-e sa*'ta#y %o*d't'o*s

? S%oo!s a#e sett'*gs t#oug "'% %'!d#e*

as "e!! as u% of te #est of te %ou*'ty

%a* be eas'!y #ea%ed

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STH &re'"lence *% re)ion

2 E

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R"te o# STH Mi

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STH C(m(l"ti'e &re'"lence *%

re)ion

4

Re)ionC(m(l"ti'e STH 7re'"lence

No,

III 342 /,3

II 22 //,4I /4/ /,2

3. /0,/

I 2/ /,4

@II 342 /,

ARMM 2 3.,2

O@ERALL /-0 6/-3= //,/ e

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I*te*s'ty of a#as'te I*fe%t'o*s by #eg'o*

5 E

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2* E

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26 E

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STH 7re'"lence *% 7ro'ince

27

CARAGA Re)ion III 6=

Inte)r"te! Helminth Control 7ro)r"m

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/02 SAC De$ormin)

N"me o#7ro'ince

Tot"l7o&(l"tiono# SAC6NSO=

Act("l7o&(l"tion

Tot"l n(m*erenrolle!

Tot"l n(m*ertre"te! 6(l%/02=

Accom&lishment *"se! on

tot"l&o&(l"tion

6NSO=

Tot"l n(m*ertre"te!6"n("r%/0=

Accom&lishment *"se!

on tot"l&o&(l"tion

6NSO=

A)(s"n !elNorte

3- E/-//H.-200

0-.4-/

,4/,0

2-/0-420

0,2.,0

Su#'gao de!@o#te

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$* of SAC6@SO7

$* e*#o!!ed t#eated

6Gu!y20147

based o*tota!

$o$u!at'o* 6@SO7

t#eated6Ga*ua#y201)7

based o*tota!

$o$u!at'o* 6@SO7

S'a#gaoIs!a*d

21,:42 EF22,:?2F?,?)4

1?,)4:(,2

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Lesso* f#o te -ete#'*a#y f'e!dThese "nim"ls "re o# the s"me s&ecie- se< "n! ")e

e#'od'%a!!y de"o#ed @ot #e%e'-'*g de"o#'*g

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deped sth

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