title: Parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines: Lessons for monitoring the outcome of Community-Led Total Sanitation.
abstract: While preventive chemotherapy remains to be a major strategy for the prevention and control of soil-transmitted helminthiases (STH), improvements in water, sanitation, and hygiene (WASH) comprise the long-term strategy to achieve sustained control of STH. This study examined the parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines where two of the villages attained Open-Defecation-Free (ODF) status after introduction of Community-Led Total Sanitation (CLTS). A total of 341 children (89.0% of the total eligible population) submitted stool samples which were examined using the Kato-Katz technique. Results showed that 27.9% of the total stool samples examined had at least one type of STH (cumulative prevalence), while 7.9% had moderate-heavy intensity infections. Between the two villages where CLTS was introduced, Buenavista had a significantly higher cumulative prevalence of STH at 67.4% (p<0.001) and prevalence of moderate-heavy intensity STH at 23.5% (p=0.000), while Caubang had a significantly lower cumulative prevalence at 4.9% and prevalence of moderate-heavy intensity at 1.8%. On the other hand, the non-CLTS villages of Bitoon and Saub had similar rates for cumulative prevalence (16.7% and 16.8%, respectively; p=0.984) and prevalence of moderate-heavy intensity STH (2.0% and 3.1%, respectively; p=1.000). The findings may be explained by factors that include possible reversion to open defecation, non-utilization of sanitary facilities, and mass drug administration (MDA) coverage, although further studies that can accurately assess the impact of CLTS are recommended. While this study was descriptive, the data indicate no clear pattern among the parasitological and nutritional parameters, as well as the presence of CLTS in the village, suggesting the need to monitor the ODF status of villages on a regular basis even after the end of CLTS activities to ensure the sustainability of the CLTS approach. In order to achieve effective control of STH, deeper collaboration between the WASH and STH sectors are recommended where partners can work together in the area of monitoring and evaluation that may include improved parasitological and nutritional status in high-risk groups, as well as sustainable behavior change as outcome indicators.
authors.affiliation: Department of Parasitology, College of Public Health, University of the Philippines Manila, 625 Pedro Gil St., Ermita, Manila 1000, Philippines; Neglected Tropical Diseases Study Group, National Institutes of Health, University of the Philippines Manila, 623 Pedro Gil St., Ermita, Manila 1000, Philippines.
authors.forename: Vicente Y
authors.initials: VY
authors.lastname: Belizario
authors.affiliation: Neglected Tropical Diseases Study Group, National Institutes of Health, University of the Philippines Manila, 623 Pedro Gil St., Ermita, Manila 1000, Philippines; Ateneo School of Medicine and Public Health, Ateneo de Manila University, Ortigas Campus, Pasig City 1605, Metro Manila, Philippines. Electronic address: hjcliwanag@post.upm.edu.ph.
authors.forename: Harvy Joy C
authors.initials: HJ
authors.lastname: Liwanag
authors.affiliation: Neglected Tropical Diseases Study Group, National Institutes of Health, University of the Philippines Manila, 623 Pedro Gil St., Ermita, Manila 1000, Philippines.
authors.forename: June Rose A
authors.initials: JR
authors.lastname: Naig
authors.affiliation: Department of Parasitology, College of Public Health, University of the Philippines Manila, 625 Pedro Gil St., Ermita, Manila 1000, Philippines; Neglected Tropical Diseases Study Group, National Institutes of Health, University of the Philippines Manila, 623 Pedro Gil St., Ermita, Manila 1000, Philippines.
authors.forename: Paul Lester C
authors.initials: PL
authors.lastname: Chua
authors.affiliation: Plan International-Philippines, 205 Salcedo St., Legaspi Village, Makati City 1229, Metro Manila, Philippines.
authors.forename: Manuel I
authors.initials: MI
authors.lastname: Madamba
authors.affiliation: Department of Parasitology, College of Public Health, University of the Philippines Manila, 625 Pedro Gil St., Ermita, Manila 1000, Philippines; Neglected Tropical Diseases Study Group, National Institutes of Health, University of the Philippines Manila, 623 Pedro Gil St., Ermita, Manila 1000, Philippines.
authors.forename: Roy O
authors.initials: RO
authors.lastname: Dahildahil
mesh_terms: D002648:Child; D002675:Child, Preschool; D003256:Community Participation; D060766:Drinking Water / Q000469:parasitology; D005260:Female; D006235:Hand Disinfection; D006373:Helminthiasis / Q000453:epidemiology*; D006801:Humans; D006920:Hygiene; D008297:Male; D009752:Nutritional Status; D010679:Philippines / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D012499:Sanitation; D012574:Schools; D012987:Soil / Q000469:parasitology
chemical_list: D060766:Drinking Water; D012987:Soil
keywords: Defecation; Intestinal helminthiasis; Preschool child; Sanitation; School-age population; Tropical medicine