RESOURCE UNIT ON DOH PROGRAMS ON FILARIASIS, SCHISTOSOMIASIS,

LEPROSY CONTROL PROGRAM AND MALARIA CONTROL PROGRAM

Time Allotment: 30 minutes

Topic Description: This topic deals with the different programs of the Department of Health on filiarasis, schistosomiasis,
leprosy and malaria.
General Objective: At the end of the activity, the learners shall gain knowledge on filiarasis, schistosomiasis, leprosy and
malaria.
Specific Objectives
At the end of the
activity, the learners
shall:
1. Identify what
is filariasis

Content
I.

Introduction

II. Filariasis
Filariasis is an infection caused by microscopic, threadlike worms called filarial worms. This parasitic disease is
transmitted to people through the bite of an infected
mosquito which develops into adult worms in the
lymphatic vessels. It causes great damage and
overwhelming swelling known as lymphoedema.
Elephantiasis is a condition characterized by painful,

Time
Allotment
2 min

7 min

T-L
Strategy
Info shop

Evaluation
Method

distorting swelling of the legs and genital organs. This is

the typical sign of filariasis in its late-stage.
Filarial parasites affect the lives of millions of people,
especially those who live in tropical countries.

Despite the constraints of resources and capacity, the

Department of Health (DOH) has made considerable
contributions to public health improvements since health
sector reforms began in the late 1990s. To prevent,
control and eliminate as many of these infectious and
tropical diseases as possible national campaigns were
launched such as the Garantisadong Pambata (Assured
for the Child), a 2006 campaign for immunization, vitamin
A and iron supplements. In keeping with global
agreements, DOH designed and implemented the Soil
Transmitted Helminthiasis Control Program (STHCP) in
2002, the National Filariasis Elimination Program (NFEP)
in 2000 and, the Schistosomiasis Control Program (SCP)
in 2001. The accomplishment of the endemicity and
prevalence mapping activity (despite being heavily

resource-constrained) for the three diseases was a first step

towards effective elimination and control.
Greater political and government support was also
accomplished with the 2006 Executive Order signed by
the President of the Philippines declaring November as
Filariasis Mass Treatment Month in addition to formal
expressions of commitment to the elimination of
lymphatic filariasis, control of schistosomiasis and STH,
in DOH programs such as FOURmula One (an
implementation strategy to push for health sector reforms),
the Disease Free Zones Initiative, and the National
Objectives for health.
Lymphatic Filariasis is also known as elephantiasis or
tibak in the local language. Three million (3M) Filipinos
are at risk of getting the disease. To date, 44 provinces
from the 80 provinces in the Philippines are endemic of
elephantiasis.
As of 2011, nine (9) provinces have eliminated lymphatic
filariasis namely, Agusan del Sur, Biliran, Bukidnon,
Compostela Valley, Cotabato Province, Dinagat Island,
Romblon, Sorsogon and Southern Leyte.
2. Identify

elephantiasis

Elephantiasis is a disease transferred by mosquitoes from

a person infected with microfilaria parasite to another
person. Lymphatic Filariasis is a parasitic infection in the
blood. Enlargement (lympheodema) of the arms and legs
are common among Filipinos. Aside from the
lymphoedema of the upper or lower extremities,
enlargement of the breast of women and enlargement of
the scrutom for males.
Every November there is a Mass Drug Administration
(MDA) being conducted in identified endemic provinces.
Two drugs namely, Diethylecarbamacine (DEC) and
albendozale should be taken by the residents of the
provinces that are endemic of the disease.
Anti-parasitic Drug Therapy. This treatment prevents
possible transmission of LF to other people. Infected
individuals are treated with a series of anti-parasitic drugs.
Supportive Clinical Care.
Lymphoedema management. The patient is advised to
follow these simple procedures. These simple measures

3. Name the
pharmacologic
therapy
management to
filariasis

can improve elephantiasis condition over time:

o Wash affected areas of the body twice daily with
soap and clean, cool water. Dry the said areas
with care.
o Raise the affected limb during the evening.
o Conduct regular exercises for the affected limb.
o Wear comfortable shoes.
o Keep nails and spaces between the toes clean.

4. Learn
supportive
clinical care in
patients with
filariasis

o Apply medicated creams or antibiotics on small

wounds or cuts.
Hydrocele surgery. Surgery is a treatment option for
most hydrocele patients. Early hydrocele and corrective
surgery can be done with local anaesthetic. However,
other genital damage may require more complicated
surgery. In reality, hydrocele surgery is often seen as an

expensive treatment for people with LF.

5. Gain
knowledge on
coalition for
the elimination
of lymphatic
filariasis
(CELF)
Philippines

Patient education and counselling. Psychological

counselling is also important in helping patients with LFinduced disability. Physical treatment is vital but
emotional support can be very significant in dealing with
shame, isolation, sexual dysfunction, intense chronic pain
and suffering.

COALITION FOR THE ELIMINATION OF

LYMPHATIC FILARIASIS (CELF) PHILIPPINES
Partners:
1. Department of Health
2. Department of Education
3. Department of Social Welfare and Development
4. University of the Philippines National Institutes of

Health
5. National Commission on Idigenous People
6. Catholic Bishops Conference of the Philipines
7. Physicians for Peace
The Program started in 1998 with the Department of
Health and the Coalition was launched 2004
The disease is called Lymphatic Filariasis. This is the 2nd
debilitating disease caused by worms that thrive in the
Lymphatic system transmitted by mosquitoes.
The Program is for all people living in the endemic
provinces from 2 years old and above.
Deskripsyon ng programa:
The Program is composed of three areas, one is Mass
Drug Administration. All people living in the endemic
areas from 2 years old and above will take two medicines,
albendazole and di-ethyl carbamazine citrate once a year

for 5 consecutive years or until the area (province) is

declared LF Free. Second is the Disability Management
whereby all patients affected with manifestations are
taught on how to manage their deformities to have no reinfection to take place or their deformities will worsen.
Third is the Hydrocoelectomy. This is for patients with
affected giant scrotums that will undergo surgery and
become productive again.
If the area reached a consecutive 85% above performance
for the 5 years period, they will be monitored, screened
and tested for LF Free status and if their microfilaremia
rate will fall 0.1%, WHO will declare the area as LF Free
but if the rate is higher than the 0.1% rate, It will be
extended for another year.
DOH will give a grant to those provinces declared as LF
Free to sustain and retain their LF Free Status.
The medicines are available in all health centers of the
endemic provinces of the country. The meds were
provided by the Department of Health for the di-ethyl
carbamazine citrate and GlaxoSmithKline for the

7 min

6. Identify what
is
schistosomiasi
s

albendazole through DOHs Center for Health and

Development in all endemic regions.
For further inquiries about the program, they may
reach the Department of Health Infectious Disease
Office c/o Dr. Leda Hernandez at (632) 6517800 or
The Coalition for the Elimination of Lymphatic
Filariasis Philippines at 09153296997
III.

Schistosomiasis
Schistosomiasis, also called bilhariasis and snail
fever, affects nearly 240 million people worldwide.
It is one of the important tropical diseases in the
country. This disease is caused by a blood fluke,
Scistosoma Japonicum, which can be transmitted by
a tiny snail oncomelania quadrasi. Due to the
chronicity of the disease and the population group
that it affects, which is mostly comprised of farmers
and their family in the rural areas, it results in loss of
human resources and decline in agricultural
productivity.
Therefore, schistosomiasis does not only affect the

7. Enumerate
regions that
have a high
prevalence of
scistosomiasis

8. Recognize the
signs and
symptoms of
patients having
schistosomiasi
s

9. Enumerate the
infectious
agents of the
disease

health of the people, but as well as the socioeconomic status of the country.
This disease is endemic in 10 regions, 24 provinces,
183 municipalities and 1212 barangays with an
estimated exposed population of 6.7 million. In these
areas, there are about 3391 snail colonies with an
approximate area of 11,250 hectares.
Regions that have a high prevalence of
scistosomiasis:
Region 5 (Bicol)
Region 8 (Samar and Leyte)
Region 11 (Davao)

Clinical Manifestations:
Diarrhea
Bloody stools
Enlargement of the abdomen
Splenomegaly
Weakness
Anemia

 Inflamed liver
10.
Identify
the mode of
transmission of
the disease

11.
Enumerat
e the methods
of control

Infectious agents (Major species causing human

disease):
Schistosoma mansoni
S. haematobium
S. japonicum (endemic in the Philippines)

Mode of Transmission:
Infection occurs when skin comes in contact with
contaminated fresh water in which certain types of
snails that carry scistosomes are living. It is the free
swimming larvae forms (cercariae) of the parasite that
penetrate the skin.
Schistosoma parasites can penetrate the skin of the
persons who are wading, swimming, bathing, or
washing in contaminated water.
Methods of Control:
a.
Preventive Measures

Educate the public in endemic areas regarding

mode of transmission and methods of protection.

Dispose of feces and urine so that viable eggs will

not reach bodies of fresh water containing intermediate
snail host.

Improve irrigation and agriculture practices:

reduce snail habitats by removing vegetation or by
draining and filling.

Treat snail-breeding sites with molluscides.

Prevent exposure to contaminated water. Apply

70% alcohol immediately to the skin to kill surface
cercariae.

Effective measures for inactivating cercariae

include water treatment with iodine or chlorine, or use
of paper filters.

Treat patients in endemic areas to prevent disease

progression and to reduce transmission by reducing egg
passage.
b.
Control of Patient, Contacts, and the Immediate
Environment:

Report to local health authority in selected

endemic areas.


Isolation: none

Concurrent disinfection: Sanitary disposal of

feces and urine.

Quarantine: none

Immunization of contacts: none

12.
Identify
the vison,
mission, goal
and objectives
of the program

c.
Investigation of contacts and source of infection:
Examine contacts for infection from a common source.

Specific treatment: Praziquantel (Biltricide) is the

drug of choice against all species. Alternative drugs are:
Oxamniquine for S. mansoni and Metrifonate for
haematobium.

Epidemic measures: Examine for schistosomiasis

and treat all who are infected, but especially those with
moderate to heavy intensities of egg passage; pay
particular attention to children.

Motivate people in these areas to have annual

stool examination.

Public health nurse in endemic areas participates

actively in the above preventive and control measures.
IV.

Leprosy Control Program

7 min

Leprosy Control Program

Vision: Empowered primary stakeholders in leprosy and
eliminated leprosy as a public health problem by 2020
Mission: To ensure the provision of a comprehensive,
integrated quality leprosy services at all levels of health
care
Goal: To maintain and sustain the elimination status
Objectives:
The National Leprosy Control Program aims to:
Ensure the availability of adequate anti-leprosy drugs or
multiple drug therapy (MDT).
Prevent and reduce disabilities from leprosy by 35%
through Rehabilitation and Prevention of Impairments and
Disabilities (RPIOD) and SelfCare.
Improve case detection and post-elimination
surveillance system using the WHO protocol in selected
LGUs.
Integration of leprosy control with other health services
at the local level.
Active participation of person affected by leprosy in
leprosy control and human dignity program in

collaboration with the National Program for Persons with

Disability.
Strengthen the collaboration with partners and other
stakeholders in the provision of quality leprosy services
for socio-economic mobilization and advocacy activities
for leprosy.
Beneficiaries:
The NLCP targets individuals, families, and communities
living in hyperendemic areas and those with history of
previous cases.
Global Strategy
(2006-2010) NLCP Strategy
(2011-2016)
MDG& NOHUniversal Health Care
(Kalusugang Pangkalahatan)
Sustain leprosy control in all endemic countries
Provision of Quality Leprosy services at all levels

Governance for Health

Strengthen routine & referral service
Health
System Strengthening
Service Delivery
Ensure high quality diagnosis, case management,

13.
Gain
knowledge
about leprosy

recording & reporting in all endemic communities

Capability building of an efficient, effective, accessible
human and facility resources
Policy, Standards &
Regulations
Establish the Sentinel Surveillance System to monitor
Drug Resistance
Develop policies/ guidelines/
sentinel sites/referral centers (Luzon,Visayas & Mindanao)

Human Resources for Health

Develop procedures/ tools that are home/communitybased, integrated and locally appropriate for Self
Care/POD, rehabilitation services (CBR)
Collaborate with NEC/RESU/ PESU / MESU

Health Information

NLAB, NCCL
Health Financing

RA 7277- Rights of PWD & Caregivers

BP 34- Accessibility & Human Rights Law

PhilHealth Insurance Package

Facts About Leprosy
Leprosy is an infectious disease that causes severe,
disfiguring skin sores and nerve damage in the arms and
legs.

14.
Identify
the cause of
leprosy

15.
Enumerat
e the
symptoms of
leprosy

16.
Differenti
ate the various
forms of
leprosy

The disease has been around since ancient times, often

surrounded by terrifying, negative stigmas and tales of
leprosy patients being shunned as outcasts.
You can catch it only if you come into close and
repeated contact with nose and mouth droplets from
someone with untreated leprosy.
Children are more likely to get leprosy than adults.
What Causes Leprosy?
Leprosy, also known as Hansen's disease, is caused by
a slow-growing type of bacteria called Mycobacterium
leprae (M. leprae)
What Are the Symptoms of Leprosy?
The main symptom of leprosy is disfiguring skin sores,
lumps, or bumps that do not go away after several weeks
or months. The skin sores are pale-colored.
Loss of feeling in the arms and leg
Muscle weakness
It usually takes about 3 to 5 years for symptoms to
appear after coming into contact with the leprosy-causing
bacteria

17.
Enumerat
e the ways in
diagnosing
leprosy
18.
Name the
treatment of
leprosy

Forms of Leprosy
Leprosy is defined by the number and type of skin sores
you have. The types are:
Tuberculoid. A mild, less severe form of leprosy.
People with this type have only one or a few patches of
flat, pale-colored skin (paucibacillary leprosy). The
affected area of skin may feel numb because of nerve
damage underneath. Tuberculoid leprosy is less contagious
than other forms.
Lepromatous. A more severe form of the disease which
has widespread skin bumps and rashes (multibacillary
leprosy), numbness, and muscle weakness. The nose,
kidneys, and male reproductive organs may also be
affected. It is more contagious than tuberculoid leprosy.
Borderline. People with this type of leprosy have
symptoms of both the tuberculoid and lepromatous forms.
How Is Leprosy Diagnosed?
Skin biopsy
Skin smear test

19.
Enumerat
e the
complications
of leprosy

20.
Identify
what is malaria

How Is Leprosy Treated?

Treatment depends on the type of leprosy that you have
Antibiotics are used to treat the infection.
Anti-inflammatory drugs are used to control nerve pain
and damage related to leprosy
Thalidomide
Leprosy Complications
Without treatment, leprosy can permanently damage
your skin, nerves, arms, legs, feet, and eyes such as:
Blindness or glaucoma.
Disfiguration of the face (including permanent
swelling, bumps, and lumps).
Erectile dysfunction and infertility in men.
Kidney failure.
Muscle weakness that leads to claw-like hands or an
inability to flex the feet.
Permanent damage to the inside of the nose, which can
lead to nosebleeds and a chronic, stuffy nose.
Permanent damage to the nerves outside the brain and
spinal cord, including those in the arms, legs, and feet.

7 min

V.

21.
Identify
the vision,
mission, goal
and objectives
of the program

Malaria Control Program

Malaria is a parasite-caused disease that is usually

acquired through the bite of a female Anopheles mosquito.
It can be transmitted in the following ways: (1) blood
transfusion from an infected individual; (2) sharing of IV
needles; and (3) transplacenta (transfer of malaria
parasites from an infected mother to its unborn child).
This parasite-caused disease is the 9th leading cause of
morbidity in the country. As of this year, there are 58 out
of 81 provinces that are malaria endemic and 14 million
people are at risk. In response to this health problem, the
Department of Health (DOH) coordinated with its partner
organizations and agencies to employ key interventions
with regard to malaria control.
Vision: Malaria-free Philippines
Mission: To empower health workers, the population at
risk and all others concerned to eliminate malaria in the
country.
Goal: To significantly reduce malaria burden so that it

will no longer affect the socio-economic development of

individuals and families in endemic areas.

22.
Name the
beneficiaries of
the program

23.
Enumerat
e the program

Objectives:
Based on the 2011-2016 Malaria Program Medium Term
Plan, it aims to:
1. Ensure universal access to reliable diagnosis, highly
effective, and appropriate treatment and preventive
measures;
2. Capacitate local government units (LGUs) to own,
manage, and sustain the Malaria Program in their
respective localities;
3. Sustain financing of anti-malaria efforts at all levels of
operation; and
4. Ensure a functioning quality assurance system for
malaria operations.
Beneficiaries:
The Malaria Control Program targets the meagerresourced municipalities in endemic provinces, rural poor
residing near breeding areas, farmers relying on forest
products, indigenous people with limited access to quality

strategy

24.
Enumerat
e the program
accomplishme
nts

health care services, communities affected by armed

conflicts, as well as pregnant women and children aged
five years old and below.
Program Strategies:
The DOH, in coordination with its key partners and the
LGUs, implements the following interventions:
1.Early diagnosis and prompt treatment
Diagnostic Centers were established and
strengthened to achieve this strategy. The utilization of
these diagnostic centers is promoted to sustain its
functionality.
2. Vector control
The use of insecticide-treated mosquito nets,
complemented with indoor residual spraying, prevents
malaria transmission.
3. Enhancement of local capacity
LGUs are capacitated to manage and implement
community-based malaria control through social
mobilization.
Program Accomplishments:

25.
Identify
the partner
organizations
or agencies of
the program

For the development of health policies, the Malaria

Medium Term Plan (2011-2016) is already in its final draft
while the Malaria Monitoring and Evaluation Framework
and Plan is being drafted. The Malaria Program is being
monitored in six provinces as the Philippine Malaria
Information System is being reviewed and enhanced.
In strengthening the capabilities of the LGUs, trainings are
conducted. These include: series of Basic and Advance
Malaria Microscopy Training; Malaria Program
Management Orientation and Training for the rural health
unit (RHU) staff; and Data Utilization Training. Also,
there are the Clinical Management for Uncomplicated and
Severe Malaria and the Malaria Epidemic Management.
Lastly, health services are leveraged through the provision
of anti-malaria commodities.
Partner Organization/Agencies:
The following organizations/agencies take part in
achieving the goals of Malaria Control Program:
Pilipinas Shell Foundation, Inc, (PSFI)
Roll Back Malaria (RBM); World Health Organization
(WHO)

Act Malaria Foundation, Inc

Field Epidemiology Training Program Alumni
Foundation, Inc. (FETPAFI)
Research Institute of Tropical Medicine (RITM)
University of the Philippines-College of Public Health
(UP-CPH)
Philippine Malaria Network
Australian Agency for International Development
(AusAID)
Asia Pacific Malaria Elimination Network (APMEN)
Malaria Elimination Group (MEG)
Local Government Units (LGUs)
Program Manager:
Dr. Mario S. Baquilod
Department of Health-National Center for Disease
Prevention and Control (DOH-NCDPC)
Contact Number: 651-78-00 local 2353
Email: marbaquilod@yahoo.com

Oral
evaluation

References:
Cuevas, F. P. L. (2007). Public health nursing in the Philippines (10th ed.). Philippines: Publications Committee, National
Leage of Philippine Government Nurses.
Department of Health.(2011, October). Leprosy Control Program. Retrieved from:
<http://www.doh.gov.ph/node/1071.html>
DOH National Filariasis Elimination Program. Retrieved from: http://kalusugan.ph/doh-nationalfilariasis-elimination-program/
Farmoca, Z. U., Nies, M. A., & McEwen, M. (2013). Nursing care of the community: A comprehensive text on community
and public health nursing in the Philippines. Singapore: Elsevier.
Republic of the Philippines, Department of Health. Malaria Control Program. Retrieved June 21, 2015 from
http://doh.gov.ph
WebMd. (n.d.). Skin Problems and Treatments Health Center. Retrieved from: <http://www.webmd.com/skin-problemsand-treatments/guide/leprosy-symptoms-treatments-history?page=2 >