Schistosomiasis in the Philippines

Schistosomiasis in the Philippines

When I applied for summer research funding last year, I had no idea how much time I’d spend explaining myself. My friends and family were confused – What in the world was schistosomiasis? Why was I going home to the Philippines, but heading straight for Leyte Province? And, why, as a DVM student, had I chosen to spend my time talking to people instead of working with animals? Months before I saw Palo, Leyte, I learned to explain what researchers have been trying to show the Department of Health for years.

Schistosomiasis is a chronic disease caused by the trematode worm Schistosoma japonicum. It’s endemic to the poorest regions of Eastern Visayas, including Leyte. In Palo, the town I visited, schistosomiasis control is patterned after programs around the country, focusing on human mass treatment with praziquantel. However, S. japonicum is also zoonotic, persisting in over 40 animal reservoirs. Studies by the Research Institute for Tropical Medicine (RITM) in Leyte and Samar Province have reported a high prevalence of schistosomes in carabaos, water buffalos used widely for farming. These animals are often left to graze in fields and swamps, where they inadvertently excrete large numbers of eggs which play a major role in disease transmission.

348AStudying in the field

My job at the RITM lab in Palo was to administer a questionnaire assessing community knowledge on schistosomiasis as well as attitudes toward proposed interventions, like vaccinating farmer’s carabaos. We quickly found that disease awareness was high, but only half the carabao owners we surveyed were willing to have their animals vaccinated. What concerned us even more was that 40% of the participants no longer believed that preventing schistosomiasis was actually possible. Farmers that did believe in prevention, however, were over three times more likely to let us vaccinate their carabaos in the future.

338AThe Necessity for One Health

That summer was the first time I saw One Health as essential to public health. Without multidisciplinary work, schistosomiasis eradication will continue to be thwarted by its complex epidemiology. Studies by the RITM have called for a more integrated, One Health approach, and it’s clear to me that in order to prevent further disillusionment within endemic communities, this need is urgent.

Since then, my RITM mentor, Mario Jiz, has been conducting a carabao vaccine trial, building onto bovine vaccine work by the Cummings School’s very own Akram Da’Dara. The Canada-based International Development Research Center is also funding a multi-sectoral program in Cagayan Province, fostering cooperation between the Philippine Departments of Agriculture and Education. After my work in Leyte, I believe that my country’s only hope for schistosomiasis eradication lies in similarly updating their approach nationwide.363A