First bovine vaccine to prevent human schistosomiasis - a cluster randomised Phase 3 clinical trial.

Objective: Schistosomiasis is a neglected tropical parasitic disease caused by blood flukes of the genus Schistosoma. Schistosoma japonicum is zoonotic in China, the Philippines, and Indonesia, with bovines acting as major reservoirs of human infection. The primary objective of the trial was to examine the impact of a combination of human mass chemotherapy, snail control through mollusciciding, and SjCTPI bovine vaccination on the rate of human infection.

Clinical management of quadriplegia in low and middle-income countries: a patient's road to physiotherapy, prostheses and rehabilitation.

Here we discuss the follow-up case of a 27-year-old male patient from rural Philippines, who was neglected by local health services after losing all four of his limbs as a result of a high-voltage electrical accident. The case follows the patient's road to accessing prostheses, rehabilitation health services and physiotherapy. Significant disparities were found between the government health services and the private sector with respect to quality, accessibility and affordability.

Clinical management of electrical burns in the developing world: a case of electrical burn injury left untreated leading to amputation.

We discuss the case of a 26-year-old male patient from Northern Samar, the Philippines who was left without essential health services after the amputation of all four limbs following a high voltage (20 000 volts) injury in Metro Manila in 2011. Local health services in the developing world are faced with enormous challenges in providing first-line care for burn patients. The cost of maintaining a burn unit, finding suitable qualified staff, and appropriate referral mechanisms are only some of the challenges faced.

Risk of human helminthiases: geospatial distribution and targeted control.

Objectives: We conducted a cross-sectional survey in 2012 among 22 rural barangays in Northern Samar, the Philippines in order to determine the prevalence of single and multiple species helminth infections, their geospatial distribution and underlying risk factors.

Methods: A total of 10,434 individuals who had completed both a medical questionnaire and a stool examination were included in the analysis. Barangay specific prevalence rates were displayed in ArcMap.

Risk factors for human helminthiases in rural Philippines.

Background: A cross-sectional survey was performed in 2012 among 18 rural barangays in Northern Samar, the Philippines in order to determine the prevalence of single and multiple species helminth infections and the underlying risk factors of acquiring one or more parasites.

Methods: A total of 6976 participants who completed a medical questionnaire and provided a stool sample for examination were included in the final analysis.

Results: The overall prevalence rates of Schistosoma japonicum, Ascaris lumbricoides, Trichuris trichiura, and hookworm were found to be moderate to high at 28.

Access to essential paediatric surgery in the developing world: a case of imperforate anus with rectovaginal and rectocutaneous fistulas left untreated.

Anorectal malformations consist of a wide spectrum of conditions which can affect both sexes and involve the distal anus and rectum as well as the urinary and genital tracts. Patients have the best chance of a good functional outcome if the condition is diagnosed early and efficient anatomic repair is promptly instituted. This report describes a rare case of imperforate anus associated with both rectovaginal and rectocutaneous fistulas in a 6-year-old Filipino girl.

Access to essential paediatric eye surgery in the developing world: a case of congenital cataracts left untreated.

Childhood cataracts are a major cause of treatable blindness. Early recognition, surgical intervention and appropriate follow-up after surgery can result in good visual outcomes. However, several factors may impact on the availability of such services, including lack of an available, affordable and accessible comprehensive eye care centre, financial limitations affecting coverage by the national healthcare provider, and household socioeconomic status.

Can mass drug administration lead to the sustainable control of schistosomiasis?

Background: In the Philippines, the current national control strategy for schistosomiasis is annual mass drug administration (MDA) with 40 mg/kg of praziquantel in all schistosomiasis-endemic villages with a prevalence ≥10%.

Methods: A cross-sectional survey of schistosomiasis was conducted in 2012 on 18 221 individuals residing in 22 schistosomiasis-endemic villages in the province of Northern Samar. The prevalence of schistosomiasis, intensity of Schistosoma infection, and morbidity of disease were assessed.

Clinical management of advanced schistosomiasis: a case of portal vein thrombosis-induced splenomegaly requiring surgery.

We report for the first time in the Philippines a case of portal vein thrombosis in a 12 year old Filipino boy with advanced schistosomiasis. The boy was referred to the Research Institute for Tropical Medicine (RITM), Manila, due to a rapidly enlarging spleen post-praziquantel treatment. At RITM, liver function tests were within normal limits but complete blood examinations showed pancytopenia and abnormal coagulation times.

Childhood malnutrition and parasitic helminth interactions.

Background: There is evidence to support that nutritional deficiency can reduce the body's immune function, thereby decreasing resistance to disease and increasing susceptibility to intestinal parasites.

Methods: A cross-sectional survey was carried out on 693 school-aged children from 5 schistosomiasis-endemic villages in Northern Samar, the Philippines. Data on dietary intake, nutritional status, and intestinal parasitic infection were collected.

Road to the elimination of schistosomiasis from Asia: the journey is far from over.

Schistosomiasis is a neglected tropical disease with a very long endemic history in Asia. Great strides have been made to control the disease in China and the Philippines but the road to elimination is far from over, given the zoonotic nature of the schistosome parasites in both countries.