The National Task Force for the Control of Soil-Transmitted Helminths, Schistosolmiasis, and for the Elimination of Lymphatic Filariasis
Soil-transmitted helminths are common in Cambodia, and alarming data were reported in recent epidemiological investigations. In some areas of the country the prevalence of Ascaris lumbricoides and hookworms can reach the peaks of 70.1% and 86.4% respectively. Children and women in reproductive age are particularly vulnerable to soil-transmitted helminthiases, which decreases work capacity and fitness and influences the nutritional status. Hookworm infections are a recognized cause of iron-deficiency anemia.
Appropriate and affordable control measures are available to relieve poor people of this unnecessary burden of disease. There is the evidence that regular distribution of anthelminthic drugs can effectively reduce morbidity, as well as it delays the effects of re-infection. Drug distribution and education should be combined with the simultaneous implementation of plans for basic sanitation and adequate safe water supplies.
The World Health Assembly 2001 has set up clear objectives for the control of STH. With the emanation of this policy the Government of Cambodia accept as a minimum target the regular administration of chemotherapy to at least 75% and up to 100% of all school-age children at risk of morbidity by 2010.
Schistosomiasis due to Schistosoma mekongi infection has also relevant public health significance in Cambodia. The infection results from contact with river water in areas where the infection is endemic, namely inhabited areas along the Mekong and its tributaries in the provinces of Kratie and Stung Treng. A potentially fatal disease is associated with the infection, and symptoms range from mild manifestation to a severe portal hypertension with ascites, esophageal bleeding, and growth and sexual development delay.
Over the last seven years, effective schistosomiasis control measures were established in the endemic areas. The strong control pressure, result of a combination of annual universal treatment campaign and information, education and communication (IEC) campaigns, keeps now parasitological indicators at a very low level. However there is a consensus among experts that the release of this pressure could determine an infection and morbidity recrudescence.
Lymphatic filariasis by Wuchereria bancrofti, a chronic and invalidating disease, is endemic in Cambodia. Four provinces are endemic: Rattanakiri, Stung Treng, Preah Vihea and Sieam Reap. Clinical cases, suffering from severe manifestation like hydrocoele or elephantiasis of limbs or genitals, were also identified.
The World Health Assembly resolution n.5.20 of 1997 called for the global elimination of the lymphatic filariasis as a public health problem. Endemic countries are requested to apply standard procedures to achieve the elimination goal. Purpose of this global initiative, funded by several donors, is to eliminate this fearful disease and to alleviate the sufferance of affected individuals.
Simple tools that will enable the eventual elimination of the disease now exist. A rapid diagnostic test is available that effectively detects the presence of adult worms. When given on a mass scale in endemic areas over a period of three to five years, a combination treatment of albendazole and diethylcarbamazine can interrupt transmission of the parasite.
To face these public health problems, The Ministry of Health, Royal Kingdom of Cambodia is pleased to set up the National Task Force for the control of soil-transmitted helminths and schistosomiasis, and for the elimination of lymphatic filariasis in Cambodia.
Function of the Group:
The National Task Force of the Program of soil-transmitted helminth, schistosomiasis, and the Program for the elimination of the lymphatic filariasis is envisaged to perform the following functions.
1. To establish a national policies for helminth control and lymphatic filariasis elimination
2. To facilitate the endorsement of the national policy by the Ministry of Health and the Government of Cambodia
3. To define the national objectives and the control/elimination strategies
4. To promote political will and commitment through appropriate and targeted advocacy
5. To seek the cooperation of other ministries, the private sector, nongovernmental organizations, and international organization.
6. To facilitate the integration of control activities into other disease control programs and health activities.
7. To identify key issues requiring operational research for improved implementation of the above-mentioned strategies.
8. To advocate for resource mobilization in order to sustain control and elimination activities.
9. To monitor and evaluate program implementation and achievement.
A broad spectrum of relevant eminent technical expertise and knowledge is represented on the Committee so that issues can be examined thoroughly and considered on their merits. The members appointed to this committee, have expertise in a wide range of areas including public health, health management, social sciences, epidemiology, parasitology, etc.
The nominated members of the National Task Force will meet twice a year; a core group within the national task force may meet as and when necessary. The member-secretary fixing the dates and agenda in consultation with the Chairman of the Group will convene and follow up on the recommendation of the Task Force.
The Group is constituted as follows:
1- Chairman: H.E Proff Eng Huot, Director General for Health, Ministry of Health (MoH)
2- Vice-Chairman: Dr. Sok Touch, Head of CDC, MoH
3- Member-Secretary:Dr. Duong Socheat, Director of the National Malaria Centre
4- Member-Secretary:Dr. Nong Saokry, Dupty Director of the National Malaria Centre
5- Member: Dr. Chroeng Sokhon, Department of Drug, Food and Cosmetic MoH
6- Member: Dr. Char Meng Chour, Department of Planning, MoH
7- Member: Dr. Chy Mean Hear, Department of Hospital, MoH
8- Member: Ms. Keat Phuong, Department of Human Resource, MoH
9- Member: Dr. Ung Sam An, National Institute of Public Health, MoH
10- Member: Representative from the Ministry of Education
11- Member: Representative from Ministry of Rural Development
12- Member: Representative from Ministry of Water Supply and Meteorology
13- Member: WHO Representative
14- Member: UNICEF Representative
15- Member: Dr. Hiroshi Ohmae, Sasakawa Memorial Health Foundation
The Ministry of Health, Royal Kingdom of Cambodia is pleased to approve the establishments of the National Programs for the Control of Soil-Transmited Helminths, Schistosomiasis, and for the Elimination of Lymphatic Filariasis and its national program management group. A national program manager for each program is nominated to be in charge of implementation of the program. The members of the National Management Group are the program manager in each program, and the senior officers of the National Malaria Program.
Membership of the National Program Management Group (NPMG)
The technical expertise and knowledge is required to conduct the programs. The members should be appointed by the National Task Force to the program.
The Nominated National Program Managers and Leadership of NPMG
1. National Program Manager for Lymphatic Filariasis Elimination Program
2. National Program Manager for Soil-Transmitted Helminthiasis Program and Schistosomiasis Program
School Health Department, Ministry of Education
National Malaria Centre
WHO technical officer
UNICEF technical officer
Program managers from collaborative partners
Function of the National Management Group
1. To follow a national policies for helminth control and lymphatic filariasis elimination
2. To develop and propose a national objectives and strategic plan for the three programs for the approval of the National Task Force.
3. To disseminate the national policy and guideline throughout the health delivery system as well as various partners
4. To cooperate of other ministries, the private sector, nongovernmental organizations, and international organization under the guidance of the National Task Force
5. To integrate the control activities into other disease control programs and health activities
6. To design and propose key issues requiring operational research for improved implementation of the above-mentioned strategies to the National Task Force.
7. To mobilize and allocate resources in order to sustain control and elimination activities
8. To monitor the control program of soil transmitted helminthiases and schistosomiasis control according to the guidelines
9. To monitor the elimination program for LF
10. To ensure that program objectives are achieved on schedule
11. To review and analyze the report of the activities and use it to improve quality of the control activities
12. To coordinate with the relevant ministries, NGOs, international organizations and other partners
13. To organize IEC campaigns, coordinate with mass media in the public and the private sectors
The nominated national program manager of each program for the control of soil-transmitted helminths, schistosomiasis and the elimination program of the lymphatic filariasis, will attend all the meetings of the national task force in order to follow up the decisions of the national task force.