BACKGROUND

The Philippines has the highest number of new leprosy cases in the Western Pacific Region, with 1,000 to 2,000+ cases detected annually over the past decade. Out of 46 filariasis-endemic provinces in the country, 43 have eliminated lymphatic filariasis. However, many grade 2 disabilities acquired from these neglected tropical diseases (NTDs) remain undetected due to inadequate monitoring during and after treatment. This was further exacerbated by the detrimental impact of COVID-19 on healthcare access. The pandemic prompted initial adoption of teletraining, making a feasibility study necessary.

This study aimed to determine the feasibility of using telehealth and distance learning to train healthcare workers and patients in the integrated rehabilitation and prevention of impairments and disabilities from leprosy, lymphatic filariasis, mycetoma, diabetes, pressure ulcers, and other chronic wounds.

Selected rural health units, patients with disabilities, and their caregivers in a leprosy- and lymphatic filariasis-endemic region were recruited. Municipal health officers and leprosy coordinators helped in the conceptualization, planning, implementation, and evaluation of the teletraining program to ensure its acceptability and utilization. Asynchronous and synchronous methods were used. The main reference was the "Ten Steps" guide. Training materials were shared via Google Drive and flash drives sent to each study site. One-day didactics and skills trainings were conducted through live-interactive sessions using online platforms (Zoom or Google Meet). Topics focused on nerve function assessment (for leprosy and diabetes), problems of mobility, lymphedema, wound care, and self-care. Participants practiced and demonstrated their skills on local patients, with mentoring through Messenger chats. Knowledge and performance assessments were conducted.

The study was conducted from 2021 to 2022 and the actual training implemented within four months of 2022. Two municipalities of Sultan Kudarat province, Mindanao Island group with one rural health unit (RHU) each had participated. All participants (N=16; eight RHU personnel and eight village health workers) attended the synchronous skills training, 12 (75%) submitted return demo videos, and 13 (81.25%) had practicum patients. All participants rated the training as successfully attaining objectives and activities. All were generally satisfied with the teletraining because of improved knowledge and skills gained and were willing to continue it. Efficiency, speed, quality of training, and trainers had high ratings. Teletraining was considered effective in improving the wound care of their patients. Patients were also satisfied with the home care. However, the unreliable internet service in the study sites created difficulties during synchronous sessions and negatively affected appropriateness of teletraining. Finding patients for practicum was challenging. Some supplies were not available in local drugstores and had to be shipped from Manila, raising costs. Overall, the rating of the teletraining was good.

Teletraining of health workers from distant health units on integrated disability prevention and care is feasible in terms of implementation, acceptability, and practicality if stable internet connectivity is available. Larger studies are recommended.

The term cutaneous chylous reflux refers to the back flow of chyle from its normal route and the discharge of chyle from the skin. Primary chylous reflux suggests the absence of an apparent etiology and may be due to malformations of mesenteric lymphatics. On the other hand, secondary chylous reflux is the result from irradiation, neoplasm, trauma and infection with filariasis. Here we report a case of primary cutaneous chylous reflux that has a unique clinical feature.
Chyle ; Filariasis ; Hand ; Skin

Filariasis mosquitoes and susceptibility of Cx. quinquefasciatus and Cx. vishnui to insecticides were investigated in September 2004 and May 2005 in Khanh Trung commune, Khanh Vinh district, Khanh Hoa province. Twenty two mosquito species belonging to 5 genus have been found, of which the primary vector of W.bancrofti filariasis was captured with a high density, while vectors of B.malayi was found in a lower density. A total of 805 mosquitoes of 6 species (An.barbumbrosus, An. vagus, Cx.fuscocephala, Cx.quinquefasciatus, Cx.tritaeniorhynchus and Cx. vishnui) were dissected. None of them were positive with microfilaria. Cx.quinquefasciatus was found highly resistant to lambdacyhalothrin, alphacypermethrin and malathion with the mortalities of 11 %, 21%, and 60%, respectively. Similarly, the mortalities of Cx.vishnui were 19.76%, 23.83% and 13%-17%, respectively.
Filariasis ; Culicidae ; Malaria

Study on filariaisis mosquitoes and susceptibility of Cx.quinquefasciatus to some insecticides were conducted in September 2003 at Khanh Trung commune, Khanh Vinh district, Khanh Hoa province. The results showed that: 16 mosquito species of 5 races had been found, in which mosquitoes were main vectors of Wuchereria bancrofti (Cx quinquefasciatus, Cx.vishnui) had high density, while the vectors of Brugia malayi (Ma.uniformis) had very low density. 227 mosquitoes of 4 species (An.barbumborsus, Cx quinquefasciatus, Cx.vishnui, Cx.tritaeniorhynchus) were dissected, none of them were positive with microfilaria. Cx. quinquefasciatus was found to be highly resistant to malathion, lambda-cyhalothrin and alpha-cypermethrin with mortalities of 60,5%, 11% and 21%, respectively
mosquitoes ; Filariasis ; epidemiology ; Insecticides

An epidemiological study on brugian filariasis was carried out in endemic areas including Cheju Island in Korea, with a brief review of literatures.The results showed that the incidence among residents has remarkably decreased in Cheju Island, which was the main endemic area. Reviewing available informations on the prevalence of filariasis reported in recent years and also judging from the present socio-economic conditions which enable people to practice personal protection against mosquitos, it can be said with confidence that filariasis has almost disappeared from Cheju Island and inland areas. The disease is considered to remain at a low level of endemicity in Hugsan Islands. Certainly mass diethylcarbamazine (DEC) treatment carried out in Cheju Island in the 1960s and 1970s and remarkable economic growth followed by improved living standard and altered life-style of inhabitants could all have combined effects on the disappearance of this mosquito-borne diseae in this island. If the present trends go on, the possibility of resurgence of filariasis in Cheju Island is hardly postulated.
parasitology-helminth-nematoda ; Brugia malayi ; filariasis ; epidemiology

The clinical manifestations in filarial infection were examined during 1965-1966 from the known endemic areas: Yongju, a mountainous inland area and Cheju-Do, an island. All the microfilaria which were found during the survey were Brugia malayi. The principal symptom was cuticular hypertrophy (elephantiasis). It was found in 4 cases from Yongju among 707 villagers, 84 cases from Cheju-Do among 2,376 villagers. Four microfilaremia cases (4.5%) were found among a total of 88 cases of elephantiasis. In Cheju-Do, the higher incidence of elephantiasis was observed among people over 20 years old and the females showed much higher incidence than males (30 males and 54 females). The cuticular hypertrophic changes (elephantiasis) appeared more often in the lower extremities(77%) than in the upper part of the body, and in the right side than in the left.
parasitology-helminth-nematoda ; Brugia malayi ; filariasis ; hypertrophy

*Aedes ; *Anopheles ; *Culex ; *Filariasis ; *Malaysia ; *Statistics ; *Wuchereria

Parasitic infections in Korea have been well controlled during the last 40 years. Soil-transmitted helminthes, Ascaris lumbricoides, Trichuris trichiura and hookworm infections are almostly removed in this country. Recently, filariasis by Brugia malayi disappeared and no lymphatic filariasis in Korea was announced by WHO in 2008. However, foodborne parasitic infection, such as clonorchiasis and anisakiasis are prominent, recently. Indigenous malaria by Plasmodium vivax has been eradicated in 1970s, and a re-emerged vivax malaria from demilitary zone (DMZ) was reported in 1993. Above 1,000 cases of vivax malaria were reported annually in soldiers and civilians. Imported parasitic diseases, including malaria would be increased by travelers going abroad. This review focused on the changing patterns of human parasitic infections in Korea.
Anisakiasis ; Ascaris lumbricoides ; Brugia malayi ; Clonorchiasis ; Elephantiasis, Filarial ; Filariasis ; Helminths ; Hookworm Infections ; Humans ; Korea ; Malaria ; Malaria, Vivax ; Military Personnel ; Parasitic Diseases ; Plasmodium vivax ; Trichuris

A night blood survey was carried out among inhabitants aged over 1 year from the fifteen villages throughout Cheju-Do (Quelpart Island). Blood films from 2,139 persons were examined and 183(8.6 percent) showed microfilariae, the incidences varying according to geographical sources are from 0.8 to 19.5 per cent. All the microfilariae found in this survey were of the nocturnal periodic Brugia malayi. The microfilarial density was 1.9 per cent of blood. The age and sex distributions of microfilaria rate in Cheju-Do were not distinctly different. On the other hand, the intradermal test using Dirofilaria antigen (FPT antigen) and clinical survey of filariasis were also undertaken in same areas of microfilaria survey. Out of 2,449 inhabitants examined 1,434(58.6 percent) persons showed positive reaction of skin test, 503(20.5 percent) persons have clinical manifestations and 112 (4.6 percent) persons showed elephantiasis . It is assumed that Aedes togoi may be the most probable vector of B. malayi in the areas of Cheju-Do.
parasitology ; helminth ; nematoda ; Brugia malayi ; epidemiolgy ; filariasis ; intradermal test ; blood

During 1964 to 1967, a survey of 30,534 persons for filariasis was made on all over the country with the following results: Among 24,816 draftees from all over the country in the army recruitment camp 155(0.63 %) were found infected with Brugia malayi. Cheju Do showed the highest microfilaria rate(3.5 %), North Kyongsang Do(1.4 %) the next and South Cholla Do(1.2 %) the third. Blood films from 2,308 inhabitants were examined and 407(17.6 %) showed microfilaria in Cheju Do. 30(3.1 %) out of 974 inhabitants in North Kyongsang Do were found to be infected. The microfilaria rates were 2.0 per cent for 400 inhabitants of Chindo island in South Cholla Do. However, no positive case of microfilaria was found in the inhabitants of Kokumdo among 1,820 persons examined in South Cholla Do and of Namhae island(among 165 persons examined) in South Kyongsang Do. The mean microfilarial density per 20 cu. mm of blood was 52.6 in the inhabitants of Cheju Do, 12.2 in North Kyongsang Do and 27.3 in Chindo island(South Cholla Do). Any distinct relationship between the incidence of positive cases of microfilariae and age or sex of the cases was not observed in Cheju Do. However, in Norh Kyongsang Do and South Cholla Do the microfilaria rate of the male group is higher than the one of the female group of the inhabitants. From the above survey results it turned out that filariasis was found throughout Southern Korea except Kyonggi Do and South Kyongsang Do. A total 30,534 persons examined, 601(2.0 %) were found to be infected by Brugia malayi. Therefore, it seems that there are some endemic foci of malayian filariasis in three main areas such as North Kyongsang Do, South Cholla Do and Cheju Do.
parsitology-helminth-nematoda-Brugia malayi ; filariasis ; epidemiology ; Army