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.

Parasitic diseases are widely distributed throughout the world. Recently, travel abroad and migration from abroad are increasing in Korea. Therefore, it is necessary to appropriately control imported parasitic disease. The drugs for the treatment of the parasitic diseases that can be imported from abroad are reserved by the government. To guide proper treatment of parasitic diseases, recommended chemotherapy focused on these reserved drugs has been introduced. The diseases reviewed in this article include malaria, babesiosis, toxoplasmosis, leishmaniasis, Chagas disease, African sleeping sickness, filariasis, angiostrongyliasis, and fascioliasis. Because most of the parasitic diseases produce severe illness or fatal results, rapid and accurate diagnosis is important and following fully the recommended therapy is needed. The recommended drug therapy changes from time to time due to various factors, so always recognizing and applying the latest therapy and is very important.
Animals ; Babesiosis ; Chagas Disease ; Fascioliasis ; Filariasis ; Korea ; Leishmaniasis ; Malaria ; Parasitic Diseases ; Strongylida Infections ; Toxoplasmosis ; Trypanosomiasis, African

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

Adult ; Chyle ; Female ; Filariasis ; complications ; Humans ; Laparoscopy ; Lymphatic System ; surgery ; Male ; Middle Aged ; Retroperitoneal Space ; Urine ; Urologic Surgical Procedures ; methods

In this report, we present a case of chyluria that is a very rare urine abnormality in Korea. A 43-year-old woman was referred to our clinic with intermittent turbid and creamy-colored urine for 10 days. The urine tests, including a urine lipid profile, indicated a diagnosis of chyluria. There was no evidence of secondary causes of chyluria such as a tumor and filariasis, and a urinary-lymphatic fistula was not found. The patient was instructed to begin a high protein diet with low fat content and medium chain triglyceride oil supplementation. To the best of our knowledge, this is the first report describing a patient that presented with chyluria in Korea.
Adult ; Diagnosis ; Diet ; Female ; Filariasis ; Fistula ; Humans ; Korea ; Triglycerides

The transition of important parasitic diseases in Korea is briefly reviewed in this article. Soiltransmitted helminthiases, such as ascariasis, trichuriasis, and hookworm infections, which had been prevalent all over the country, decreased remarkably, largely owing to the national control activities by means of mass examination-mass treatment schemes for school students. Paragonimiasis has shown significant reduction in its incidence, but clonorchiasis still remains as an important health-threatening trematode infection. Intestinal trematodiases, including metagonimiasis, heterophyidiases, and echinostomiases are prevalent, and new species, such as Gymonphalloides seoi and Neodiplostomum seoulense, have been documented as new human parasitic diseases. Tapeworm infections including larval cestodiases are also decreasing. Among the protozoan infections, amebiasis and malaria showed an apparent decreasing trend, but in recent years, vivax malaria has become a re-emerging disease. Brugian filariasis, which was prevalent in southern parts of the Korean peninsula, has been completely eliminated nowadays. In terms of the prevalence and distribution, clonorchiasis, enterobiasis, and vivax malaria are currently the major parasitoses of public health importance in Korea.
Amebiasis ; Ascariasis ; Cestode Infections ; Clonorchiasis ; Echinostomiasis ; Enterobiasis ; Filariasis ; Helminthiasis ; Hookworm Infections ; Humans ; Incidence ; Korea* ; Malaria ; Malaria, Vivax ; Paragonimiasis ; Parasitic Diseases* ; Prevalence ; Protozoan Infections ; Public Health ; Trematode Infections ; Trichuriasis

Mondor's disease is also called thrombophlebitis and it is not a common condition. The characteristics finding of Mondor's disease is a subcutaneous cord that is tender and tense. This disease commonly occurs in the breast and abdomen. The etiology of Mondor's disease is unknown, but the generally agreed on causes are trauma, excessive exercise and breast surgery. On rare occasions, this disease is related to malignancy, pregnancy, filariasis and so on. This disease is self limiting and it is usually treated conservatively and symptomatically. We treated one woman who had Mondor's disease on the anterior side of the left elbow. This is a very rare location for Mondor's disease and so clinicians need to be aware about the possibility of this unusual presentation for this disease.
Abdomen ; Breast ; Elbow ; Female ; Filariasis ; Humans ; Pregnancy ; Thrombophlebitis ; Transcutaneous Electric Nerve Stimulation

The Brugian filariasis in Korea was once endemic in several areas including Jeju-do and small remote islands located in the southwestern part of the Korean peninsula. But recently it has almost been controlled. The first patient was a 42-year-old man, who visited the hospital with the chief complaints of fatigue, jaundice and edema on the right low extremity. Examination of a peripheral blood smear revealed non-megaloblastic macrocytic anemia, thrombocytopenia and eosinophilia, and a parasite, which was identified as microfilaria of Brugia malayi on the glass slide of blood obtained from the patient at midnight. The second patient was a 23-year-old man, who visited the hospital with the chief complaints of cough, sputum and fever. A parasite resembling that of the first patient was found in a peripheral blood smear accompaning neutrophilia. No more parasites, however, were found in the peripheral blood obtained from the patient at midnight. These two clinical cases of Brugian filariasis indicate that the clinical laboratory in Korea should be able to detect microfilariae for the diagnosis of filariasis.
Adult ; Anemia, Macrocytic ; Brugia malayi ; Cough ; Diagnosis ; Edema ; Eosinophilia ; Extremities ; Fatigue ; Fever ; Filariasis* ; Glass ; Humans ; Islands ; Jaundice ; Jeju-do ; Korea ; Microfilaria ; Parasites ; Sputum ; Thrombocytopenia ; Young Adult

INTRODUCTION: Lymphedema develops due to the abnormality of the transport capacity of the lymphatic system. Clinically lymphedema is not only a cosmetic deformity, but also a disabling and distressing condition. CLASSIFICATION: Primary lymphedema is an inborn defect caused by such condition as absence or underdevelopment of the lymphatic system. It occurs in approximately 1 in 10,000 persons less than 20 years of age, with females being affected more frequently than males. Secondary lymphedema is an acquired condition resulting from loss or obstruction of the previously normal lymphatic system due to infection, tumor, filariasis and other miscellaneous conditions. CLINICAL FEATURES: Clinical symptoms and signs depend on the duration and the severity of the lymphedema. In the early stage of disease, the edema is soft and pits easily with pressure (pitting edema) and may decrease or disappear with elevation of the limbs. In the advanced stage, the skin texture turns woody as the surrounding tissue becomes indurated and fibrotic. DIAGNOSIS: Lymphangiography was introduced in the early 19th century. But there are several drawbacks to this procedure, including the complexity of the procedure, irradiation by contrast agent that may result in lymphangitis and potentially worsen the lymphedema. Lymphoscintigraphy is easier to perform than lymphangiography and is not reported to cause lymphangitis. Lymphoscintigraphy is gradually replacing lymphangiography. TREATMENT: The mainstay of the treatment is complex decongestive physical therapy including leg elevation, elastic or rigid compression, manual lymph drainage, and intermittent pneumatic compression. When the function of the limb is significantly impaired, surgical reduction is considered. The surgery is not curative, but it can make the disorder more manageable by complex decongestive physical therapy.
Classification ; Congenital Abnormalities ; Diagnosis ; Drainage ; Edema ; Extremities ; Female ; Filariasis ; Humans ; Leg ; Lymphangitis ; Lymphatic System ; Lymphedema* ; Lymphography ; Lymphoscintigraphy ; Male ; Skin

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