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Users of the University of the Philippines (UP) Manila’s Medical Teleparasitology Project are able to access a database, share their digital images, express medical opinions, and communicate with experts.

The Medical Teleparasitology Project referral system provides local health professionals with the link to experts in the referral center without requiring the experts to travel to rural areas. This referral system may result in accurate and timely diagnosis and may improve the diagnostic capacity of laboratory personnel in the provinces.

This type of “tele” or distance health services also aims to develop database of the cases referred to the system that will map out the distribution of parasitic infections in the Philippines. This will be useful in providing quality data and evidence vital for advocacy and policy formulations.

The UP College of Public Health Department of Parasitology offers intensive training course in diagnostic parasitology. The Emerging Parasitoses Laboratory at UP Manila’s Institutes of Health has been tapped to provide technical support.

The Medical Teleparasitology Project is now working at the Cordillera Administrative Region. Trainings in diagnostic parasitology and medical teleparasitology have been conducted at the Saint Louis University, Baguio City, one of the regional partner academic institutions.

The system as undergone lpha testing to identify bugs, errors, crashes, missing documents and the concerns of test engineers or website developers and project staff. Beta testing followed to improve the quality of the system by integrating the inputs of the medical technologists, members of the expert pool and the system administrators.

Initially, a low response was observed among the medical technologists in terms of the number of consultations or referrals submitted. The administrator was able to trace the difficulties mostly to unstable Internet connections.

Far from city centers, the Medical Teleparasitology Project often means the difference between life or death or, at the least, suffering from the debilitating effects of neglected tropical diseases.

Neglected tropical diseases include infections caused by a variety of pathogens such as viruses, bacteria and protozoa, and parasitic worms. According to the World Health Organization, these are mostly ancient diseases that have plagued humanity for centuries and are associated with unsafe water, poor sanitation, and impoverished living conditions. These old diseases have reared their deadly presence or are re-emerging, especially in developing countries.

The Philippines is endemic for a number of parasitic infections, many of which are “neglected” because of the peripheral care that is afforded to those who suffer from tropical diseases that affect mostly the poor in communities hardly served by health services. What is worse is that there have been previous reports of misdiagnoses of these infectious diseases of poverty, resulting in the delay of treatment that prolongs suffering.

Only a few years back, schistosomiasis, for example, was initially misdiagnosed before it was finally reported in the provinces of Cagayan and Negros Occidental.

A “mystery disease” that resulted in 12 deaths in Monkayo, Compostela Valley, was confirmed as capillariasis only when a local medical technologist sent a stool specimen to the University of the Philippines all the way to Manila.

An outbreak of intestinal capillariasis in Compostela Valley was eventually confirmed through an investigation by a group of experts from the Department of Health and at the Philippines General Hospital, UP Manila.

The situation makes it a significant public health concern. Addressing these challenges in diagnoses needs serious efforts in developing the proficiency of laboratory analysis, especially in government health facilities mostly catering to the poor who have no access to accurate but expensive laboratory tools.

Appropriate medical management of parasitic infections by health professionals largely depends on accurate and timely diagnosis through microscopy and other laboratory techniques. However, most peripheral laboratories in the Philippines, especially those in government health units, lack the necessary expertise for accurate diagnosis of less common parasitic infections which are emerging or re-emerging diseases.

The expertise is available in certain referrals centers like UP Manila or in regional medical centers. However, most health professionals in the provinces, especially those far from urban centers, encounter difficulties in diagnosis and do not have the benefit of a referral mechanism.

As a result, parasitic infections are either misdiagnosed and mismanaged or left undiagnosed and untreated.

The Medical Teleparasitology Project has provided training, reference, diagnostic assistance, and continuing education for medical technologists for timely and accurate diagnosis of parasitic infections and to develop a database of the cases referred to the system software that will map out the distribution of parasitic infections in the country.

Correct and timely diagnosis of parasitic infections has been provided, preventing misdiagnosis and allowing the appropriate management of cases especially in far-flung and undeserved areas. Members of the network are part of a feedback mechanism that shares microscopy and laboratory findings, express opinion and communicate with experts in the field – and vice versa.

The initiative supports the Neglected Tropical Disease Information System being developed by the Department of Health through a database of all referred cases that will utilized in mapping parasitic infections. It will also update data and generate new information to improve current guidelines and policies on Neglected Tropical Diseases.

It is a collaborative project with the Department of Science and Technology, Department of Health Regional Offices, and the Philippine Association of Medical Technologists.

 

Written by: 
Dr. Vicente Belizario Jr. and Herschel Don Go
University of the Philippines Manila

Published by:
Department of Science and Technology-Science and Technology Information Institute (DOST-STII)

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