Patients coming to IMPE Quy Nhon's clinic for Fascioliasis treatment.

Central Vietnam is facing high infection of Fascioliasis, including the provinces of Binh Dinh, Quang Ngai, Phu Yen, Gia Lai, Quang Nam, Khanh Hoa, Da Nang... From the outbreak of Fascioliasis in 2006 to now, over 80% of all Fascioliasis cases were detected from these provinces every year, especially in the first 6 months of 2009, the number of Fascioliasis patients have tended to increase more drastically than the previous years, thus demanding early solutions.

Confronted with the increase of Fascioliasis cases, o­n June 10, 2009, the IMPE Quy Nhon submitted the Document No.173/VSR-KST to the Ministry of Health (MoH) and concerned bodies o­n the increasing situation of Fascioliasis patients and proposed priority measures to protect people's health.

Fascioliasis patients raise in some provinces of Central Vietnam in early 2009

According to the unofficial statistics from some severely-hit provinces of Fascioliasis infection of Central Vietnam, in the first months of 2009 (from Jan 2009 to present) there were 2,085 Fascioliasis cases detected and treated, of which 1,258 in the IMPE Quy Nhon's specialist clinic, 390 in Binh Dinh, 200 in Quang Ngai, 82 in Gia Lai, 71 in Quang Nam, 30 in Phu Yen, 17 in Da Nang, 15 in Thua Thien-Hue, 14 in Khanh Hoa, 6 in Dak Lak, and 2 in Quang Tri, raising 70% against that of the previous years.

 

Fascioliasis patients are waiting for medical	examination and treatment at the Institute's clinic.

Reasons for the increasing number of Fascioliasis patients

1. At present, Fascioliasis is no longer an uncommon parasitic disease, and human is no longer an Fasciola's accidental but adaptable host.

2. The rate of Fascioliasis infection in herbivorous animals is reportedly very high (35-45%), Fasciola eggs were mainly found in the excretion of grass-grazing animals, but now also in human's, creating more favourable conditions for Fascioliasis infection.

3. The protection for the community against Fascioliasis meets a lot of difficulties because of the people's complex habit of eating and drinking, such as eating raw vegetables grown in the water, drinking water contaminating larvae.

The habits of eating raw vegetables grown in the water and drinking water contaminating larvae make the protection for the community against Fascioliasis meet a lot of difficulties.

Fascioliasis control measures in Central Vietnam in recent times

To deal with the complicated situation of Fascioliasis, since 2006, IMPE Quy Nhon proactively reported o­n the disease to MoH, executed ministerial projects involving malaria epidemiology, diagnosed and medically treated Fascioliasis cases; providing MoH with professional advice o­n issuing a guide to Fascioliasis diagnosis and treatment; presented to the World Health Organization (WHO) in Vietnam the needs of specific medicine and to the Ministry of Science and Technology the major national-level projects so as to solve Fascioliasis systematically; trained and supplied drugs to the health care centers of high-infected provinces in Central Vietnam... However, these Institute's proposals haven't been satisfied absolutely; in the past years the dectection and treatment of Fascioliasis patients just conducted in some provincial hospitals and specialist institutes with the supply of specific drug from WHO; the activities of mass communication and education, environmental sanitation and other interventions haven't been carried out yet due to lack of budget and concrete control programme.

In early 2009, the Institute also sent the Document No.110/VSR-KH reporting the situation of Fascioliasis and requesting Egaten supplies to the National Institute of Malarialogy, Parasitology and Entomology (NIMPE) and concerned bodies. From the WHO's medicine support, NIMPE transferred 5,500 Egaten 250 mg tablets to IMPE Quy Nhon to provide the provinces with high rate of Fascioliasis infection; however, from the beginning of this year to now the Fascioliasis cases have increased unexpectedly, so the Institute is facing the risk of lacking drugs in the next month.

Solutions need to be given as a priority

Fascioliasis continues to show an increasing tendency in Central Vietnam, especially in the provinces of Binh Dinh, Quang Ngai, Quang Nam, Phu Yen and Khanh Hoa. Meanwhile, the supply of Egaten 250mg from WHO in Vietnam is not regular, making it difficult for the Institute to take the initiative in providing drugs for provinces consequently.

            In order to solve the Fascioliasis situation effectively in the long term, IMPE Quy Nhon has some suggestions:

The National Institute of Malariology-Parasitology and Entomology

Supporting IMPE Quy Nhon a considerable amount of Egaten 250 mg to provide provinces with high infection rates in the region.

In the short term, transferring a number of Egaten 250 mg from the provinces with fewer Fascioliasis cases to those with patients superior in number to reduce the patient pressure.

The Ministry of Health

Authorising the Institute to purchase Egaten from the import of pharmaceutical companies to take the initiative in treating patients and supplying to health care centers in the region; to propose the budget for drug purchase and methods of drug distribution (selling for budget reclaim or freely allocating to patients)

Providing guidelines o­n the diagnosis and treatment of Fascioliasis patients at the health care centers of highly-infected provinces.

Allowing the Institute to set up the methods for executing projects and the budget for carrying out other measures such as mass communication and education, environmental sanitation and control activities at the community.

Setting up a specific plan or programme for Fascioliasis control in Central Vietnam-a highly-endemic region of the disease - in order to reduce the patient pressure and to control the disease stably.

Holding an intersectoral workshop with the participation of the veterinary sector and other concerned bodies in order to work out the plan for Fascioliasis control o­n the national scale.

The World Health Organization in Vietnam

Continuing to support Egaten to timely meet the demands of health centres in the period of Fascioliasis cases increasing.

Supporting budget to carry out the activities of disease control at the serevely-hit provinces of Fascioliasis infection.

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