HELMINTHS

1. Clinics in endemic areas for schistosomiasis receive a visit at least every month during months December to March from an environmental health officer looking specifically at schistosomiasis control.

2. Clinics receive from the laboratory a summary of results of helminth infections identified from their clinics at least every 6 months.

3. Staff have continuing education in helminth infection in children together with integrated management of childhood illness at least once a year.

1.1 The clinics in endemic areas for schistosomiasis are able to obtain from the district health office a copy of Bilharzia in South Africa, JHS Gear and R J Pitchford, latest edition.
1.2 The clinic has

1.2.1 Posters and public information handouts in endemic areas on schistosomiasis, hydatid disease, cerebral cysticercosis.
1.2.2 Posters and public information handouts on common intestinal helminths (ascaris, trichuris, necator, enterobius, taenia).
1.2.3 Any dam, river or pond near a clinic in a schistosomiasis endemic area has a notice board about the danger for children of swimming there if the EHO has identified it as having infected snails.

2.1 Plastic stool jars for urine and stool specimen
2.2 Laboratory forms and registers

3.1

4.1 Staff know whether the clinic is in an endemic area for Schistosomiasis or other helminths.
4.2 Staff know the relationship between taenia solium from pigs and neurocysticercosis and epilepsy.
4.3 Staff give the correct information to patients on the life cycle of worms and how to prevent future infections.
4.4 Staff take a stool specimen for the laboratory and initiate treatment when a mother complains her child has recurrent abdominal pains, occasional blood in stool, recurrent cough, or when mother says she has seen worms.

5.1 Referred according to protocols for relevant conditions

6.1 Staff advise children against swimming in infected pools and especially between 10:00-15:00 hours when S. haematobium cercariae are shed especially in warmer months. S. mansoni shed earlier 08:00-14:00 so people fetching water or washing are at risk.
6.2 Staff advise the community on the danger of, and to store water for 48 hours before, washing or drinking if from an identified schistosoma infected dam or pool.
6.3 Staff educate mothers on bringing up children to wash hands, wash fruit and vegetables, use a toilet correctly, not swim in dangerous water, not defecate near a river or urinate in water.

7.1 All records kept according to protocol.

8.1 Staff help with mass prevention or treatment projects initiated by district e.g. deworming pre-school children, treating school children in hyper-endemic areas of schistosomiasis.

9.1 Staff seek to involve the community with EHO in control measure advocated by District.
9.2 Staff work with schools to involve teacher, pupils and parents in district advocated control measures.
9.3 Staff discuss the importance of the "health promoting school" with teachers and parent-teacher associations in the catchment area.