Journal Duty Day 6 - Baetiong
Journal Duty Day 6 - Baetiong
Journal Duty Day 6 - Baetiong
A.
Title of the Article: Community-based surveillance of Cryptosporidium in the
indigenous community of boliwong, philippines: From april to december 2017
Authors: Ryan V. Labana, Julieta Z. Dungca, Veeranoot Nissapatorn
Source in APA format:
Labana, RV., Dungca, J.Z., & Nissapatom, V., (2018, September 28). Community-based
surveillance of Cryptosporidium in the indigenous community of boliwong,
philippines: from april to december 2017. Retrieved from
https://www.eepih.org/journal/view.php?doi=10.4178/epih.e2018047.
Year Published: 2018
B.
Objectives of the Study
The researchers of the study aimed to identify the possible role of Cryptosporidium in the
emergence of waterborne diseases in the Philippines. It also deemed to make the data
from the study using a specific ethnic group from Cordillera Administrative Region
(CAR), a model that may be used as a basis for other indigenous groups in terms of
epidemiology. The researchers also wanted to know the risk factors of Cryptosporidium
infection and to know the mode of transmission, to aid in developing sensitive and
effective health programs.
C.
Characteristics of the sample
The researchers made CAR the focus, and source of sample and data for their research.
The Tuwalis ethnic group were inhabitants of Boliwong, Lagawe, Philippines. They were
distributed in three types of lands: the lowland, midlang, and the upland. Each land type
had Tuwalis people that participated in the study. The total number of Tuwalis
participants was 137 out of the 1680 Tuwalis that reside in the community. There were 30
participants out of 560 occupants, 35 participants out of 550 inhabitants, and 72
participants out of 570 occupants from lowland, midland, and upland respectively. The
researchers also used animals such as 7 cats, 12 dogs, 6 goats, 4 pigs, 2 carabaos, and 6
chickens as sample. They also gathered the necessary data from the bodies of water that
surround the area like river, creek, and pumps.
D.
Research design, tools, method, and data analysis
The researchers made a quantitative study. The researchers conducted a cross-sectional
study from April-December 2017. They distributed consent forms and asked the
participants to read and sign them before proceeding in gathering data from them. They
gave a standardized questionnaire which contains questions to the Tuwalis participants
about their household income, water sources, sanitation, and hygiene practices. They then
asked them to give fecal sample with the provided container with spoon. The researchers
also obtained fecal samples from the animals in the community. They also went to get
water sample from rivers, creek, and pumps. After obtaining the necessary data, the water
sample and the fecal sample were tested in a laboratory. The fecal sample was tested
using Ziehl-Neelsen staining, which was conducted to identify Cryptosporidium oocysts.
The researchers followed the usual method of using Ziehl-Neelsen staining. After
staining, they then looked at the slides that contain the sample to look for the oocysts of
Cryptosporidium. The water sample was tested for Cryptosporidium by: first, the samples
were filtrated using nitrocellulose membrane by mild suction using a vacuum pump. The
sediments that were collected were washed and put in a centrifuge. Thirdly, the sample
was aspirated in a 10 mL syringe. Then, they isolated the Cryptosporidium oocysts usin
magnetic particle concentrator. After isolation, the sample was fixed in a slide. The slide
which contains sample was tested using fluorescence to detect and confirm the presence
of the oocysts which all depended on the shape, and the bright apple-green color of
fluorescence of oocysts. The researchers divided the sample that has Cryptosporidium
oocysts by the total number of samples from each group to determine the prevalence rate.
The data was analysed by SPSS version 23.0 and univariate logistic regression analysis.
E.
Findings and conclusion
The researchers found out that there were Cryptosporidium oocysts in all their sample
groups. For fecal sample, there were 39 that were positive for the Crytosporidium
oocysts. These participants that were infected had some of them reported that they were
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already experiencing diarrhea in the past six months, had amoebiasis, had hastroenteritis,
and had a case of vomiting. Some on the other hand, had no signs of infection. The
animal fecal sample reported that all except cat and carabao groups have at least one
sample that has Cryptosporidium. The water sample then showed that each water body
contains oocysts of Cryptosporidum. The researchers concluded that the Tuwalis group in
Boliwong are at risk of getting Cryptosporidium infections. They made a correlation
between the general sanitation of each household with the risk of getting the infection.
The sample that has low quality of sanitation have the most number of people that was
positive for occysts of Cryptosporidium. They noted that many of the Tuwalis have
untreated natural spring as their main and only source of water while others go to other
places to buy mineral and distilled water. They also noted that some of the people have
their children run around without footwear, and have animals freely roaming around their
outdoors. Many of the people also open defecate. Lastly, they also noted that the water
irrigation used in farming in various neighbour towns have the long stretch of river and
creek that have Cryptosporidium oocysts and said that there is a possible risk for others to
consume contaminated produces and get the infection.
F. Nursing implication, significance, and personal reaction
It is important for a community to understand the health risk present in their environment
and how they could change or avoid it. In a community setting, health teaching plays an
important role in improving the community’s health because it also allows the members
to become independent and capable of managing their health. The study showed that
there is a risk of Cryptosporidium infection in Boliwong and risk of spreading the
infection further to other neighbouring towns through water contamination. Nurses
attending Boliwong should teach the people the importance of proper sanitation. They
should tell them that the infection can easily be transmitted with the current general
sanitation and hygienic practices in their community. They should also explain them the
effects of the acquiring the infection and that some of them are actually experiencing
already. For example, they should tell them that they can get diarrhea, they could be
nauseous, and they could vomit, have stomach cramps and pain, lose weight, get fever,
and get complications especially if they have weak immune system. The nurses should
also teach the community how to prevent acquiring the infection. For example, for
households that have the natural spring as their source of drinking water, and have low
income, nurses can advise them to at least boil their water for a minute before drinking.
The nurses can also inform the people, that if their house has a filter for water, that it
cannot filter bacteria or viruses, and a different filter system can do it. The nurses also
teach the people to not let children run around without footwear because they can acquire
not only Cryptosporidium but also many other microorganisms that can threaten their
health. They should also be taught to not defecate in their water sources or any body of
water; if their socio-economic status cannot afford a toilet and private bathroom, they
should at least use other alternatives like arinolas and then dump then in proper places or
bury them at least 6 feet deep. They could also just urge their local government to
provide a clean, public bathroom, and that the people then should maintain cleanliness of
the public bathroom. The nurses should promote proper handwashing to avoid spreading
and acquiring of other communicable and transmitted illnesses as well. The nurses in the
community and neighbouring community should urge the people to clean or cook their
rice, fruits and vegetables thoroughly since the water in the farm had the contaminated
water bodies as sources for irrigation. The nurse should also tell the people to not let their
domestic pets defecate everywhere, because they can also spread the infection. In
general, a nurse should teach and make the people understand the importance of
sanitation and hygiene.
There are many communities in the country that have people that have low-income and
are therefore expected to not have the proper means of maintaining a good sanitation and
proper hygiene practices. However, for me, it is important for nurses and student nurses
to teach educate them the importance, and then provide them alternatives that are
appropriate for them and easy. The people can understand the risks of their current
conditions but most of them do not have the knowledge and money to change them. They
can be willing but still not be able to do anything, and it will be them and other people
that may suffer the consequences. So, it will be good to help them with those problems by
giving options. Nurses and other health care professionals should always consider the
situations of their clients and adjust to them to the best of their knowledge and abilities.