Implementation of the

Harmonized Schedule and

Combined Mass Drug
Administration (HSCMDA)
for the Prevention and
Control of Lymphatic
Filariasis,
Schistosomiasis and
Soil-Transmitted
Helminthiasis

Rationale :
recognizes the importance thereof and
acknowledges the responsibility of the
government to accelerate its activities on
prevention and control of neglected tropical
diseases that are implementing the preventive
chemotherapy (PC) strategy specifically
lymphatic filariasis (LF), schistosomiasis (SCH)
and soil-transmitted helminthiasis (STH). As a
response, the DOH is streamlining its strategies
and enhancing resources to successfully
implement mass drug administration (MDA) by
harmonizing the schedule and combining mass

General Objective:

To improve the service delivery of mass drug

administration for the prevention and control of
lymphatic filariasis (LF), schistosomiasis (SCH) and
soil-transmitted helminthiasis (STH).

Specific Objectives :
1. To increase MDA coverages to at least 85%
using
the
target
population
as
the
denominator.
2. To improve efficiency of health service delivery
and to maximize limited resources by:
(i) harmonizing the schedule of community &
school based MDA;
(ii)harmonizing the MDA schedules of LF, SCH
and STH; and
(iii)combining drug administration especially for
school aged children

Specific Objectives :
3.To improve quality and timeliness of recording and
reporting for
evidence-based decision making by
ensuring completeness and accuracy of data and by
providing identified deadline periods and mode of
submission.

Scope and Coverage :

This guideline includes information on:
(1) drug of choice and dose,
(2) schedule of MDA by disease and by target
population,
(3) computing for target population and actual drug
requirement
(4) drug delivery and monitoring,
(5) master listing,
(6) assessment of eligible and ineligible individuals,
(7) step by step process of conducting MDA,
(8) recording and reporting procedure, and
(9) management of different levels of adverse events
following MDA.

Scope and Coverage :

This Department Memorandum shall serve as guide
for all DOH personnel who are involved in the
harmonized schedule and combined mass drug
administration for lymphatic filariasis, schistosomiasis
and soil-transmitted helminthiasis.

Drug of Choice and Dose

Lymphatic Filariasis
The drug of choice for lymphatic filariasis is a
combination of Diethylcarbamazine citrate (DEC)
and Albendazole (ALB).

Dose: DEC will be given at a dose of 6mg/kg of body

weight and Albendazole at a dose of 400mg/single
standardized dose. Both should be given within 2
hours after a meal.

Health workers may also use agewise dosing as shown below.

Table 1. Age-Wise Dose for Diethylcarbamazine citrate and
Albendazole
NUMBER OF DEC NUMBER OF ALB
AGE
TABLETS
TABLETS
2-5 years
1 tablet
1 tablet
old
6-12 years
2 tablets
1 tablet
old
13-20 years
4 tablets
1 tablet
old
21+ years
5 tablets
1 tablet
old

Drug of Choice and

Dose
Schistosomiasis
Praziquantel (PZQ) for mass drug administration in
schistosomiasis endemic areas.

Dose: Single dose of 40mg/kg body weight to be

given within 2 hours after a meal. In facilities that
do not have a weighing scale, the table below could
be used to estimate the PZQ dosages based on
weight.

Table 2. Dose Calculation of Praziquantel, 600mg

WEIGHT (kg)
8-11
12-15
16-18
19-22
23-26
27-30
31-33
34-37
38-40
41-45
46-49
50-52
53-56
57-60
61-63
64-67
68-71

NUMBER OF
TABLETS

1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4

TOTAL DOSE
(mg)
450
600
750
900
1050
1200
1350
1500
1650
1800
1950
2100
2250
2400
2550
2700
2850

Alternatively, health
workers may also
use the modified
WHO dose pole for
praziquantel for
school-age children
(SAC) which will be
provided by the
DOH Central Office.

Drug of Choice and

Dose

oil-Transmitted Helminthiasis
Albendazole (ALB) or Mebendazole (MBD) for the
prevention, control and treatment of soil-transmitted
helminthiasis.

Dose:
Albendazole 200mg or tablet for children who are
more than 1 but below 2 years old.
Albendazole 400mg or 1 tablet for children who are 2 to
18 years old.
Mebendazole 500 mg for 1 to 18 years old.

These drugs are given every 6 months. Drug is

Specific Guidelines

edule of MDA by Disease and by Target Population

Mass drug administration for lymphatic filariasis
and schistosomiasis shall be done once a year
whereas
Mass Drug Administration for soil-transmitted
helminthiasis shall be done twice a year.

Table 3. Schedule of MDA by Disease and by Target

Population
DISEASE
Lymphatic
Filariasis
Schistosomiasis

Soil-Transmitted
Helminthiasis

TARGET
POPULATION

MONTH

2 years old and above

July

5 to 65 years old

January

1 to 4 years old
(Round 1)

January

1 to 4 years old
(Round 2)

July

5 to 18 years old
(Round 1)

July

5 to 18 years old
(Round 2)

January
(of the following
year)

Computing for Target Population,

Drug Requirement and Actual Drug
Requirement

Computing for Target Population

Formula:

Target Population = Total Population x Percent by

Age Group

Definition of Terms:
Total Population- is the total number of people
living or residing in a particular endemic area.
Target Population- is the proportion of
individuals/people eligible for treatment from the
Total Population.

Table 4. Percent by Age Group

DISEASE

AGE GROUP

Lymphatic
Filariasis
Schistosomiasi
s
SoilTransmitted
Helminthiasis

2 years old and

above
5 to 65 years old
1 to 4 years old
5 to 18 years old

% FROM TOTAL
POPULATION
94.85%
83.66%
10.23%
32.14%

mputing for Drug Requirement:

For Lymphatic Filariasis Endemic Areas still

Implementing MDA

Albendazole = Total Population x 1 tablet

Diethylcarbamazine citrate = Target Population x 4 tablets

For Schistosomiasis Endemic Areas

Praziquantel = Target Population x 4 tablets

For Soil-Transmitted Helminthiasis Endemic Areas

Albendazole = Target Population x 1 tablet x 2 rounds

Computing for Actual Drug

Requirement
Formula:

Actual Drug Requirement = Drug Requirement Remaining

Balance

The
DOH Central Office shall provide an Excel File that will

automatically compute for the target population and

actual drug requirement.

rug Delivery and Monitoring

1. Diethylcarbamazine
citrate,
praziquantel
and
albendazole for community based deworming shall
be delivered to the DOH Regional Offices whereas
albendazole for school-based deworming shall be
delivered to the school divisions.
2. Supportive drugs for the management of adverse
events shall be the counterpart of Local
Government Units.
3. DOH Central Office and Regional Offices must assign
one (1) point person from the programs for the
coordination and monitoring of drug delivery.
4. DOH Central Office and Regional Offices shall use
the prescribed drug delivery monitoring tool for
HSCMDA (Annex C).

Master Listing
DOH Regional Office Staff are responsible for reminding their
counterparts on the following:
1. Rural health midwives, with the assistance of other
rural/barangay health workers if available, shall prepare an
official master list of eligible individuals from their latest census
one month before the MDA.
2. The official master list shall contain the following information:
surname and given name, gender, age and address. The official
master list shall also serve as the recording form.
3. Rural/barangay health workers shall request for a copy of school
enrollment from public kinder, elementary and secondary
schools within their barangay to confirm enrolment of schoolage children (5 to 18 years) against the official master list.
4. School-based MDA shall use Form 1-Classroom Level from the
Department of Education Memorandum No. 80, s. 2015,
Annex B.1 as the school master list in public elementary and
secondary schools.

Assessment of Eligible and Ineligible

Individuals
for MDA
Similarly, DOH Regional
Staff are responsible for reminding their
counterparts on the following:
Health workers and/or teachers are strongly advised to make careful
assessment of all individuals before administering the drug/s especially for
contraindications.

Table 5. Ineligible Individuals by Disease and by Health

Condition
DISEASE
CONTRAINDICATION
GIVE WITH CAUTION

Lymphatic Filariasis

Drug of Choice:
Diethylcarbamazine citrate
and Albendazole

Particularly on DEC

Should not be given to the

following individuals:
1. Children below 2 years old
2. Those who have cardiac or
renal disease
3. Those who are pregnant
4. Bed ridden and seriously ill

Particularly on DEC

Should be given with caution to

the following individuals:
1. Those who have asthma
2. Those who have history or
are predisposed to seizure
episodes
3. Those who have very low
weight for height or those
severely malnourished

Table 5. Ineligible Individuals by Disease and by Health

Condition

DISEASE

CONTRAINDICATION

Schistosomiasis

Drug of Choice:
Praziquantel

Should not be given to those

who are bed ridden and
seriously ill

Soil-Transmitted
Helminthiasis

Drug of Choice:
Albendazole or
Mebendazole

No contraindication

GIVE WITH CAUTION

Should be given with caution

to those who are taking
rifampicin because it
decreases plasma
concentration of praziquantel.
Should be given with caution
to the ff. individuals:
1. Children who are seriously
ill
2. Children experiencing
abdominal pain at the
time of MDA
3. Children with diarrhea
4. Children who previously
suffered hypersensitivity
to the drug
5. Severely acute
malnutrition children

Step by Step Process of Conducting MDA

House-to-House MDA Procedure

Table 6. House-to-House MDA Procedure
ACTIVITY

RESPONSIBLE
PERSON/S
1. Prepare official master list
Rural Health
Midwife (RHM)
2. Inspect and prepare drug/s taking note of
RHM and other
name, batch number, lot number, expiration
health workers in
date and appearance. This also applies to
the Rural Health
supportive drugs for the management of mild to Unit (RHU) or
moderate adverse events. Report near expiring Barangay Health
or suspicious/odd looking drugs immediately to Station (BHS)
the Municipal/City Health Office. This
information must be shared up to the DOH
Central Office level.
3.Inform community about the schedule of MDA RHM and other
and conduct health education about lymphatic
health workers in

TIMEFRAME
One month
before MDA
before MDA

1-2 weeks
before MDA

Table 6. House-to-House MDA Procedure

ACTIVITY

RESPONSIBLE
PERSON/S

TIMEFRAME

4. Conduct house-to-house visit and drug

administration.

Important reminders:
Assess for any contraindications prior to
administering the drug. Give drugs within 2
hours after a meal.
Observe and manage for any acute mild to
moderate adverse event right after drug
administration. Advise household members to
report any adverse events following MDA to
RHU or BHS, especially serious adverse events.
Adverse events usually happen within 12 hours
after ingesting the drug/s.
Refer individual/s immediately to any
government hospital if adverse event becomes
severe or serious.
Conduct mop up of missed eligible individuals
based on the official master list/recording form.

RHM and other health

workers in the RHU or
BHS

1 month

Criteria for House-toHouse MDA:

House-to-house MDA is suggested to be done only in

circumstances where the target population are
located in Geographically Isolated and
Disadvantaged Areas (GIDA) or during mopping-up
operations. Fixed site MDA is recommended for a
more practical use of limited resources such as
manpower, time and funding.

ixed Site MDA Procedure

Table 7. Fixed Site MDA Procedure
(Rural Health Unit/Barangay Health Station)
ACTIVITY

RESPONSIBL TIMEFRAME
E PERSON/S
1. Prepare official master list
Rural Health
One month

Midwife
before MDA
2. Inspect and prepare drug/s taking note of RHM and other before MDA
name, batch number, lot number,
health workers
expiration date and appearance. This also
in the RHU or
applies to supportive drugs for the
BHS
management of mild to moderate adverse

events. Report near expiring or

suspicious/odd looking drugs immediately
to the Municipal/City Health Office. This
information must be shared up to the DOH

Table7.FixedSiteMDAProcedure
(RuralHealthUnit/BarangayHealthStation)
3. Inform community about the schedule of MDA and
conduct health education about lymphatic filariasis,
schistosomiasis and/or soil-transmitted helminthiasis as
appropriate.
4. Conduct fixed site MDA

Important reminders:
Assess for any contraindications prior to
administering the drug. Give drugs within 2 hours
after a meal.
Observe and manage for any acute mild to
moderate adverse event right after drug
administration. Advice individuals to report any
adverse events following MDA to RHU or BHS,
especially serious adverse events. Adverse
events usually happen within 12 hours after
ingesting the drug/s.
Refer individual/s immediately to any government
hospital if adverse event becomes severe or
serious.

RHM and other

health workers in
the RHU or BHS

RHM and other

health workers in
the RHU or BHS

1-2 weeks before

MDA
3 weeks


Table 8. School Based MDA
ACTIVITY
RESPONSIBLE
Procedure
PERSON/S

1. Prepare school master list

Teacher/DepEd
2. Take note of all enrolled SAC after comparing official
master list and school master list.
3. Inspect and prepare drug/s taking note of name,
batch number, lot number, expiration date and
appearance. This also applies to supportive drugs for
the management of mild to moderate adverse events.
Report near expiring or suspicious/odd looking drugs
immediately to the School Division then to the
Municipal/City Health Office. This information must be
shared up to the DOH Central Office level.
4. Inform parents about the schedule of MDA in school
and conduct health education about lymphatic
filariasis, schistosomiasis and/or soil-transmitted
helminthiasis as appropriate.

RHM and other

health workers in
the RHU or BHS
DOH Regional
Office, RHU/BHS,
DepEd Warehouse
Staff and Teachers

RHM and other

health workers in
the RHU or BHS

TIMEFRAME
One month before
MDA
before MDA
before MDA

2 weeks before
MDA

5. Inform parents about the schedule of MDA in school

and conduct health education about lymphatic filariasis,
schistosomiasis and/or soil-transmitted helminthiasis as
appropriate.
6. Bring diethylcarbamazine citrate or praziquantel
(depending on schedule of MDA) from RHU/BHS to
school.
7. Conduct school-based MDA
Important reminders:
Assess for any contraindications prior to
administering the drug. Give drugs within 2
hours after a meal.
Observe and manage for any acute mild to
moderate adverse event right after drug
administration. Advice students and parents to
report any adverse events following MDA to
RHU or BHS, especially serious adverse events.
Adverse events usually happen within 12 hours
after ingesting the drug/s.
Refer student/s immediately to any government
hospital if adverse event becomes severe or
serious.

RHM and other

health workers in the
RHU or BHS

RHM and other

health workers in the
RHU or BHS
Rural Health Midwife
and other health
workers in the
RHU/BHS; School
Teachers and other
DepEd staff

2 weeks before
MDA
During MDA
1 month

All SAC enrolled in public kinder, elementary and secondary

schools shall receive drug/s in school.
SAC who are not in the school master list shall receive
drug/s in the rural health units/barangay health stations or
through house-to-house visit, unless the child is enrolled in
a public school in another barangay. If so, the child will
receive the drug/s in the other school and counting will
belong in the same school.
This information must be coordinated properly between
school and RHU/BHS so that there will be no confusion in
the reporting of accomplishment.
SAC enrolled in private schools shall receive the
drug/s in the RHU/BHS unless the school is
participating. If so, SAC enrolled in participating private
school shall receive the drug/s in school. It is the
responsibility of the RHU/BHS to collect accomplishment
report of MDA in private schools.

ording and Reporting Procedure

Recording and Reporting of
Accomplishments

1. Health workers and teachers must ensure completeness and

accuracy of MDA data. Completeness is defined as all
variables in the MDA recording and reporting form are filled.
Accuracy is defined as correct computation of treated versus
target population to determine accomplishment. Correct and
truthful information must be guaranteed at all times.

ording and Reporting Procedure

rmula for computing accomplishment

Accomplishment (MDA Coverage) =
(Total number of individuals who ingested the drug / Target
Population) x 100%
2. Community- based MDA shall use the prescribed
accomplishment reporting form.
3. A report is considered official if the document contains
the signatures of the person who accomplished and who
verified. Unsigned reports are not valid.

. Schedule of submission of reports will be as follows:

Table 9. Deadline of Submission of Reports to DOH Central
MODE OF
Office
REPORT
DEADLINE
REPORTING

Community and School Based MDA

Accomplishment

Weekly Report

Final Report

Every Wednesday of the

Week at 5:00 PM

2 weeks after end of MDA

month (Wednesday at
5:00 PM)

Using Excel File

disseminated by DOH
Central Office, send
report to
ntd.doh@gmail.com

Official Document via

Email (PDF) or through
courier

5. Only text and email messages from

designated Regional MDA Focal Persons
shall be acknowledged by the DOH Central

Recording and Reporting of

Adverse Events (AE) Following
MDA
1. Health workers and teachers are strongly advised to record and
report all adverse events regardless of severity (mild, moderate,
severe or serious).
2. Severe and serious adverse events must be reported
immediately to the Municipal/City, Provincial & Regional
Epidemiology Services Unit (MESU/CESU, PESU, and RESU), the DOH
Central Office (DOH CO) Epidemiology Bureau (EB) and the Food
and Drug Administration (FDA).
3. Confirmed severe or serious adverse events must be relayed
by the DOH Regional Office to the DOH Central Office as soon as
possible.
4. Official EB and FDA forms shall be used for the reporting of severe

Management of Different Levels of Adverse

Events Following MDA
Table 11. Management of Adverse Events
LEVEL
Mild

Moderate
Severe

Serious

DEFINITION
An undesirable
experience associated
with the use of
albendazole but not
affecting daily activity.
Those affecting
performance of daily
activities.
Those requiring total rest
and/or medication.

Those requiring

MANAGEMENT
Observe, document and provide supportive
drugs as necessary.

Observe, document and provide supportive

drugs as necessary.

Refer immediately to any government

hospital
MESU/CESU and PESU to alert upper
levels
RESU to alert DOH CO EB and FDA
Refer immediately to any government

Table 10. Recording and Reporting of AEs

following
MDA
ADVERSE
TIMEFRAME
FOR
FORM
EVENT
Mild

Severe

REPORTING
Together with Final
Accomplishment Report

Together with Final

Accomplishment Report

Immediately

Serious

Immediately

Moderate

DOH CO Form for

AEs
DOH CO Form for
AEs
Both EB and FDA
forms
Both EB and FDA
forms

Note: Technical and funding support shall be provided by the

DOH Regional Office in the event of hospitalization (in
government hospitals) due to severe/serious adverse event
following mass drug administration.

In view of the foregoing, each Region shall designate one (1)

coordinator to oversee the implementation of HSCMDA.

Please be guided accordingly.

Thank
you!