Community Health Workers' Concept and Understanding of Diabetes: A Qualitative Study.

Objectives: Community health workers (CHWs) fill in the insufficiency of health professionals in low-income countries. The CHWs' roles include health education of their constituents whose health they likewise take care. This study aimed to describe the concept and understanding of diabetes among CHWs in the Philippines. Methods: Fifty female CHWs currently working in rural and urban areas participated in six focus group discussions with guidance from Kleinman's eight questions. With the written informed consent of the participants, discussions were recorded and transcribed by the Research Assistant. A multi-disciplinary team manually analyzed the data. Disagreements were discussed among them and the physicians provided clinical analyses and explanations on the results. Quotations of an important point of view were also presented. Pseudonyms were utilized to uphold anonymity. Results: CHWs were aged 32 to 72 years; older participants reside in rural areas. Majority were married, housekeepers, and high school graduates. Some CHWs and their family were suffering from diabetes or dyabetis, the disease of the rich according to them. Its causes were food and lifestyle, and believed to be hereditary. Complications lead to death. Amputation was feared the most. Diabetes is incurable. Persons with diabetes should take maintenance medicines, and seek physicians' and family's help. Together with the patient, the family must decide on its management. Balanced diet, healthy lifestyle, maintenance medicines, food supplements, and herbal plants were perceived treatments. The internist should lower blood sugar level as well as prolong life span. Proper diet and regular check-up prevent diabetes. Conclusions: CHWs' concept and understanding of diabetes reflect some of the biomedical causes, effects, treatment, and prevention of diabetes as well as its social determinants. The efficacy and safety of herbal plants in the treatment of diabetes, however, should be further studied. Training on diabetes care should be provided to address their fears of amputation, insulin injection, and complications.

Designathons in health research: a global systematic review.

INTRODUCTION: A designathon is a three-stage participatory activity informed by design thinking. There is a growing literature on designathons in health. This study synthesised designathons' effectiveness and implementation-related factors to address health challenges. METHODS: We searched Cochrane Library, Embase, PubMed, Scopus and the ClinicalTrials.gov registry for articles containing primary data on designathons for health from their dates of inception to 29 November 2022. We retrieved additional studies from citation searching and a complementary open call. We synthesised data on designathons' effectiveness (ie, engagement, outputs and implementation), required resources and implementation-related factors (ie, resources, facilitators, barriers, strengths and limitations). We assessed the risk of bias using a checklist adapted from Joanna Briggs Institute Critical Appraisal tools. RESULTS: In total, 4973 citations were identified, and 42 studies were included. In total, 26 studies (62%) were from high-income countries. The median number of total participants was 49, divided into a median of 8 teams. The duration of the intensive collaboration phase ranged from 3 hours to 7 days. Common evaluation criteria were feasibility, innovation and impact. Idea and prototype outputs included mobile phone applications, educational programmes and medical devices. Interventions developed from a designathon was estimated to be highly cost-effective. The most common facilitators were interdisciplinary participants and high-quality mentorship. The most common barriers were suboptimal execution of the events, difficulties in balancing interdisciplinary participants across teams and limited support for participants along the process. There were limited data on required resources and further implementation of solutions after designathons. CONCLUSION: Given designathons' adaptability in terms of budget, mode of delivery, type of output and involvement of diverse participants, including end users, designathons can be implemented in a wide range of contexts to address various health issues. PROSPERO REGISTRATION NUMBER: CRD42023389685.

High TB burden and low notification rates in the Philippines: The 2016 national TB prevalence survey.

SETTING: The 3rd national tuberculosis (TB) survey in the Philippines in 2007 reported a significant decline in the prevalence of TB. Since then, more significant investments for TB control have been made, yet TB burden estimates from routine surveillance data remain relatively stable. OBJECTIVE: To estimate the prevalence of bacteriologically confirmed pulmonary TB in the Philippines amongst individuals aged ≥15 years in 2016. DESIGN: In March-December 2016, we conducted a population-based survey with stratified, multi-stage cluster sampling of residents in 106 clusters aged ≥15 years. Survey participants were screened for TB by symptom-based interview and digital chest X-ray. Those with cough ≥2 weeks and/or haemoptysis and/or chest X-ray suggestive of TB were requested to submit 2 sputum specimens for Xpert MTB/RIF, direct sputum smear microscopy using LED fluorescent microscopy, and mycobacterial solid culture (Ogawa method). Bacteriologically confirmed pulmonary TB was defined as MTB culture positive and/or Xpert positive. RESULTS: There were 46,689 individuals interviewed, and 41,444 (88.8%) consented to a chest X-ray. There were 18,597 (39.8%) eligible for sputum examination and 16,242 (87.3%) submitted at least one specimen. Out of 16,058 sputum-eligible participants, 183 (1.1%) were smear-positive. There were 466 bacteriologically confirmed TB cases: 238 (51.1%) Xpert positive, 69 (14.8%) culture positive, and 159 (34.1%) positive by both Xpert and culture. The estimated TB prevalence per 100,000 population aged ≥15 years was 434 (95% CI: 350-518) for smear-positive TB, and 1,159 (95% CI: 1,016-1,301) for bacteriologically confirmed TB. CONCLUSION: This nationally representative survey found that the TB burden in the Philippines in 2016 was higher than estimated from routine TB surveillance data. There was no evidence of a decline in smear and culture positive TB from the 2007 survey despite significant investments in TB control. New strategies for case-finding and patient-centered care must be intensified and expanded.

Quality of life of patients with traumatic brachial plexus injuries.

BACKGROUND: Traumatic brachial plexus injuries are devastating injuries with lifelong disability and pain. The objective of this paper was to determine the functional disability of adult patients with traumatic brachial plexus injuries. PATIENTS AND METHODS: A cross-sectional study was done to determine the functional disability of patients using the FIL-DASH (Filipino Disability of the Arm, Shoulder and Hand) and the BPI (Brief Pain Inventory) Severity Pain Score (Tagalog version) questionnaires to determine the functional disability and quality of life of patients with traumatic brachial plexus injuries. A regression analysis was done to determine the factors associated with the FIL-DASH score with the level of significance set at p < 0.05. RESULTS: A total of 126 adult patients with traumatic brachial plexus injuries were evaluated with a mean age of 30.1(standard deviation [SD], 9.1; range, 17-69). There were 123 males and three females. The mean quality of life (FIL-DASH Score) of the 126 patients was 45.6 (95% CI: 42.5 - 48.7), (SD, 17.4), (range, 2.5 - 89.2), the mean BPI Severity Pain Score was 16.1 (95% CI: 14.6-17.8; SD, 8.9; range, 0-36) among 126 patients. On multivariate analysis using the hierarchical method of model building, higher range of elbow flexion, lower Brief Pain Inventory Severity Score, and longer months from injury were found to be associated with a better FIL-DASH score. CONCLUSION: The study showed that elbow flexion recovery, pain and duration of the injury were significantly associated with the FIL-DASH scores.

Design and Evaluation of Risk Assessment Tools to Identify Pediatric Tuberculosis Infection in Bohol, the Philippines, a Low-HIV- and High-TB-Burden Setting.

Identifying children with, or at substantial risk of, Mycobacterium tuberculosis infection (TBI) and providing TB preventive therapy (TPT) represent an important, yet challenging, strategy in curbing the global burden of childhood TB. Risk assessment scoring tools, which quantify risks associated with unique factors characterizing an individual, could act as a surrogate measure of TBI risk and guide effective and efficient TPT delivery. We assessed important risk factors of childhood TBI and created risk assessment tools through secondary analysis of data from a large, community-based childhood TB prevalence study in the island province of Bohol in the Philippines, a low-HIV- and high-TB-burden, post-disaster setting. We identified four factors that were statistically associated with acquiring TBI-being 5 years or older, having a known TB contact, having a known TB contact who was either the mother or another primary caregiver, and living in a high-TB-burden municipality. We created 2-item, 4-item, and 9-item scores intended to identify child TBI in this low-resource, low-HIV-, and high-TB-burden setting. In addition to the design, evaluation, and impact analysis of these generalizable and valuable risk assessment tools, our study findings emphasize the necessity of targeting both household and community-associated transmissions of childhood TBI to achieve the global goal to end TB.

Moving Towards Optimized Noncommunicable Disease Management in the ASEAN Region: Recommendations from a Review and Multidisciplinary Expert Panel.

INTRODUCTION: Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality in the Association of Southeast Asian Nations (ASEAN) member states. Progress has been slow despite the World Health Organization action plan for the prevention and control of NCDs in the region. This paper presents recommendations focused on practical strategies for optimizing NCD management in the ASEAN region. METHODS: A multidisciplinary group of experts from six ASEAN member states convened for two face-to-face meetings to discuss barriers and possible recommendations for optimizing NCD management, focused on cardiovascular diseases and mental disorders, in the region. Multiple approaches, ie, analysis of insights from the meetings and a review of existing literature on NCD programs in the ASEAN region were followed. The proposed recommendations were also based on selected successful interventions in ASEAN member states, thus providing actionable strategies. RESULTS: The gaps identified in NCD management for cardiovascular diseases and mental disorders in the ASEAN region were classified into gaps relating to policies and to clinical and public health practice. The proposed solutions addressing policy gaps include fostering multisectoral public-private partnerships, employing "whole-of-government" and "whole-of-society" approaches and promoting "health-in-all policies approach" to manage issues with financing, accessibility, efficiency and quality of health services. Whereas proposed solutions to bridge clinical and public health practice gaps entail strengthening primary care services, building the capacity of trained healthcare workers and employing collaborative care for holistic management of patients. CONCLUSION: The scale of premature and preventable deaths from NCDs in the ASEAN region remains a serious public health concern and requires a "whole-of-system approach". The interventions proposed in this paper build on regional collaborations and knowledge sharing to help develop a concerted and targeted response to NCDs.

The Validity, Reliability and Internal Consistency of the Cross-Cultural Adaptation of the FIL-DASH (Filipino Version of the Disability of the Arm, Shoulder and Hand) Questionnaire in Patients with Traumatic Brachial Plexus Injuries.

Background: The objective of this paper was to determine the validity, reliability and internal consistency of the translated FILIPINO DASH (FIL-DASH) questionnaire in patients with traumatic brachial plexus injuries. Methods: Thirty-five adult patients with traumatic brachial plexus injury were enrolled in the validation stage. The same questionnaire was given to the patient between 7 to 14 days for the test-retest reliability. The validated Filipino version of the SF-36 was used as the gold standard to determine the construct validity of the translated DASH. We also compared the DASH score with the SF-36 total and subscale, validated Brief Pain Inventory Severity and Interference Scale and the Visual Acuity Scale (VAS) for Pain. Results: The internal consistency was adequate, with Cronbach's Alpha for the 30 items of 0.93 and an average inter-item covariance of 0.399. The test-retest reliability was 0.87 (p < 0.001). There was no significant difference in establising the validity of the translated DASH against SF-36 total and Subscale, validated Brief Pain Inventory Severity and Interference Scale and the Visual Analogue Scale (VAS). Conclusions: The translated DASH (FIL-DASH) questionnaire was internally consistent and showed no difference in testing for test-retest reliability and validity against functional outcome measures and pain scales validated for adult Filipinos.

Prevalence of Tuberculosis in Children After Natural Disasters, Bohol, Philippines.

In 2013, a severe earthquake and typhoon affected Bohol, Philippines. To assess the postdisaster risk for emergence of Mycobacterium tuberculosis infection in children, we conducted a cross-sectional multistage cluster study to estimate the prevalence of tuberculin skin test (TST) positivity and tuberculosis (TB) in children from 200 villages in heavily affected and less affected disaster areas. Of the 5,476 children we enrolled, 355 were TST-positive (weighted prevalence 6.4%); 16 children had active TB. Fourteen (7%) villages had >20% TST-positive prevalence. Although prevalence did not differ significantly between heavily affected and less affected areas, living in a shelter with >25 persons approached significance. TST positivity was independently associated with older age, prior TB treatment, known contact with a person with TB, and living on a geographically isolated island. We found a high TST-positive prevalence, suggesting that national programs should consider the differential vulnerability of children and the role of geographically isolated communities in TB emergence.

Prevalence of Metabolic Syndrome and Cardiovascular Risk Factors among Community Health Workers in Selected Villages in the Philippines.

OBJECTIVE: This study aimed to estimate the prevalence of cardiovascular risk factors and metabolic syndrome among community health workers (CHWs) in selected villages in the Philippines. It also determined the association of urbanization and socio-demographic characteristics with hypertension, diabetes mellitus and metabolic syndrome among CHWs. METHODOLOGY: A cross-sectional study was conducted among CHWs who were actively rendering service from selected communities at the time of the study. Standardized interviews were conducted and clinical measurements were collected. RESULTS: Of the total of 457 CHWs who participated, 96% were females with a median age of 50 years. The prevalence of hypertension in this population was 32.4%. Hypertension was found to be associated with older age [adjusted odds ratio (aOR) 5.3, 95% CI: 3.2 to 8.8, p<0.001], obesity (aOR 2.4, 95% CI: 1.4 to 4.0, p=0.002) and alcohol consumption (aOR 1.7, 95% CI: 1.0 to 3.0, p<0.040). The prevalence of diabetes mellitus (DM) was 13.6%. It was found to be more prevalent among CHWs who were at least 50 years old (aOR 2.7, 95% CI: 1.4 to 5.1, p=0.002), and those who spent at least 5 hours a day in sedentary activities (aOR 3.8, 95% CI: 1.1 to 12.7, p<0.033). Borderline to high total cholesterol, low density lipoprotein cholesterol (LDL-c) and triglycerides (TG) were seen in 41%, 37% and 20%, respectively. Sixty percent had low high density lipoprotein cholesterol (LDL-c). The overall prevalence of metabolic syndrome was 52.3%. CONCLUSION: Metabolic syndrome is prevalent among CHW participants, with obesity, hypertension and low LDL-c as the most common components present. The prevalence of cardiovascular risk factors in this population was not found to be significantly different between rural and urban areas after adjusting for other factors.

Development and validation of a sunlight exposure questionnaire for urban adult Filipinos.

OBJECTIVES: To develop and validate a self-reported sunlight exposure questionnaire (SEQ) for urban adult Filipinos. METHODS: The study included adults (19-76 years old) in Metro Manila, Philippines, well-versed in the Filipino (Tagalog) language and had resided in Metro Manila for at least 1 year. Exclusion criteria included pregnancy, active skin disorders, and immunocompromised states. An expert panel created a questionnaire in Likert-scale format based on a conceptual framework and 4 existing instruments. The study proceeded in 4 phases: questionnaire item development, translation and back-translation, pretesting, and construct validity and reliability testing using factor analysis, the Cronbach alpha coefficient, and the paired t-test. RESULTS: A 25-item, self-administered, Filipino (Tagalog) SEQ answerable using a 4-point Likert scale was created. The questionnaire was administered to 260 adult participants twice at a 2-week interval, with all participants completing both the first and second rounds of testing. All questionnaire items possessed adequate content validity indices of at least 0.86. After factor analysis, 3 questionnaire domains were identified: intensity of sunlight exposure, factors affecting sunlight exposure, and sun protection practices. Internal consistency was satisfactory for both the overall questionnaire (Cronbach alpha, 0.80) and for each of the domains (Cronbach alpha, 0.74, 0.71, and 0.72, respectively). No statistically significant differences were observed in the responses between the first and second rounds of testing, indicating good test-retest reliability. CONCLUSIONS: We developed a culturally-appropriate SEQ with sufficient content validity, construct validity, and reliability to assess sunlight exposure among urban adult Filipinos in Metro Manila, Philippines.

Cardiac events occurred commonly among apparently healthy Filipinos with the Brugada ECG pattern in the LIFECARE cohort.

BACKGROUND: Brugada syndrome is the mechanism for sudden unexplained death. The Brugada ECG pattern is found in 2% of Filipinos. There is a knowledge gap on the clinical outcome of these individuals. The clinical profile and 5-year cardiac event rate of individuals with the Brugada ECG pattern were determined in this cohort. METHODS: This is a sub-study of LIFECARE (Life Course Study in Cardiovascular Disease Epidemiology), a community based cohort enrolling healthy individuals 20 to 50 years old conducted in 2009-2010. ECGs of all enrollees were screened independently by three cardiologists. The prevalence of the coved Brugada ECG pattern was ascertained, and the 5-year cardiac event rate was determined among those individuals with this pattern. The participants were contacted to determine the occurrence of cardiac events, which included syncope, presyncope, seizures, cardiac arrest and unexplained vehicular accidents. RESULTS: A total of 3072 ECGs were reviewed, and 14 subjects (0.4%) with the coved Brugada ECG pattern were identified. Four had a cardiac event on follow-up at 5 years, but all remained alive. Most of these 14 coved Brugada individuals were healthy and asymptomatic at baseline. CONCLUSION: Cardiac events occurred commonly among initially asymptomatic Filipinos with the coved Brugada ECG pattern. Such patients need to be followed up closely.

Attitudes, Behaviors and Beliefs of Urban Adult Filipinos on Sunlight Exposure: A Qualitative Study.

OBJECTIVE: To explore the attitudes, behaviors, and beliefs of urban adult Filipinos on sunlight exposure as an initial step in the development and validation of a culturally-appropriate questionnaire. METHODOLOGY: Focus groups were conducted among urban Filipinos 19 years old and above (n=38). The transcribed results underwent qualitative content and thematic analyses and were used to develop a conceptual framework. RESULTS: Qualitative analysis revealed four main themes of sunlight exposure: internal influences, external influences, perceived benefits, and perceived risks. Both internal and external influences lead to perceived risks and benefits. Consequently, the perceived benefits (or lack) of sunlight exposure influence an individual's attitude towards vitamin D supplementation; whereas the perceived risks of sunlight exposure influence an individual's attitude towards the need for sun protection. CONCLUSION: The attitudes, behaviors and beliefs of urban adult Filipinos on sunlight exposure are influenced by both internal and external factors, that in turn lead to perceived risks and benefits. An increased awareness of these factors is necessary to establish future recommendations on proper sunlight exposure in this population. The study results will be used to develop and validate a culturally-appropriate sunlight exposure questionnaire.

Personalising care of adults with asthma from Asia: a modified e-Dephi consensus study to inform management tailored to attitude and control profiles.

REALISE Asia-an online questionnaire-based study of Asian asthma patients-identified five patient clusters defined in terms of their control status and attitude towards their asthma (categorised as: 'Well-adjusted and at least partly controlled'; 'In denial about symptoms'; 'Tolerating with poor control'; 'Adrift and poorly controlled'; 'Worried with multiple symptoms'). We developed consensus recommendations for tailoring management of these attitudinal-control clusters. An expert panel undertook a three-round electronic Delphi (e-Delphi): Round 1: panellists received descriptions of the attitudinal-control clusters and provided free text recommendations for their assessment and management. Round 2: panellists prioritised Round 1 recommendations and met (or joined a teleconference) to consolidate the recommendations. Round 3: panellists voted and prioritised the remaining recommendations. Consensus was defined as Round 3 recommendations endorsed by >50% of panellists. Highest priority recommendations were those receiving the highest score. The multidisciplinary panellists (9 clinicians, 1 pharmacist and 1 health social scientist; 7 from Asia) identified consensus recommendations for all clusters. Recommended pharmacological (e.g., step-up/down; self-management; simplified regimen) and non-pharmacological approaches (e.g., trigger management, education, social support; inhaler technique) varied substantially according to each cluster's attitude to asthma and associated psychosocial drivers of behaviour. The attitudinal-control clusters defined by REALISE Asia resonated with the international panel. Consensus was reached on appropriate tailored management approaches for all clusters. Summarised and incorporated into a structured management pathway, these recommendations could facilitate personalised care. Generalisability of these patient clusters should be assessed in other socio-economic, cultural and literacy groups and nationalities in Asia.

Texting-Based Reporting of Adverse Drug Reactions to Ensure Patient Safety: A Feasibility Study.

BACKGROUND: Paper-based adverse drug reaction (ADR) reporting has been in practice for more than 6 decades. Health professionals remain the primary source of reports, while the value of patients' reporting is yet unclear. With the increasing popularity of using electronic gadgets in health, it is expected that the electronic transmission of reports will become the norm within a few years. OBJECTIVE: The aims of this study are to investigate whether short messaging service or texting can provide an alternative or supplemental method for ADR reporting given the increasing role of mobile phones in health care monitoring; to determine the usefulness of texting in addition to paper-based reporting of ADRs by resident physicians; and to describe the barriers to ADR reporting and estimate the cost for setting up and maintaining a texting-computer reporting system. METHODS: This was a pre-post cross-sectional study that measured the number of ADRs texted by 51 resident physicians for 12 months from the Department of Obstetrics and Gynecology and the Department of Adult Medicine of a tertiary government hospital in Manila, Philippines, with 1350-bed capacity. Reports were captured by a texting-computer reporting system. Prior to its implementation, key informant interview and focus group discussion were conducted. Baseline information and practice on the existing paper-based reporting system were culled from the records of the hospital's Pharmacy and Therapeutics Committee. A postintervention survey questionnaire was administered at the end of 12 months. RESULTS: Only 3 ADRs were texted by 51 resident physicians in 12 months (reporting rate 3/51 or 6%). By contrast, 240 ADRs from the paper-based reporting system from 848 resident physicians of the study hospital were collected and tabulated (reporting rate 240/848 or 28.3%). Texting ADRs was not efficient because of power interruption, competition with the existing paper-based reporting system, and unforeseen expiration of prepaid text loads/credits. The 3 ADRs texted were a report of vivid dreams and nightmares, a report of disturbing dreams and memory lapses, both of which were due to montelukast use, and a report of hepatitis from an isoniazid/rifampicin fixed-dose combination. Nineteen of 51 resident physicians (37%) registered in the reporting system responded to the postintervention survey. The most common reasons for not reporting ADRs were no adverse reaction identified 11/19 (58%) and restrictive reporting syntax 4/19 (21%). All doctors preferred a free form of reporting. The direct cost of the texting-based reporting system was calculated to be US $5581.40 and the indirect cost was US $9989.40. The total cost for texting-based ADR reporting system for 12 months was US $15,570.79. CONCLUSIONS: Reporting of ADRs via texting could be lower compared with an existing ADR paper-based system. Problems of Internet connectivity, reporting syntax, and expiration and reliability of text loads/credits should be addressed while implementing a text-based ADR reporting system in a developing country.

Assessing the residual risk for transfusion-transmitted infections in the Philippine blood supply.

Due to a USAID-funded study on blood banks, a national policy was instituted in 1994 that set standards for Philippine blood services, promoted voluntary donation, and led to a ban on commercial blood banks. In this follow-up study, we assess the safety of the supply by determining the residual risk for transfusion-transmitted infections (syphilis, hepatitis B and C, HIV). We also identified unsafe facility practices and generated policy recommendations. A 1992 study found that transfusion-ready blood was not safe using the LQAS method (P > 0.05). We found that the 2012 residual risk became 0 to 0.9 percent attributable to the national policy. We noted poor to fair adherence to this policy. We identified unsafe practices such as use of rapid tests and lack of random blood retesting. Training and use of regional networks may improve safety. Despite improvement in safety, facilities complain of funding and logistical issues regarding compliance with the policy.

Socio-demographic factors and the prevalence of metabolic syndrome among filipinos from the LIFECARE cohort.

BACKGROUND: Metabolic syndrome(MetS) is an aggregation of multiple metabolic risk factors shown to lead to the development of cardiovascular disease. The International Diabetes Federation(IDF) and the modified National Cholesterol Education Program Adult Treatment Panel Ⅲ(mNCEP) criteria are used in identifying MetS. This report will determine the prevalence of MetS and its component risk factors of the Philippine cohort of the LIFE course study in CARdiovascular disease Epidemiology(LIFECARE). METHODS: Our study recruited 3,072 participants aged 20-50 years old from Metro Manila and four nearby provinces. Baseline anthropometric and clinical parameters were measured. Prevalence of MetS and its component factors were determined. Associations with socio-demographic factors were determined. RESULTS: The prevalence of MetS was 19.7% and 25.6% by IDF and mNCEP, respectively(kappa 0.83). Both were associated with increasing age, urban residence, and employed status. It was higher in females by IDF and in males by mNCEP. IDF missed 40% of males and 10% of females identified with MetS by mNCEP. More males were identified by the mNCEP as MetS despite relatively normal waist circumference. CONCLUSION: MetS is common in the Philippines among older, educated, and urban residents. The mNCEP criteria identified more MetS than the IDF criteria.

Prevalence of cardiovascular risk factors in relation to socio-demographic profile of the life course study in cardiovascular disease epidemiology study (LIFECARE) Philippine cohort

OBJECTIVE: To describe the distribution of the clinical cardiovascular risk profile of the LIFECARE Philippine cohort in relation to its socio-demographic factors. METHODS: We recruited a total of 3,072 apparently healthy participants from Manila and nearby provinces of Rizal, Batangas, Bulacan and Quezon. Face-to-face interview was done to obtain socio-demographic data. Baseline clinical parameters and biochemical tests were obtained. Prevalence of cardiovascular risk factors was determined by sex, place of residence, level of education and employment. RESULTS: Overall prevalence of diabetes mellitus was at 5%, similar between sexes, area class, educational attainment and employment status. More smokers were male, employed or with an elementary level of education. Prevalence of hypertension was at 14.5% and was seen more in males, urban dwellers, employed or with an elementary level of education. Dyslipidemia was seen more in males, living in the rural areas, employed or with a college level of education. Lastly, obese participants were seen more in females, living in urban areas, employed with a college level of eduction. CONCLUSION: Older, male and employed participants who are living in the urban areas have more cardiovascular risk factors.

"You are what you eat:" Self-reported preferences for food taste and cooking methods of adult Filipinos (20-50 years old)

OBJECTIVE: To describe the self-reported preferences for food taste and cooking methods of adult Filipinos (20-50 years old). METHODS: This is a cross-sectional community survey of 3,072 adults from Metro Manila, Bulacan, Batangas, Quezon, Rizal. RESULTS AND CONCLUSION: There were differences in preferred tastes of males (food that tasted "just right", spicy) vs. females (salty); younger adults (sweet, spicy) vs. older adults (bland); urban (salty, spicy) vs. rural adults ("just right") adults with higher education (sweet, salty, spicy) vs. those with less schooling who liked food which tasted "just right." Smokers preferred spicy taste vs. non-smokers who liked sweet-tasting food. Adults who reported having had alcohol intake preferred spicy food. Those who reported feeling stressed liked savoury taste (sweet, salty) while those who were not stressed liked food which tasted "just right." Cooking with oil was the usual and the most preferred cooking method. Younger adults and smokers liked to use oil in cooking. Food which tasted "just right"/moderate was most preferred by adult Filipinos with hpertension or MeTS. Diabetics did not prefer sweet tasting food. More diabetics (p=0.05) and those with MeTS (p=0.003) usually use other cooking methods instead of frying. Eliciting self-reported taste preferences as well as the usual and preferred cooking methods is important for nutritional management and relevant lifestyle advice which healthcare providers should incorporate in their management of patients, especially those with hypertension, diabetes, and metabolic syndrome.

Where we are: socio-ecological and health profile of the Philippine LIFEcourse study in CARdiovascular disease epidemiology (LIFECARE) study sites

OBJECTIVE: This study aims to describe the socio-ecological and health profile of the Philippine LIFECARE study sites, its health care services and leading causes of mortality and morbidity. METHODS: This is a prospective cohort study that recruited participants aged 20-50 years from Metro Manila and four provinces (Bulacan, Batangas, Quezon, Rizal). Study sites were characterized according to their geographical area, terrain and environmental profile, and available health care system. RESULTS: 3,072 subejects were included, with male-to-female ratio of 1:1.3 and majority aged 30-50 years. Metro Manila was the most congested site. Two-thirds of the 62 villages (barangays) were rural, outside the town proper, and in lowlands. One-fourth were along coastal area. Almost all were accessible by public transportation. Majority have reduced forest cover, but were relatively safe from environmental hazards. Rural health units, hospitals, and professional health care workers were concentrated in Metro Manila. Leading cause of morbidity was respiratory tract infection, while cardiovascular diseases caused most of mortalities. CONCLUSION: Study sites were mainly rural, outside the town proper and in lowlands, with available public transportation. There is an unequal distribution of health resources. Cardiovascular diseases is still the leading cause of mortality. The disparities in geographical access to health care play an important role in shaping human health.