Burden of obstructive lung disease in a rural setting in the Philippines.

BACKGROUND AND OBJECTIVE: The aim of this study was to determine the prevalence of and risk factors associated with COPD in a rural setting in the Philippines. METHODS: The study was conducted in two municipalities in Nueva Ecija province in the Philippines. Using the Burden of Obstructive Lung Disease (BOLD) protocol and study design, non-hospitalized men or women, aged 40years or older, were recruited by multi-stage random sampling procedures. Participants completed questionnaires on respiratory symptoms and exposure to potential risk factors for COPD, including smoking, occupation and exposure to burning of biomass fuel. Spirometry was performed according to American Thoracic Society criteria. RESULTS: Of the 1188 individuals selected for recruitment, 722 had acceptable post-bronchodilator spirometry and were classified according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage. The overall prevalence of COPD for all stages was 20.8%. The prevalence of COPD at GOLD Stage I or higher was greater in men compared with women (26.5% vs 15.3%), and increased between the ages of 40 to >70years. Logistic regression analysis showed a significant association between all stages of COPD and farming for >40years (odds ratio (OR) 2.48, 95% confidence interval (CI): 1.43-4.30), use of firewood for cooking for >60years (OR 3.48, 95% CI: 1.57-7.71), a smoking history of ≥20 pack-years (OR 2.86; 95% CI: 1.78-4.60), and a history of tuberculosis (OR 6.31, 95% CI: 2.67-15.0). CONCLUSIONS: The prevalence COPD in a rural community in Nueva Ecija, Philippines was 20.8% for GOLD Stage I or higher, and 16.7% for GOLD Stage II or higher. In addition to smoking history, the use of firewood for cooking, working on a farm and a history of tuberculosis were significantly associated with fixed airflow obstruction, as assessed by spirometry.

A six-month assessment of medical news reporting in leading local newspaper in the Philippines: Is it based on good evidence?

BACKGROUND: Evidence-Based Medicine (EBM) has brought about a paradigm shift in medical practice. However, evidence in peer-reviewed medical journals is inaccessible to a lay person for whom the newspaper is the most accessible source of information. This study aims to determine if medical news articles (MNAs) in leading local newspapers in the Philippines are based on good evidence. OBJECTIVES: To characterize MNAs based on: (1) references cited and their level of evidence as appraised by authors and two independent EBM experts; (2) use of clinical outcomes; (3) mention of treatment beneft and potential harm in measurable terms; (4) mention of cost of treatment; and (5) disclosure of pharmaceutical industry support. METHODS: MNAs on non-surgical prevention and treatment of adult diseases from January to June 2002 in three leading local Philippine newspapers were appraised. MNAs on diagnosis, pediatric and surgical treatments, multiple treatment modalities, columns were excluded. References were assessed independently by two EBM experts; diferences were resolved by consensus. RESULTS: The fve conditions most frequently reported on were: diabetes, coronary heart disease, cancer, arthritis and hypertension. Of 113 MNAs, 94 (83%) cited references4 were medical journal articles, 34 (63%) of which were based on good quality evidence. Out of the 94 MNAs, 51 (54%) reported clinical endpoints, 31 (33%) quantifed beneft, 21 (22%) cited potential harm, 22 (23%) disclosed industry support, and 4 (4%) mentioned cost of treatment. None of the MNA authors mentioned critically appraising their references. CONCLUSION: The 113 MNAs published in three leading local newspapers in the Philippines during the six-month period showed shortcomings in providing information to beneft the public. EBM awareness among journalists and studies covering a longer period and a broader line of the print media are recommended.