RESUMO
The COVID-19 pandemic has challenged healthcare systems worldwide. In the Philippines, long-term care for patients with conditions identified through newborn screening (NBS) is coordinated through Newborn Screening Continuity Clinics (NBSCCs). These clinics are integral to achieving optimal outcomes by providing follow-up oversight and assistance for individuals identified through screening. Continuity of NBSCC care for NBS during the COVID-19 pandemic was both challenging and necessary and was accomplished through innovative strategies of dedicated personnel. Following the discontinuation of the community quarantine, a situation assessment survey was completed by each NBSCC to better understand the challenges encountered and their effect on patient care. Performance data from each NBSCC were reviewed both before and after an extended community quarantine (2018-2021) to evaluate the impact of NBSCC disaster contingency plans in overcoming the resultant challenges (transportation, supply chain, etc.). Thematic analysis of the survey showed three primary challenges: Operations, communications, and safety. In 2018 and 2019, successful patient contacts were 70.6% and 70.2%, respectively. During the pandemic, successful contacts were 74.9% in 2020 and 76.8% in 2021, demonstrating that the contact approaches taken by the NBSCCs were sufficient to maintain (and even improve) patient contacts. The number of unresponsive patients decreased during the pandemic likely due to decreased mobility and improved follow-up actions from the NBSCCs.
RESUMO
@#Introduction: The influenza virus is a single stranded RNA virus which has the potential to cause periodic global pandemics. The first major Influenza A global pandemic devastated the 20th century with the Spanish flu in 1918; it had more than 2.5% case fatality rate. In the 21st century, the Influenza A pandemic was first detected in Mexico in March 2009 and from then, there had been a rapid increase in the number of reported cases and deaths reported which created panic. Objectives: This study aims to determine the profile of pediatric patients with confirmed Novel Influenza AH1N1 at a Local Tertiary Hospital from June 2009 to December 2009. Methods: This study is retrospective chart review of patients aged 0-19 years old, confirmed to have influenza A H1N1 and were admitted at Baguio General Hospital. Their demographic profile, signs and symptoms, laboratory examinations, treatment and outcome were recorded in a uniform case repot form. Results: Of the 235 pediatric cases of influenza-like illness seen, 31(13%) were admitted. Fifteen (48.3%) of the admitted patients were positive for the novel influenza AH1N1. Majority of the cases were from the five-to-nine age group (34%), while three (20%) were from the age group, two years old and below. The presenting signs or symptoms were fever (100%), cough (80%), colds (47%) and sore throat (34%). Most common underlying conditions noted were bronchial asthma in six (40%) of the cases. Complete blood count revealed anemia in 40%, leukopenia in 26.67%, and lymphocytosis in 26.67% cases. Using chest radiograph, pneumonia was seen in 40% (6/15) of patients. Two (13.3%) revealed no growth in their blood cultures while one had Klebsiella pneumonia and another one grew Candida non-albicans. All received Oseltamivir upon admission and was completed for five days. Antibiotics were given to those with bacterial co-infection. The mean duration of hospital stay was eight days: 13 (86%) patients were discharged in improved condition; while, two (13.3%) died due to respiratory failure. Conclusion: There was an equal distribution of both sexes in the study. Incidence was highest among five years old and below. The pediatric influenza AH1N1 infection presented with mild acute respiratory tract infection. Most cases were uncomplicated although majority of them had underlying medical conditions putting them at risk for complications. Oseltamivir was the mainstay of treatment in conjunction with antimicrobials for those who had bacterial co-infections. Most of the patients improved with a case fatality rate of 13.3%.
