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1.
Artigo em Inglês | MEDLINE | ID: mdl-34360484

RESUMO

Epidemiological studies have quantified the association between ambient temperature and diarrhoea. However, to our knowledge, no study has quantified the temperature association for severe diarrhoea cases. In this study, we quantified the association between mean temperature and two severe diarrhoea outcomes, which were mortality and hospital admissions accompanied with dehydration and/or co-morbidities. Using a 12-year dataset of three urban districts of the National Capital Region, Philippines, we modelled the non-linear association between weekly temperatures and weekly severe diarrhoea cases using a two-stage time series analysis. We computed the relative risks at the 95th (30.4 °C) and 5th percentiles (25.8 °C) of temperatures using minimum risk temperatures (MRTs) as the reference to quantify the association with high- and low-temperatures, respectively. The shapes of the cumulative associations were generally J-shaped with greater associations towards high temperatures. Mortality risks were found to increase by 53.3% [95% confidence interval (CI): 29.4%; 81.7%)] at 95th percentile of weekly mean temperatures compared with the MRT (28.2 °C). Similarly, the risk of hospitalised severe diarrhoea increased by 27.1% (95% CI: 0.7%; 60.4%) at 95th percentile in mean weekly temperatures compared with the MRT (28.6 °C). With the increased risk of severe diarrhoea cases under high ambient temperature, there may be a need to strengthen primary healthcare services and sustain the improvements made in water, sanitation, and hygiene, particularly in poor communities.


Assuntos
Temperatura Baixa , Temperatura Alta , Diarreia/epidemiologia , Humanos , Filipinas/epidemiologia , Temperatura
2.
Circ Heart Fail ; 14(8): e008478, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34372666

RESUMO

BACKGROUND: Immune regulation and inflammation play a role in the pathogenesis and progression of acute and chronic heart failure (HF). Although the clinical course of acute, severe inflammatory cardiomyopathy is well described, the effects of chronic systemic inflammation on cardiovascular function over time are less clear. To investigate this question, we compared trajectories over time in left ventricular ejection fraction for patients with HF with different chronic inflammatory diseases (CIDs): HIV, systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, inflammatory bowel disease, and/or psoriasis. METHODS: Using a database of patients receiving care in a large metropolitan health care system since January 1, 2000, we analyzed serial, clinically indicated echocardiograms from patients with HF with CIDs and frequency-matched patients with HF without CIDs. We included patients with ≥3 serial echocardiograms (N=974; median 6.1 years between first and most recent echo). We assessed left ventricular ejection fraction trajectories over time using latent trajectory models, then investigated differences in left ventricular ejection fraction trajectories for specific CID subtypes compared with controls. RESULTS: Overall, the majority of patients studied (N=687; 70.5%) had left ventricular ejection fraction trajectories consistent with HF with preserved or midrange EF, whereas 255 (26.2%) had HF with reduced EF and 32 (3.3%) had HF with recovered EF. Compared with non-CID controls with HF, patients with rheumatoid arthritis, inflammatory bowel disease, and systemic lupus erythematosus were significantly more likely than controls to have HF with preserved or midrange EF whereas patients with HIV were significantly more likely to have HF with reduced EF. CONCLUSIONS: Among patients with HF with CIDs, distinct left ventricular ejection fraction trajectory patterns associate with different specific individual CIDs. This highlights the heterogeneity of HF subtypes and changes over time across different CIDs.

3.
JCI Insight ; 6(13)2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34236048

RESUMO

BackgroundImmunomodulatory therapy may help prevent heart failure (HF). Data on immune cells and myocardial remodeling in older adults with cardiovascular risk factors are limited.MethodsIn the Multi-Ethnic Study of Atherosclerosis cohort, 869 adults had 19 peripheral immune cell subsets measured and underwent cardiac MRI during the baseline exam, of which 321 had assessment of left ventricular global circumferential strain (LV-GCS). We used linear regression with adjustment for demographics, cardiovascular risk factors, and cytomegalovirus serostatus to evaluate the cross-sectional association of immune cell subsets with left ventricular mass index (LVMI) and LV-GCS.ResultsThe average age of the cohort was 61.6 ± 10.0 years and 53% were women. Higher proportions of γ/δ T cells were associated with lower absolute (worse) LV-GCS (-0.105% [95% CI -0.164%, -0.046%] per 1 SD higher proportion of γ/δ T cells, P = 0.0006). This association remained significant after Bonferroni's correction. Higher proportions of classical monocytes were associated with worse absolute LV-GCS (-0.04% [95% CI -0.07%, 0.00%] per 1 SD higher proportion of classical monocytes, P = 0.04). This did not meet significance after Bonferroni's correction. There were no other significant associations with LV-GCS or LVMI.ConclusionPathways associated with γ/δ T cells may be potential targets for immunomodulatory therapy targeted at HF prevention in populations at risk.FundingContracts 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 and grant R01 HL98077 from the National Heart, Lung, and Blood Institute/NIH and grants KL2TR001424, UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences/NIH.

4.
PLoS One ; 16(5): e0250434, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33939722

RESUMO

INTRODUCTION: HIV self-testing (HIV-ST) is an effective means of improving HIV testing rates. Low- and middle-income countries (LMIC) are taking steps to include HIV-ST into their national HIV/AIDS programs but very few reviews have focused on implementation in LMIC. We performed a scoping review to describe and synthesize existing literature on implementation outcomes of HIV-ST in LMIC. METHODS: We conducted a systematic search of Medline, Embase, Global Health, Web of Science, and Scopus, supplemented by searches in HIVST.org and other grey literature databases (done 23 September 2020) and included articles if they reported at least one of the following eight implementation outcomes: acceptability, appropriateness, adoption, feasibility, fidelity, cost, penetration, or sustainability. Both quantitative and qualitative results were extracted and synthesized in a narrative manner. RESULTS AND DISCUSSION: Most (75%) of the 206 included articles focused on implementation in Africa. HIV-ST was found to be acceptable and appropriate, perceived to be convenient and better at maintaining confidentiality than standard testing. The lack of counselling and linkage to care, however, was concerning to stakeholders. Peer and online distribution were found to be effective in improving adoption. The high occurrence of user errors was a common feasibility issue reported by studies, although, diagnostic accuracy remained high. HIV-ST was associated with higher program costs but can still be cost-effective if kit prices remain low and HIV detection improves. Implementation fidelity was not always reported and there were very few studies on, penetration, and sustainability. CONCLUSIONS: Evidence supports the acceptability, appropriateness, and feasibility of HIV-ST in the LMIC context. Costs and user error rates are threats to successful implementation. Future research should address equity through measuring penetration and potential barriers to sustainability including distribution, cost, scale-up, and safety.


Assuntos
Infecções por HIV/diagnóstico , Kit de Reagentes para Diagnóstico/normas , Autoteste , Países em Desenvolvimento/estatística & dados numéricos , Humanos , Ciência da Implementação , Kit de Reagentes para Diagnóstico/economia , Kit de Reagentes para Diagnóstico/estatística & dados numéricos
5.
Qual Life Res ; 30(8): 2137-2147, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33677770

RESUMO

PURPOSE: The purpose of this study was to identify the determinants of Filipinos' health-related quality of life (HRQoL). METHODS: Data were collected from 1000 Filipinos across the nation who reported that they did not have known active disease or disability. HRQoL was measured through EuroQoL's (EQ) 5-level tool (EQ-5D-5L) and the EQ Visual Analog Scale (EQ-VAS). Both were implemented via the EQ Valuation Technology software. HRQoL was regressed on socioeconomic characteristics (age, sex, marital status, educational attainment, employment, poverty status, and availability of savings), social support factors (religion, religious attendance, and caregiving status), community- or societal-level factors (type and major island group of residence), and disease status. RESULTS: Majority of respondents reported that they did not have any problems across all EQ-5D-5L dimensions, namely mobility, self-care, usual activity, pain or discomfort, and anxiety or depression. Pain or discomfort had the highest rate of respondents reporting slight to extreme problems followed by anxiety or depression. Having savings was positively associated with HRQoL, while religious attendance, caregiver status, living in an urban area, living in Visayas or Mindanao, and having a diagnosed disease were negatively associated with HRQoL. CONCLUSION: This current study confirms that HRQoL varied across socioeconomic statuses and communities in the Philippines.


Assuntos
Nível de Saúde , Qualidade de Vida/psicologia , Determinantes Sociais da Saúde , Ansiedade/psicologia , Cuidadores , Estudos Transversais , Depressão/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Dor/psicologia , Filipinas , Saúde da População , Fatores Sexuais , Apoio Social , Fatores Socioeconômicos , Inquéritos e Questionários
8.
Artigo em Inglês | MEDLINE | ID: mdl-33124003

RESUMO

INTRODUCTION: Data from the USA reveal disparities in hospitalization and mortality from coronavirus disease 2019 (COVID-19). Social determinants of health (SDoH) could account for disparities in disease incidence and outcomes. We investigated the association between zip code racial composition and COVID-19 incidence and case fatality in Oakland County, MI. METHODS: We conducted an ecological study using publicly available data on COVID-19 in 70 zip codes in Oakland County, MI. We obtained demographic surrogate markers of SDoH by zip code from the US Census Bureau website. Using negative binomial regression models, we investigated the association between the percentage of Blacks in each zip code and COVID-19 incidence and case fatality, including markers of SDoH as potential confounders. RESULTS: Reported COVID-19 cases ranged from 13.2 to 255.2 per 10,000 population. Each percentage increase in Blacks within a zip code was associated with a 3% increase in COVID-19 cases (95% CI: 1.02 to 1.04, p ≤ 0.0001), and this remained significant after adjusting for income or poverty level, number of persons per household, mode of transportation, age, and level of education (incidence rate ratio: 1.02, 95% CI: 1.01 to 1.03, p ≤ 0.0001). Zip codes with a higher percentage of Blacks also experienced a faster increase in COVID-19 rates from April 3 to May 16. However, the proportion of Blacks in a zip code was not associated with case fatality. CONCLUSION: Zip codes with larger Black populations were disproportionately affected by COVID-19.

11.
J Occup Health ; 62(1): e12133, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32533807

RESUMO

AIMS: Employers in the United States incur substantial costs associated with substance use disorders. Our goal was to examine the effectiveness of employer-led interventions to reduce the adverse effects of drug misuse in the workplace. METHODS: We conducted a systematic review of studies that evaluated the effectiveness of recommended workplace interventions for opioids and related drugs: employee education, drug testing, employee assistance programs, supervisor training, written workplace drug-free policy, and restructuring employee health benefit plans. We searched PubMed MEDLINE, EMBASE (embase.com), PsycINFO (Ebsco), ABI Inform Global, Business Source Premier, EconLit, CENTRAL, Web of Science (Thomson Reuters), Scopus (Elsevier), Proquest Dissertations, and Epistemonikos from inception through May 8, 2019, with no date or language restrictions. We included randomized controlled trials, quasi-experimental studies, and cross-sectional studies with no language or date restrictions. The Downs and Black questionnaire was used to assess the quality of included studies. The results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS: In all, 27 studies met our inclusion criteria and were included in the systematic review. Results were mixed, with each intervention shown to be effective in at least one study, but none showing effectiveness in over 50% of studies. Studies examining the impact of interventions on workplace injuries or accidents were more commonly reported to be effective. Although four studies were randomized controlled trials, the quality of all included studies was "fair" or "poor." CONCLUSIONS: Despite the opioid epidemic, high-quality studies evaluating the effectiveness of employer-led interventions to prevent or reduce the adverse effects of substance use are lacking. Higher quality and mixed methods studies are needed to determine whether any of the interventions are generalizable and whether contextual adaptations are needed. In the meantime, there is a reason to believe that commonly recommended, employer-led interventions may be effective in some environments.


Assuntos
Uso Indevido de Medicamentos/prevenção & controle , Saúde do Trabalhador , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Local de Trabalho , Humanos , Avaliação de Programas e Projetos de Saúde , Estados Unidos
12.
PLoS One ; 15(4): e0231037, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32240254

RESUMO

BACKGROUND: Previous reviews have demonstrated that shift work and long work hours are associated with increased risk for chronic conditions. However, these reviews did not comprehensively assessed the body of evidence, and some were not conducted in a systematic manner. A better understanding of the health consequences of shift work and long work hours will aid in creating policy and practice recommendations. This review revisits the epidemiologic evidence on the association of shift work and long work hours with chronic conditions with particular emphasis on assessing the quality of the evidence. METHODS AND FINDINGS: We conducted a systematic review of systematic reviews with meta-analyses (SR-MA) that assessed the link between shift work or long work hours and chronic conditions (PROSPERO CRD42019122084). We evaluated the risk of bias of each SR-MA using AMSTAR v2 and assessed the overall evidence for each condition using the GRADE approach. We included 48 reviews covering cancers, cardiovascular diseases, metabolic syndrome and related conditions, pregnancy complications, depression, hypertension, and injuries. On average, only 7 of 16 AMSTAR items were fulfilled. Few SR-MAs had a registered protocol and nearly all failed to conduct a comprehensive search. We found moderate grade evidence linking shift work to breast cancer and long work hours to stroke. We found low grade evidence linking both shift work and long work hours with low to moderate increase in risk for some pregnancy complications and cardiovascular diseases. Low grade evidence also link long work hours and depression. CONCLUSIONS: Moderate grade evidence suggest that shift work and long work hours increase the risk of breast cancer and stroke, but the evidence is unclear on other chronic conditions. There is a need for high-quality studies to address this gap. Stakeholders should be made aware of these increased risks, and additional screening and prevention should be considered, particularly for workers susceptible to breast cancer and stroke.


Assuntos
Doença Crônica/epidemiologia , Jornada de Trabalho em Turnos/efeitos adversos , Humanos , Risco
14.
J Occup Environ Med ; 62(4): 303-306, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32032186

RESUMO

OBJECTIVE: Describe manufacturing workers' perceptions of the effect of shift work, following the Framework for Worker Well-Being. METHODS: Eight focus groups and 43 interviews were conducted across four large manufacturing plants. Thematic analysis was used to analyze the data within each of the five domains of the Framework: physical environment and safety climate; workplace policies and culture; health status; work evaluation and experience; and home, community, and society. RESULTS: Respondents described shift work as detrimental to well-being across four of the five Framework domains. The exception was in the workplace policies and culture domain, where some respondents described shift work as necessary, fair, and financially beneficial. CONCLUSIONS: Shift work negatively influences worker well-being in a holistic way. Employers could consider reconfiguring workplace wellness benefits to transcend the boundaries of the workplace and better support workers and their families.


Assuntos
Saúde do Trabalhador , Jornada de Trabalho em Turnos , Local de Trabalho , Adulto , Grupos Focais , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Estados Unidos
15.
Int J Pediatr Otorhinolaryngol ; 128: 109704, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31606683

RESUMO

OBJECTIVE: This study compared otoacoustic emission (OAE) and automated auditory brainstem response (AABR) in terms of concordance and cost impact for newborn hearing screening (NBHS) in the Philippine setting. METHODS: This was a prospective observational study to assess concordance between OAE and AABR involving 253 infants. Each infant underwent OAE and AABR testing. Infants who passed both tests were not required to follow up for additional testing. Infants who failed in any test were scheduled for repeat screening and diagnostic ABR after 1 month. Concordance was computed using B-statistic. FOR COST ANALYSIS: 4 scenarios were compared to 1-step both tests scenario: (1) OAE alone, (2) AABR alone, (3) 2-step OAE, and (4) 2-step AABR in terms of number of infants with hearing loss (HL) detected, cost of diagnosis, and economic loss from lack of treatment. RESULTS: There was high concordance between OAE and AABR (B-statistic = 0.8). AABR had a higher refer rate (18.58%) than OAE (10.27%) but higher number of detected babies with HL. Cost analysis favored an AABR alone scenario while the 2-step OAE protocol fared poorly. CONCLUSION: A change from 2-step OAE to AABR alone is worth considering in our institution.


Assuntos
Potenciais Evocados Auditivos do Tronco Encefálico , Triagem Neonatal/economia , Triagem Neonatal/métodos , Emissões Otoacústicas Espontâneas , Algoritmos , Custos e Análise de Custo , Feminino , Perda Auditiva/diagnóstico , Humanos , Recém-Nascido , Masculino , Filipinas , Estudos Prospectivos , Centros de Atenção Terciária
16.
Front Neurol ; 10: 1249, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31849816

RESUMO

Background: X-linked dystonia parkinsonism (XDP) is a neurodegenerative disease endemic to Filipinos with maternal lineage from Panay Island, Philippines. Patients present with dystonia concurrent with or followed by parkinsonism. Non-motor symptoms also predominate, affecting behavior and cognition. We aimed to translate and do cross-cultural adaptation and validation of the Montreal Cognitive Assessment Tool (MoCA) into Hiligaynon (MoCA-Hil), the language spoken in Panay Island, to perform baseline cognitive screening of XDP patients. Methods: Forward translation to Hiligaynon was done by two translators, then back translation of a single version was adapted and approved by a committee. A pilot testing was done yielding the final translated version, which was then tested on 46 XDP patients. The test-retest reliability was measured for 11 patients. The XDP-MDSP (Movement Disorder Society of the Philippines) rating scale was used to assess disease severity. Results: The MoCA-Hil showed an acceptable test-retest reliability [intraclass correlation (ICC) 0.74] and internal consistency (Cronbach's alpha 0.86 at baseline, 0.81 at 12 weeks). The two subscales with low ICC at 0.09 and 0.21 were delayed recall and orientation, respectively. Conclusion: Translation, cultural adaptation and validation of the MoCA to Hiligaynon was successfully done. This tool may now be used in clinical practice and in research for Hiligaynon-speaking subjects.

17.
Rev Bras Ter Intensiva ; 31(1): 79-85, 2019 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30970094

RESUMO

OBJECTIVE: We aimed to determine the incidence, risk factors, and outcomes of unplanned extubation among adult patients. METHODS: We conducted a prospective cohort study of adult intubated patients admitted to the charity wards of a government tertiary teaching hospital in the Philippines. Patients managed in both intensive care and nonintensive care settings were included. Patients were followed-up until discharge or until seven days postextubation. RESULTS: The outcomes of the 191 included patients were planned extubation (35%), unplanned extubation (19%), death (39%), and discharge against advice (7%). Competing risk regression showed that male sex (Crude OR: 2.25, 95%CI: 1.10 - 4.63) and age (Crude OR 0.976, 95%CI: 0.957 - 0.996) were significant baseline factors. The night shift (Crude OR: 24.6, 95%CI: 2.87 - 211) was also consistently associated with more unplanned extubations. Among postextubation outcomes, reintubation (unplanned extubation: 61.1% versus planned extubation: 25.4%), acute respiratory failure (unplanned extubation: 38.9% versus planned extubation: 17.5%), and cardiovascular events (unplanned extubation: 8.33% versus planned extubation: 1.49%) occurred significantly more often among the unplanned extubation patients. Admission in an intensive care unit was not associated with a lower risk of unplanned extubation (Crude OR 1.15, 95%CI: 0.594 - 2.21). CONCLUSION: Many intubated patients had unplanned extubation. Patients admitted in nonintensive care unit settings did not have significantly higher odds of unplanned extubation.


Assuntos
Extubação/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Intubação Intratraqueal/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos , Adulto , Idoso , Estudos de Coortes , Feminino , Seguimentos , Hospitais de Ensino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Filipinas , Estudos Prospectivos , Fatores de Risco , Centros de Atenção Terciária
18.
Rev. bras. ter. intensiva ; 31(1): 79-85, jan.-mar. 2019. tab
Artigo em Português | LILACS | ID: biblio-1003630

RESUMO

RESUMO Objetivo: Determinar a incidência, os fatores de risco e os desfechos da extubação não planejada em pacientes adultos. Métodos: Conduzimos estudo prospectivo de coorte de pacientes adultos intubados admitidos em ala de atendimento gratuito em um hospital governamental terciário de ensino nas Filipinas. Incluíram-se tanto pacientes em cuidados de terapia intensiva quanto fora dela. Os pacientes foram seguidos até a alta ou até o sétimo dia após a extubação. Resultados: Os desfechos dos 191 pacientes incluídos foram: extubação planejada (35%), extubação não planejada (19%), óbito (39%) e alta a pedido (7%). A regressão de riscos competitivos demonstrou que o sexo masculino (OR bruta de 2,25; IC95% 1,10 - 4,63) e a idade (OR bruta: 0,976; IC95%: 0,957 - 0,996) foram fatores basais significantes. O turno da noite (OR bruta: 24,6; IC95%: 2,87 - 211) também teve associação consistente com maior ocorrência de extubação não planejada. Dentre os desfechos após a extubação, ocorreram significantemente mais, entre os pacientes com extubação não planejada, reintubação (extubação não planejada, com 61,1%, versus extubação planejada, com 25,4%), insuficiência respiratória aguda (extubação não planejada, com 38,9%, versus extubação planejada, com 17,5%) e eventos cardiovasculares (extubação não planejada, com 8,33%, versus extubação planejada, com 1,49%). A admissão à unidade de terapia intensiva não se associou com risco menor de extubação não planejada (OR bruta de 1,15; IC95% 0,594 - 2,21). Conclusão: Muitos pacientes intubados tiveram extubação não planejada. Os pacientes admitidos em outras unidades, que não a de terapia intensiva, não tiveram tendências mais elevadas de extubação não planejada.


ABSTRACT Objective: We aimed to determine the incidence, risk factors, and outcomes of unplanned extubation among adult patients. Methods: We conducted a prospective cohort study of adult intubated patients admitted to the charity wards of a government tertiary teaching hospital in the Philippines. Patients managed in both intensive care and nonintensive care settings were included. Patients were followed-up until discharge or until seven days postextubation. Results: The outcomes of the 191 included patients were planned extubation (35%), unplanned extubation (19%), death (39%), and discharge against advice (7%). Competing risk regression showed that male sex (Crude OR: 2.25, 95%CI: 1.10 - 4.63) and age (Crude OR 0.976, 95%CI: 0.957 - 0.996) were significant baseline factors. The night shift (Crude OR: 24.6, 95%CI: 2.87 - 211) was also consistently associated with more unplanned extubations. Among postextubation outcomes, reintubation (unplanned extubation: 61.1% versus planned extubation: 25.4%), acute respiratory failure (unplanned extubation: 38.9% versus planned extubation: 17.5%), and cardiovascular events (unplanned extubation: 8.33% versus planned extubation: 1.49%) occurred significantly more often among the unplanned extubation patients. Admission in an intensive care unit was not associated with a lower risk of unplanned extubation (Crude OR 1.15, 95%CI: 0.594 - 2.21). Conclusion: Many intubated patients had unplanned extubation. Patients admitted in nonintensive care unit settings did not have significantly higher odds of unplanned extubation.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Respiração Artificial/estatística & dados numéricos , Extubação/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Intubação Intratraqueal/estatística & dados numéricos , Filipinas , Incidência , Estudos Prospectivos , Fatores de Risco , Estudos de Coortes , Seguimentos , Centros de Atenção Terciária , Hospitais de Ensino , Pessoa de Meia-Idade
19.
Yale J Biol Med ; 87(3): 299-306, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25191145

RESUMO

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.


Assuntos
Bancos de Sangue , Doenças Transmissíveis/etiologia , Reação Transfusional , Fidelidade a Diretrizes , Humanos , Filipinas , Fatores de Risco
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