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1.
Hemoglobin ; 46(1): 36-38, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35950581

RESUMO

For an archipelago that has a rich history of trade with overseas merchants and colonial rule, the Philippine Islands are models of ethnic and cultural diversity, including hereditary blood disorders such as hemoglobinopathies. Pending a government-led comprehensive national screening program, available cluster data provides evidence of the prevalence of thalassemia in the country. The National Blood Services Act of 1994 was enacted to promote voluntary blood donation to address the supply of blood products but falls short in addressing the immense blood transfusion requirements of the thalassemic community. Iron overload monitoring and management is a considerable challenge due to high cost of laboratory tests and iron chelators on top of minimal health insurance coverage for the majority of Filipino patients with thalassemia. Continuous engagement with the thalassemia patient community and multi sectoral efforts are the means to ensure sustained improvement in the delivery of care.


Assuntos
Hemoglobinopatias , Sobrecarga de Ferro , Talassemia , Humanos , Quelantes de Ferro/uso terapêutico , Sobrecarga de Ferro/diagnóstico , Sobrecarga de Ferro/epidemiologia , Sobrecarga de Ferro/etiologia , Filipinas/epidemiologia , Talassemia/diagnóstico , Talassemia/epidemiologia , Talassemia/terapia
2.
Front Immunol ; 13: 899311, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35774791

RESUMO

Schistosomiasis remains to ha/ve a significant public health impact in the Philippines. The Kato-Katz (K-K) technique is the reference standard and most used technique for definitive diagnosis of intestinal schistosomiasis for control programs in endemic regions. However, this has a very low sensitivity when applied in areas of low endemicity and patients with light infection. Hence, this study determined the diagnostic performance of immunological, molecular, parasitological, and ultrasonographic tests in diagnosing intestinal schistosomiasis in endemic municipalities in the Philippines. We performed a community-based cross-sectional study to determine the positivity of schistosomiasis in Leyte, Philippines. The diagnostic performance of five different detection techniques: (1) three stool K-K with duplicate smears; (2) soluble egg antigen IgG ELISA; (3) urine point-of-care circulating cathodic antigen (POC-CCA) test; (4) detection of Schistosoma japonicum circulating DNA (SjcDNA) in serum and urine samples; (5) focused abdominal ultrasound (US), were also obtained in this study. Multiple stool examinations enhanced the sensitivity of K-K from 26.2% (95% CI [16.4, 38.8]) with single stool to 53.8% (95% CI [41.1, 66.1]) and 69.2% (95% CI [56.4, 80.0]) with two and three stools from consecutive days, respectively. Among the SjcDNA nucleic acid amplification test (NAAT)-based detection assays, loop-mediated isothermal amplification (LAMP) PCR using sera had the highest sensitivity at 92.3% (95% CI [82.2, 97.1]) with LAMP consistently identifying more positive cases in both serum and urine samples. This study showed that single stool K-K, which remains the only diagnostic test available in most endemic areas in the Philippines, had low sensitivity and failed to identify most patients with light infection. SjcDNA detection assay and POC-CCA urine test were more sensitive than stool microscopy in detecting schistosomiasis. On the other hand, US was less sensitive than the widely utilized K-K technique in diagnosing schistosomiasis. This study emphasizes the need to revisit the use of single stool K-K in the surveillance and case detection of schistosomiasis in endemic areas of the Philippines. The availability of advanced and more sensitive diagnostic tests will help better control, prevent, and eliminate schistosomiasis in the country.


Assuntos
Esquistossomose mansoni , Esquistossomose , Animais , Antígenos de Helmintos/urina , Cidades , Estudos Transversais , Humanos , Filipinas/epidemiologia , Sistemas Automatizados de Assistência Junto ao Leito , Prevalência , Schistosoma mansoni , Esquistossomose/diagnóstico , Esquistossomose/epidemiologia , Esquistossomose mansoni/diagnóstico , Esquistossomose mansoni/epidemiologia , Sensibilidade e Especificidade
3.
J Physiol Anthropol ; 41(1): 26, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35778758

RESUMO

Frailty, particularly traits which are related to sex steroid hormone production, results from the age-associated decline in function considered to be part of the typical aging process. This process may vary with influences including environmental, biological, or lifestyle factors. An area of concern that has received relatively little attention is the impact of cumulative lifetime changes in sex steroid hormones related to the traits we see that typify the human aging process. Women's lifetime reproductive profiles include menstrual/ovulatory cycles, gestation, and lactation, all of which respond to changes in sex steroid hormone levels. Here, we review data on reproductive profiles and risks of frailty among post-menopausal women. In the current study, our team collected reproductive histories of women to determine the estimated number of lifetime reproductive cycles (ELC). We interviewed 44 women in the USA and 67 women in the Philippines aged 65 years plus to obtain data on reproductive cycles, pregnancy, and breastfeeding. Participants completed several frailty tasks including grip strength, a sit-to-stand test, and gait speed. While ELC was not associated with frailty in the US population, higher ELC was associated with lower frailty among the Philippine population. The current study should be considered as an exploratory project investigating field-friendly methods to use when considering lifetime reproductive histories and the influence on the aging process.


Assuntos
Fragilidade , Envelhecimento , Feminino , Fragilidade/epidemiologia , Hormônios Esteroides Gonadais , Humanos , Estilo de Vida , Filipinas/epidemiologia , Gravidez , Estados Unidos/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-35886640

RESUMO

Over 60 countries have integrated wastewater-based epidemiology (WBE) in their COVID-19 surveillance programs, focusing on wastewater treatment plants (WWTP). In this paper, we piloted the assessment of SARS-CoV-2 WBE as a complementary public health surveillance method in susceptible communities in a highly urbanized city without WWTP in the Philippines by exploring the extraction and detection methods, evaluating the contribution of physico-chemical-anthropogenic factors, and attempting whole-genome sequencing (WGS). Weekly wastewater samples were collected from sewer pipes or creeks in six communities with moderate-to-high risk of COVID-19 transmission, as categorized by the City Government of Davao from November to December 2020. Physico-chemical properties of the wastewater and anthropogenic conditions of the sites were noted. Samples were concentrated using a PEG-NaCl precipitation method and analyzed by RT-PCR to detect the SARS-CoV-2 N, RdRP, and E genes. A subset of nine samples were subjected to WGS using the Minion sequencing platform. SARS-CoV-2 RNA was detected in twenty-two samples (91.7%) regardless of the presence of new cases. Cycle threshold values correlated with RNA concentration and attack rate. The lack of a sewershed map in the sampled areas highlights the need to integrate this in the WBE planning. A combined analysis of wastewater physico-chemical parameters such as flow rate, surface water temperature, salinity, dissolved oxygen, and total dissolved solids provided insights on the ideal sampling location, time, and method for WBE, and their impact on RNA recovery. The contribution of fecal matter in the wastewater may also be assessed through the coliform count and in the context of anthropogenic conditions in the area. Finally, our attempt on WGS detected single-nucleotide polymorphisms (SNPs) in wastewater which included clinically reported and newly identified mutations in the Philippines. This exploratory report provides a contextualized framework for applying WBE surveillance in low-sanitation areas.


Assuntos
COVID-19 , SARS-CoV-2 , COVID-19/epidemiologia , Humanos , Filipinas/epidemiologia , Projetos Piloto , RNA Viral , SARS-CoV-2/genética , Águas Residuárias , Vigilância Epidemiológica Baseada em Águas Residuárias
5.
PLoS Negl Trop Dis ; 16(7): e0010595, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35852994

RESUMO

Rabies remains a public health problem in the Philippines despite the widespread provision of rabies vaccines and rabies immunoglobulin (RIG) as post-exposure prophylaxis (PEP). Detailed descriptions of recent human rabies cases in the Philippines are scarce. This study aimed to describe the clinical, epidemiological, and spatial features of human rabies cases between January 1, 2006, and December 31, 2015. We conducted a retrospective hospital-based case record review of all patients admitted to one referral hospital in Manila who received a clinical diagnosis of rabies. During the 10-year study period there were 575 patients (average 57.5 cases per year, range 57 to 119) with a final diagnosis of rabies. Most patients were male (n = 404, 70.3%) and aged ≥ 20 years (n = 433, 75.3%). Patients mostly came from the National Capital Region (n = 160, 28.0%) and the adjacent Regions III (n = 197, 34.4%) and IV-A (n = 168, 29.4%). Case mapping and heatmaps showed that human rabies cases were continuously observed in similar areas throughout the study period. Most patients had hydrophobia (n = 444, 95.5%) and/or aerophobia (n = 432, 93.3%). The leading causative animals were dogs (n = 421, 96.3%) and cats (n = 16, 3.7%). Among 437 patients with animal exposure history, only 42 (9.6%) had been administered at least one rabies vaccine. Two patients (0.5%), young children bitten on their face, had received and a full course of rabies vaccine. Human rabies patients were continuously admitted to the hospital, with no notable decline over the study period. The geographical area in which human rabies cases commonly occurred also did not change. Few patients received PEP and there were two suspected cases of PEP failure. The retrospective design of this study was a limitation; thus, prospective studies are required.


Assuntos
Mordeduras e Picadas , Vacinas Antirrábicas , Raiva , Animais , Mordeduras e Picadas/tratamento farmacológico , Criança , Pré-Escolar , Cães , Feminino , Humanos , Masculino , Filipinas/epidemiologia , Transtornos Fóbicos , Profilaxia Pós-Exposição , Raiva/tratamento farmacológico , Raiva/epidemiologia , Raiva/prevenção & controle , Estudos Retrospectivos
6.
J Infect Dev Ctries ; 16(5): 787-794, 2022 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-35656949

RESUMO

INTRODUCTION: The World Health Organization has categorized coronavirus disease 2019 (COVID-19) into mild, moderate, severe, and critical illness severities to guide clinical decision-making. This study aimed to describe the clinical characteristics, complications, and outcomes of COVID-19 patients by illness severity, at a tertiary healthcare center in Cebu City, Philippines. METHODOLOGY: This was a retrospective, observational cohort study that examined clinical information of patients with confirmed COVID-19 infection admitted between March and September 2020. RESULTS: Data from 901 admitted patients were analyzed, with 185 (20.5%) classified as mild, 429 (47.6%) as moderate, 223 (24.7%) as severe, and 64 (7.1%) as critical. The frequency of male gender, advancing age, co-morbidities (hypertension and diabetes mellitus), inflammatory marker elevation (LDH, CRP, Ferritin, Procalcitonin), and elevated mean white blood cell counts with relative neutrophilia and lymphopenia increased with COVID severity. Severe and critical cases of COVID presented with more diffuse lung involvement in chest radiographs and abnormal electrocardiographic patterns such as ischemic changes, PVCs, PACs, and sinus tachycardia. The most common complications on admission were ARDS (10.9%), AKI (10.1%), shock (6.6%), and cardiac arrest (6.3%). Mortality rates were highest in critical cases (82.8%). Severe and critical COVID-19 cases were predominant on final disposition, rising to 62.5% of the study population from 32.1% on admission. CONCLUSIONS: This study highlights key differences in clinical characteristics, complications, and outcomes between illness severities. Risk prediction models are needed for disease progression and poor outcomes.


Assuntos
COVID-19 , Animais , COVID-19/epidemiologia , Cebus , Estudos de Coortes , Humanos , Masculino , Filipinas/epidemiologia , Centros de Atenção Terciária
8.
PLoS One ; 17(6): e0270555, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35771739

RESUMO

Throughout 2020, national and subnational governments worldwide implemented nonpharmaceutical interventions (NPIs) to contain the spread of COVID-19. These included community quarantines, also known as lockdowns, of varying length, scope, and stringency that restricted mobility. To assess the effect of community quarantines on urban mobility in the Philippines, we analyze a new source of data: cellphone-based origin-destination flows made available by a major telecommunication company. First, we demonstrate that mobility dropped to 26% of the pre-lockdown level in the first month of lockdown and recovered and stabilized at 70% in August and September of 2020. Then we quantify the heterogeneous effects of lockdowns by city's employment composition. A city with 10 percentage points more employment share in work-from-home friendly sectors is found to have experienced an additional 2.8% decrease in mobility under the most stringent lockdown policy. Similarly, an increase of 10 percentage points in employment share in large and medium-sized firms was associated with a1.9% decrease in mobility on top of the benchmark reduction. We compare our findings with cross-country evidence on lockdowns and mobility, discuss the economic implications for containment policies in the Philippines, and suggest additional research that can be based on this novel dataset.


Assuntos
COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Humanos , Filipinas/epidemiologia , Políticas , Quarentena
10.
Stud Health Technol Inform ; 290: 1082-1083, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35673216

RESUMO

We used KoBo Collect and KoBo Toolbox as an electronic data capture platform for a dog population and rabies knowledge and practices community survey in the Philippines. It has allowed for easy design and deployment of an electronic form with minimal technical knowledge from the investigators. Using this platform allowed for shorter training for data collectors, minimal errors during data collection, and faster turn-around time for data cleaning and analysis.


Assuntos
Doenças do Cão , Raiva , Animais , Estudos Transversais , Doenças do Cão/epidemiologia , Cães , Conhecimentos, Atitudes e Prática em Saúde , Filipinas/epidemiologia , Raiva/epidemiologia , Raiva/prevenção & controle , Raiva/veterinária , Inquéritos e Questionários
13.
Geriatr Gerontol Int ; 22(7): 511-515, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35670130

RESUMO

AIMS: This study contributes to previous initiatives examining healthy and active aging in the Philippines. METHODS: We employed the Sullivan method to calculate healthy life expectancy (HLE) and active life expectancy (ALE) using the 2007 Philippine Survey on Aging and the 2018 Longitudinal Study of Ageing and Health. We compared the estimates at two time points, providing evidence of change over time. RESULTS: There was no statistically significant change in the relative proportion of HLE over time for both sexes, suggesting dynamic equilibrium. For men, the increase in life expectancy was mainly an increase in unhealthy state (UHLE). The slight increases in HLE for all ages were not statistically significant. The differences in relative increase in HLE were not statistically significant. HLE for women increased over time, with statistically significant increases at ages 60 and 70 years. ALE declined in all age groups for both sexes, but the decline was statistically significant only among women in their 60s and 70s. There was also a statistically significant decline in the proportion of remaining life in an active state for all ages among both men and women, suggesting an expansion of morbidity. CONCLUSIONS: Findings suggest no evidence of compression of morbidity in the Philippines from 2007 to 2018. The HLE results suggest a dynamic equilibrium, while ALE results indicate an expansion of morbidity. The findings emphasize the need for the government to promote life course interventions that foster healthy choices and conduct further research to understand the factors influencing longevity and active aging in the Philippines. Geriatr Gerontol Int 2022; 22: 511-515.


Assuntos
Nível de Saúde , Expectativa de Vida , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Morbidade , Filipinas/epidemiologia
14.
PLoS Negl Trop Dis ; 16(6): e0010447, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35648735

RESUMO

BACKGROUND: Yaws is a chronic, highly contagious skin and bone infection affecting children living in impoverished, remote communities. It is caused by Treponema pallidum subsp. pertenue. We report the prevalence of active yaws among elementary schoolchildren based on clinical and serological criteria in selected municipalities of Southern Philippines. METHODS: From January to March 2017, exploratory cross-sectional surveys and screening of skin diseases were conducted in the Liguasan Marsh area of the provinces Maguindanao, Sultan Kudarat, and Cotabato. We included 9 municipalities and randomly selected one public elementary school per municipality. Members of students' households and the communities were also examined and treated. Yaws suspects and contacts had blood tests for treponemal and non-treponemal antibodies using Dual Pathway Platform and Treponema pallidum particle agglutination (TPPA) tests. RESULTS: A total of 2779 children and adults were screened for any skin disease: 2291 students, 393 household members, and 95 community members. Among 210 yaws suspects and contacts, 150 consented to serologic tests. The estimated prevalence of active yaws among schoolchildren screened was 1 out of 2291 (0.04%). Among 2532 children who were 14 years old and younger, 4 (0.2%) had active yaws. Eight adult household contacts and community members had latent yaws and 2 had past yaws. Five out of 9 municipalities were endemic for yaws. CONCLUSIONS: This study confirmed that the Philippines is endemic for yaws but at a low level in the schools surveyed. This is an under-estimation due to the limited sampling. The lack of proper disease surveillance after the eradication campaign in the 1960's has made yaws a forgotten disease and has led to its resurgence. Yaws surveillance is needed to determine the extent of yaws in the Philippines and to help develop a strategy to eradicate yaws by 2030.


Assuntos
Bouba , Adolescente , Adulto , Criança , Estudos Transversais , Humanos , Filipinas/epidemiologia , Estudos Soroepidemiológicos , Treponema , Treponema pallidum , Bouba/diagnóstico
15.
PLoS Negl Trop Dis ; 16(6): e0010478, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35700164

RESUMO

BACKGROUND: Vector surveillance is an essential public health tool to aid in the prediction and prevention of mosquito borne diseases. This study compared spatial and temporal trends of vector surveillance indices for Aedes vectors in the southern Philippines, and assessed potential links between vector indices and climate factors. METHODS: We analysed routinely collected larval and pupal surveillance data from residential areas of 14 cities and 51 municipalities during 2013-2018 (House, Container, Breteau and Pupal Indices), and used linear regression to explore potential relationships between vector indices and climate variables (minimum temperature, maximum temperature and precipitation). RESULTS: We found substantial spatial and temporal variation in monthly Aedes vector indices between cities during the study period, and no seasonal trend apparent. The House (HI), Container (CI) and Breteau (BI) Indices remained at comparable levels across most surveys (mean HI = 15, mean CI = 16, mean BI = 24), while the Pupal Productivity Index (PPI) was relatively lower in most months (usually below 5) except for two main peak periods (mean = 49 overall). A small proportion of locations recorded high values across all entomological indices in multiple surveys. Each of the vector indices were significantly correlated with one or more climate variables when matched to data from the same month or the previous 1 or 2 months, although the effect sizes were small. Significant associations were identified between minimum temperature and HI, CI and BI in the same month (R2 = 0.038, p = 0.007; R2 = 0.029, p = 0.018; and R2 = 0.034, p = 0.011, respectively), maximum temperature and PPI with a 2-month lag (R2 = 0.031, p = 0.032), and precipitation and HI in the same month (R2 = 0.023, p = 0.04). CONCLUSIONS: Our findings indicated that larval and pupal surveillance indices were highly variable, were regularly above the threshold for triggering vector control responses, and that vector indices based on household surveys were weakly yet significantly correlated with city-level climate variables. We suggest that more detailed spatial and temporal analyses of entomological, climate, socio-environmental and Aedes-borne disease incidence data are necessary to ascertain the most effective use of entomological indices in guiding vector control responses, and reduction of human disease risk.


Assuntos
Aedes , Dengue , Aedes/fisiologia , Animais , Humanos , Larva , Controle de Mosquitos , Mosquitos Vetores/fisiologia , Filipinas/epidemiologia
19.
Vaccine ; 40(27): 3802-3811, 2022 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-35606237

RESUMO

Cervical cancer is the second most common cancer among women in the Philippines. Human papillomavirus (HPV) vaccination provides protection from the most common cancer-causing HPV types. This analysis used a proportionate outcomes model to estimate the potential cost-effectiveness of four different HPV vaccine products-Cervarix™, Cecolin®, GARDASIL®, and GARDASIL®9-for routine HPV vaccination of 10 cohorts of 9-year-old girls from the government and societal perspectives. Model parameters included cervical cancer burden, healthcare and program costs, vaccine efficacy with and without potential cross-protection, and vaccination coverage. Univariate and probabilistic sensitivity analyses evaluated the impact of uncertainty on model results. Compared to no vaccination, HPV programs with Cecolin®, Cervarix™, and GARDASIL® are projected to be cost-effective at US$1,210, US$1,300, and US$2,043 per DALY averted, respectively, from the government perspective, and at US$173, US$263, and US$1,006 per DALY averted, respectively, from the societal perspective when cross-protection was considered. When direct comparisons were made across vaccines, GARDASIL® was dominated by Cervarix™ and Cecolin®. In a scenario where cross-protection was not considered, results were similar except that Cervarix™ and GARDASIL® were both dominated by Cecolin®. GARDASIL®9 was not cost-effective under any of the modeled scenarios.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Criança , Análise Custo-Benefício , Feminino , Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18 , Humanos , Infecções por Papillomavirus/prevenção & controle , Filipinas/epidemiologia , Vacinação/métodos
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