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1.
J Med Internet Res ; 23(2): e25454, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33464207

RESUMO

BACKGROUND: The COVID-19 pandemic has had a profound global impact on governments, health care systems, economies, and populations around the world. Within the East Asia and Pacific region, some countries have mitigated the spread of the novel coronavirus effectively and largely avoided severe negative consequences, while others still struggle with containment. As the second wave reaches East Asia and the Pacific, it becomes more evident that additional SARS-CoV-2 surveillance is needed to track recent shifts, rates of increase, and persistence associated with the pandemic. OBJECTIVE: The goal of this study is to provide advanced surveillance metrics for COVID-19 transmission that account for speed, acceleration, jerk, persistence, and weekly shifts, to better understand country risk for explosive growth and those countries who are managing the pandemic successfully. Existing surveillance coupled with our dynamic metrics of transmission will inform health policy to control the COVID-19 pandemic until an effective vaccine is developed. We provide novel indicators to measure disease transmission. METHODS: Using a longitudinal trend analysis study design, we extracted 330 days of COVID-19 data from public health registries. We used an empirical difference equation to measure the daily number of cases in East Asia and the Pacific as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS: The standard surveillance metrics for Indonesia, the Philippines, and Myanmar were concerning as they had the largest new caseloads at 4301, 2588, and 1387, respectively. When looking at the acceleration of new COVID-19 infections, we found that French Polynesia, Malaysia, and the Philippines had rates at 3.17, 0.22, and 0.06 per 100,000. These three countries also ranked highest in terms of jerk at 15.45, 0.10, and 0.04, respectively. CONCLUSIONS: Two of the most populous countries in East Asia and the Pacific, Indonesia and the Philippines, have alarming surveillance metrics. These two countries rank highest in new infections in the region. The highest rates of speed, acceleration, and positive upwards jerk belong to French Polynesia, Malaysia, and the Philippines, and may result in explosive growth. While all countries in East Asia and the Pacific need to be cautious about reopening their countries since outbreaks are likely to occur in the second wave of COVID-19, the country of greatest concern is the Philippines. Based on standard and enhanced surveillance, the Philippines has not gained control of the COVID-19 epidemic, which is particularly troubling because the country ranks 4th in population in the region. Without extreme and rigid social distancing, quarantines, hygiene, and masking to reverse trends, the Philippines will remain on the global top 5 list of worst COVID-19 outbreaks resulting in high morbidity and mortality. The second wave will only exacerbate existing conditions and increase COVID-19 transmissions.


Assuntos
/epidemiologia , Ásia Sudeste/epidemiologia , Australásia/epidemiologia , Extremo Oriente/epidemiologia , Política de Saúde , Humanos , Indonésia/epidemiologia , Estudos Longitudinais , Malásia/epidemiologia , Pandemias , Filipinas/epidemiologia , Polinésia/epidemiologia , Saúde Pública , Vigilância em Saúde Pública , Sistema de Registros
2.
Epilepsy Behav ; 115: 107491, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33323340

RESUMO

OBJECTIVE: Epilepsy is a neurologic disease that carries a high disease burden and likely, a huge treatment gap especially in low-to-middle income countries (LMIC) such as the Philippines. This review aimed to examine the treatment gaps and challenges that burden Philippine epilepsy care. MATERIALS & METHODS: Pertinent data on epidemiology, research, health financing and health systems, pharmacologic and surgical treatment options, cost of care, and workforce were obtained through a literature search and review of relevant Philippine government websites. RESULTS: The estimated prevalence of epilepsy in the Philippines is 0.9%. Epilepsy research in the Philippines is low in quantity compared with the rest of Southeast Asia (SEA). Inequities in quality and quantity of healthcare services delivered to local government units (LGUs) have arisen because of devolution. Programs for epilepsy care by both government and nongovernment institutions have been implemented. Healthcare expenditure in the Philippines is still largely out-of-pocket, with only partial coverage from the public sector. There is limited access to antiseizure medications (ASMs), mainly due to cost. Epilepsy surgery is an underutilized treatment option. There are only 20 epileptologists in the Philippines, with one epileptologist for every 45,000 patients with epilepsy. In addition, epilepsy care service delivery has been further impeded by the coronavirus disease of 2019 (COVID-19) pandemic. CONCLUSION: There is a large treatment gap in epilepsy care in the Philippines in terms of high epilepsy disease burden, socioeconomic limitations and inadequate public support, sparse clinico-epidemiologic research on epilepsy, inaccessibility of health care services and essential pharmacotherapy, underutilization of surgical options, and lack of specialists capable of rendering epilepsy care. Acknowledgment of the existence of these treatment gaps and addressing such are expected to improve the overall survival and quality of life of patients with epilepsy in the Philippines.


Assuntos
/prevenção & controle , Efeitos Psicossociais da Doença , Epilepsia/terapia , Acesso aos Serviços de Saúde/tendências , Programas Nacionais de Saúde/tendências , Anticonvulsivantes/economia , Anticonvulsivantes/uso terapêutico , /epidemiologia , Países em Desenvolvimento/economia , Epilepsia/economia , Epilepsia/epidemiologia , Serviços de Saúde/economia , Serviços de Saúde/tendências , Acesso aos Serviços de Saúde/economia , Humanos , Programas Nacionais de Saúde/economia , Filipinas/epidemiologia , Qualidade de Vida
3.
Am J Trop Med Hyg ; 103(5): 1818-1826, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32975174

RESUMO

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.


Assuntos
Infecções por HIV/epidemiologia , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Adolescente , Envelhecimento , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Feminino , Infecções por HIV/complicações , HIV-1 , Humanos , Lactente , Modelos Logísticos , Masculino , Filipinas/epidemiologia , Fatores de Risco , Tuberculose/complicações
4.
Epidemiol Infect ; 148: e204, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32928322

RESUMO

The Philippines confirmed local transmission of COVID-19 on 7 March 2020. We described the characteristics and epidemiological time-to-event distributions for laboratory-confirmed cases in the Philippines recorded up to 29 April 2020 and followed until 22 May 2020. The median age of 8212 cases was 46 years (IQR 32-61), with 46.2% being female and 68.8% living in the National Capital Region. Health care workers represented 24.7% of all detected infections. Mean length of hospitalisation for those who were discharged or died were 16.00 days (95% CI 15.48-16.54) and 7.27 days (95% CI 6.59-8.24). Mean duration of illness was 26.66 days (95% CI 26.06-27.28) and 12.61 days (95% CI 11.88-13.37) for those who recovered or died. Mean serial interval was 6.90 days (95% CI 5.81-8.41). Epidemic doubling time prior to the enhanced community quarantine (ECQ; 11 February and 19 March) was 4.86 days (95% CI 4.67-5.07) and the reproductive number was 2.41 (95% CI 2.33-2.48). During the ECQ (20 March to 9 April), doubling time was 12.97 days (95% CI 12.57-13.39) and the reproductive number was 0.89 (95% CI 0.78-1.02).


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Filipinas/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Quarentena , Adulto Jovem
5.
PLoS One ; 15(9): e0238815, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32913363

RESUMO

The Philippines confirmed its first epidemic of Highly Pathogenic Avian Influenza (HPAI) on August 11, 2017. It ended in November of 2017. Despite the successful management of the epidemic, reemergence is a continuous threat. The aim of this study was to conduct a mathematical model to assess the spatial transmission of HPAI among poultry farms in Central Luzon. Different control strategies and the current government protocol of 1 km radius pre-emptive culling (PEC) from infected farms were evaluated. The alternative strategies include 0.5km PEC, 1.5km PEC, 2 km PEC, 2.5 km PEC, and 3 km PEC, no pre-emptive culling (NPEC). The NPEC scenario was further modeled with a time of government notification set at 24hours, 48 hours, and 72 hours after the detection. Disease spread scenarios under each strategy were generated using an SEIR (susceptible-exposed-infectious-removed) stochastic model. A spatial transmission kernel was calculated and used to represent all potential routes of infection between farms. We assumed that the latent period occurs between 1-2 days, disease detection at 5-7 days post-infection, notification of authorities at 5-7 days post-detection and start of culling at 1-3 days post notification. The epidemic scenarios were compared based on the number of infected farms, the total number of culled farms, and the duration of the epidemic. Our results revealed that the current protocol is the most appropriate option compared with the other alternative interventions considered among farms with reproductive ratio (Ri) > 1. Shortening the culling radius to 0.5 km increased the duration of the epidemic. Further increase in the PEC zone decreased the duration of the epidemic but may not justify the increased number of farms to be culled. Nonetheless, the no-pre-emptive culling (NPEC) strategy can be an effective alternative to the current protocol if farm managers inform the government immediately within 24 hours of observation of the presence of HPAI in their farms. Moreover, if notification is made on days 1-3 after the detection, the scale and length of the outbreak have been significantly reduced. In conclusion, this study provided a comparison of various control measures for confronting the spread of HPAI infection using the simulation model. Policy makers can use this information to enhance the effectiveness of the current control strategy.


Assuntos
Surtos de Doenças/veterinária , Influenza Aviária/epidemiologia , Doenças das Aves Domésticas/virologia , Animais , Surtos de Doenças/prevenção & controle , Epidemias/veterinária , Fazendas , Modelos Biológicos , Modelos Teóricos , Filipinas/epidemiologia , Aves Domésticas , Doenças das Aves Domésticas/prevenção & controle
6.
J Affect Disord ; 277: 379-391, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32861839

RESUMO

BACKGROUND: The 2019 coronavirus disease (COVID-19) pandemic poses a threat to societies' mental health. This study examined the prevalence of psychiatric symptoms and identified the factors contributing to psychological impact in the Philippines. METHODS: A total of 1879 completed online surveys were gathered from March 28-April 12, 2020. Collected data included socio-demographics, health status, contact history, COVID-19 knowledge and concerns, precautionary measures, information needs, the Depression, Anxiety and Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) ratings. RESULTS: The IES-R mean score was 19.57 (SD=13.12) while the DASS-21 mean score was 25.94 (SD=20.59). In total, 16.3% of respondents rated the psychological impact of the outbreak as moderate-to-severe; 16.9% reported moderate-to-severe depressive symptoms; 28.8% had moderate-to-severe anxiety levels; and 13.4% had moderate-to-severe stress levels. Female gender; youth age; single status; students; specific symptoms; recent imposed quarantine; prolonged home-stay; and reports of poor health status, unnecessary worry, concerns for family members, and discrimination were significantly associated with greater psychological impact of the pandemic and higher levels of stress, anxiety and depression (p<0.05). Adequate health information, having grown-up children, perception of good health status and confidence in doctors' abilities were significantly associated with lesser psychological impact of the pandemic and lower levels of stress, anxiety and depression (p<0.05). LIMITATIONS: An English online survey was used. CONCLUSION: During the early phase of the pandemic in the Philippines, one-fourth of respondents reported moderate-to-severe anxiety and one-sixth reported moderate-to-severe depression and psychological impact. The factors identified can be used to devise effective psychological support strategies.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Pandemias , Pneumonia Viral , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Fatores Etários , Ansiedade/psicologia , Betacoronavirus , Criança , Depressão/psicologia , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Filipinas/epidemiologia , Prevalência , Fatores Sexuais , Pessoa Solteira , Estresse Psicológico/psicologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
7.
PLoS One ; 15(8): e0236278, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32841247

RESUMO

Rabies is a lethal viral disease and dogs are the major disease reservoir in the Philippines. Spatio-temporal variations in environmental factors are known to affect disease dynamics. Some rabies-affected countries considered investigating the role of weather components in driving rabies cases and it has helped them to strategize their control efforts. In this study, cointegration analysis was conducted between the monthly reported rabies cases and the weather components, such as temperature and precipitation, to verify the effect of weather components on rabies incidence in Davao City, Philippines. With the Engle-Granger cointegration tests, we found that rabies cases are cointegrated into each of the weather components. It was further validated, using the Granger causality test, that each weather component predicts the rabies cases and not vice versa. Moreover, we performed the Johansen cointegration test to show that the weather components simultaneously affect the number of rabies cases, which allowed us to estimate a vector-error correction model for rabies incidence as a function of temperature and precipitation. Our analyses showed that canine rabies in Davao City was weather-sensitive, which implies that rabies incidence could be projected using established long-run relationship among reported rabies cases, temperature, and precipitation. This study also provides empirical evidence that can guide local health officials in formulating preventive strategies for rabies control and eradication based on weather patterns.


Assuntos
Reservatórios de Doenças/virologia , Cães/virologia , Monitorização de Parâmetros Ecológicos/estatística & dados numéricos , Raiva/epidemiologia , Tempo (Meteorologia) , Animais , Causalidade , Cidades/estatística & dados numéricos , Conjuntos de Dados como Assunto , Previsões/métodos , Humanos , Incidência , Modelos Estatísticos , Filipinas/epidemiologia , Raiva/prevenção & controle , Raiva/virologia , Vírus da Raiva , Análise Espaço-Temporal
8.
J Stroke Cerebrovasc Dis ; 29(9): 105059, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807464

RESUMO

BACKGROUND AND PURPOSE: Since the declaration of the Novel Coronavirus Disease (COVID-19) pandemic, ensuring the safety of our medical team while delivering timely management has been a challenge. Acute stroke patients continue to present to the emergency department and they may not have the usual symptoms of COVID-19 infection. Stroke team response and management must be done within the shortest possible time to minimize worsening of the functional outcome without compromising safety of the medical team. METHODS: Infection control recommendations, emergency department protocols and stroke response pathways utilized prior to the COVID 19 pandemic within our institution were evaluated by our stroke team in collaboration with the multidisciplinary healthcare services. Challenges during the COVID-19 scenario were identified, from which a revised acute stroke care algorithm was formulated to adapt to this pandemic. RESULTS: We formulated an algorithm that incorporates practices from internationally devised protocols while tailoring certain aspects to suit the available resources in our system locally. We highlighted the significance of the following: team role designation, coordination among different subspecialties and departments, proper use of personal protective equipment and resources, and telemedicine use during this pandemic. CONCLUSIONS: This pandemic has shaped the stroke team's approach in the management of acute stroke patients. Our algorithm ensures proper resource management while optimizing acute stroke care during the COVID-19 pandemic in our local setting. This algorithm may be utilized and adapted for local practice and other third world countries who face similar constraints.


Assuntos
Algoritmos , Infecções por Coronavirus/terapia , Procedimentos Clínicos/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Países em Desenvolvimento , Hospitais Privados/organização & administração , Pneumonia Viral/terapia , Acidente Vascular Cerebral/terapia , Centros de Atenção Terciária/organização & administração , Comportamento Cooperativo , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Controle de Infecções/organização & administração , Comunicação Interdisciplinar , Saúde do Trabalhador , Pandemias , Equipe de Assistência ao Paciente/organização & administração , Segurança do Paciente , Filipinas/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Resultado do Tratamento , Fluxo de Trabalho
9.
Infect Dis (Lond) ; 52(12): 902-907, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32808838

RESUMO

BACKGROUND: There is a growing literature on the association of SARS-CoV-2 and other chronic conditions, such as noncommunicable diseases. However, little is known about the impact of coinfection with tuberculosis. We aimed to compare the risk of death and recovery, as well as time-to-death and time-to-recovery, in COVID-19 patients with and without tuberculosis. METHODS: We created a 4:1 propensity score matched sample of COVID-19 patients without and with tuberculosis, using COVID-19 surveillance data in the Philippines. We conducted a longitudinal cohort analysis of matched COVID-19 patients as of May 17, 2020, following them until June 15, 2020. The primary analysis estimated the risk ratios of death and recovery in patients with and without tuberculosis. Kaplan-Meier curves described time-to-death and time-to-recovery stratified by tuberculosis status, and differences in survival were assessed using the Wilcoxon test. RESULTS: The risk of death in COVID-19 patients with tuberculosis was 2.17 times higher than in those without (95% CI: 1.40-3.37). The risk of recovery in COVID-19 patients with tuberculosis was 25% lower than in those without (RR = 0.75,05% CI 0.63-0.91). Similarly, time-to-death was significantly shorter (p = .0031) and time-to-recovery significantly longer in patients with tuberculosis (p = .0046). CONCLUSIONS: Our findings show that coinfection with tuberculosis increased morbidity and mortality in COVID-19 patients. Our findings highlight the need to prioritize routine and testing services for tuberculosis, although health systems are disrupted by the heavy burden of the SARS-CoV-2 pandemic.


Assuntos
Infecções por Coronavirus/microbiologia , Pneumonia Viral/microbiologia , Tuberculose/mortalidade , Tuberculose/virologia , Betacoronavirus/isolamento & purificação , Estudos de Coortes , Coinfecção/microbiologia , Coinfecção/virologia , Infecções por Coronavirus/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Filipinas/epidemiologia , Pneumonia Viral/mortalidade , Fatores de Risco , Análise de Sobrevida , Resultado do Tratamento , Tuberculose/terapia
10.
Int J Infect Dis ; 99: 312-323, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32768695

RESUMO

OBJECTIVE: The current study integrated Protection Motivation Theory (PMT) and extended Theory of Planned Behavior (TPB) to evaluate factors affecting the perceived effectiveness of COVID-19 prevention measures among Filipinos during Enhanced Community Quarantine (ECQ) in Luzon, Philippines. METHODS: A total of 649 Filipinos answered an online questionnaire, which contained 63 questions. Structural Equation Modeling (SEM) was utilized to derive the causal relationships of the latent variables construct. RESULTS: SEM showed that understanding of COVID-19 had significant direct effects on perceived vulnerability and perceived severity. Also, perceived vulnerability and perceived severity had significant indirect effects on intention to follow. Intention to follow had significant direct effects on actual behavior and adapted behavior, which subsequently led to perceived effectiveness. Of note, an understanding of COVID-19 was found to have a significant indirect effect on perceived effectiveness. CONCLUSIONS: The current study is one of the first studies to analyze factors affecting the perceived effectiveness of COVID-19 prevention measures during the global pandemic. It is proposed that the integrated PMT and extended TPB of this study can be applied and extended to evaluate the perceived effectiveness of COVID-19 measures in other countries that are currently dealing with COVID-19 pandemic.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Idoso , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Motivação , Filipinas/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Teoria Psicológica , Quarentena , Inquéritos e Questionários , Adulto Jovem
11.
J Prim Care Community Health ; 11: 2150132720946951, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32715893

RESUMO

The coronavirus disease (COVID-19) pandemic and subsequent public health interventions have disrupted food systems all over the world. In the Philippines, where stringent lockdown rules have been implemented, households living in poverty have had to rely largely on food aid in the form of food packs distributed by local governments and private donors. An evaluation of the commonly distributed food items reveals a diet that addresses acute hunger but does not contain sufficient nutrients to promote and maintain health. Such a diet puts low-income households at a greater risk of acute and chronic disease. The negative health impact of commonly distributed food packs on food aid-dependent households shine a light on how the COVID-19 pandemic and public health policies exacerbate health inequities. A primary care perspective is essential in creating food security policies that can effectively address acute hunger and malnutrition without contributing to the long-term deleterious effects of inadequate nutrition on the health of indigent communities.


Assuntos
Infecções por Coronavirus/epidemiologia , Abastecimento de Alimentos , Pandemias , Pneumonia Viral/epidemiologia , Populações Vulneráveis , Infecções por Coronavirus/prevenção & controle , Dieta/efeitos adversos , Características da Família , Assistência Alimentar , Humanos , Pandemias/prevenção & controle , Filipinas/epidemiologia , Pneumonia Viral/prevenção & controle , Pobreza , Atenção Primária à Saúde , Política Pública
12.
Am J Trop Med Hyg ; 103(3): 1211-1214, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32729461

RESUMO

COVID-19 is an emerging disease threatening the lives of patients and healthcare workers (HCWs) alike. In this article, we present initial results of COVID-19 screening performed among the hospital staff of an infectious diseases referral hospital in Manila, the Philippines. Of 324 HCWs tested, eight were positive; only one was exposed to COVID-19 patients, whereas seven others belonged to two different departments. Routine screening of hospital staff is invaluable for the safety of the HCWs and the patients in hospitals and should be performed on a regular basis. In monitoring HCWs, we protect one of our most valuable assets against COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde , Pneumonia Viral/epidemiologia , Adulto , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Filipinas/epidemiologia , Pneumonia Viral/prevenção & controle , Centros de Atenção Terciária
13.
Asia Pac J Public Health ; 32(5): 235-241, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32608243

RESUMO

This study aimed to estimate the prevalence of hearing loss in the Philippines using a nationally representative sample. A cross-sectional national survey was undertaken utilizing a 3-stage stratified cluster design. Participants in the present study comprised 2275 adults and children with pure tone hearing assessment results. Prevalence of moderate or worse hearing loss, defined as 4FA ≥41 dBHL, was 7.5% in children <18 years, 14.7% in adults between 18 and 65 years, and 49.1% in adults >65 years. Factors associated with greater risk of moderate hearing loss in the better ear were presence of a middle ear condition (adjusted odds ratio = 2.39, 95% confidence interval = 1.49-3.85) and socioeconomic status (household income; adjusted odds ratio = 1.64, 95% confidence interval = 1.23-2.19). Age was also associated with increased risk, with adjusted odds ratios varying with age category. Prevalence of wax occlusion and outer and middle ear disease was 12.2% and 14.2%, respectively. Prevalence of hearing loss, outer, and middle ear disease appear comparatively high in the Philippines when compared with rates reported in high-income countries. Higher proportions of severe to profound hearing loss were also identified, indicating that there is both an increased prevalence and severity of hearing loss in this population.


Assuntos
Perda Auditiva/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Filipinas/epidemiologia , Prevalência , Adulto Jovem
14.
Nat Commun ; 11(1): 2719, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32483195

RESUMO

National networks of laboratory-based surveillance of antimicrobial resistance (AMR) monitor resistance trends and disseminate these data to AMR stakeholders. Whole-genome sequencing (WGS) can support surveillance by pinpointing resistance mechanisms and uncovering transmission patterns. However, genomic surveillance is rare in low- and middle-income countries. Here, we implement WGS within the established Antimicrobial Resistance Surveillance Program of the Philippines via a binational collaboration. In parallel, we characterize bacterial populations of key bug-drug combinations via a retrospective sequencing survey. By linking the resistance phenotypes to genomic data, we reveal the interplay of genetic lineages (strains), AMR mechanisms, and AMR vehicles underlying the expansion of specific resistance phenotypes that coincide with the growing carbapenem resistance rates observed since 2010. Our results enhance our understanding of the drivers of carbapenem resistance in the Philippines, while also serving as the genetic background to contextualize ongoing local prospective surveillance.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Genoma Bacteriano/genética , Genômica/métodos , Sequenciamento Completo do Genoma/métodos , Bactérias/efeitos dos fármacos , Bactérias/genética , Bactérias/crescimento & desenvolvimento , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/prevenção & controle , Humanos , Testes de Sensibilidade Microbiana/métodos , Filipinas/epidemiologia , Inquéritos e Questionários
15.
J Glob Health ; 10(1): 011007, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32566169

RESUMO

Background: The presence of COVID-19 in low- and middle-income countries (LMICs) is raising important concerns about effective pandemic response and preparedness in the context of fragile health systems and the pervasiveness of misinformation. The objective of this study was to gain an understanding of how COVID-19 was perceived by households experiencing extreme poverty in the Philippines. Methods: This study was conducted in partnership with International Care Ministries (ICM), a Philippine-based non-governmental organization (NGO) that runs a poverty-alleviation program called Transform targeted towards extreme low-income households. We integrated knowledge, attitudes, and practices (KAP) questions into ICM's cross-sectional program monitoring and evaluation systems from February 20 through March 13, 2020. Frequencies and proportions were calculated to describe the respondents' responses, and the Kruskal-Wallis test and binomial logistic regression were undertaken to determine the socio-demographic characteristics associated with COVID-19 KAPs. Results: In total, 2224 respondents from 166 communities in rural, urban and coastal settings were surveyed. Although the survey was administered during the earlier stages of the pandemic, 94.0% of respondents had already heard of COVID-19. Traditional media sources such as television (85.5%) and radio (56.1%) were reported as the main sources of information about the virus. Coughing and sneezing were identified as a transmission route by 89.5% of respondents, while indirect hand contact was the least commonly identified transmission route, recognized by 72.6% of respondents. Handwashing was identified by 82.2% of respondents as a preventive measure against the virus, but social distancing and avoiding crowds were only identified by 32.4% and 40.6%, respectively. Handwashing was the most common preventive practice in response to COVID-19, adopted by 89.9% of respondents. A greater number of preventive measures were taken by those with more knowledge of potential transmission routes. Conclusions: There is a need for targeted health education as a response strategy to COVID-19 in low-income settings, and it is important that strategies are contextually relevant. Understanding KAPs among populations experiencing extreme poverty will be important as tailored guidance for public health response and communication strategies are developed for LMICs.


Assuntos
Infecções por Coronavirus/prevenção & controle , Características da Família , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pobreza , Adulto , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Filipinas/epidemiologia , Pneumonia Viral/epidemiologia , Inquéritos e Questionários , Adulto Jovem
16.
PLoS One ; 15(6): e0234715, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555618

RESUMO

Influenza-associated mortality has not been quantified in the Philippines. Here, we constructed multiple negative binomial regression models to estimate the overall and age-specific excess mortality rates (EMRs) associated with influenza in the Philippines from 2006 to 2015. The regression analyses used all-cause mortality as the dependent variable and meteorological controls, time, influenza A and B positivity rates (lagged for up to two time periods), and annual and semiannual cyclical seasonality controls as independent variables. The regression models closely matched observed all-cause mortality. Influenza was estimated to account for a mean of 5,347 excess deaths per year (1.1% of annual all-cause deaths) in the Philippines, most of which (67.1%) occurred in adults aged ≥60 years. Influenza A accounted for 85.7% of all estimated excess influenza deaths. The annual estimated influenza-attributable EMR was 5.09 (95% CI: 2.20-5.09) per 100,000 individuals. The EMR was highest for individuals aged ≥60 years (44.63 [95% CI: 4.51-44.69] per 100,000), second highest for children aged less than 5 years (2.14 [95% CI: 0.44-2.19] per 100,000), and lowest for individuals aged 10 to 19 years (0.48 [95% CI: 0.10-0.50] per 100,000). Estimated numbers of excess influenza-associated deaths were considerably higher than the numbers of influenza deaths registered nationally. Our results suggest that influenza causes considerable mortality in the Philippines-to an extent far greater than observed from national statistics-especially among older adults and young children.


Assuntos
Influenza Humana/mortalidade , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Filipinas/epidemiologia , Sistema de Registros/estatística & dados numéricos , Análise de Regressão , Estudos Retrospectivos , Adulto Jovem
17.
J UOEH ; 42(2): 151-160, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32507838

RESUMO

Pain in the muscles and tendons is one of the most common complaints among teachers. The objective of this study was to investigate the prevalence of musculoskeletal disorders (MSDs) and their risk factors among public school teachers in the Philippines. It involved 200 public school teachers in the secondary level from Calbayog City division, Samar Province, Philippines, and used an English version of the Korean Occupational Safety and Health Agency's questionnaire on MSDs for an analysis of musculoskeletal symptoms. The researchers employed frequency and percentages computations to determine the prevalence of MSDs in the respondents. Chi-square test and logistic regression were utilized to compute the correlation among socio-demographic profiles, teaching variables and MSDs. The reported overall prevalence of musculoskeletal pain was 74.5%, with legs (56.5%) and lower back (56%) having the highest prevalence. Significant differences in the prevalence of MSDs were found between age-groups (P = 0.032) and salary-groups (P = 0.045). Musculoskeletal disorders were prevalent among secondary public school teachers in the Philippines, suggesting that school administrators, curriculum and policy makers, and other stakeholders should improve the working conditions of teachers.


Assuntos
Doenças Musculoesqueléticas/epidemiologia , Instituições Acadêmicas/estatística & dados numéricos , Feminino , Humanos , Masculino , Filipinas/epidemiologia , Prevalência , Fatores de Risco
18.
PLoS One ; 15(5): e0232620, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32396559

RESUMO

BACKGROUND: The prevalence of having ever tested for HIV in the Philippines is very low and is far from the 90% target of the Philippine Department of Health (DOH) and UNAIDS, thus the need to identify the factors associated with ever testing for HIV among Filipino women. METHODS: We analysed the 2013 Philippine National Demographic and Health Survey (NDHS). The NDHS is a nationally representative survey which utilized a two-stage stratified design to sample Filipino women aged 15-49. We considered the following exposures in our study: socio-demographic characteristics of respondent and her partner (i.e., age of respondent, age of partner, wealth index, etc.), sexual practices and contraception (i.e., age at first intercourse, condom use, etc.), media access, tobacco use, HIV knowledge, tolerance to domestic violence, and women's empowerment. The outcome variable is HIV testing. We used logistic regression for survey data to study the said associations. RESULTS: Out of 16,155 respondents, only 372 (2.4%) have ever tested for HIV. After adjusting for confounders, having tertiary education (adjusted odds ratio (aOR) = 2.15; 95% Confidence Interval (CI): 1.15-4.04), living with partner (aOR = 1.72; 95% CI: 1.19-2.48), tobacco use (aOR = 1.87; 95% CI: 1.13-3.11); belonging to the middle class (aOR = 2.72; 95% CI: 1.30-5.67), richer (aOR = 3.00; 95% CI: 1.37-5.68), and richest (aOR = 4.14; 95% CI: 1.80-5.91) populations, having weekly television access (aOR = 1.75; 95% CI: 1.04-2.94) or internet access (aOR = 2.01; 95% CI: 1.35-3.00), living in a rural area (aOR = 1.87; 95% CI: 1.34-2.61); and being a Muslim (aOR = 2.30; 95% CI: 1.15-4.57) were associated with ever testing for HIV. CONCLUSIONS: The low percentage of respondents who test for HIV is a call to further strengthen efforts to promote HIV testing among Filipino women. Information on its determinants can be used to guide the crafting and implementation of interventions to promote HIV testing to meet DOH and UNAIDS targets.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Programas de Rastreamento , Adolescente , Adulto , Anticoncepção , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Filipinas/epidemiologia , Prevalência , Parceiros Sexuais , Fatores Socioeconômicos , Adulto Jovem
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