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1.
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
3.
Health Hum Rights ; 24(1): 147-158, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35747271

RESUMO

The international consensus to end compulsory drug treatments and close forced rehabilitation facilities needs urgent transformation to country policies. In the Philippines, as with other countries in Asia, rehabilitation can be compulsory and is seen as the humane alternative to the "war on drugs." In this paper, we present the landscape of rehabilitation and narrate the ways in which people who use drugs are forced to undergo treatment. We unpack the politics behind rehabilitation and explain the sociocultural foundations that support compulsory treatment. We argue that a transition to a human rights-based approach, including voluntary alternatives in community settings, is possible by capitalizing on the reforms that are, unwittingly, the result of the "war on drugs."


Assuntos
Direitos Humanos , Política , Ásia , Países em Desenvolvimento , Humanos , Filipinas
4.
Sci Total Environ ; 838(Pt 4): 156522, 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-35679944

RESUMO

Laguna de Bay, the 3rd largest lake in Southeast Asia, is the most significant source of freshwater fish in the Philippines. With decades of unregulated discharge of industrial, domestic, and agricultural wastewaters into the lake, this study investigates the apportionment of heavy metals from the bottom sediments and its impact on the toxicity of Corbicula fluminea (Asiatic clam), a popular food item in the markets. The sediment samples from the western part of the lake contained higher Cd, Cu, Pb, and Zn and lower As and Cr concentrations compared to the eastern part. There were positive correlations for As, Cr, Cu, Pb, and Zn and negative correlations for Cd and Ni concentrations noted between sediments and C. fluminea. Human health risk associated with the consumption of C. fluminea collected from Laguna de Bay was attributed to the following heavy metals: Cu > As > Zn > Cd > Pb > Cr > Ni. Interestingly, the observed trend in toxicities of the shellfish was consistent with the transport phenomenon of heavy metals facilitated by the counterclockwise direction of the bottom current. This study strongly suggests the re-evaluation of the waste management plan in the industrial zones and policies regulating the sale of the shellfish harvest.


Assuntos
Corbicula , Metais Pesados , Poluentes Químicos da Água , Animais , Baías , Cádmio , China , Monitoramento Ambiental , Sedimentos Geológicos , Lagos , Chumbo , Metais Pesados/análise , Filipinas , Medição de Risco , Poluentes Químicos da Água/análise
5.
Artigo em Inglês | MEDLINE | ID: mdl-35682313

RESUMO

Mental health problems have emerged as one of the biggest problems in the world and one of the countries that has been seen to be highly impacted is the Philippines. Despite the increasing number of mentally ill Filipinos, it is one of the most neglected problems in the country. The purpose of this study was to determine the factors affecting the perceived usability of mobile mental health applications. A total of 251 respondents voluntarily participated in the online survey we conducted. A structural equation modeling and artificial neural network hybrid was applied to determine the perceived usability (PRU) such as the social influence (SI), service awareness (SA), technology self-efficacy (SE), perceived usefulness (PU), perceived ease of use (PEOU), convenience (CO), voluntariness (VO), user resistance (UR), intention to use (IU), and actual use (AU). Results indicate that VO had the highest score of importance, followed by CO, PEOU, SA, SE, SI, IU, PU, and ASU. Having the mobile application available and accessible made the users perceive it as highly beneficial and advantageous. This would lead to the continuous usage and patronage of the application. This result highlights the insignificance of UR. This study was the first study that considered the evaluation of mobile mental health applications. This study can be beneficial to people who have mental health disorders and symptoms, even to health government agencies. Finally, the results of this study could be applied and extended among other health-related mobile applications worldwide.


Assuntos
Aplicativos Móveis , Humanos , Análise de Classes Latentes , Saúde Mental , Redes Neurais de Computação , Filipinas
6.
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
7.
Clin Epigenetics ; 14(1): 78, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35733189

RESUMO

Adverse birth outcomes, such as early gestational age and low birth weight, can have lasting effects on morbidity and mortality, with impacts that persist into adulthood. Identifying the maternal factors that contribute to adverse birth outcomes in the next generation is thus a priority. Epigenetic clocks, which have emerged as powerful tools for quantifying biological aging and various dimensions of physiological dysregulation, hold promise for clarifying relationships between maternal biology and infant health, including the maternal factors or states that predict birth outcomes. Nevertheless, studies exploring the relationship between maternal epigenetic age and birth outcomes remain few. Here, we attempt to replicate a series of analyses previously reported in a US-based sample, using a larger similarly aged sample (n = 296) of participants of a long-running study in the Philippines. New pregnancies were identified prospectively, dried blood spot samples were collected during the third trimester, and information was obtained on gestational age at delivery and offspring weight after birth. Genome-wide DNA methylation was assessed with the Infinium EPIC array. Using a suite of 15 epigenetic clocks, we only found one significant relationship: advanced age on the epigenetic clock trained on leptin predicted a significantly earlier gestational age at delivery (ß = - 0.15, p = 0.009). Of the other 29 relationships tested predicting gestational age and offspring birth weight, none were statistically significant. In this sample of Filipino women, epigenetic clocks capturing multiple dimensions of biology and health do not predict birth outcomes in offspring.


Assuntos
Cebus , Complicações na Gravidez , Adulto , Idoso , Animais , Peso ao Nascer/genética , Metilação de DNA , Epigênese Genética , Feminino , Idade Gestacional , Humanos , Filipinas , Gravidez
9.
Sci Total Environ ; 838(Pt 3): 156408, 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-35660612

RESUMO

The Philippines is identified as one of the major marine plastic litter polluters in the world with a discharge of approximately 0.75 million tons of marine plastic debris per year. However, the extent of the plastic problem is yet to be defined systematically because of limited research. Thus, this study aims to quantify plastic litter occurrence in mangrove areas as they function as sinks for plastic litter due to their inherent nature of trapping plastics. To define the extent of marine plastic pollution on an island scale, mangrove areas in 14 municipalities around Cebu Island were sampled, with 3 to 9 transects in each site depending on the length of coastline covered by mangroves. Sampling and characterization of both plastics and the mangrove ecosystem was performed in three locations along the transect - landward, middle, and seaward. A total of 4501 plastic items were sampled throughout the study sites with an average of 1.29 ± 0.67 items/m2 (18.07 ± 8.79 g/m2). The average distribution of plastic loads were 2.68 ± 1.9 items/m2 (38.52 ± 25.35 g/m2), 0.27 ± 0.10 items/m2 (6.65 ± 4.67 g/m2), and 0.94 ± 0.61 items/m2 (9.04 ± 4.28 g/m2) for the landward, middle, and seaward locations, respectively. The most frequent plastic types found were i) packaging, ii) plastic bags and iii) plastic fragments. The plastic loads and types suggest that most plastic wastes trapped in mangroves come from the nearby communities. Fishing-related plastics originated from the sea and were transported across the mangrove breadth. The findings confirm that mangroves are major traps of plastic litter that might adversely affect the marine ecosystem. The study underscores the urgent need for waste mitigation measures, including education, community engagement, infrastructure, technological solutions and supporting policies.


Assuntos
Ecossistema , Resíduos , Animais , Cebus , Monitoramento Ambiental , Filipinas , Plásticos/química , Políticas , Resíduos/análise
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
11.
PLoS One ; 17(6): e0268023, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35675344

RESUMO

Understanding the underlying and unpredictable dynamics of the COVID-19 pandemic is important. We supplemented the findings of Jones and Strigul (2020) and described the chaotic behavior of COVID-19 using state space plots which depicted the changes in asymptotic behavior and trajectory brought about by the increase or decrease in the number of cases which resulted from the easing or tightening of restrictions and other non-pharmaceutical interventions instituted by governments as represented by the country's stringency index (SI). We used COVID-19 country-wide case count data and analyzed it using convergent cross-mapping (CCM) and found that the SI influence on COVID-19 case counts is high in almost all the countries considered. When we utilized finer granular geographical data ('barangay' or village level COVID-19 case counts in the Philippines), the effects of SI were reduced as the population density increased. The authors believe that the knowledge of the chaotic behavior of COVID-19 and the effects of population density as applied to finer granular geographical data has the potential to generate more accurate COVID-19 non-linear prediction models. This could be used at the local government level to guide strategic and highly targeted COVID-19 policies which are favorable to public health systems but with limited impact to the economy.


Assuntos
COVID-19 , COVID-19/epidemiologia , Governo , Humanos , Pandemias , Filipinas , Densidade Demográfica
13.
J Infect Dev Ctries ; 16(5): 787-794, 2022 May 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
15.
Int J Med Inform ; 163: 104787, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35552190

RESUMO

PURPOSE AND OBJECTIVES: The study determined the usability of the online and offline versions of the Philippine Electronic National Newborn Hearing Screening Registry (ENNHSR) as well as user perspectives and satisfaction on the training modules and the online and offline systems. The steps in creating the systems, training modules, and evaluation of the user training manual and video training modules, accuracy and time and motion studies on data entry as well as determination of user perspectives and satisfaction were the specific objectives. METHODOLOGY: With the combined efforts of the staff of Newborn Hearing Screening Reference Center (NHSRC), Philippine National Ear Institute (PNEI) and the National Telehealth Center (NTHC) of the National Institutes of Health UP Manila, the development of the online and offline versions of the ENNHSR took six (6) months from January 2021 to June 2021 to complete. Creation of the user manual and training modules took three (3) months from July 2021 to September 2021. The pilot of the systems was carried out in 2 Zoom Conferencing sessions with the participation of 28 existing certified newborn hearing center users with different roles, backgrounds, demographics from all over the Philippines. Written evaluation as well as focused group discussions on the training modules and the database were conducted during the sessions. Effectivity of the training modules was determined using a 10-point learning check. The time and accuracies in encoding each data field per user were also determined. RESULTS: All 28 participants were able to attend and actively participate in the required Zoom Conferencing sessions as well as submit the 2 evaluation surveys for the training modules and the ENNHSR. During the learning check 93% or 26 out of 28 passed. The surgical intervention module took the longest time to encode while the fastest module to complete was for speech therapy. The average mean time to complete all modules was 3382 s or around 57 min while the time range was between 32 and 104 min. A screener would need 18 min while an implant programmer who is a clinical audiologist would need 52 min to enter data. The accuracy in encoding patient data was 92% while hearing screening results was 88.64%. The system usability scale (SUS) score of ENNHSR was computed at 75.5 which was the average of individual SUS scores, falling within grade B or 74.1 to 77.1 as its corresponding numerical score range in percentile. Most of the participants noted that it was easy to find patient data, results and that it was streamlined with easy to track information. CONCLUSIONS AND RECOMMENDATIONS: Data gathering and analysis both play important roles in health management, policy implementation and quality assurance. We were able to uncover areas where the system performed well - effectively, efficiently, and with satisfaction. We realize that all the possible problems cannot be detected with a small number of participants and variety in information. This testing will serve as both a means to record or benchmark current usability, but also to identify areas where improvements must be made.


Assuntos
Design Centrado no Usuário , Interface Usuário-Computador , Eletrônica , Audição , Humanos , Recém-Nascido , Filipinas , Sistema de Registros , Estados Unidos
16.
J Glob Health ; 12: 05015, 2022 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-35596944

RESUMO

Background: The COVID-19 pandemic has severely impacted populations globally, and knowledge, attitudes and practices (KAPs) surrounding the virus have necessarily evolved. This study was conducted in partnership with International Care Ministries (ICM), a Philippine-based non-governmental organization that runs the "Transform" poverty alleviation program. The main objective of this study was to describe the changes in COVID-19 KAPs among households experiencing extreme poverty in the Philippines over an 8-month period. Methods: A KAP questionnaire was integrated into the household survey collected as part of ICM's regular monitoring and evaluation of "Transform". Data collection for the first survey was conducted between February 20 and March 13, 2020, and the second survey was conducted between November 12 and December 12, 2020. Frequencies and proportions were calculated to describe the respondents' responses and the Kruskal-Wallis test was used to assess if there were significant differences in KAP identification between the two time points. Results: We observed a distinct increase across all KAP domains. Over 90% of study participants were able to correctly identify COVID-19 transmission modes and preventive measures, and an even higher percentage reported adopting these measures. However, the intention to seek care from public hospitals for COVID-19 symptoms dropped from 43.6% to 28.4%, while reports of self-treatment using stored medicines or antibiotics increased. Trust in community members and local health authorities was correlated with higher knowledge and practice scores. Conclusions: Our study results reflect the extraordinary speed of information dissemination and behaviour change globally over the course of the pandemic, but they also highlight the changes in KAP that show the additional challenges faced by populations experiencing poverty in the Philippines. Prioritization of reducing inequities in the implementation and adoption of the evolving public health measures will be integral as the pandemic continues.


Assuntos
COVID-19 , COVID-19/epidemiologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pandemias/prevenção & controle , Filipinas/epidemiologia , Pobreza , Inquéritos e Questionários
18.
Lancet ; 399(10338): 1863, 2022 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-35569459
19.
BMJ Open ; 12(5): e054060, 2022 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-35636785

RESUMO

BACKGROUND AND AIMS: In 2012, the Philippines passed a law popularly known as the 'Sin Tax Reform'. This law increased excise tax on both tobacco and alcohol. While a victory for public health, the total amount of taxes paid by the tobacco and alcohol industries was an uneven 69-31 split. The primary aim of this study is to explore why collective action of Sin Tax proponents resulted in greater advances for tobacco control as compared with alcohol control. METHODS: A case study approach was used. Key informant interviews were carried out with 25 individuals from academic, governmental, non-governmental and international organisations and industry who had first-hand knowledge of the Sin Tax policy process, led an organisation that participated in the process and/or possessed expert knowledge of Sin Taxes in the Philippines. Interviews were subsequently transcribed then analysed using inductive coding. RESULTS: Four factors contributed to the varying tax treatment of the two industries: (1) absence of advocacy-oriented alcohol control groups, (2) the proponents' 'divide and conquer' strategy, which aimed to prevent the alcohol and tobacco industries from joining forces, (3) the perception that moderate drinking is acceptable among some of the Sin Tax proponents, public and medical community and (4) a weaker global push for alcohol control. CONCLUSIONS: Our findings suggest the need to cultivate advocacy-oriented alcohol control civil society organisations, generate consensus at the local and global level regarding the problem definition and policy solutions for alcohol control and consider global instruments to strengthen norms and standards for alcohol control. Given that proponents also negotiated for a lower alcohol tax compared with tobacco due to the concern that the two industries might join forces, it also raises the question of whether or not a health tax bill should tackle more than one health harming product at a time.


Assuntos
Indústria do Tabaco , Produtos do Tabaco , Etanol , Humanos , Filipinas , Impostos , Tabaco
20.
PLoS Negl Trop Dis ; 16(5): e0010414, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35613181

RESUMO

Community-acquired bacterial bloodstream infections are caused by diverse pathogens with changing antimicrobial-resistance patterns. In low-middle income countries in Southeast Asia, where dengue fever is endemic and a leading cause of fever, limited information is available about bacterial bloodstream infections due to challenges of implementing a blood culture service. This study describes bacterial bloodstream pathogens and antimicrobial-resistance patterns in Metro Manila, the Philippines. We aimed to identify the proportion of patients with a positive blood culture, the bacteria isolated and their antimicrobial resistance patterns, and the clinical characteristics of these patients, in this dengue endemic area. We conducted a prospective observational study in a single hospital enrolling febrile patients clinically suspected of having a community-acquired bacterial bloodstream infection between 1st July 2015 and 30th June 2019. Each patient had a blood culture and additional diagnostic tests according to their clinical presentation. We enrolled 1315 patients and a significant positive blood culture was found in 77 (5.9%) including Staphylococcus aureus (n = 20), Salmonella enterica Typhi (n = 18), Escherichia coli (n = 16), Streptococcus pneumoniae (n = 3) and Burkholderia pseudomallei (n = 2). Thirty-four patients had meningococcal disease diagnosed by culture (n = 8) or blood PCR (n = 26). Additional confirmed diagnoses included leptospirosis (n = 177), dengue virus infection (n = 159) and respiratory diphtheria (n = 50). There were 79 (6.0%, 95%CI 4.8%-7.4%) patients who died within 28 days of enrollment. Patients with a positive blood culture were significantly more likely to die than patients with negative culture (15.2% vs 4.4%, P<0.01). Among S. aureus isolates, 11/20 (55%) were methicillin-resistant (MRSA) and ST30: USA1100 was dominant sequence type (88.9%). Antimicrobial-susceptibility was well preserved in S. enterica Typhi. Among hospitalized patients with clinically suspected community-acquired bacterial bloodstream infection in Metro Manila, the Philippines, 5.9% had a blood culture confirmed infection of whom 15.6% died. S. aureus, including a significant number of MRSA (USA1100 clones), S. enterica Typhi, E.coli and Neisseria meningitidis were frequently identified pathogens.


Assuntos
Bacteriemia , Infecções Comunitárias Adquiridas , Dengue , Salmonella enterica , Sepse , Infecções Estafilocócicas , Antibacterianos/uso terapêutico , Bacteriemia/microbiologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Dengue/complicações , Farmacorresistência Bacteriana , Escherichia coli , Febre/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Filipinas/epidemiologia , Salmonella typhi , Sepse/microbiologia , Staphylococcus aureus
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