Prevalence of asthma among Filipino adults based on the National Nutrition and Health Survey (NNHeS)

BACKGROUND: Prevalence surveys are important to aid in assessing the current burden of diseases, which will impact on the public health agenda as well as preventive interventions and health policies. Three previous local surveys on asthma prevalence of Filipino adults have been carried out. This is the fourth local survey and is also a part of the second NNHeS study, which is carried out every five years. The purpose of the survey is to determine the trend in asthma prevalence and to aid in formulating and evaluating local initiatives.OBJECTIVE: To determine the prevalence of asthma among Filipino adultsMETHODOLOGY: Using a multi-staged cluster sampling methodology, this study evaluated 7,202 adults at least 20 years old, from 3,744 households, 79 provinces and 17 regions. A pre-validated written questionnaire for wheezing among children based on the International Study of Asthma and Allergies of Childhood (ISAAC) was used as the survey instrument. This instrument was adopted since it has been widely used as a case definition for asthma, which allows for comparison of prevalence outcomes across time and population.RESULTS: The overall prevalence of asthma based on wheezing for the past 12 months was 8.7% (SE 0.4%). Males had a higher prevalence of wheezing for the past 12 months at 9.4% (SE 0.5%) compared to females at 8.2% (SE 0.5%). The overall prevalence of asthma based on wheezing at any time was 14.3% (SE 0.5%). Males had a higher prevalence of wheezing at any time of 14.8% (SE 0.7%) compared to females at 13.8% (SE 0.6%). The prevalence of adult asthma in the rural area was slightly higher than in the urban area (15.3% vs 13.3%), but the difference was not statistically significant.CONCLUSION: The overall prevalence of adult asthma in the Philippine based on the second NHHeS is 8.7%. This figure is lower than previous reported local prevalence data. The prevalence of adult asthma in the rural and urban setting is almost similar.

Level of understanding and areas of application of cochrane reviews among practicing physicians affiliated with the Philippine General Hospital

Objective. The main objective of this study is to determine the level of understanding, accessibility and areas of application of Cochrane reviews (CR) among medical practitioners affiliated with a tertiary care medical center in Metro Manila, Philippines. Study Design. Survey using a self-administered questionnaire was conducted. Target Population and Setting. Consultant doctors of the Philippine General Hospital (PGH) were invited to participate. The PGH is the national university hospital of the Philippines and is a tertiary referral center and teaching hospital of the University of the Philippines Manila. Sampling Scheme. 101 doctors were chosen by stratified random sampling with the clinical department as the stratification variable. Strata samples were targeted according to strata size (proportional to size). Measurement Instrument. Eight domains that are important in the understanding of the CR were included in a 25-item multiple-choice questionnaire. In addition, facilitating factors and barriers to the application of CR or systematic reviews (SR) were asked. Data Analysis. Using a 25-point Multiple Choice Questionnaire, the knowledge of the respondents was measured and the mean score was estimated at a 95% confidence level. The percentage of CR awareness was also estimated at 95% confidence level. Facilitating factors and barriers in the use of SR were described. In addition, the following post-hoc analyses were done: descriptions of the total score according to gender, age, year graduated and year of last training. Results. Of 101 consultants invited, 59 participated (58% response rate) within the 6-month data collection period. The mean age was 47.2 years with a standard deviation (SD) of 7.8 years. Forty-five respondents (76%) had their last formal medical-related training from 1991 onwards. The mean score was 14.7 points (SD 6.7) using the 25-item multiple choice questions on concepts and principles of systematic reviews. Of these 59 respondents, 49 (83.0%: 95% CI: 75.2 - 90.9) indicated that they were aware of the existence of CR. Of those who were aware of CR, 42 (85.7%, 95% CI: 75.9 -95.6) have actually used them. The following factors help the respondents use CR: efficient Internet access, working knowledge of research methodology, working knowledge of how to critically appraise the medical literature, and familiarity with the terms used in the review. On the other hand, the following were considered barriers: inefficient access, poor knowledge of general research methodology, poor understanding of the principles of Evidence-based medicine (EBM) and difficulty in understanding the reviews. Conclusion. Practicing physicians in a tertiary university hospital in the Philippines were only able to get about 60% of the principles and concepts of understanding SR. Eighty three percent of them are aware of CR. Access to internet, familiarity with terms and working knowledge of CR and evidence-based medicine are the facilitating factors for application of the results of SR and CR. Although most claimed to use the SR results in literature reviews, only about 60% are able to use them in teaching, clinical practice or health policy development.