Handler hygienic practices and aerobic plate counts of blenderized whole food tube feedings among selected tertiary and specialty hospitals in the National Capital Region, Philippines

OBJECTIVE: This work presents an updated and broad documentation of current practices of blenderized whole food tube feed (BTF) handlers (n=40) in some tertiary (n=8) and specialty (n=2) hospitals in the National Capital Region, Philippines.STUDY DESIGN: Descriptive study METHODS: Survey questionnaire and checklists which reflect processes and practices on BTF production were developed and pre-tested. These tools were then administered to 40 respondents from 8 tertiary and 2 specialty hospitals in the National Capital Region, Philippines. Observations were also recorded concerning BTF handling and administration as well as the sanitation of the preparation facility. The study further conducted additional interviews, and on-the-job observations with the same group of respondents in each of the test hospitals to validate survey responses and actual demonstration made in the documentation phase. RESULTS: Not all of the participating BTF handlers were observed to follow even simple personal and workplace hygienic practices. Moreover, not all BTF handlers had previous exposures to food safety systems training, and all test hospitals have yet to establish hazard analysis critical control point (HACCP) plans for BTF. The absence of accredited raw ingredient suppliers for the majority of the BTF facilities, failure to always wash raw materials prior to preparation, and the use of soft-boiled whole eggs were identified as sources of potential microbiological hazards. Total plate count was established to be as high as log10 7.19 CFU.ml-1. Ninety-three percent of the BTFs had plate counts exceeding the acceptable standard limit. CONCLUSION: The microbiological quality of the BTFs analyzed was attributed to the observed poor hygienic practices, as well as the inherent microflora of BTF ingredients. Familiarity with good manufacturing practices (GMPs), good hygienic practices (GHPs), and HACCP is recommended to improve the microbiological quality of BTFs. The results of this work may be used as basis for advancing efforts to further improve BTF safety, especially that the country had just recently ratified the Philippine Food Safety Act of 2013.

Validity of dietary diversity score as an indicator of nutrient adequacy among older adults in Pasay City, Philippines

OBJECTIVE:The study was conducted to determine the validity of Dietary Diversity Score (DDS) as an alternative indicator for nutrient adequacy among older adults in Pasay City, Philippines.METHODS: An analytic cross sectional study design was used on a representative sample of older adults (n = 82) in all barangays under the Doña Marta Health Center in Pasay City. A 5-stage multiple pass single 24-hour food recall was performed to determine the dietary intake of each respondent. Subject's nutrient intake was obtained using the FCT+Menu Eval software. Nutrient Adequacy Ratio (NAR) was then computed using the ratio of subject's nutrient intake to the Recommended Energy and Nutrient Intakes (RENI) for Filipinos.  The Mean Adequacy Ratio (MAR) was then obtained by computing for the average of the NARs, expressed as a ratio ranging from 0 - 1. Dietary Diversity Score was calculated using the DDS Questionnaire recommended by the FAO Guideline. For the statistical analysis, Pearson's correlation was used to determine the relationship between MAR and DDS. ROC curve analysis was done to determine the most appropriate cut-off points for using DDS among the older adults.RESULTS: The selected older adults of Pasay City had a mean DDS of 4.15 (0.14) and a mean MAR of 0.64 (0.02). There was a significant and strong correlation between MAR and DDS (r = 0.519; P CONCLUSION: DDS may be used as an indicator of nutrient adequacy among the randomly selected older adults.

Partnership for health development through the field practice

This article describes the partnership between the College of Public Health, University of the Philippines Manila and the province of Laguna in the context of implementation of the field practice course. This partnership paved the way for the development and implementation of projects in seven field practice sites. Projects concentrated mainly on improving quality of data and health information system, development of educational materials, and addressing health problems such as tuberculosis, hypertension and rabies. After the implementation of the various activities, there is a need for both parties (the College of Public Health and the Provincial Health Office of Laguna) to monitor and evaluate if projects have been sustained. Moreover, successful projects must also be fully documented which can serve as models for other areas in the province of Laguna.

Dietary diversity score as an indicator of nutritional adequacy of diets among 16-19 year-old adolescents

OBJECTIVES: This study was conducted to determine the dietary diversity score and its relation to nutritional adequacy among 16-19 year-old adolescents. METHODS: Secondary data analyses were undertaken with a representative sample of 16-19 year-old adolescents (n=521) in a university campus in Manila in 2008. Dietary diversity scores (DDS) were calculated. Nutrient adequacy ratio (NAR) is the ratio of subject's nutrient intake to the 2002 Recommended Energy and Nutrient Intakes (RENI) for Filipinos. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a ratio (range from 0-1). MAR was used as a measure of adequacy of overall diet. Pearson correlation coefficients between DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. RESULTS: The adolescents had a mean DDS of 3.94 (1.21) and a mean MAR of 0.67 (0.18). There was a strong correlation between MAR and DDS (r=0.543; P CONCLUSION: DDS can be used as a simple and quick indicator of the nutritional adequacy of the diets among these group of adolescents. Further investigation of this tool is needed for other population groups i.e., adults and elderly.

Dietary diversity score as an indicator of nutritional adequacy of diets among 16-19 year-old adolescents

Objective. This study was conducted to determine the dietary diversity score and its relation to nutritional adequacy among 16-19 year-old adolescents. Methods. Secondary data analyses were undertaken with a representative sample of 16-19 year-old adolescents (n=521) in a university campus in Manila in 2008. Dietary diversity scores (DDS) were calculated. Nutrient adequacy ratio (NAR) is the ratio of subject's nutrient intake to the 2002 Recommended Energy and Nutrient Intakes (RENI) for Filipinos. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a ratio (range from 0-1). MAR was used as a measure of adequacy of overall diet. Pearson correlation coefficients between DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. Results. The adolescents had a mean DDS of 3.94 (1.21) and a mean MAR of 0.67 (0.18). There was a strong correlation between MAR and DDS (r=0.543; P < 0.0001). A DDS of 4 was shown to be the best indicators for both MAR equivalent to 0.5 and 0.7 since they provided the best sensitivity and specificity. Conclusion. DDS can be used as a simple and quick indicator of the nutritional adequacy of the diets among these group of adolescents. Further investigation of this tool is needed for other population groups i.e., adults and elderly.