Economic costs and burden of dengue disease in Cavite Province, Philippines / Custos econômicos e impacto da dengue na Província de Cavite, Filipinas

AIMS: To determine the economic costs and the burden of dengue disease in Cavite Province, one of the areas highly inflicted by dengue disease in the Philippines. METHODS: This study used Disability Adjusted Life Years (DALYs) to calculate burden of dengue disease and quantified direct and indirect costs due to hospitalization and ambulatory dengue cases. DALYs were estimated using methods developed by the World Health Organization and the World Bank. We specifically calculated Years of Life Lost from 2009 to 2014 using patient-level data from hospitals and derived Years Lived with Disability from hospital records of dengue specific type (dengue fever/dengue hemorrhagic fever) in Cavite Province. RESULTS: An annual cost of Philippine Peso (PHP) 99,147,173 which is equivalent to United States Dollar (USD) 2,300,000 was obtained. The average annual cost per dengue case was PHP 32,324 (USD 734). The 21-25 age sub-groups had the highest average annual direct cost which amounted to PHP 243,181 (USD 5,526), followed by the 45-54 age sub-groups which amounted to PHP 201,481 (USD 4,579). From 2009 to 2014, the annual burden of disease was estimated at 178,282 DALYs (equivalent to one DALY lost per 17 persons in Cavite Province). CONCLUSIONS: The estimates of costs and DALYs suggested substantial dengue disease burden and economic costs in Cavite Province, Philippines.

OBJETIVOS: Determinar os custos econômicos e o impacto da dengue na Província de Cavite, uma das áreas altamente infligidas por dengue nas Filipinas. MÉTODOS: Este estudo utilizou os anos de vida ajustados por incapacidade (Disability Adjusted Life Years - DALYs) para calcular o impacto da dengue e quantificar os custos diretos e indiretos devidos aos casos de dengue atendidos em hospital ou em ambulatório. Os DALYs foram estimados usando métodos desenvolvidos pela Organização Mundial de Saúde e pelo Banco Mundial. Calculamos especificamente os anos de vida perdidos entre 2009-2014, usando dados dos pacientes hospitalizados. Os anos vividos com incapacidade foram derivados de registros hospitalares sobre o tipo específico da dengue (dengue clássica / dengue hemorrágica) na Província de Cavite. RESULTADOS: Foi identificado um custo anual de 99.147.173 pesos das Filipinas (PHP), equivalentes a 2.300.000 dólares dos Estados Unidos (USD). O custo médio anual por caso de dengue foi 32.324 PHP (734 USD). O subgrupo etário 21-25 anos teve o maior custo direto anual, que atingiu 243.181 PHP (5.526 USD), seguido pelo subgrupo 45-54 anos, que atingiu 201.481 PHP (4.579 USD). De 2009 a 2014, o impacto anual da doença foi estimado em 178,282 DALYs (equivalentes a um DALY pedido por cada 17 pessoas na Província de Cavite). CONCLUSÕES: As estimativas de custos e os DALYs sugerem um alto impacto e substanciais custos econômicos da dengue na Província de Cavite, Filipinas.

Detecção sorológica da infecção por Toxoplasma gondii em gatos errantes e domiciliados e sua avaliação hematológica / Serologic detection of toxoplasma gondii infection in stray and household cats and its hematologic evaluation

Aims: This study focused on the serologic detection of Toxoplasma gondii infection in two groups of cats:stray and household groups. In addition, hematologic assessment of seropositive and seronegative cats was done. Methods: Sixty cats were serologically tested for anti-Toxoplasma gondii antibodies using the latex agglutination test. Six collection sites for each group of cats were identified in the urban communities of Sta Rosa and San Pedro, Laguna, Philippines. The 60 cats collected were divided into 30 stray and 30 household cats. Results: Results revealed that 28 (46.67%) of the 60 cats were seropositive. There were more household cats (28.33%) which showed seropositivity compared to stray cats (18.33%), however the difference was statistically insignificant (p>0.05) . Hematologic tests through complete blood count showed significantly (p<0.05) higher number of seropositive cats with abnormalities on hemoglobin level, red blood cell count, segmenter (neutrophil) and monocyte counts compared to the control. Other parameters such as percent packed cell volume, white blood cell count, eosinophil and lymphocyte counts showed insignificant (p>0.05) results across seropositive cats and the control. Blood chemistry analysis showed significantly higher (p<0.05) potassium level irregularities in seropositive cats relative to the seronegative cats. Other parameters such as amylase, blood sugar, blood uric acid, creatinine and blood urea nitrogen were statistically insignificant (p>0.05). Conclusions: Although Toxoplasma gondii infection suggests possible cause of hematologic abnormalities, it is recommended that further studies on this aspect be done to provide more basic and clinical research information that would improve cat health management.

Parasite biodiversity in Rattus spp caught in wet markets.

Rattus spp trapped in wet markets in Quiapo, Manila and Balayan, Batangas had ectoparasites, Echinolaelaps echidnius (mite), and Polyplax spinulosa (louse). The endoparasites identified were Hymenolepis diminuta; the acanthocephalan Moniliformis moniliformis; Taenia taeniaeformis strobilocercus larvae and Capillaria hepatica in liver; Trichosomoides crassicauda of the urinary bladder; Sarcocystis sp of muscle tissue; and two different species of stronglyloid-looking intestinal nematodes. Rats had 100% infection with C. hepatica and T. taeniaeformis, exhibiting high parasitemia. The co-existence of rats with diverse parasitic species is reflective of the host's capability to support parasites' behavioral, physiological, and developmental needs. Despite heavy infection with intestinal parasites, and marked hepatic tissue damage owing to severe capillariasis and strobilocercus larval infection, all rats appeared healthy and agile, suggestive of a well-established rat host-parasite relationship. In view of the diversity and zoonotic nature of rat parasites, and the impoverished conditions prevailing in communities where Rattus spp survive and proliferate, they can readily facilitate parasite transmission to humans and other susceptible animal hosts.

Serologic detection of Toxoplasma gondii infection in Rattus spp collected from three different sites in Dasmariñas, Cavite, Philippines.

Acute and chronic cases of toxoplasmosis in Rattus norvegicus and Rattus rattus mindanensis caught in agricultural, commercial and residential sites in Dasmariñas, Cavite, Philippines were determined serologically. Fifty-eight percent of R. norvegicus and 42.0% of R. r. mindanensis were positive for anti-T. gondii antibodies (Abs). Infection was higher in male rats, and those caught in the commercial site had 100.0% seropositivity. Thirty percent of the R. norvegicus and 51.0% R. rattus mindanensis had acute infection, with 1:64-1:128 Abs titer. Seventy percent of the R. norvegicus and 49.0% of R. rattus mindanensis were chronically-infected with Abs titer 1:256-1:2048 and 1:256-1024, respectively. The association between the presence of infection with the rat gender and species and their collection sites was insignificant (p>0.05). In a related study, however, mice experimentally-inoculated brain tissue homogenate obtained from chronically-infected Rattus spp, manifested differences in the onset as well as, severity of infection which was histopathologically evaluated, suggestive of a possible difference in T. gondii parasite strain(s) infecting different rat populations.