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Background@#Posttraumatic stress disorder (PTSD) is a condition involving the manifestation of negative biological, behavioral, affective, and cognitive responses to a triggering event or stimulus. In the Philippines, PTSD can be caused by typhoon-related trauma which is borne out of the country's relative proneness to this natural disaster. Research has shown that PTSD can be effectively mitigated through prolonged exposure therapy. Contemporary studies have also shown promise in the utility of virtual reality as a tool for aiding prolonged exposure therapy. @*Objectives@#To address current research gaps, the study intended to discuss the development of an adjunct virtual reality tool (Typhoon VRET) whose elements were mainly derived using data from narrative review and a consultation interview with a Filipino psychotherapy practitioner. @*Methodology@#The study utilized in-depth literature review and consultation interview with a Filipino trauma response specialist as primary sources of data. Key themes and findings were virtually represented through Unity, Blender, and Cardboard SDK. @*Results@#The Typhoon VRET features a relaxation scene, a rescue scene, and a typical Filipino house that showcases cultural elements so as to stimulate clients' traumatic reminders and fear structures. Users are given the option to control the environment, including the strength and volume of the flooding, wind, and rain. @*Conclusion@#Virtual reality could may be an adjunct tool to aid in addressing typhoon-related trauma among Filipinos. Several recommendations are provided in improving the technical features of the tool and integrating it into psychotherapy practice.
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Virtual Reality , Stress Disorders, Post-TraumaticABSTRACT
Objective: To study the distribution of human leptospirosis cases across the different geographic regions in the Philippines in 2015-2017 and to determine the relationship between the frequency of typhoon occurrence and human leptospirosis cases. Methods: Information on the frequency of leptospirosis cases and typhoon occurrence across the different regions in the Philippines from 2015 to 2017 was retrieved from the databases of the Department of Health and the Philippine Atmospheric, Geophysical, and Astronomical Services Administration, respectively. Descriptive measures on the prevalent cases and occurrence of typhoons across the different regions were summarized. Linear regression analysis was employed to establish the functional relationship between leptospirosis cases and typhoon occurrence. The distribution of human leptospirosis cases was assessed using the Poisson distribution. Results: The frequency of typhoon occurrence accounted for the significant linear variation in the geographic distribution of human leptospirosis cases in the Philippines (P<0.001). Moreover, the human leptospirosis cases obeyed a Poisson distribution (λ=6.89, P<0.001). Conclusions: The Philippines has frequently experienced severe weather perturbations such as typhoons resulting in flooding and subsequently increasing the risk of transmitting bacterial infections including leptospirosis. Information obtained regarding the determinants and distribution of human leptospirosis will provide better understanding of the disease propagation for subsequent design of optimal disease prevention measures, appropriate resource allocation, effective control strategies, and necessary public health programs.
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Objective: To study the distribution of human leptospirosis cases across the different geographic regions in the Philippines in 2015-2017 and to determine the relationship between the frequency of typhoon occurrence and human leptospirosis cases. Methods: Information on the frequency of leptospirosis cases and typhoon occurrence across the different regions in the Philippines from 2015 to 2017 was retrieved from the databases of the Department of Health and the Philippine Atmospheric, Geophysical, and Astronomical Services Administration, respectively. Descriptive measures on the prevalent cases and occurrence of typhoons across the different regions were summarized. Linear regression analysis was employed to establish the functional relationship between leptospirosis cases and typhoon occurrence. The distribution of human leptospirosis cases was assessed using the Poisson distribution. Results: The frequency of typhoon occurrence accounted for the significant linear variation in the geographic distribution of human leptospirosis cases in the Philippines (P<0.001). Moreover, the human leptospirosis cases obeyed a Poisson distribution (λ=6.89, P<0.001). Conclusions: The Philippines has frequently experienced severe weather perturbations such as typhoons resulting in flooding and subsequently increasing the risk of transmitting bacterial infections including leptospirosis. Information obtained regarding the determinants and distribution of human leptospirosis will provide better understanding of the disease propagation for subsequent design of optimal disease prevention measures, appropriate resource allocation, effective control strategies, and necessary public health programs.
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@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to determine the prevalence of Acute Stress Disorder and Post Traumatic Stress Disorder among residents of Barangay Tumana, Marikina exposed to Typhoon Ondoy in September 2009 and Habagat rains in August 2012.</p><p style="text-align: justify;"><strong>METHODOLOGY:</strong> The Acute Stress Disorder Scale (ASDS) and Impact of Events Scale-Revised (IESR) were administered to 212 subjects. Trauma history was also obtained. When screened positive for Acute Stress Disorder (ASD) and/or Post Traumatic Stress Disorder (PTSD), a confirmatory diagnosis was done through psychiatric clinical interview.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The study showed a prevalence rate of 10% for ASD and 5% for PTSD. Co-morbid ASD and PTSD were seen in 4% of the subjects. Frequency and type of prior traumatic events were not significantly different among subjects who were positive or negative for ASD/PTSD diagnoses.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> There was a significant prevalence of ASD/PTSD diagnoses among residents exposed to Typhoon Ondoy and Habagat, thus the need for developing a means of early detection and immediate therapeutic intervention in Filipino communities exposed to natural disasters.</p>
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Humans , Prevalence , Stress Disorders, Traumatic, Acute , Stress Disorders, Post-Traumatic , Cyclonic StormsABSTRACT
@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Despite existing disaster preparedness policies in the Philippines, there has not been any validated assessment of the quality of disaster medical response, which would require reliable aggregate data on patient diagnoses and management.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This mixed-methods study documented the diagnoses, triage classification and case management of patients seen by Philippine EMS groups who responded to the Typhoon Haiyan disaster in the Philippines in November and December 2013, as well as difficulties associated in gathering these data, using the Utstein-style Template for Uniform Data Reporting of Acute Medical Response in Disasters as framework.</p><p style="text-align: justify;"><strong>METHODS:</strong> Three hundred (300) individuals vetted by EMS organizations were invited to answer a survey modeled after the Utstein-style template, and submit tallies of patients seen. Out of 52 responses received, policy recommendations were subsequently generated on concerns assessed by the template using the nominal group technique.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The submitted data yielded a total of 41,202 patients with information on age, sex, and diagnosis; 19,193 with triage classification; and 27,523 with information on case management. The focus group discussion underlined the absence of a standard communication and information management system. Participants recommended establishing such a system and highlighted the role of the Department of Health - Health Emergency Management Bureau in coordinating disaster medical response efforts and information management.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> This study underlines the importance of effective communication, and multisectoral coordination, to generate reliable data and thus, facilitate resource allocation for disaster medical response.</p>
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Humans , Cyclonic Storms , Disaster Medicine , Emergency Medical Services , Relief WorkABSTRACT
@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Despite the implementation of policies related to disaster risk reduction and management in the Philippines, the response after Typhoon Haiyan in November 2013 was hampered by operational challenges.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> The purpose of this study was to document disaster response experiences of Typhoon Haiyan from field level emergency medical service (EMS) responders, a key component of the disaster response, specifically the enabling factors and hindrances to disaster medical response activities, including their self-perceived level of preparedness in these activities.</p><p style="text-align: justify;"><strong>METHODS:</strong> In this mixed-methods study, 52 respondents identified enabling factors and hindrances to their disaster response and their corresponding self-perceived level of preparedness. In a subsequent focus group discussion, the researchers used the nominal group technique to process the respondents' experiences.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The respondents identified factors that enabled or hindered their response activities such as coordination, stress debriefing, infrastructure, and preparedness. Furthermore, an average of 33% of the respondents said they were adequately prepared to deliver the necessary medical services during the disaster response, thus validating previous studies on preparedness and disaster response operations.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The government should critically examine its cluster approach to disaster response and consider an integrated, inclusive, and proactive approach in disaster planning.</p>
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Humans , Male , Female , Disasters , Emergency Medical ServicesABSTRACT
Following natural disasters, rapid health needs assessments are required to quickly assess health status and help decision making during the recovery phase. The Korean Centers for Disease Control and Prevention (KCDC) developed the Public Health Assessment for Emergency Response (PHASER) Toolkit which was optimized for a weather disaster in Korea. The goal of this study is to assess public health needs following the 2012 typhoons Bolaven and Tembin in both urban and rural areas in Korea. We conducted pilot trials using the PHASER toolkit to assess health needs following typhoons Bolaven and Tembin in Paju and Jeju during summer 2012. We sampled 400 households in Jeju and 200 households in Paju using a multistage cluster sampling design method. We used a standardized household tracking sheet and household survey sheet to collect data on the availability of resource for daily life, required health needs, clinical results and accessibility of medical services. The primary outcomes were clinical results and accessibility of medical service after the typhoons. We completed surveys for 190 households in Paju and 386 households in Jeju. Sleeping disorders were identified in 6.8% (95% confidence interval [CI], 2.8%–10.8%) surveyed in Paju and 17.4% (95% CI, 12.8%–22.0%) in Jeju. We used the PHASER toolkit to assess healthcare needs rapidly after 2 typhoons in Korea. Sleeping disorders were frequently identified in both Paju and Jeju following the 2 typhoons.
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Cyclonic Storms , Decision Making , Delivery of Health Care , Disasters , Emergencies , Family Characteristics , Korea , Mental Health Services , Methods , Needs Assessment , Public Health , WeatherABSTRACT
@#<p style="text-align: justify;"><strong>BACKGROUND AND OBJECTIVES:</strong> In September 2009, Metro Manila was hit by a heavy rainfall typhoon Ketsana inundating several cities of Metro Manila causing an outbreak of leptospirosis. We analyzed the prognostic factors associated with mortality among leptospirosis patients admitted after the typhoon at nine tertiary hospitals from September to November 2009.<br /><strong>METHODS:</strong> We reviewed the charts of patients with probable and confirmed leptospirosis. Confirmed leptospirosis was based on any of the following: positive leptospiral culture of blood or urine, single high leptospira microagglutination titer (MAT) of 1:1600 or a fourfold rise in MAT antibody titers or seroconversion. Patients with negative serology or cultures but with history of wading in floodwaters plus any of the following signs and symptons: fever, headache, myalgia, conjunctival suffusion, diarrhea and abdominal pain, jaundice, oliguria and changes in sensorium were considered probable cases. <br /><strong>RESULTS:</strong> We analyzed 332 probable and 259 confirmed leptospirosis patients. Mean age was 37.95± 14.09, mostly males (80.2%). Almost all patients (98%) waded in floodwaters. Majority had moderate to severe form of leptospirosis (83%). Acute renal failure was the most common complication (87.1%). Mortality was 11.3% mostly due to pulmonary hemorrhage. On multivariate analysis of confirmed and probable cases, the factors independently associated with mortality were pulmonary hemorrhage (OR 2.75, 95% CI 1.46 to 5.20), severity of the disease (OR 3.85, 95% CI 1.60 to 9.26), thrombocytopenia (OR 3.16, 95% CI 1.22-8.16), duration of illness before admission (OR 0.88, 95% CI 0.78-0.99) and age (OR 1.03, 95% CI 1.00-1.06).<br /><strong>CONCLUSION:</strong> Pulmonary hemorrhage remains a poor prognostic factor and strong predictor of mortality among patients with severe leptospirosis. Early consult through heightened awareness of the public and prompt recognition of leptospirosis among clinicians can decrease the risk for progression to complications of leptospirosis and mortality. <br /><br /> </p>
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Humans , Male , Female , Adult , Adolescent , Hemorrhage , Mortality , Serology , Abdominal Pain , Acute Kidney Injury , Cyclonic Storms , Diarrhea , Disease Outbreaks , Fever , Headache , Jaundice , Leptospira , Leptospirosis , Multivariate Analysis , Myalgia , Oliguria , Philippines , Prognosis , Seroconversion , Tertiary Care Centers , ThrombocytopeniaABSTRACT
OBJECTIVE@#To investigate residents' psychological stress factors and research the correlation between post-traumatic stress disorder (PTSD) and platelet 5-HT concentrations so as to provide scientific bases for diagnosis and treatment of PTSD and psychological intervention for people in the disaster area.@*METHODS@#A questionnaire survey of 5500 residents who have accepted psychological help was conducted by the emphatic investigation method. While high performance liquid chromatography was used to detect the platelet serotonin concentration of 100 PTSD patients and 100 healthy people.@*RESULTS@#(1) Of the 5114 cases, 3167 (61.93%) showed positive results in screening for psychological stress symptoms, and 399 (7.8%) were tested having apparent PTSD symptoms. Male and female prevalence showed no significant difference (χ(2) = -0.380, P = 0.704). The differences of prevalence between different age groups were statistically significant (χ(2) = 381.89, P = 0.000). (2) The differences in the level of platelet 5-HT between PTSD patients and normal control group were statistically significant.@*CONCLUSIONS@#The typhoon of Hainan Province caused relatively large psychological problems to the disaster victims. Compared with normal control group, the platelet 5-HT levels of PTSD patients in the disaster areas are lower. It may be related to incidents exposure levels, cultural background, religious ideas, social concerns and psychological rescue of the residents who live in the disaster areas of Hainan.
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Objective To investigate residents' psychological stress factors and research the correlation between post-traumatic stress disorder (PTSD) and platelet 5-HT concentrations so as to provide scientific bases for diagnosis and treatment of PTSD and psychological intervention for people in the disaster area. Methods A questionnaire survey of 5 500 residents who have accepted psychological help was conducted by the emphatic investigation method. While high performance liquid chromatography was used to detect the platelet serotonin concentration of 100 PTSD patients and 100 healthy people. Results (1) Of the 5 114 cases, 3 167 (61.93%) showed positive results in screening for psychological stress symptoms, and 399 (7.8%) were tested having apparent PTSD symptoms. Male and female prevalence showed no significant difference (χ
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BACKGROUND: Three weeks after Typhoon Haiyan, an increasing number of acute gastroenteritis cases were reported in Kananga, Leyte, an area where evacuated residents had returned home two days after the disaster. An outbreak investigation was conducted to identify the source and risk factors associated with the increase of gastroenteritis. METHODS: A case was defined as any person in Kananga who developed acute diarrhoea (≥ 3 times/24 hours) and any of the following symptoms: fever, nausea, vomiting or abdominal pain from 11 November 2013 to 10 December 2013. Active case finding was conducted by reviewing medical records, and a case-control study was conducted. Rectal swabs and water samples were tested for bacteriological examination. RESULTS: One hundred and five cases were identified. Multivariate analysis revealed that consumption of untreated drinking-water was associated with illness (adjusted odds ratio: 18.2). Both rectal swabs and municipal water samples tested positive for Aeromonas hydrophila. On inspection of the municipal water system, breaks in the distribution pipes were found with some submerged in river water. CONCLUSION: This acute gastroenteritis outbreak was most likely caused by Aeromonas hydrophila and transmitted through a contaminated water source. This study highlights that areas less damaged by a disaster that do not require ongoing evacuation centres can still have acute gastroenteritis outbreaks. All affected areas should be monitored during a disaster response, not just those with evacuation centres. Boiling or chlorinating of water should also be recommended for all areas affected by disaster.
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We conducted a descriptive study on the deployment of all FMTs to Haiyan-affected areas in the Philippines from 8 November 2013 to 30 June 2014. An FMT coordinating body was established at the national level which comprised representatives from the DOH and the World Health Organization (WHO) Representative Office in the Philippines. This team disseminated the new registration form to all FMTs that had contacted the WHO Western Pacific Regional Office, WHO Representative Office in the Philippines and the DOH from 10 November (two days after the typhoon made landfall). All FMTs were required to register regardless of their location inside or outside the Philippines at the time.
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The objective of this paper is to compare the role of the administrative team from the WHO Representative Office in the Philippines in the response following Typhoon Haiyan to the response with the three previous large-scale events, assess the lessons learnt and provide recommendations for managing future responses.
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During the overlap period between response and recovery activities, the authors were all working in the health sector at the national level supporting coordination and strategic planning with government and partners and at the field level implementing response activities and revisiting the medium- and long-term programming approach to recovery. It is from this perspective, combined with data from existing documents such as plans, reports and policies, that we highlight the need to define a period of transition from response to recovery of the health sector as it may have important implications on the health system functioning as a whole.
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During the overlap period between response and recovery activities, the authors were all working in the health sector at the national level supporting coordination and strategic planning with government and partners and at the field level implementing response activities and revisiting the medium- and long-term programming approach to recovery. It is from this perspective, combined with data from existing documents such as plans, reports and policies, that we highlight the need to define a period of transition from response to recovery of the health sector as it may have important implications on the health system functioning as a whole.
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Objective To summarize the medical rescue work of China emergency medical team in Philippines disaster area by typhoon Haiyan.Methods The rescue experience was summarized by retrospective study.Results A total of 1 831 patients visited the outpatient and emergency departments during those 10 days.According to the rapid risk assessment,the insect borne diseases,acute gastroenteritis infection and hospital infection were the major problems.The medical team took measures such as disinfection,vector control,cleaning up the environment,hospital infection control and providing the safe water to prevent the infectious diseases.Conclusion A sound organization and management system,high -quality members of the medical team,preparing the reasonable rescue plan and epidemic prevention measures,adequate supplies and effective communication were responsible for the success of the medical rescue.It is necessary to establish several international medical rescue teams at the national level.
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PURPOSE: On November 8, 2013, Typhoon Haiyan attacked the Philippines, causing damage to many houses and trees as well as loss of many lives. A medical team from our hospital and university was sent to Philippines in order to provide medical assistance. We wish to describe our experiences of disaster medicine and discuss problems and improvement points. METHODS: We analyzed the characteristics of patients who received medical treatment administered by us at Tagobon city in the Philippines for five days. RESULTS: We provided medical services to 951 patients for five days. Most patients visited us for medical treatment not trauma. Almost all chief complaints were associated with respiratory, gastrointestinal, dermatologic, and ophthalmologic symptoms. We mainly treated the patients with medications. CONCLUSION: During the subacute period after the disaster, most patients complained of medical and dermatologic problems due to lack of sanitation rather than traumatic complications. Medical assistance for disaster should be administered appropriately according to the types of diseases that occurduring each period after disaster.
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Humans , Cyclonic Storms , Disaster Medicine , Disasters , Medical Assistance , Philippines , SanitationABSTRACT
Objective To establish a suitable index system for typhoon disaster relief training of nurses.Methods Based on literature review and semi-structure expert interview,an index system frame work of typhoon disaster relief training of nurses was developed.Indexes were determined by adopting Delphi method and inquiring 21 experts with questionnaire.The weight of every index had been set up.Results The index system for typhoon disaster relief training of nurses was composed of 6 flintlevel indicators,28 second-level indicators and 37 third-level indicators.Conclusions The index system for typhoon disaster relief training of nurses is reliable and valid,which can provide objective and quantitative standards for the employment,training and evaluation of emergency specialized nurses.
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Objective To explore the impact on survivors's health and to determine the risk factors involved in the typhoon in order to investigate the characteristics of traumatic symptoms of casualties in the aftermath of the Saomai Typhoon sweeping over the rural area of Zhejiang province in 2006. Method A cluster sampling study was carried out and a total of 389 survivors were assessed. Data were analyzed by univariate and multivariate Logistic analysis to clarify the characteristics and the risk factors of getting traumatize. Results Of 389, there were 113 (29.1% ) victims suffered from a variety of injuries mainly crush trauma (24.4 % ) and wounded by hard object (23.1% ). Moreover, the combined injuries accounted for 9.2%. The risk factors causing injuries in the residential area were the building collapse, glass fragments from broken windows, flying debris as well as fall from high place. Condclusions Outdoor activity and the crumbled building are the leading causes for injuries during the sweeping of typhoon. Meanwhile, we should make more effort to publicize the precautions against typhoon to the local residents.
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OBJECTIVES: The purpose of this study was to compare the physical and mental health status of disaster victims according to disaster types, such as a typhoon disaster and an oil spill disaster, and to suggest adequate health care services for them. METHODS: A total of 484 people who suffered disasters were selected for this study, and data were collected from July to August, 2008. The data-set for this study included 286 victims of typhoon disasters in Jeju and Jeollanamdo district in South Korea, and 198 victims of the oil spill disaster in Taean. Physical health status was measured using revised Patient Health Questionnaire and mental health status was measured using the Korean version of 'Post-traumatic Diagnostic Scale'. RESULTS: According to the comparative analyses of typhoon disaster victims and oil spill disaster victims, poorer physical health outcomes were shown among the oil spill disaster victims when compared to the typhoon disaster victims. Also, the oil spill disaster victims showed symptoms of depression, anxiety, and post-traumatic stress disorder, at rates higher than those found among the typhoon disaster victims. CONCLUSIONS: These findings suggest that there is a need to provide adequate physical and mental health-related care services for oil spill disaster victims. The seriousness of oil spill disaster should be realized and reconsidered in developing recovery strategies and disaster preparedness for physical and mental health services.