COVID-19 breakthrough infections among medical students under the SLICE and CLARO Programs: Ateneo School of Medicine and Public Health experience

Objective@#This study aims to report the incidence and characteristics of breakthrough infections among medical students in the first Philippine private medical school that resumed limited face-to-face classes and clinical rotations from July to December 2021. @*Methods@#This is a descriptive study using secondary worksheet from multiple-source records review of breakthrough infections among medical students from July to December 2021. @*Results@#Among the 837 vaccinated medical students, 23 (2.7%) experienced COVID-19 breakthrough infections. Of these, 9 were male and 14 were female. Four were asymptomatic and 19 were symptomatic. Of the 19 symptomatic, 18 had mild and 1 had severe disease. Mild infections presented with upper respiratory tract symptoms. Duration of symptoms ranged from 4 to 27 days with an average of 10 days. Timing of breakthrough infections ranged from 35 to 212 days after the second dose of COVID-19 vaccine with a mean of 86 days. Contact with confirmed cases was reported in 14 of 23 cases, 13 were from household members and none within the SLICE and CLARO programs. @*Conclusion@#Our study showed that even in the midst of the Delta surge, low breakthrough infection rate with mostly mildly symptomatic cases and no case transmissions within the SLICE and CLARO programs are possible with vaccination, regular health surveillance, and strict adherence to minimum health protocols.

A systematic review of epidemiologic studies on scabies in the Philippines

Background and Objective@#Scabies is the second most common cause of disability due to skin disease in the Philippines. However, there were no cited studies in Global Burden of Disease 2019 and the disability-adjusted life years (DALY) computations were most likely based on statistical modelling. The Philippine Department of Health has embarked on a program to estimate the disease burden of priority diseases in the country, which include scabies. The last nationwide prevalence survey was 23 years ago. This systematic review aimed to estimate the prevalence or incidence of scabies in the Philippines. @*Methods@#We searched PubMed, Scopus, Herdin, and Philippine Health Research Registry (search date October 2022) for studies on prevalence/incidence (including systematic reviews, cross-sectional studies, cohort studies, case series, registry or census studies) of patients diagnosed with scabies in the Philippines. We excluded narrative reviews, commentaries, and conference proceedings or abstracts. Two reviewers independently screened titles and abstracts, assessed full text reports for eligibility, appraised the quality of included studies, and collected data using a pretested data extraction form. We did not pool studies due to clinical heterogeneity but plotted the individual studies in a forest plot with prevalence estimates and confidence intervals. We reported the median and interquartile range for entire group or relevant subgroups (age, setting) of studies. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of evidence.@*Results@#We included nine studies (N=79,065). Most were clinic-based prevalence studies, retrospective chart reviews, conducted in dermatology outpatient clinics, Metro Manila area, and on pediatric populations. Prevalence of scabies was moderate (i.e., between 2 and 10%), ranging from 2.75% (national prevalence survey) to 6.8% (communitybased review), to high (> 10%) among pediatric patients in clinic-based retrospective chart reviews (29 to 36%) and institution-based surveys (39.0% to 45%), and a tertiary government university training hospital dermatology clinic (22.9%). The most affected age group was from 0 to 14 y/o, while males tended to have a higher prevalence than females. The cooler month of January had higher prevalence than the hotter month of June in one study. @*Conclusion@#Scabies is common in the Philippines, especially among children and elderly in institutional settings, and during the month of January. There is a need to do a national prevalence survey to identify high-risk areas and to monitor the prevalence of scabies, especially in crowded settings and vulnerable populations. This information can be used for estimating the burden of disease for scabies and guide appropriate health resource allocation.

Perspectives on the use of telegenetics services in the Philippines

@#The Philippines is a densely populated nation faced with multiple challenges in the healthcare field given its geographic, cultural, and socioeconomic barriers. Due to the geographic limitations of medical services in the country, many patients must travel a great distance to referral centers. This was further exacerbated by the Coronavirus disease 2019 (COVID-19) pandemic, which spread across the world and upended lives. This pandemic triggered a public health crisis that impacted healthcare systems, healthcare workers, and communities worldwide. It compounded current difficulties with the provision and accessibility of medical services, necessitating the employment of alternative methods of providing health coverage. As a result, advanced technological methods for patient diagnosis, monitoring, treatment, and counseling were rapidly implemented.1 Interest in these technological advances began prior to the COVID-19 pandemic, though primarily in developed countries. However, during this global outbreak, telehealth practices – which refer to online health care services provided by all health care professions – have seen a rapid increase in popularity.2,3 Telehealth was brought to the forefront in all countries in order to surmount lockdown constraints, allow continuous provision of health care for patients, and limit exposure to health systems and health providers.4 Traditional medical education and training were likewise disrupted during this time, resulting in the incorporation of telehealth into medical education. To reduce the risks associated with more personnel in the hospital, medical students were withdrawn from clinical environments during the COVID-19 outbreak. This created an environment of uncertainty and limited clinical exposure, with concerns surrounding progression through the medical course and training program.5 Continuing medical education, which has traditionally been based on clinical knowledge and skills, now requires online technical communication skills. Innovative services were rapidly developed with health professionals embracing this new technological competence, enabling general consultation for patients, remote patient monitoring, and self-directed patient care, thereby decreasing the burden on health facilities. Digital learning platforms also provided an effective way to address the learning gaps caused by the pandemic. The restriction of “in-person” delivery of healthcare services due to the global outbreak has prompted physicians, including clinical geneticists and genetic counselors, to investigate alternative methods of providing health care to patients. A telehealth innovation for online delivery of clinical genetic and genetic counseling services is the Philippine General Hospital’s Telegenetics Service. Despite being launched in 2013 to serve genetics patients across the country, this service has since been upgraded and capitalized resulting in patient appreciation for its COVID-19 exposure prevention, increased access, and time and cost efficiency. However, the telegenetics service has its limitations.6,7 Despite the expanding scope of telehealth/telegenetics and its immediate application, issues such as data/patient privacy, organizational readiness, digital maturity, regulatory impediments, access and acceptance of the technology, geographical and digital disparities, and its integration with traditional medical services have emerged.8 Lack of a detailed physical examination is also lost in a virtual visit, with focused questions leading to fragmented, impersonal interactions. Even when restrictions were lifted, telehealth usage nonetheless remained significantly higher than it had been prior to the pandemic. This may indicate a shift in public opinion in favor of this innovative medical practice.9 With the expansion of genetic services in the country, there is now a greater need for telegenetics due to the increased demand for clinical genetic and genetic counseling expertise. Therefore, evidence on the safety and efficacy of this technology in comparison to the traditional healthcare delivery approach is required. If the technology has the potential to improve health care, we must guarantee its availability in all resource-limited areas. Future efforts should thus focus on establishing solutions to address the aforementioned issues and concerns within our healthcare and education systems, thereby ultimately enhancing the standard of medical care.

Clinical characteristics and outcomes of coronavirus disease 2019-infected adult cancer patients in the Philippines from March to December 2020

Background@#Data on the clinical characteristics and outcomes of Filipino cancer patients who acquired the coronavirus disease 2019 (COVID-19) are limited and local information is lacking. Here we characterize the outcomes of patients with cancer and COVID-19.@*Methods@#Medical records of Filipino cancer patients with COVID-19 from the University of the Philippines – Philippine General Hospital (UP-PGH), Southern Philippines Medical Center (SPMC), De La Salle – University Medical Center (DLS- UMC), and St Luke’s Medical Center (SLMC) from March to December 2020 were reviewed.@*Results@#Sixty-nine cancer patients were identified to have COVID-19. The mean age was 53 years (range 19-88) and 45 (65%) patients were female. The most prevalent malignancies were from the gastrointestinal tract (16 [23%]) and the breast (14 [20%]). The majority (34 [49%]) had metastatic disease and had a functional status of Eastern Cooperative Oncology Group (ECOG) 2 or worse (39 [57%]). Forty-two (61%) patients had active oncologic treatment given for the past three months and twenty-four (35%) of these patients were on chemotherapy. The most common symptoms upon presentation were cough (34 [49%]) followed by dyspnea (28 [41%]). COVID-19 severity of this series was as follows: 15 mild (22%), 32 moderate (46%), 7 severe (10%), and 15 critical (22%). The majority received intravenous antibiotics (54 [78%]), investigational treatments (27 [39%]), and steroids (20 [29%]). Common complications were acute respiratory failure (20 [29%]), acute respiratory distress syndrome (17 [25]), and septic shock (15 [22%]). At the end of the collection period, 21 (30%) cancer patients died. The mean length of hospital stay was 22 days.@*Conclusion@#Based on the findings of our case series, ECOG 2 and higher, metastatic stage, higher neutrophil to lymphocyte ratio showed a trend to worse outcomes. Cancer-related treatment within the past months did not appear to affect outcomes.

Reintegration of returning migrant healthcare workers into the Philippine workforce: A qualitative case study

AIM@#This study aims to explore the reintegration experiences of returning migrant healthcare workers in the Philippines.@*BACKGROUND@#Return migration and reintegration of healthcare labor force is a relevant part of the migration process valuable in the improvement of human capital in source countries through transfer of knowledge and skills. However, this research field has received little attention in terms of policy, program, and research development. Hence, there is a paucity of information in the Philippines describing the reintegration experiences of returning migrant healthcare workers despite its maturity in health worker migration.@*METHODS@# A qualitative case study approach was utilized in this study. Initially, an online literature review of electronic databases and grey literature regarding reintegration of migrant workers in the Philippines was performed. This was followed by online in- depth interviews among purposively selected potential, current, or returning nurses, rehabilitation therapists, and caregiver health worker migrants through Zoom web conferencing platform. Government, private, and non-government institutions involved in the migration of health workers were also invited to participate in online focus group discussions and key informant interviews. An inductive content analysis using matrices was utilized to determine relevant descriptive codes, categories, and themes.@*RESULTS@#Return migration and reintegration is perceived as an uncommon phenomenon among healthcare worker migrants. Nonetheless, motivations and grounds of opting to return and reintegrate in the Philippines can mostly be due to personal reasons or entrepreneurial aspirations. Upon return, they successfully held teaching and training positions, engaged in business through specialized clinics, or established professional associations. There was largely a perceived lack of awareness of government efforts on reintegration as it was felt that services and assistance were limited. Further observed restraints to return migration include lower wages in the Philippines, lack of knowledge on financial management, paucity of skills and qualifications recognition acquired overseas in their home country, and absence of professional network support. The COVID-19 pandemic also positively or negatively influenced healthcare worker migration.@*CONCLUSION@#This study highlighted the motivations and restraints of health worker migrants in returning to reintegrate in the Philippines. The availability and deficiency in policies, programs, and services for returning migrant workers were also emphasized. In addition, the aspects and prospects of return migration and reintegration, as well as the challenges posed by the COVID-19 pandemic on healthcare worker reintegration was identified. The Philippine government and other concerned agencies need to ensure a supportive environment that will foster a positively conducive reintegration experience for returning healthcare worker migrants.

A comparative study on health risks, lifestyle behaviors, health perceptions, and health seeking patterns between older and younger Filipinos in the rural areas

BACKGROUND@#Worldwide trends in health risks, lifestyle behaviors, health perceptions, and health-seeking patterns suggest alarming disparities among individuals from low- and middle-income countries. Such international comparisons are particularly troubling for older individuals (≥60 years).@*OBJECTIVES@#This study aims to compare health risks, lifestyle behaviors, health perceptions, and health-seeking patterns between younger (<60) and older (≥60) Filipinos from rural communities in the Philippines.@*METHODS@# A comparative cross-sectional study was employed with 863 younger and 427 older Filipinos. Data were analyzed using frequencies, chi-squares, and T-tests.@*RESULTS@#Older participants were more likely to be single/widowed, ≤ high school education and had higher rates of hypertension, high cholesterol, diabetes, and depression. They reported poorer health status and went to the village health center when sick. Furthermore, they were less likely to drink alcohol and see a physician.@*CONCLUSION@#There were significant differences in modifiable health risks and lifestyle behaviors and differences in health perceptions between younger and older cohorts of Filipinos living in rural areas in the Philippines. Our findings suggest the need to design separate health promotion interventions that target older and younger Filipinos' unique needs from rural communities.

Examination of the right to confidentiality

@#With the establishment of the Republic Act No. 11036, more popularly known as the Mental Health Act, improvement in the mental, neurologic, and psychosocial health took a step forward in the Philippines. This law, which was signed on June 2018, gave specific provisions in different aspects of delivery of mental health services to Filipinos. This law proved very useful in the dilemma faced in the following case where a potential problem in confidentiality was encountered.

A qualitative study on the Facebook experience of young adult university students in Metro Manila

Objectives@#The purpose of this study was to explore qualitatively Facebook engagement amongyoung adult university students and the perceived effects of their use.@*Methodology@#The study utilized a qualitative design using in-depth interview. Recruitment wasdone using maximum variation purposive sampling via Facebook advertisement and posters withinthe university. Interested students were asked to contact the principal investigator for aninterview schedule. Prior to interview, the respondents answered a socio-demographicquestionnaire.@*Results@#Among the 19 students, the average time spent on social media was 4.3 hours or 260minutes. On Facebook, specifically, the average time spent daily was 2.9 hours or 176 minutes.Positive and negative experiences when viewing Facebook posts was found to be influenced bythe level of closeness between the student who posted and the reader. Commemoration posts byclose friends elicited happiness and benign envy. Factors that point to a positive experienceinclude positive social comparison, ease of communication and purpose of use, especiallyacademics. However, negative experiences also included witnessing meanness online and readingabout opposing views on sociopolitical issues, which led to depressive symptoms. Negative socialcomparison also led to feelings of envy and sadness, which the respondents described to be moresevere in adolescence than in young adulthood.@*Conclusion@#The study explored how social media, especially Facebook, has shaped the way inwhich people engaged with the world. Positive experiences were related to the level of closenessof relationship while negative experiences were mostly due to negative encounters with friendsand the general tone of the feed. The study also determined that experiential change fromadolescent to young adulthood influence their perception of Facebook.

Needs assessment for establishment of telepathology in the Philippines

Objective@#The Philippines has more than a hundred ten million population with a very limited number of general pathologists and subspecialist pathologists. Consultation of pathologists with other pathologists is important to ensure accurate results for difficult cases. However, pathologists are not always accessible to review slides. Telepathology can provide access to other pathologists by sending microscopic images through the internet. This study explores the needs of pathologists for consultation in their practice that may be aided by telepathology. The status of current pathology practice and subspecialty consultations across the different regions in the Philippines were determined and the readiness of pathologists for telepathology was identified.@*Methodology@# This is a cross-sectional descriptive study using an 18-item online survey questionnaire based on the World Health Organization guidelines on needs assessment for medical devices. The survey was distributed among anatomic pathologists practicing in the Philippines.@*Results@#One hundred forty (140) pathologists responded and were included in this study. 5-10% of cases of respondents required subspecialty referral. Diagnostically challenging cases and confirmation of malignancy are the most common reasons for consultation. Respondents practicing outside the National Capital Region (NCR) have fewer subspecialist pathologists available for referrals within their region. Turnaround times for signing out challenging cases are longer outside NCR (>7 days) compared to NCR (4-7 days). Most respondents have access to the basic equipment to perform telepathology, which includes, an internet link, a smartphone with high-resolution camera and a computer. Almost all respondents will use telepathology if it is available.@*Conclusion@#A hub-and-spoke telepathology network can provide access to subspecialty consultation to reduce the diagnostic turnaround time and to increase the accuracy of results for challenging cases. The availability of the minimum telepathology infrastructure and the positive attitude of the pathologists towards telepathology may be indicators of readiness for a local telepathology system in the Philippines.

Impact of the COVID-19 pandemic on blood supply: A comparative cross-sectional study of the pre-pandemic and pandemic era

Objective@#The study aimed to determine the impact of the COVID-19 pandemic on local blood supply management in the Davao Region, Philippines from 2019 to 2021 through the analysis of trends in blood supply in Davao Region, Philippines.@*Methodology@#Secondary data from two blood centers in the Davao Region for the years 2019 to 2021 were used to determine the trends on blood donation supply. To evaluate trends, the overall number of blood donors and the quantities of various types of blood components in whole blood, packed red blood cells (PRBCs), fresh frozen plasma (FFPs) and platelet concentrate have been compared between pre-pandemic, pandemic periods and as restrictions eased.@*Results@#A substantial decrease of 51.6% in the number of blood donors was seen during 2021 in comparison with 2019. The trend in collection by blood components also showed a significant trend from 2019 to 2021, whole blood (200.8%), packed RBCs (37.1%), fresh frozen plasma (113.6%). While the platelet concentrate supply declined by 34.9% from 2019 to 2020, an increase of 10.7% was noted onwards to 2021.@*Conclusion@#The results demonstrate that during the COVID-19 pandemic, there was a major reduction in donation and supply of blood. The challenges faced by blood banks in ensuring a stable and sufficient blood supply are highlighted by the decrease in the number of donors and by the different trends in the supply of blood components. The targeted efforts to promote blood donation and enhance the resilience of the blood supply during and after the pandemic is important.

Clinical profiles and in-hospital short-term outcomes of suspect, probable, and confirmed adult COVID-19 patients at the Philippine Heart Center: A descriptive study

Introduction@#COVID-19 emerged as a new disease during the early period of 2020. Given that our institution is a cardiac specialty center and our patients have numerous co-morbidities compared to the general population, we wanted to determine the clinical profiles and in-hospital short-term outcomes of suspect, probable and confirmed adult COVID-19 patients seen at our institution.@*Methodology@#We prospectively enrolled 323 adult (115 health care workers) suspect, probable and confirmed COVID- 19 patients admitted from March to June 2020. We described and analyzed their clinical presentation, and in-hospital outcomes.@*Results@#There were 117 (36.22%) RT-PCR positive patients with 36.53% confirmed, 13.00% probable and 50.46% suspect patients. For probable and confirmed patients, 25%, 21.25%, 23.13% 16.25% had no, mild, moderate, and severe symptoms, respectively with 14.28% critical cases. Over-all mortality rate for probable and confirmed cases was 25.54% with 91.3% mortality rate for critical cases. Co-morbidities with statistically significant association with severity of disease were as follows: hypertension, heart disease, cerebrovascular disease, diabetes mellitus and COPD.@*Conclusion@#During the early period of the COVID-19 pandemic, only 36.53% of cases admitted at our institution were COVID-19 confirmed by RT-PCR. One-third of the cases were severe and critical, with more clinical instability, increased inflammatory markers, and higher in-hospital morbidity and mortality.

Bridging the gap or widening the divide: A call for capacity-building in Artificial Intelligence for Healthcare in the Philippines

@#The emerging field of generative artificial intelligence (GAI) and some of its well-known technologies: ChatGPT, Google Bard and Claude, have gained substantial popularity due to their enormous potential in healthcare applications, as seen in medically fine-tuned models such as Med-PaLM and ChatDoctor. While these advancements are impressive, the dependence of AI development on data volume and quality raises questions about the generalizability of these models. Regions with lower medical research output risk bias and misrepresentation in AI-generated content, especially when used to assist clinical practice. Upon testing of a prompt concerning the isoniazid dosing of Filipinos versus other ethnic and racial groups, responses from GPT-4, GPT-3, Bard and Claude resulted in 3 out of 4 outputs showing convincing but false content, with extended prompting illustrating how response hallucination happens in GAI models. To address this, model refinement techniques such as fine-tuning and prompt ensembles are suggested; however, refining AI models for local contextualization requires data availability, data quality and quality assurance frameworks. Clinicians and researchers in the Philippines and other underrepresented regions are called to initiate capacity-building efforts to prepare for AI in healthcare. Early efforts from all stakeholders are needed to prevent the exacerbation of health inequities, especially in the new clinical frontiers brought about by GAI.

Short-acting β2-agonist prescription patterns in patients with asthma in the Philippines: Results from SABINA III

Objectives@#As asthma is a chronic inflammatory disease of the airways, anti-inflammatory treatment should be positioned at the forefront of guideline-directed asthma care. However, patients tend to rely on short-acting β2-agonists (SABAs) for rapid-onset symptom relief. The impact of SABA overuse and associated clinical outcomes have been investigated extensively in Europe and North America. Limited data are available from countries in Asia, Africa, Latin America, and the Middle East. The SABA use IN Asthma (SABINA) III program, a large multicountry, observational study, was undertaken to describe the global extent of SABA use and its potential contribution to suboptimal disease control. As part of the SABINA III study, we aimed to characterize SABA prescription collection and asthma-related clinical outcomes among patients in the Philippines.@*Methods@#This nationwide, observational, cross-sectional, SABINA III study included patients (aged ≥12 years) with a documented asthma diagnosis recruited between May 2019 and January 2020 from 10 sites in the Philippines. Demographics, disease characteristics and prescribed asthma treatments, including SABA and inhaled corticosteroids (ICS) in the 12 months preceding study start, were recorded during a single visit, and transcribed onto an electronic case report form (eCRF). Patients were classified by investigator-defined asthma severity, guided by the 2017 Global Initiative for Asthma (GINA) report and practice type, either primary or pulmonary medicine specialist care.@*Results@#Of 245 patients analyzed, 63.3% were classified as having moderate-to-severe asthma (GINA steps 3−5), and most patients (63.3%) were enrolled by pulmonary medicine specialists. Overall, 33.1% (n=81) of patients had experienced ≥1 severe exacerbation in the previous 12 months and 18.4% (n=45) of patients had uncontrolled asthma. With respect to asthma treatments, a total of 6.5% (n=16), 40.4% (n=99), and 2.4% (n=6) of patients were prescribed SABA monotherapy, SABA in addition to maintenance therapy, and ICS, respectively, in the 12 months prior to their study visit. Most patients (n=156 [63.7%]) received prescriptions of fixed-dose combina-tions of ICS and long-acting β2-agonists. SABA over-prescription, defined as ≥3 SABA canister prescriptions per year, was observed in 10.6% (n=21) of patients. Additionally, 25.6% (n=23) of patients classified as having mild asthma were prescribed either nebulized SABA (n=17) or oral SABA (n=6). Nearly one-third of patients (n=75 [30.6%]) had purchased over-the-counter (OTC) SABA, and 46.9% (n=115) were prescribed antibiotics.@*Conclusions@#In this SABINA III Philippines study cohort, more than 10% of patients were over-prescribed SABA canisters. Additionally, prescriptions for oral or nebulized SABA, the purchase of non-prescription (OTC) SABA, and the high percentage of prescriptions for antibiotics warrant country-wide improvements in asthma care and management.

Shortening training duration to address the insufficiency of Ophthalmologists: A deeper look at the China experience

@#The availability of ophthalmologists is vital to making eyecare accessible to everyone. Medical education and ophthalmology residency training in China was reduced to address the high demand for ophthalmologists. This is something the Philippines can consider to increase the number of ophthalmologists in the country. However, decreasing the duration, together with insufficient monitoring of medical education and ophthalmology residency training, were not without consequences in eyecare in China.

Pediatrician knowledge, attitude and practices on children’s oral health in a tertiary public hospital in the Philippines: A descriptive study

Background@#Dental caries is a tolerated and overlooked chronic disease in the Philippines. The 2018 National Survey on Oral Health of the Department of Health found that 85.2% of Filipino children aged five years old have dental caries. Prevention and management of this disease can be established early with better collaborations between dental professionals and pediatricians who generally see children promptly in their well-baby check-ups.@*Objective@#The study aimed to evaluate pediatricians' knowledge, attitude, and practices on dental caries prevention among their child patients.@*Method@#A cross-sectional descriptive study was conducted in March 2017 among pediatricians working in a tertiary public hospital in Metro Manila through a self-administered questionnaire. The questionnaire gathered data on knowledge about dental caries prevention, attitude towards the importance of dental screening and oral hygiene instructions, and dental health practices.@*Results@#Among the 122 participants, 67.8% scored high in the oral health knowledge part, 85.0% revealed a positive attitude toward dental caries prevention, and many claimed that they frequently included dental caries risk assessment and preventive oral health education in their clinical practices.@*Conclusion@#Most pediatricians had high knowledge and a positive attitude toward dental caries prevention, although responses varied in the practice component. It will be valuable to continue improving the oral health proficiency of pediatricians to benefit early dental caries prevention in young patients.

Schistosomiasis and soil-transmitted helminthiasis morbidity control in selected communities in Eastern Visayas, Philippines: Post-Haiyan

Objective@#As part of the evaluation of control programs recommended by WHO, this study describes the local implementation of schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) morbidity control as well as water, sanitation, and hygiene (WASH) interventions post calamity. It likewise determines the challenges, areas for improvement, and good practices in SCH and STH morbidity control strategies in Haiyan-stricken areas in Eastern and Western Samar, the Philippines. @*Methods@#Twenty key informant interviews and eight focus group discussions documented the implementation of SCH and STH control strategies in Eastern Visayas. Data analysis was done manually by a multi-disciplinary team. @*Results@#Mass drug administration (MDA) in schools and communities was conducted for morbidity control. MDA for STH for pre-school-age children was integrated into the Garantisadong Pambata program, while a schoolbased teacher-assisted approach was used for school-age children. WASH facilities, such as sanitary toilets, were constructed through the initiatives of the local government units (LGUs) and other private sectors. Partnerships with Plan International Philippines helped in the implementation of WASH through the conduct of Community-led Total Sanitation. Health advocacies helped instill behavioral change in the community. SCH surveillance was conducted annually while STH surveillance was irregularly implemented. Data on MDA coverage were validated through Rapid Coverage Assessment before final reporting. Discrepancies were observed due to typographical errors and the inclusion of teachers and transient migrants in the reports submitted. Challenges in the implementation of MDA include delays in drug delivery, lack of human resources, non-compliance of participants, and drug unpalatability. Challenges in WASH included the lack of hand washing facilities, inaccessibility to safe water, as well as non-utility of sanitary toilets. Strengthening health advocacy and education may help address these challenges.@*Conclusion@#The involvement and partnership of various stakeholders such as LGUs, WASH, and veterinary sectors, together with the academe are needed to strengthen and enhance the implementation of SCH and STH control activities. An integrated approach may contribute to improvements in SCH and STH prevention and control of the communities in selected Haiyanstricken areas.

Factors affecting voluntary blood donations among adults in Metro Manila, Philippines, as a basis for policy improvement on donor recruitment

Background@#Blood donation practice in the Philippines is low despite numerous efforts to recruit potential donors and increase blood supply.@*Objectives@#This study aimed to explore the sociodemographic profile of potential donors and their perceived level of knowledge, motivators, and hindrances on blood donation practice to recommend improvements in policies and strategies regarding blood donation recruitment.@*Methods@#A descriptive study design was utilized to attain the objectives of the study. A piloted questionnaire was floated through various social media platforms to gather data. Data were analyzed using descriptive statistics and Pearson's product-moment correlation.@*Results@#We included 260 Metro Manila residents, 18 to 65 years old and without conditions that merited permanent deferral in blood donation. Overall, the respondents had an adequate perceived level of knowledge (x̄ = 3.13, SD = 0.70) on blood donation but the lowest level of knowledge on the interval between successive blood donations (x̄ = 2.71, SD = 1.04). Furthermore, respondents were considerably motivated to donate blood (x̄ = 2.67, SD = 0.42) mainly due to relatives and friends requiring blood (x̄ = 3.73, SD = 0.60), and have minimal discernment of being discouraged from blood donation (x̄ = 2.09, SD = 0.48) mainly due to time constraints (x̄ = 3.23, SD = 0.78). Moreover, there is a significant but low inverse correlation (r = -0.151, p = 0.015) between age and motivation, suggesting younger individuals have more motivation to donate blood. Thus, policies and strategies that target young donors are highly suggested.@*Conclusion@#Poor blood donation practices in the Philippines suggest recalibration of policies and strategies by targeting young individuals and showcasing altruism to improve donor recruitment. Moreover, it is recommended to strategically establish blood service facilities in accessible areas with flexible operating hours to accommodate potential donors with hectic schedules.

Mapping the journey of patients with painful diabetic peripheral neuropathy in the Philippines

Objectives@#Knowing the limited epidemiological studies on painful diabetic peripheral neuropathy (pDPN) in the Philippines, the present review aimed to map the prevalence of pDPN and identify the associated healthcare gaps. @*Materials and Methods@#A systematic search of MEDLINE, Embase and BIOSIS was conducted using predefine inclusion criteria, and relevant studies published in English between 2004 and 2021 were identified. An unstructured literature search was also conducted on public and government websites with no date restriction. Data combined from all sources were synthesized and presented as a simple mean.@*Results@#Three studies were considered for final analyses of the 26 articles retrieved from structured and unstructured searches. The sample sizes for the three studies were 103, 172, and 100, respectively. The simple mean prevalence of pDPN was estimated at 26.5%. Awareness of pDPN based on a published study was 89%. According to published studies, screening and diagnosis of pDPN were 65% and 76.7%, respectively. One-third of the patients with pDPN (75%) were treated. No literature is available for adherence and control.@*Conclusion@#Limited data exist on the different management stages of patients with pDPN in the Philippines. The study analysis will help address the knowledge gaps, improve patient care and pain management, and aid decisionmaking.

Clinical profile of cerebrovascular disease population in Sorsogon: A hospital-based study

Objectives@#In the Philippines, an estimated half million are affected annually by stroke. It is the third most common cause of mortality among Filipinos. Locally, there are limited data on the epidemiology of stroke in the country. This study aimed to study cerebrovascular disease in the rural setting in the country, primarily exploring the demographic characteristics, risk factors, clinical profile, and outcomes of patients assessed with cerebrovascular disease in the province of Sorsogon.@*Methods@#This was a retrospective study of all adult patients admitted to two tertiary hospitals in Sorsogon between February 1, 2020, and January 31, 2021, with a stroke diagnosis (International Classification of Diseases, Revision 10). A manual review of the charts and demographics, risk factors, clinical presentation, neuroimaging findings, and outcome were recorded.@*Results@#A total of 721 cases with a mean age of 63.06 ± 13.96 years were involved in the analysis. Of all the stroke cases, 64.7% were ischemic, and 29.7% were hemorrhagic strokes. The most common risk factors for stroke occurrence were hypertension (65%), history of stroke (16.2%), and diabetes (11.4%). Most sought consultation was due to one-sided weakness (41.3%) and slurring speech (14.2%).@*Conclusion@#In a third-class province in the Philippines, the most common type of stroke was an ischemic stroke. Analysis showed that diabetes was more associated with ischemia while hypertension was significantly associated with hemorrhagic stroke. A mortality rate of 26.8% was seen in this cerebrovascular disease population.

Relationship of work engagement with nurse work and patient outcomes among nurses in Central Philippines

Objective@#This study determined the association between work engagement among hospital nurses and their work outcomes (i.e., job satisfaction, stress, burnout, and turnover intention) and patient outcomes (i.e., missed nursing care, adverse events, and quality of care).@*Methods@#A cross-sectional study was employed using secondary data derived from 549 registered nurses working in different hospitals in Central Philippines. Eight self-report questionnaires were adopted to gather data in this study. Multiple linear and logistic regression analyses were used to test the hypotheses.@*Results@#Nurses with lower levels of work engagement reported increased levels of job burnout and turnover intention. Those nurses with higher scores on the dedication subscale reported increased job satisfaction and perceived quality of patient care.@*Conclusion@#Work engagement influences nurse work and patient outcomes in the Philippines. Higher levels of work engagement prevent nursing staff from leaving their workplaces and may help them find their work fulfilling personally and professionally. Nursing management should highly consider promoting work engagement through enhancing job resources to meet the needs of nurses and, eventually, improve professional work outcomes and quality patient care.