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2.
Vaccine ; 41(23): 3550-3555, 2023 05 26.
Artigo em Inglês | MEDLINE | ID: covidwho-2309898

RESUMO

Vaccination is the most important strategy in preventing COVID-19. Vaccine efficacy and safety have been established in clinical trials but real-world data are useful to determine occurrence of adverse events in a population with heterogeneous characteristics. Knowledge on the hematologic events associated with different COVID-19 vaccines would be beneficial for patients as well as hematologists who oversee the care of these patients. This study aimed to determine the rates and outcomes of hematologic adverse events after COVID-19 vaccination in the Philippines. In this self-controlled case series, there were 268 individuals reported to have hematologic adverse events. Most received Comirnaty at 29.85%. Majority (62.31%) reported hematologic adverse events following the first dose of the vaccine. The overall event rate was 0.0182 per 10,000 vaccine doses; and lymphadenopathy was the most common hematologic adverse effect with a rate of 0.011 per 10,000 vaccine doses, followed by anemia at 0.0034 per 10,000 vaccine doses and thrombocytopenia at 0.0017 per 10,000 vaccine doses. Autoimmune cytopenias were also reported with an event rate of 0.0007 per 10,000 vaccine doses for ITP. One-hundred thirty two (49.25%) were fully recovered and 23.88% were recovering from hematologic adverse events as of the time of writing. The study showed a low rate of hematologic adverse events post COVID-19 vaccination with the seven different vaccine brands administered in the Philippines.


Assuntos
COVID-19 , Leucopenia , Trombocitopenia , Vacinas , Humanos , Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Filipinas/epidemiologia , Vacinação/efeitos adversos , Trombocitopenia/induzido quimicamente
3.
Western Pac Surveill Response J ; 14(1): 1-11, 2023.
Artigo em Inglês | MEDLINE | ID: covidwho-2300075

RESUMO

Objective: Excess mortality is an indicator of the impact of the coronavirus disease (COVID-19) pandemic. This study aims to describe excess mortality in the Philippines from January 2020 to December 2021 using an online all-cause mortality and excess mortality calculator. Methods: All-cause mortality data sets from 2015 to 2021 from the Philippine Statistics Authority were obtained and analysed using the World Health Organization Western Pacific Regional Office All-Cause Mortality Calculator. Expected mortality, excess mortality and P-scores were obtained using two models, 5-year averages and negative binomial regression, for total deaths and by administrative region. Results: Reported national all-cause mortality exceeded the expected mortality in August 2020 and from January to November 2021, peaking in September 2021 at 104 per 100 000. Total excess mortality using negative binomial regression was -13 900 deaths in 2020 and 212 000 deaths in 2021, peaking in September 2021. P-scores were -2% in 2020 and 33% in 2021, again peaking in September 2021 at 114%. Reported COVID-19 deaths accounted for 20% of excess deaths in 2021. In 2020, consistently high P-scores were recorded in the National Capital Region from July to September and in the Bangsamoro Autonomous Region in Muslim Mindanao from June to July. In 2021, most regions recorded high P-scores from June to October. Discussion: Tracking excess mortality using a robust, accessible and standardized online tool provided a comprehensive assessment of the direct and indirect impacts of the COVID-19 pandemic in the Philippines. Furthermore, analysis by administrative region highlighted the key regions disproportionately affected by the pandemic, information that may not have been fully captured from routine COVID-19 surveillance.


Assuntos
COVID-19 , Mortalidade , Humanos , Pandemias , Filipinas/epidemiologia , SARS-CoV-2
4.
BMJ Open ; 13(4): e070688, 2023 04 17.
Artigo em Inglês | MEDLINE | ID: covidwho-2299036

RESUMO

OBJECTIVE: To determine the potential risk factors associated with having COVID-19 among unvaccinated pregnant and non-pregnant women. DESIGN: A multicentre prospective cohort study among eligible women in Metro Manila, Philippines, from 2020 to 2022. SETTING: Five national and local hospital research sites altogether recruited and screened 500 consenting eligible individuals. PARTICIPANTS: Pregnant and non-pregnant participants meeting the eligibility criteria were admitted for a reverse-transcription PCR determination of SARS-CoV-2, pregnancy testing and ultrasound, and an interview with an administered questionnaire. EXPOSURES: Primary exposure was pregnancy; secondary exposures involve sociodemographic, lifestyle and obstetric-gynaecologic factors. OUTCOME MEASURE: Outcome being measured was COVID-19 status. RESULTS: The significant COVID-19 risk factors were: pregnancy (PR=1.184, 95% CI 1.096, 1.279), having a white-collar job (PR=1.123, 95% CI 1.02, 1.235), travelling abroad (PR=1.369, 95% CI 1.083, 1.173) and being infected by at least one vaccine-preventable disease (VPD) (PR=1.208, 95% CI 1.113, 1.310). Protective factors included having graduate-level education (PR=0.787, 95% CI 0.649, 0.954), immunisation against a VPD (PR=0.795, 95% CI 0.733, 0.862) and practising contraception (PR=0.889, 95% CI 0.824, 0.960). CONCLUSION: This study is the first in the country to determine the risks influencing COVID-19 infection among unvaccinated pregnant and non-pregnant women. Pregnancy is a significant risk for COVID-19 among women in Metro Manila. Educational attainment and positive health behaviours seem to confer protection. Occupations and activities that increase the frequency of interactions, as well as history of communicable diseases may predispose women to COVID-19. Further studies are needed to elucidate the development of the disease in pregnant women, including the maternal and neonatal effects of COVID-19 via potential vertical mechanisms of transmission.


Assuntos
COVID-19 , Complicações Infecciosas na Gravidez , Gravidez , Recém-Nascido , Feminino , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Estudos Prospectivos , Filipinas/epidemiologia , Estudos Longitudinais , Complicações Infecciosas na Gravidez/epidemiologia
5.
PLoS One ; 18(4): e0283068, 2023.
Artigo em Inglês | MEDLINE | ID: covidwho-2291286

RESUMO

The Coronavirus disease 2019 (COVID-19) has exposed many systemic vulnerabilities in many countries' health system, disaster preparedness, and adequate response capabilities. With the early lack of data and information about the virus and the many differing local-specific factors contributing to its transmission, managing its spread had been challenging. The current work presents a modified Susceptible-Exposed-Infectious-Recovered compartmental model incorporating intervention protocols during different community quarantine periods. The COVID-19 reported cases before the vaccine rollout in Davao City, Philippines, are utilized to obtain baseline values for key epidemiologic model parameters. The probable secondary infections (i.e., time-varying reproduction number) among other epidemiological indicators were computed. Results show that the cases in Davao City were driven by the transmission rates, positivity proportion, latency period, and the number of severely symptomatic patients. This paper provides qualitative insights into the transmission dynamics of COVID-19 along with the government's implemented intervention protocols. Furthermore, this modeling framework could be used for decision support, policy making, and system development for the current and future pandemics.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , SARS-CoV-2 , Filipinas/epidemiologia , Quarentena , Vacinação
6.
PLoS One ; 18(3): e0282644, 2023.
Artigo em Inglês | MEDLINE | ID: covidwho-2278736

RESUMO

OBJECTIVE: The study aimed to demonstrate the feasibility of an unassisted and community-based HIV self-testing (HIVST) distribution model and to evaluate its acceptability among men-having-sex-with-men (MSM) and transgender women (TGW). METHODS: Our demonstration study focused on implementing the HIVST distribution model in Metro Manila, Philippines. Convenience sampling was done with the following inclusion criteria: MSM or TGW, at least 18 years old, and had no previous HIV diagnosis. Individuals taking HIV pre-exposure prophylaxis, on antiretroviral therapy, or female sex at birth were excluded. The implementation of the study was done online using a virtual assistant and a delivery system via courier due to COVID-19-related lockdowns. Feasibility was measured by the number of HIVST kits successfully delivered and utilized and the HIV point prevalence. Moreover, acceptability was evaluated by a 10-item system usability scale (SUS). HIV prevalence was estimated with linkage to care prioritized for reactive participants. RESULTS: Out of 1,690 kits distributed, only 953 (56.4%) participants reported their results. Overall, HIV point prevalence was 9.8%, with 56 (60.2%) reactive participants linked to further testing. Furthermore, 261 (27.4%) of respondents self-reported, and 35 (13.4%) of the reactive participants were first-time testers. The HIVST service had an overall median and interquartile range (IQR) SUS score of 82.5 (IQR: 75.0, 90.0), rendering the HIVST kits very acceptable. CONCLUSIONS: Our study suggests the acceptability and feasibility of HIVST among the MSM and TGW in Metro Manila, Philippines, regardless of their age or HIV testing experience. In addition, other platforms of information dissemination and service delivery of HIVST should be explored, including access to online instructional videos and printed materials, which may facilitate easier use and interpretation of results. Furthermore, due to our study's limited number of TGW respondents, a more targeted implementation strategy to reach the TGW population is warranted to increase their access and uptake of HIVST.


Assuntos
COVID-19 , Infecções por HIV , Minorias Sexuais e de Gênero , Pessoas Transgênero , Masculino , Recém-Nascido , Humanos , Feminino , Adolescente , Homossexualidade Masculina , HIV , Autoteste , Filipinas/epidemiologia , Pandemias , COVID-19/diagnóstico , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Teste de HIV
8.
BMC Health Serv Res ; 23(1): 277, 2023 Mar 22.
Artigo em Inglês | MEDLINE | ID: covidwho-2274354

RESUMO

BACKGROUND: The capacity to deliver essential health services has been negatively impacted by the COVID-19 pandemic, particularly due to lockdown restrictions. Telemedicine provides a safe, efficient, and effective alternative that addresses the needs of patients and the health system. However, there remain implementation challenges and barriers to patient adoption in resource-limited settings as in the Philippines. This mixed methods study aimed to describe patient perspectives and experiences with telemedicine services, and explore the factors that influence telemedicine use and satisfaction. METHODS: An online survey consisting of items adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group Adult Visit Survey 4.0 (beta) and the Telehealth Usability Questionnaire (TUQ) was completed by 200 participants aged 18 to 65 years residing in the Philippines. A subsample of 16 participants was interviewed to provide further insights on their experiences. We used descriptive statistics to analyze survey data and thematically analyzed data from interviews guided by the principles of grounded theory. RESULTS: Participants were generally satisfied with telemedicine, and found it to be an efficient and convenient means of receiving healthcare. About 3 in 5 perceived telemedicine as affordable, with some finding telemedicine costs to be high and comparable to in-person consultations. Our results suggest that participants preferred telemedicine services, especially in cases where they feel that their condition is not urgent and does not need extensive physical examination. Safety against COVID-19, privacy, accessibility, and availability of multiple communication platforms contributed to patient satisfaction with telemedicine. Negative perceptions of patients on quality of care and service related to their telemedicine provider, inherent limitations of telemedicine in the diagnosis and management of patients, perceived high costs especially for mental health conditions, and poor connectivity and other technological issues were barriers to telemedicine use and satisfaction. CONCLUSION: Telemedicine is viewed as a safe, efficient, and affordable alternative to receiving care. Expectations of patients on costs and outcomes need to be managed by providers to increase satisfaction. Continued adoption of telemedicine will require improvements in technology infrastructure and technical support for patients, training and performance evaluation of providers to ensure quality of care and service, better patient communication to meet patient needs, and integration of telemedicine services in remote areas that have limited access to medical services. Telemedicine, to realize its full potential, should be centered in health equity - addressing patient barriers and needs, reducing health disparities across population groups and settings, and providing quality services to all.


Assuntos
COVID-19 , Telemedicina , Adulto , Humanos , COVID-19/epidemiologia , Satisfação do Paciente , Pandemias , Filipinas/epidemiologia , Controle de Doenças Transmissíveis , Telemedicina/métodos
9.
BMC Public Health ; 23(1): 493, 2023 03 14.
Artigo em Inglês | MEDLINE | ID: covidwho-2274817

RESUMO

BACKGROUND: Due to the COVID-19 pandemic, many challenges in adolescent health have been exacerbated including increased cases of early marriages, domestic violence, higher rates of anxiety and depression, and reduced access to sexual and reproductive health services for adolescents. This study examines the impacts of the pandemic on adolescent health services utilization and potential adaptations in the Philippines. METHODS: The data used in this study was from a rapid telephone assessment survey of 148 adolescent-friendly health facilities (rural health units) in the Philippines. We employed a mixed-methods research approach comprising both quantitative and qualitative analyses in three phases. First, we conducted a descriptive analysis of the status of adolescent healthcare access and utilization during COVID-19. Next, we examined using multivariate ordered logistic regressions how staff availability and adolescent health (AH) service provision modalities influenced AH service utilization in terms of the average number of adolescents served per week during compared to before the pandemic. We also conducted a complementing qualitative analysis of the challenges and corresponding adaptive solutions to ensuring continuity of AH services in facilities. RESULTS: We find that two months into the pandemic, 79% of adolescent-friendly trained staff were reporting for duty and 64% of facilities reported no staff disruptions. However, only 13% of facilities were serving the same number of adolescents or greater than before COVID-19. The use of more modalities for AH service provision (including telehealth) by facilities was significantly associated with increased likelihood to report serving the same number of adolescent or greater than before COVID-19 compared to those who used only one modality. CONCLUSION: Investments in multiple modalities of care provision, such as telehealth could improve AH services utilization and help sustain connection with adolescents during shocks, including future outbreaks or other stressors that limit physical access to health facilities.


Assuntos
Serviços de Saúde do Adolescente , COVID-19 , Adolescente , Humanos , COVID-19/epidemiologia , Pandemias , Filipinas/epidemiologia , Acessibilidade aos Serviços de Saúde
10.
Health Place ; 79: 102929, 2023 01.
Artigo em Inglês | MEDLINE | ID: covidwho-2242501

RESUMO

This article argues that local constructions of risky and safe spaces, as articulated by the notions 'loob' (inside) and 'labas' (outside), informed popular and political responses to the COVID-19 pandemic in the Philippines, leading to an overemphasis on staying at home and, conversely, a general avoidance or fear of outdoor spaces that was at times reinforced by public health authorities. Practices and policies related to the pandemic response rendered this binary opposition between 'loob' and 'labas' visible, from regulations concerning the use of personal protective equipment to restrictions of access to outdoor spaces. While this emergent form of bodily proxemics was contested and negotiated over time, its tenacity throughout the pandemic underscores the importance of understanding how people spatialize risk in times of health crises.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias , Filipinas/epidemiologia , Medo , Saúde Pública
11.
Sci Rep ; 13(1): 2310, 2023 02 09.
Artigo em Inglês | MEDLINE | ID: covidwho-2235297

RESUMO

Four endemic human coronaviruses (HCoV), HCoV-229E, HCoV-NL63, HCoV-HKU1, and HCoV-OC43, are closely related to SARS-CoV-2. These coronaviruses are known to infect humans living in temperate areas, including children under 5 years old; however, the seroprevalence of four HCoVs among children in tropical areas, including the Philippines, remains unclear. This study aimed to assess the prevalence of antibodies against four HCoVs and to determine the reactivity and neutralization of these antibodies against SARS-CoV-2 among children in the Philippines. A total of 315 serum samples collected from 2015 to 2018, before the emergence of SARS-CoV-2, in Biliran island, Philippines, were tested for the presence of antibodies against four HCoVs and SARS-CoV-2 using recombinant spike ectodomain proteins by IgG-enzyme-linked immunosorbent assay (ELISA). Reactivity to and neutralization of SARS-CoV-2 were also investigated. The seroprevalence of the four HCoVs was 63.8% for HCoV-229E, 71.4% for HCoV-NL63, 76.5% for HCoV-HKU1, and 83.5% for HCoV-OC43 by ELISA. Age group analysis indicated that seropositivity to all HCoVs reached 80% by 2-3 years of age. While 69/315 (21.9%) of the samples showed reactive to SARS-CoV-2, almost no neutralization against SARS-CoV-2 was detected using neutralization assay. Reactivity of antibodies against SARS-CoV-2 spike protein obtained by ELISA may not correlate with neutralization capability.


Assuntos
Anticorpos Neutralizantes , COVID-19 , Infecções por Coronavirus , Coronavirus , Criança , Pré-Escolar , Humanos , Anticorpos Antivirais , Coronavirus Humano 229E , Coronavirus Humano NL63 , Coronavirus Humano OC43 , COVID-19/epidemiologia , COVID-19/imunologia , Filipinas/epidemiologia , Proteínas Recombinantes , SARS-CoV-2 , Estudos Soroepidemiológicos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Coronavirus/genética , Coronavirus/imunologia , Betacoronavirus , Anticorpos Neutralizantes/imunologia
12.
Int J Environ Res Public Health ; 20(3)2023 01 31.
Artigo em Inglês | MEDLINE | ID: covidwho-2225172

RESUMO

Dubbed the "inequality virus", coronavirus disease (COVID-19) has unveiled and magnified many of the global society's long-standing inequalities and health inequities. This work brings together the phenomena of increased inequality and health inequities felt by the poor and young working class of the Philippines and how they interact negatively with existing vaccine policies. The poor and the young were more likely to have experienced employment disruptions with limited access to technologies that allowed for teleworking. Informal economy workers suffered from diminished labor protection and draconian lockdowns. Disadvantaged areas persistently dealt with limited health resources, and the working class was disproportionately vulnerable to COVID-19 infection. Utilitarian vaccine policies such as mandatory vaccination and the prioritization scheme negatively interacted with these COVID-induced inequalities and health inequities. While the young working class was more likely to be unemployed, mandatory vaccine policy required that they get vaccinated before seeking re-employment. However, the prioritization scheme adopted by the government failed to target them as a priority. This left them in a vulnerable state of prolonged unemployment while on standby for better supply and improved infrastructure for vaccine rollout. Future prospects in terms of economic recovery and health equity will be affected by issues such as potential increased taxation, the rapidly digitalizing labor market that is evolving to favor highly-skilled workers, and the staging of universal healthcare in the country.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Filipinas/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Política Pública , Vacinação
13.
Eur J Med Res ; 28(1): 62, 2023 Feb 03.
Artigo em Inglês | MEDLINE | ID: covidwho-2224308

RESUMO

OBJECTIVE: To describe the association between hypertension and clinical outcomes in a cohort of patients with coronavirus disease 2019 (COVID-19). DESIGN: Retrospective cohort study. SETTING: Thirty-seven (37) hospitals in the Philippines. PATIENTS: 10,881 patients admitted for COVID-19 from February to December 2020. MEASUREMENTS AND MAIN RESULTS: Among the 10,881 patients included in the Philippine CORONA Study, 3647 (33.5%) had hypertension. On regression analysis adjusted for confounders (age group, sex, smoking history, diabetes, chronic cardiac disease, chronic kidney disease, chronic respiratory disease, chronic neurologic disease, chronic liver disease, HIV/AIDS, and malignancy), patients with hypertension had significantly greater odds of in-hospital mortality (OR 1.33, 95% CI 1.17-1.52), respiratory failure (OR 1.99, 95% CI 1.75-2.28), ICU admission (OR 2.16, 95% CI 1.90-2.45) and severe/critical disease (OR 1.57, 95% CI 1.41-1.75), compared to patients without hypertension. The time-to-event analysis with confounder adjustment also showed that hypertension was significantly associated with shorter time-to-event outcomes of in-hospital mortality (HR 1.13, 95% CI 1.01-1.26), respiratory failure (HR 1.86, 95% CI 1.65-2.10), and ICU admission (HR 1.99, 95% CI 1.76-2.23). CONCLUSIONS: Our analysis of nationwide data confirmed previous findings that hypertension is an independent risk factor for worse clinical outcomes among patients hospitalized for COVID-19, with increased odds of in-hospital mortality, respiratory failure, ICU admission, and severe/critical COVID-19. More specific studies should be done to elucidate the impact of hypertension characteristics, such as chronicity, severity, drug therapy, and level of control on these clinical outcomes.


Assuntos
COVID-19 , Hipertensão , Insuficiência Respiratória , Humanos , Filipinas/epidemiologia , SARS-CoV-2 , Estudos Retrospectivos , Hipertensão/complicações , Hipertensão/epidemiologia , Fatores de Risco , Mortalidade Hospitalar , Unidades de Terapia Intensiva
14.
Int J Environ Res Public Health ; 20(3)2023 01 28.
Artigo em Inglês | MEDLINE | ID: covidwho-2216034

RESUMO

The SARS-CoV-2 pandemic has had a deleterious impact on human health since its beginning in 2019. The purpose of this study was to examine the psychosocial impact of the COVID-19 pandemic in the Philippines and determine if there were differential impacts on women compared to men. A web-based survey was conducted in the Luzon Islands of the Philippines, during the pandemic quarantine. A total of 1879 participants completed online surveys between 28 March-12 April 2020. A bivariate analysis of both men and women for each psychological measure (stress, anxiety, depression, and impact of COVID-19) was conducted. Multivariable logistic regression models were built for each measure, dichotomized as high or low, separately for men and women. Younger age (p < 0.001), being married (p < 0.001), and being a parent (p < 0.004) were associated with women's poor mental health. Marriage and large household size are protective factors for men (p < 0.002 and p < 0.0012, respectively), but marriage may be a risk factor for women (p < 0.001). Overall, women were disproportionately negatively impacted by the pandemic compared to men.


Assuntos
COVID-19 , Masculino , Humanos , Feminino , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias , Filipinas/epidemiologia , Depressão/psicologia , Saúde Mental , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Ansiedade/epidemiologia
15.
East Asian Arch Psychiatry ; 32(4): 67-81, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: covidwho-2203746

RESUMO

OBJECTIVE: This study aims to determine factors associated with hesitation and motivation to work among healthcare workers (HCWs) in Indonesia, Philippines, and Taiwan during the COVID-19 pandemic. METHODS: HCWs aged ≥20 years working in five hospitals in Indonesia, Philippines, and Taiwan were invited to participate in a self-administered mental health survey between 30 January 2021 and 31 August 2021. The 33-item questionnaire measured HCWs' perceived stress, level of motivation and hesitation to work, attitude and confidence regarding work, attitude on the policies by the hospital and government, and discrimination against the occupation. Each item was rated in a 4-point Likert scale from 0 (never) to 3 (always). Sociodemographic and occupational factors were also considered in data analysis. RESULTS: Of 1349 participants, 671 (49.7%) were from Indonesia, 365 (27.1%) from Philippines, and 313 (23.2%) from Taiwan. Overall, 20.8% of participants showed motivation to work and only 4.7% showed hesitation to work. Compared with HCWs in their 20s, HCWs in their 30s, 40s, and 50s had significantly lower hesitation to work (adjusted odds ratio [AOR] = 0.42, 0.33, and 0.11, respectively; p = 0.01, 0.02, and 0.03, respectively). Similarly, compared with HCWs in their 20s, HCWs in their 30, 40s, 50s, 60s, and 70s had significantly higher motivation to work (AOR = 1.71, 2.98, 5.92, 5.40, and 7.15, respectively; p = 0.01, <0.001, <0.001, <0.001, and 0.02, respectively). Clinical staff had lower motivation to work than non-clinical staff (AOR = 0.60, p = 0.01). Those who worked in high-risk areas had lower hesitation to work than those who worked in low-risk areas (AOR = 0.51, p = 0.03). Overall, higher hesitation to work was associated with 'wanting to leave job/study' (AOR = 4.54, p = 0.03) and 'feeling isolated' (AOR = 4.84, p = 0.01), whereas lower hesitation to work was associated with 'being confident about the future of medical practice' (AOR = 0.33, p = 0.02) and 'burden of child care including lack of nursery' (AOR = 0.30, p = 0.04). Higher motivation to work was associated with 'feeling of being protected by hospital' (AOR = 2.23, p = 0.001), 'confident in my country's pandemic prevention policy' (AOR = 2.19, p = 0.001), 'feeling of elevated mood' (AOR = 4.14, p = 0.004), and 'being confident about the future of medical practice' (AOR = 2.56, p < 0.001), whereas lower motivation to work was associated with 'exhausted mentally' (AOR = 0.35, p = 0.03). CONCLUSION: Various stress-related factors contribute to hesitation and motivation to work among HCWs in Indonesia, Philippines, and Taiwan during the COVID-19 pandemic. Proactive and practical strategies should be implemented to protect HCWs from the negative behavioural and emotional effects of the COVID-19 pandemic.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Estudos Transversais , Pandemias/prevenção & controle , Saúde Mental , Indonésia/epidemiologia , Filipinas/epidemiologia , Taiwan/epidemiologia , Pessoal de Saúde/psicologia
16.
PLoS One ; 17(12): e0268145, 2022.
Artigo em Inglês | MEDLINE | ID: covidwho-2154226

RESUMO

The COVID-19 pandemic has caused a public health emergency in all sectors of society, including universities and other academic institutions. This study determined the seroprevalence of SARS-CoV-2 antibodies among administrators, faculty, staff, and students of a private tertiary academic institution in the Philippines over a 7 month period. It employed a serial cross-sectional method using qualitative and quantitative COVID-19 antibody test kits. A total of 1,318 participants were tested, showing 47.80% of the study population yielding IgG antibodies to SARS-CoV-2 virus. A general increase in seroprevalence was observed from June to December 2021, which coincided with the vaccine roll-out of the country. All brands yielded positive antibody formation, with mRNA vaccines having higher levels than other types of vaccines. A decreasing trend in IgG reactivity was found in vaccinated individuals after 1 to 6 months of completion of the 2 doses of the COVID-19 vaccine. Where possible, IgG and T-cell reactivity and/or neutralizing capacity against SAR-CoV-2 need to be monitored regardless of vaccine brand. Together with uptake of COVID-19 vaccines and boosters, other public health interventions such as wearing of masks and regular testing need to be continued for better protection. Effective communication is also needed to inform risks associated with activities across different settings. Investments in long-term measures such as air filtration and ventilation systems, and wastewater surveillance need to be made.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Estudos Transversais , Universidades , Prevalência , SARS-CoV-2 , Estudos Soroepidemiológicos , Filipinas/epidemiologia , Pandemias , Águas Residuárias , COVID-19/epidemiologia , Vigilância Epidemiológica Baseada em Águas Residuárias , Anticorpos Antivirais , Imunoglobulina G
17.
BMC Health Serv Res ; 22(1): 1385, 2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: covidwho-2139276

RESUMO

BACKGROUND: Amidst ongoing calls for increased health systems resilience, gaps remain in our understanding of how health systems can reach further into communities to ensure resilient service delivery. Indeed, public health emergencies caused by infectious hazards reveal both the value and vulnerability of the workforce delivering health services in communities. This study explores ways in which a non-governmental organization (NGO) in the Philippines protected their frontline workforce during the first year of the COVID-19 pandemic. METHODS: Guided by a qualitative descriptive approach, 34 in-depth interviews were conducted with community-based health actors employed by the NGO between June 2020 and February 2021. Data analysis was guided by an iterative deductive and inductive approach. RESULTS: We identified four key activities that enabled the NGO and their staff to provide health and social services in communities in a safe and consistent manner as part of the organization's pandemic response. These include (1) ensuring adequate personal protective equipment (PPE) and hygiene supplies; (2) providing contextualized and role-specific infection prevention and control (IPC) training; (3) ensuring access to testing for all staff; and (4) providing support during quarantine or isolation. CONCLUSION: Learning from the implementation of these activities offers a way forward toward health emergency preparedness and response that is crucially needed for NGOs to safely leverage their workforce during pandemics. Further, we describe how community-based health actors employed by NGOs can contribute to broader health systems resilience in the context of health emergency preparedness and response.


Assuntos
COVID-19 , Mão de Obra em Saúde , Pandemias , Humanos , Serviços de Saúde Comunitária , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Filipinas/epidemiologia , Serviço Social , Saúde Pública , Controle de Infecções , Organizações sem Fins Lucrativos
19.
Ann Surg Oncol ; 29(11): 6729-6730, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: covidwho-2065075

RESUMO

Female breast cancer is the most commonly diagnosed cancer worldwide; however, while high-income countries have the highest incidence rates, lower-middle income countries have the highest mortality rates. In this article, we describe the landscape of disparities in access to surgical care for patients with breast cancer in the Philippines, a lower-middle income country in Southeast Asia. We describe the payment landscape that allows access to care for patients with non-metastatic disease, and draw attention to the fact that despite some degree of insurance for most Filipinos, great barriers to access remain in the form of a low number of surgical providers, geographic disparities, and persistent socioeconomic barriers. Lastly, we suggest steps forward to improve equity in access to surgical care for Filipino patients with breast cancer.


Assuntos
Neoplasias da Mama , Povo Asiático , Neoplasias da Mama/cirurgia , Feminino , Humanos , Renda , Filipinas/epidemiologia
20.
Western Pac Surveill Response J ; 13(3): 1-6, 2022.
Artigo em Inglês | MEDLINE | ID: covidwho-2033359

RESUMO

Problem: Operation of the Philippine Antimicrobial Resistance Surveillance Program (ARSP) has been affected by the coronavirus disease 2019 (COVID-19) pandemic, during which time difficulties in maintaining laboratory functions, staffing levels and participation were reported. Context: The COVID-19 pandemic has increased pressure on most health systems and programmes in the Philippines, including ARSP. As ARSP is the source of national data on antimicrobial resistance (AMR) trends, there are concerns that the negative effects of the pandemic may have impacted the quality of data produced. Action: We describe disruptions to laboratory operations, personnel availability and participation in ARSP surveillance, and their impact on reported data for 2020. Outcome: Surveillance operations were challenged by reallocation of human, infrastructure and financial resources for pandemic response among both the sentinel sites and the coordinating laboratory, the Antimicrobial Resistance Surveillance Reference Laboratory. There was a decrease in the amount of data submitted to the surveillance system, as well as in the number of isolates sent to the reference laboratory for confirmation of bacterial identification and antimicrobial susceptibility testing. Nevertheless, overall performance scores of the sentinel sites for most parameters were comparable to 2019, the year before the pandemic. Discussion: The impact of operational changes to ARSP due to the pandemic needs to be considered when analysing AMR surveillance data from 2020. Automation of data submission, good working relationships between the coordinating laboratory and sentinel sites, and supply chain system strengthening were identified as key to maintaining AMR surveillance during the COVID-19 pandemic.


Assuntos
Antibacterianos , COVID-19 , Humanos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Filipinas/epidemiologia , Pandemias , Farmacorresistência Bacteriana , COVID-19/epidemiologia
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