Knowledge, attitudes, and practices related to dengue among public school teachers in a Central Luzon Province in the Philippines: an analytic cross-sectional study.

BACKGROUND: Dengue has become a major health issue in tropical regions as the numbers of reported cases and estimated infections continuously increase. In the Philippines, many challenges remain in preventing and controlling the disease amidst all the mitigation efforts of the government. This study sought to measure the health literacy of Filipino teachers and determine the associations among teachers' knowledge, attitudes, and selected practices (KAP) against dengue. METHODS: Elementary and secondary school teachers from the consistently declared dengue hotspots in the City of San Fernando, Pampanga, Philippines, from the years 2017 to 2019 were selected as target participants in this cross-sectional study. A self-administered online survey tool was used in this study for both screening of participants and the KAP survey proper. STATA, descriptive statistics, and multiple logistic regression were used for the data analysis. Odds Ratios (ORs) and 95% confidence intervals (CIs) were reported. RESULTS: The study comprised 604 participants whose mean age was 38.4 years. Television was determined as the top media source of information, and various health staff were the most trusted and common source of information. Good knowledge on dengue treatment (OR = 1.81; 95% CI 1.18-2.78) and dengue prevention (OR = 1.85; 95% CI 1.26-2.71) were positively associated with having good practices on protection against mosquito bites. Good knowledge on dengue signs and symptoms (OR = 1.56; 95% CI 1.02-2.37) and dengue prevention (OR = 2.38; 95% CI 1.59-3.58) were positively associated with having good practices on preventing breeding sites. Those with positive perceived susceptibility to dengue had lower odds of having good practices on protection against mosquito bites (OR = 0.64; 95% CI 0.41-0.99) and of having good practices on preventing breeding sites (OR = 0.46; 95% CI 0.26-0.81). CONCLUSION: Even with the existing dengue policies, programs, and strategies, and the high disease literacy rate of Filipinos, dengue remains a struggle with an increasing case rate. Therefore, specific concepts should be emphasized, and interventions should be fine-tuned to better reach and influence the target population to attain a dengue-free Philippines.

Intimate Partner Violence and Sexual Agency in a Nationally Representative Sample of Women and Girls in the Philippines.

This study examined the prevalence of intimate partner violence (Intimate Partner Violence) and its associations with sexual agency among women and adolescent girls in the Philippines. Data came from the 2017 Philippines National Demographic and Health Survey (DHS), a nationally representative, cross-sectional survey of women and girls ages 15-49. Participants included 11,727 women and girls who reported having a current male partner. Survey measures included three indicators of Intimate Partner Violence (physical, sexual, emotional), ability to refuse sex, ability to insist on condom use, perception that a husband/boyfriend can be justified in hitting or beating his wife/girlfriend, and sociodemographic characteristics. Descriptive and multivariable statistical analyses were conducted, with survey weightings used to account for the complex survey design. Overall, 23.9% reported Intimate Partner Violence in their current partnership (10.1% physical violence, 3.4% sexual violence, 19.0% emotional violence), 11.2% believed a husband or partner could be justified in hitting or beating their wife, 10.5% reported being unable to refuse sex with their partner, and 20.4% were unable to ask their partner to use a condom. In multivariable analyses, experiences of sexual (OR .68; 95% CI .50, .92), physical (OR .83; 95% CI .68, 1.02), and emotional violence (OR .69; 95% CI .58, .81) were associated with lower adjusted odds of being able to ask a partner to use a condom. When placed in the same model, emotional violence had the strongest association with lower odds of negotiating condom use with partner (OR .70; 95% CI .57, .85). Perception that a husband/boyfriend can be justified in hitting or beating his wife/girlfriend was associated with lower ability to refuse sex and ask a partner to use a condom. Findings indicate a need for further investment in interventions to prevent Intimate Partner Violence and support the sexual health and agency of women and girls who have experienced Intimate Partner Violence in the Philippines.

Responsive Medical Providers and Recent HIV Medical Services Engagement Among Transgender Women and Cisgender Men Who Have Sex With Men in the Philippines.

Transgender women and cisgender men who have sex with men (trans-WSM and cis-MSM) comprise the majority of new HIV infections in the Philippines. There is limited research in the Philippines on the relationship between having a provider responsive to the needs of these populations and recent engagement in HIV medical services such as HIV testing and treatment. We used multivariate logistic regression to examine the relationship between having a responsive medical provider and engagement in HIV medical services in the past 12 months among an online sample of 318 trans-WSM and cis-MSM in the Philippines. Participants without a responsive medical provider had lower adjusted odds of recent HIV medical service engagement than those who did (aOR = 0.32, 95% CI [0.16, 0.62], p = .00). In stratified analyses, this relationship was significant for trans-WSM but not cis-MSM. Increasing access to responsive providers in the Philippines could bolster recent engagement with HIV medical services.

Transgender-specific developmental milestones and associated experiences of violence, discrimination, and stigma among Filipinx transgender women who are sexually active with men.

BACKGROUND: For transgender people, reaching transgender (trans)-specific developmental milestones, including recognizing and expressing one's identity, plays an integral role in overall health, wellbeing, and the pursuit of gender affirmation. Yet trans people continue to face minority stressors, including structural violence (i.e., discrimination, violence, and stigma), which may interfere with the achievement of these milestones. Among trans women specifically, however, potential associations between gender developmental milestones and structural violence are not well characterized in the literature. In a sample of Filipinx (i.e., an inclusive term for describing non-binary genders in the Philippines) trans women who are sexually active with men (trans-WSM), we thus sought to: (a) describe the mean ages at which gender developmental milestones occur and (b) examine the associations between structural violence and mean ages at which at which Filipinx trans-WSM experience trans-specific developmental milestones. METHODS: Using data from Project #ParaSaAtin, an online survey of Filipinx trans-WSM (n = 139), we mapped age-estimates per trans-specific milestones and then tested whether structural violence is associated with the mean age at which trans women experience trans-specific developmental milestones. RESULTS: Overall, participants who reported higher levels of discrimination, stigma, and violence also experienced a later age for nearly each milestone (i.e., initial self-awareness of transfeminine identity, transfeminine expression in private, transfeminine expression in public, first consensual oral/vaginal/anal sex with a cisgender male partner, first consensual oral/vaginal/anal sex with a cisgender male partner as a trans women, and hormone integration) (all p-values <0.05). Of note, the single exception to this pattern was the non-significant association between stigma and initial disclosure of transfeminine identification to another person. CONCLUSION: Results are consistent with psychological literature outlining a temporal sequence of developmental milestones among young trans-WSM. For young trans-WSM in the Philippines, data from this study demonstrate significant associations between structural violence and the achievement of developmental milestones. These findings highlight the need for trauma-informed, strengths-based programming and institutional policies that measure and mitigate anti-trans violence.

Detecting Local Clusters of Under-5 Malnutrition in the Province of Marinduque, Philippines Using Spatial Scan Statistic.

Underweight and overweight among under-5 children continue to persist in the island Province of Marinduque, Philippines. Local spatial cluster detection provides a spatial perspective in understanding this phenomenon, specifically in which areas the double burden of malnutrition occurs. Using data from a province-wide census conducted in 2014-2016, we aimed to identify spatial clusters of different forms of malnutrition in the province and determine its relative risk. Weight-for-age z score was used to categorize the malnourished children into severely underweight, moderately underweight, and overweight. We used the multinomial model of Kulldorff's elliptical spatial scan statistic, adjusting for age and socioeconomic status. Four significant clusters across municipalities of Boac, Buenavista, Gasan, and Torrijos were found to have high risk of overweight and underweight simultaneously, indicating existence of double burden of malnutrition within these communities. These clusters should be targeted with tailored plans to respond to malnutrition, at the same time maximizing the resources and benefits.

Association between leptospirosis-related knowledge and practices of male pedicab drivers in Manila

OBJECTIVE: The study aimed to determine whether or not an association exists between leptospirosis-related knowledge and the practices of pedicab drivers in Manila. METHODS: An analytic, cross-sectional study was done among 174 male pedicab drivers. Face-to-face interviews were conducted using an interview schedule containing 12 questions covering knowledge of transmission and prevention, and 8 questions covering preventive occupation-related practices against leptospirosis. Logistic regression was employed to examine association while controlling for the confounding effects of other variables. RESULTS: Forty-nine percent were found to have good knowledge on the transmission and prevention of leptospirosis while 21% had satisfactory preventive and health-seeking practice. After controlling for the confounding effect of pedicab ownership, the odds of having unsatisfactory practices among those with low knowledge were found to be 13 times higher than those with good knowledge. Education was found to be an effect measure modifier. CONCLUSION: The results suggest that a low level of education combined with poor leptospirosis-related knowledge has a magnified effect on practices. Increasing the knowledge of pedicab drivers especially those with a low level of education is necessary to improve their practices. Information dissemination on leptospirosis should be further intensified. Collaboration between health workers and organizations of pedicab drivers can be done to organize health information seminars.

Cadmium concentration in brown and polished rice from selected farms in Barangay Real, Calamba City and its potential non-cancer health risk in adult population

OBJECTIVES: This study was conducted to determine the cadmium (Cd) concentration in brown and polished rice collected from the 9 farms in Barangay Real, Calamba City. This study also assessed the non-cancer health risk to adults (?20 years old) of long-term consumption of rice with Cd using the non-cancer hazard quotient (NHQ). METHODS: Rice grains with hull were collected in November-December 2013. Both rice types were analyzed for Cd using a graphite furnace atomic absorption spectrophotometer (GFAAS). The NHQ was calculated by dividing the estimated daily intake of Cd via rice consumption by the oral reference dose (RfD) for Cd.RESULTS: Mean Cd concentrations in brown and polished rice collected from the 9 farms in Barangay Real ranged from 0.0062 to 0.0725 mg/kg and 0.0047 to 0.0778 mg/kg, respectively. The NHQ values of Cd in both rice types were less than 1.0 for adults (?20 years old). CONCLUSION: Cd concentrations in brown and polished rice from the 9 farms did not exceed the 0.4 mg/kg maximum allowable Cd concentration in rice set by FAO/WHO. Since the NHQ did not exceed 1.0, long-term exposure to Cd through consumption of brown and polished rice from these farms is unlikely to cause non-cancer health effects in adults (?20 years old). It is unlikely for adults to develop kidney diseases such as tubular proteinuria, decreased glomerular filtration rates, and itai-itai disease.