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PubMed2006

Novel subtypes (subgenotypes) of hepatitis B virus genotypes B and C among chronic liver disease patients in the Philippines.

Several hepatitis B virus (HBV) subtypes (subgenotypes), HBV/Aa (A1 : Asia/Africa), Ae (A2 : Europe), Bj (B1 : Japan) and Ba (B2 : Asia), have been reported with respect to clinical differences between patients infected with these subtypes (subgenotypes). HBV genotype distribution among patients with chronic liver diseases was investigated in the Philippines, where such studies have not been carried out previously. One hundred sera were obtained from such patients, consisting of 32 chronic hepatitis (CH), 37 cirrhosis and 31 hepatocellular carcinoma (HCC) patients. Nine complete genomes and 100 core promoter/precore genes of HBV were sequenced directly. Phylogenetic analyses revealed 51 HBV/A (Aa/A1), 22 HBV/B and 27 HBV/C strains. Interestingly, most HBV/C strains in the Philippines formed a specific cluster distinct from previous HBV/C strains (C1-4), indicating a novel subtype (subgenotype), HBV/C5. Moreover, most HBV/B strains fell within the specific cluster of the HBV/B subtype (subgenotype) B5, with viral characteristics of HBV/Ba (B2) carrying a recombination with HBV/C over the precore and core genes. Of the three genotypes, HBV/B and HBV/C were significantly more prevalent than HBV/A in cirrhosis and HCC patients (P<0.02). The prevalence of the core promoter mutations T1762/A1764 was higher in HCC patients with HBV/B and HBV/C. Multivariate analysis indicated that age [odds ratio (OR) 3.43; 95 % confidence interval (CI) 1.04-11.36; P=0.044] and the core promoter mutation (OR 14.08; 95% CI 3.62-4.74; P<0.001) were significant factors for HCC development. In conclusion, novel HBV subtypes (subgenotypes) C5 and B5 are prevalent in the Philippines, as well as HBV/Aa (A1).

Carcinoma, Hepatocellular↗
PubMed2006

Molecular systematics of the Philippine malaria vector Anopheles flavirostris.

Allozyme and molecular sequence data from the malaria vector Anopheles flavirostris (Ludlow) (Diptera: Culicidae) were analysed from 34 sites throughout the Philippines, including the type locality, to test the hypothesis that this taxon is a single panmictic species. A finer-scaled allozyme study, of mainly Luzon samples, revealed no fixed genetic differences in sympatric sites and only low levels of variation. We obtained data from partial sequences for the internal transcribed spacer 2 (ITS2) (483 bp), the third domain (D3) (330 bp) of the 28S ribosomal DNA subunit and cytochrome c oxidase subunit I (COI) of mitochondrial DNA (261 bp). No sequence variation was observed for ITS2, only a one base pair difference was observed between Philippine and Indonesian D3 sequences and An. flavirostris sequences were unique, confirming their diagnostic value for this taxon. Sixteen COI haplotypes were identified, giving 25 parsimony informative sites. Neighbour-Joining, Maximum Parsimony, Maximum Likelihood and Bayesian phylogenetic analysis of COI sequences for An. flavirostris and outgroup taxa revealed strong branch support for the monophyly of An. flavirostris, thus confirming that Philippine populations of this taxon comprise a single separate species within the Minimus Subgroup of the Funestus Group. Variation in the behaviour of An. flavirostris is likely to be intraspecific rather than interspecific in origin.

Animals↗
PubMed1993

Labor mobility, trade and structural change: the Philippine experience.

"This article addresses three questions: (1) Is the high rate of emigration of labor from the Philippines related to the country's trade policy? (2) Why have migration and accompanying remittances not made much of an impact on the growth and structure of the Philippine economy? (3) Would economic growth and structural change eventually curtail labor emigration? The Philippines' history of labor export and its economic development are contrasted with those of Asian NIEs [newly industrialized economies] which have adopted liberal trade regimes."

Asia↗
PubMed1992

Transcultural care values and nursing practices of Philippine-American nurses.

The purpose of this ethnonursing research was to discover, explicate, and analyze the nursing care values and caregiving practices of Philippine nurses working in an American hospital context. The study, which was part of a larger study, was conceptualized within Leininger's theory of culture care. Consistent with the tenets of the theory, a brief overview of Philippine world view, social structure, culture, and ethnohistory was provided. Qualitative analysis of observation-participation and interview data revealed a major care theme of obligation to care. This care theme was supported by three care patterns which were: 1) expressed seriousness and dedication to work, 2) attentiveness to physical care as comfort, and 3) respect and patience as caring modalities. The study also showed that Philippine-American nurses attempted to achieve cultural care congruence by preserving some generic care values and practices, by accommodating to some of the host professional culture's values and practices, and by restructuring or repatterning less serviceable values. Implications for transcultural nursing education, practice, and research were discussed.

Humans↗
PubMed2006

Good governance for nutrition in the Philippines: elements, experiences, and lessons learned.

Malnutrition is a multifactorial problem that needs a multisectoral solution. This article reviews the role of good governance in nutrition programs, citing the Philippines as an example. In the Philippines, these efforts are reflected in the partnership between the public and private sectors in the establishment of the country's capability in research, policy-making, and program implementation. The establishment of the different public institutions engaged in research and policy-making is discussed, highlighting the role of political will through legislation. The evolving tasks of the nutrition program are discussed by citing the tasks in two eras. In the 1970s, the challenges were limited national nutrition data, man-power, tools, and health infrastructure. The public and private institutions were able to respond by legislating national nutrition surveys and dedicated nutrition workers in each village. The challenges in the current era are improved implementation of health programs, given the devolution of health services, and the gathering of an evidence base to further strengthen and refine the strategies of supplementation, fortification, breastfeeding, and food security. In responding to these challenges, multisectoral solutions and collaboration are critical in providing an evidence base to formulate policy. The role of the private sector, with the Nutrition Center of the Philippines used as an example, is that of a supportive and collaborative partner in good governance. Finally, the lessons learned from the past decades of implementing a national nutrition program, given changes in political and economic circumstances, are summarized.

Developing Countries↗
PubMed2005

Industry experience in promoting weekly iron-folic acid supplementation in the Philippines.

After participating in a pilot project under a government-industry partnership to promote the adoption of weekly iron-folic acid supplementation among women of reproductive age in the Philippines in 1998, United Laboratories (UNILAB), the Philippines' largest private pharmaceutical company, decided in April 2002 to launch a weekly iron-folic acid supplement for pregnant and non-pregnant women under the brand name Femina. The business objective set for the Femina brand was to build the category of preventive iron-folic acid supplements in line with the Philippine Department of Health's advocacy on weekly supplementation as an alternate to daily dosing to reduce the prevalence of anemia in the country. The brand was supported with an integrated mix of traditional advertising media with complementary direct-to-consumer educational programs that aimed to create awareness of iron-deficiency anemia, its causes and effects, and the role of weekly intake of iron-folic acid in preventing the condition. Aggressive marketing support for 1 year was successful in creating awareness among the target women. Significant lessons derived from consumers identified opportunity areas that can be further addressed in developing advocacy programs on weekly iron supplementation implemented on a nationwide scale in the future.

Adolescent↗
PubMed2006

No-take marine reserves and reef fisheries management in the Philippines: a new people power revolution.

The marine-conservation and reef fisheries-management program that exists today in the Philippines had humble beginnings in the 1970s at Sumilon and Apo islands. These islands have produced some of the best evidence available that no-take reserves, protected and managed by local communities, can play a key role in biodiversity conservation and fisheries management. Perhaps more importantly, they served as models for an extraordinary expansion of no-take reserves nationally in the Philippines in the past 2 decades. This expansion contributed substantially to a major shift in national policy of management of marine resources. This policy shift partially devolved responsibility from a centralized government bureaucracy to local governments and local communities. Local governments now comanage, along with the national government, marine resources out to 15 km from the coast. Giving some responsibility for management of marine resources to coastal people dependent upon those resources represents, in a very real sense, another "people power revolution" in the Philippines.

Animals↗
PubMed2000

Ribosomal DNA sequence markers differentiate two species of the Anopheles maculatus (Diptera: Culicidae) complex in the Philippines.

The Anopheles maculatus Theobald complex includes important vectors of malaria. Based on chromosomal and morphological evidence, two species in this complex occur in the Philippines. Because separation of these species, An. dispar Rattanarithikul & Harbach and An. greeni Rattanarithikul & Harbach, is problematic due to the difficulty or unreliability of the identification methods currently available, we sought a molecular technique for identifying these two species. We sequenced two regions of nuclear ribosomal DNA; the second internal transcribed spacer (ITS2) and the third domain (D3) of the 28S gene, from An. maculatus sensu lato (s.l.) collected throughout the Philippines. Two sequence groups were identified that corresponded morphologically to An. dispar and An. greeni. Four percent of the 318-320 bp ITS2 and 2.5% of the 367 bp D3 differed between the two species. No evidence of intraspecific variation in sequences was found. From the sequence data, we developed a more reliable and easier method for identifying An. dispar and An. greeni, based on a HaeII restriction fragment-length polymorphism in a polymerase chain reaction amplified fragment of ITS2. This method will facilitate future vector studies, which will be necessary, as previous data collected on An. maculatus s.l. in the Philippines is unreliable given the multispecies nature of this taxon.

Animals↗
PubMed2001

Cost-benefit analysis of a Haemophilus influenzae type b meningitis prevention programme in The Philippines.

BACKGROUND: Haemophilus influenzae type b (Hib) meningitis is associated with high mortality and serious sequelae in children under 5 years of age. Vaccines which can prevent this infection are available. OBJECTIVE: To evaluate the costs and benefits of a 3-dose immunisation schedule in Manila, Philippines. PERSPECTIVE: Government and societal perspectives. DESIGN AND PARTICIPANTS: A cost-benefit analysis based on a birth cohort of 100,000 children. The state of health of the cohort with and without a Hib immunisation programme was modelled over a 5-year period. A survey of medical records of patients with Hib in Manila provided data on the extent and cost of sequelae following infection. INTERVENTION: A 3-dose Hib vaccination programme given at ages 2, 3 and 4 months. RESULTS: The model predicted that vaccinating children against Hib meningitis would prevent 553 cases per year in a birth cohort of 100,000, at a cost of 56,200 Philippine pesos (PHP) [$US1,605; 1998 exchange rate] per case (base case assumptions of 90% vaccine efficacy rate, 95 per 100,000 Hib incidence rate, 85% vaccination coverage). Results from the cost-benefit analyses indicated that the saving to the government would be around PHP39 million ($US1.11 million), and the saving to society would be PHP255 million ($US7.28 million). CONCLUSION: There would be a positive economic benefit for the Philippine government and for the Filipino society if a Hib vaccination programme was introduced in Manila.

Algorithms↗
PubMed1994

Dietary sources and background levels of hippuric acid in urine: comparison of Philippine and Japanese levels.

Levels of sodium benzoate in processed food from the Philippines and Japan were analyzed by high performance liquid chromatography. Results showed that of the 44 samples from the Philippines, 31 (70%) contained the compound. The samples with sodium benzoate included 19 juice, 6 softdrink and 6 soy sauce varieties. As for the Japanese products, only 8 (26%) out of 31 food items tested positive for sodium benzoate. The values of the compound in the Philippine samples ranged from 20 micrograms/ml to more than 2,000 micrograms/ml; the Japanese products showed a range of 50 to 200 micrograms/ml. Background urinary hippuric acid levels in 43 male Filipinos and 34 male Japanese with no occupational exposure to toluene were also measured using a high performance liquid chromatograph. Hippuric acid levels expressed as geometric means (SD) were 0.11 g/g creatinine (0.41) for the Filipino subjects and 0.09 g/g creatinine (0.39) for the Japanese subjects. No statistically significant difference in hippuric acid values in the 2 groups was noted. Possible explanations for the lack of any difference in background urinary hippuric acid levels between Filipino and Japanese subjects were discussed.

Benzoates↗
PubMed1992

Prevalence of IgM antibodies to phenolic glycolipid I among household contacts and controls in Korea and the Philippines.

Phenolic glycolipid I (PGL-I) is a Mycobacterium leprae-specific antigen and the antibodies to the antigen may suggest an M. leprae infection. To compare the M. leprae transmission among the populations, we compared the prevalence of anti-PGL-I IgM antibodies among household contacts and controls between Korea and the Philippines. In Korea (prevalence of leprosy--0.04: 1000), the prevalence of anti-PGL-I antibodies were 4.8% among controls and 8.0% among contacts, respectively. On the other hand, the seroprevalence rate was 10.8% among controls and 13.4% among contacts in the Philippines (prevalence of leprosy--0.70: 1000). Interestingly, a marked difference was noted in the prevalance of anti-PGL-I antibodies among children between the countries; 10-14% among children under 10 years old and 15-18% among those aged between 10 and 19 in the Philippines compared to 0% and 2.9-6.4% in Korea, respectively. This study, therefore suggests that a high prevalance of anti-PGL-I IgM antibodies among children may indicate an active transmission of M. leprae, resulting in a higher incidence of leprosy in the population.

Adolescent↗
PubMed1976

The biology of Schistosoma japonicum, Philippine strain: a review.

Some important and adequately studied aspects of the biology of Schistosoma japonicum in the Philippines were reviewed and presented. The identity of the species of human blood fluke in the Philippines was established by Tubangui who also was the first to complete the life cycle of the parasite in his laboratory. Successful cross-infections of different strains of S. Japonicum from different mammalian hosts including man suggest that there is only one common strain for all of the definitive hosts in the Philippines. Studies on egg-laying habits, factors affecting hatching of eggs, eruption of cercariae from snails, cercarial survival and undocumented obervations are considered in this review.

Animals↗
PubMed2001

Nutritional issues and status of older persons of the Philippines: the IUNS, CRONOS and other studies.

The growing proportion of older persons in the Philippine population, with their potential contribution to development efforts as well as special needs for health and social services, presents an emerging demographic concern. The Philippines participated in the IUNS multicenter cross-cultural study of "Food Habits in Later Life" among urban elderly in three different care settings - elderly who lived with their families, those housed in government-operated homes for the aged, and older persons in private institutions. A second study employed the CRONOS protocol to differentiate nutritional and non-nutritional factors that affect the health and nutritional status of the Filipino elderly in urban and rural settings. Findings from the two studies revealed deficiencies in energy and protein intake among older persons. Those cared for by government social workers and care-givers had lowest protein-energy intakes and the highest proportion of underweight. Food habits of the urban elderly, particularly in terms of meal pattern, and use of table salt, sugar and fats were reported in the IUNS study. There was general perception of tiredness and limited social activity, network and support, but over-all self-rating of the elderly's health was good. The CRONOS study found significant association between later life status indicators, as well as between BMI and illness and physical activity scores. The paper included data from the 1993 National Nutrition Survey describing the nutritional situation of the elderly on a national scale: 30% of Filipino adults aged 60 y and over had a BMI <18.5 kg/m2 indicating chronic energy deficiency, 11% were obese with BMI >or=25 kg/m2, 41% were hypertensive and 45% anemic. Caring patterns were reflected in a 1984 four-country ASEAN study on the elderly which included the Philippines. While favorable, as the Filipino elderly generally lived in households where there was at least one adult female, the presence of other household members who likely competed for the time of the carer diminished the quality and adequacy of care for the persons. Further data is needed to update this information. The paper also discussed methodological and programmatic issues regarding improvement of the nutritional assessment of, and nutritional intervention programmes for the elderly.

Aged↗
PubMed2003

Cost-benefit analysis of newborn screening for galactosemia in the Philippines.

To determine the incidence of galactosemia (GAL) in the Philippines and to determine whether newborn screening for GAL is cost-beneficial from a societal perspective, cost-benefit analysis was performed. Newborn screening for GAL was done after the 24th hour of life using the Beutler test. Patients screened positive were recalled for confirmatory testing. Using incidence rates obtained from the different participating hospitals of the Philippine Newborn Screening Program (PNSP), the costs for the detection and treatment of GAL were compared to the expected benefits by preventing mental retardation, cataracts and other physical disabilities caused by the disorder that would lead to a loss of productivity for the individual. Sensitivity analyses for incidence and discount rates were also included. Of the 157,186 newborns screened by the PNSP since its inception in 1996, 8 screened positive results. Confirmatory testing of these patients showed that 2 had galactosemia. The incidence of galactosemia in this population therefore, is 1 in 106,006 (95% CI= 1:44,218 - 1:266,796). Projecting the figures to the actual birth rate (1.5M newborns/year), the total costs of the screening program amounted to $1.1M, while the total benefits amounted only to $0.2M, yielding net cost of $0.9M. A cost-benefit analysis of the screening program for galactosemia using the incidence 1 in 106,006 demonstrated that the costs of the program outweigh the benefits. The true incidence of galactosemia in the Philippine population may yield an incidence rate that will result in greater net benefits for the program.

Cost-Benefit Analysis↗
PubMed2003

Birth defects ascertainment in the Philippines.

In the Philippines, congenital anomalies rank among the top 20 causes of death across the life span and are already the third leading cause of death in the infancy period (Philippine Department of Health, 1996). Despite the magnitude of the problem, no formal systematic registration of birth defects has been done in the country up until 1999. Various attempts have been made by different study groups to gather data but there was never a formal effort to consolidate the information and establish a centralized registry. Data from various modes of ascertainment are hereby presented: 1) Philippine Birth Defects Registry Project, 2) Hospital In-Patient and Out-Patient Registries, 3) Prenatal Inventory and Neonatal Outcome Study Group, 4) Hospital Pathology Reports, and 5) Community Outreach Programs. Birth Defects Registry Project had the largest reporting of the different methods presented here. The most common birth defects were multiple congenital anomalies, congenital malformations of the tongue, mouth, and pharynx (ankyloglossia), cleft palate with cleft lip, Down Syndrome, congenital deformities of the feet (talipes equinovarus), anencephaly, other congenital malformations of the face and neck, congenital malformations of the musculoskeletal system (diaphragmatic hernia, gastroschisis), hypospadias, congenital hydrocephalus, polydactyly, syndactyly, and cleft lip.

Congenital Abnormalities↗
PubMed2005

Socioeconomic differentials in supplementation of vitamin A: evidence from the Philippines.

The efficacy of supplementation of vitamin A in child survival has been well-demonstrated. However, the effectiveness of a programme of vitamin A supplementation at the population level has been rarely examined. Understanding how programmes reach disadvantaged children can help improve the design of initiatives of vitamin A supplementation. The differentials in receipt of vitamin A by socioeconomic status were assessed using data from the Philippines. Factors associated with receipt of vitamin A during the last six months were examined using the Philippines Demographic and Health Surveys conducted in 1993 and 1998. In total, 6,970 and 6,118 children aged 12-59 months were included in 1993 and 1998 respectively. Logistic regression was used for identifying associations between the outcome and the household socioeconomic variables. The coverage of national-level vitamin A supplementation increased from 27% in 1993 to 79% in 1998. However, children whose mothers did not complete primary education and children living in poor households were less likely to receive supplementation. This disparity increased between the surveys: the adjusted odds of vitamin A intake by poor households compared to middle-class households declined from 0.73 [95% confidence interval (CI) 0.61-0.87) in 1993 to 0.52 (95% CI 0.42-0.63)] in 1998, resulting in an increased health inequity. The vitamin A programme in the Philippines was not uniformly successful in reaching the most vulnerable children. Approaches targeting vulnerable households or approaches not requiring mothers to travel to distribution centres may be more promising.

Child, Preschool↗
PubMed2006

Chemotherapy regimens used in the treatment of gestational trophoblastic neoplasia at Philippine General Hospital: treatment outcomes and toxicity.

OBJECTIVE: To describe different chemotherapy regimens used in the treatment of gestational trophoblastic neoplasia (GTN). METHODS: A retrospective study of GTN cases from January 1999 to December It is important 2004 at Philippine General CONCLUSION: In the Philippine General Hospital, methotrexate is first-line patients single-agent chemotherapy ntitfy those who are rh risk to be able methotrexate, ACT, cyclo-Hospital was done. Patients correctly and idc with nonmetastatic and met- truly low risk vs. phosphamide and vincristine regimen are the first line for high-risk metastatic GTN. Present regimens are effective but predispose patients to a variety of toxicities. Patients' acceptance and tolerance of adverse effects and ability to secure drug resources are factors contributing to the success of the treatment. astatic low-risk disease were managed by single-agent chemotherapy. Those with high-risk disease were given multiple-agent chemotherapy. RESULTS: Forty-five percent of patients (87/193) manifested adverse reactions to chemotherapy. Adverse effects include anemia in 51.7% (45/87), leukopenia in 16% (14/87), neutropenia in 72.4% (63/87) and elevated liver enzymes in 21.8% (19/87). Symptoms included vomiting in 9.1% (8/87) of cases, diarrhea in 6.8% (6/87), stomatitis in 24.14% (21/87) and febrile neutropenia in 19.5% (17/87). There was a significant difference between the 3 groups of regimens in terms of anemia (p = 0.002), leukopenia (p = 0.011), neutropenia (p < 0.001) and stomatitis (p < 0.001). Patients treated with etoposide, methotrexate, actinomycin (ACT), cyclophosphamide and vincristine and with etoposide, methotrexate, ACT, taxanes and cisplatin experienced most of the toxicity. CONCLUSION: In the Philippine General Hospital, methotrexate is first-line single-agent chemotherapy for low-risk GTN. Etoposide, methotrexate, ACT, cyclophosphamide and vincristine regimen are the first line for high-risk metastatic GTN. Present regimens are effective but predispose patients to a variety of toxicities. Patients' acceptance and tolerance of adverse effects and ability to secure drug resources are factors contributing to the success of the treatment.

Adolescent↗
PubMed1991

Food-borne parasitic zoonoses in the Philippines.

A number of food-borne parasitic zoonoses have been recorded in the Philippines and include echinostomiasis, artyfechinostomosis, fascioliasis, heterophydiasis, carneophallosis, clonorchiasis, paragonimiasis, taeniasis, echinococcosis/hydatidosis, diphyllobothriosis/spirometrosis and sparganosis, intestinal capillariasis, gnathostomiasis, angiostrongylosis, toxoplasmosis and sarcosporidiosis. Some are now rarely observed while others continue to be public health problems. Many are endemic in certain areas of the Philippines because of the habit of consuming raw or partly cooked fish, snails, crustaceans, and meat. Artyfechinostomosis caused by Artyfechinostomum malayanum is a recently recognized problem in the Philippines and is reported in man and pigs. Human infection results from ingesting raw or partly cooked the freshwater snail, Bullastra cumingiana which serves as second intermediate host. More information on the epidemiology, transmission including the animal hosts involved locally are still needed for some of these problems. Human infection with many of these diseases can be prevented by changing the food habits, but this requires aggressive health education campaigns.

Animals↗