OBJECTIVE

To describe in detail the research agenda-setting process of the Department of Health National Specialty Center for Eye Care with the guidance of the National Institute of Health (NIH) - Department of Clinical Epidemiology.

METHODS

A research agenda technical working group (TWG) was organized to spearhead the research agenda setting, in collaboration and guidance of the NIH. After identifying relevant internal and external stakeholders, the TWG drafted a contextual map that served as an overarching framework. Research topics were obtained from the stakeholders and the TWG collated, reviewed and summarized prior to ranking them systematically. Each topic was prioritized through a weighted ranking system evaluating its feasibility, public health benefit, and resource/cost requirements. A final en banc session including the stakeholders was held to formalize the approval of the research agenda. An infographic was developed to serve as a visual guide for consultants and trainees in initiating research.

RESULTS

The TWG tallied 85 unique research topics from both the internal and external stakeholders. These topics encompassed a broad range of areas, including epidemiology, surgical, and medical management, health systems research, economic evaluations of interventions, and occupational/environmental factors.

CONCLUSION

The 2024-2027 research agenda of the Department of Health National Specialty Center for Eye Care was crafted, with the guidance of the NIH Department of Clinical Epidemiology. The goal was to improve the center's research output by aligning it with stakeholders thereby serving as a research benchmarking tool for the local ophthalmology community

Human ; Epidemiology ; Eye ; Health ; Research

Introduction: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy, with an incidence of 1–2 cases per million annually. Its occurrence during pregnancy is exceptionally uncommon, presenting significant diagnostic and management challenges due to overlapping physiological changes and concerns for both maternal and fetal outcomes. While most cases are hormonally functional, non-functioning ACC during pregnancy is particularly rare and may result in delayed diagnosis. Case: A 35-year-old Malay female was referred following ultrasonography for persistent back and left flank pain, which revealed a left adrenal incidentaloma and a concurrent 10-week intrauterine pregnancy. There were no clinical signs of hormone excess. Physical examination revealed a normotensive patient with a large, palpable left abdominal mass, without Cushingoid or virilizing features. Magnetic resonance imaging (MRI) demonstrated a 12.1 × 10.3 × 12.8 cm heterogeneous left adrenal mass with cystic and necrotic components, displacing adjacent structures. Hormonal evaluation was within normal limits: 24-hour urinary cortisol 320.2 nmol/24 hours (reference range [RR] 11.8–350), midnight salivary cortisol <3 and 4.2 nmol/L (RR <11.3), plasma metanephrine <0.2 nmol/L (RR <0.5), normetanephrine 0.6 nmol/L (RR <0.9), and 17-hydroxyprogesterone 223 ng/dL (RR <285), consistent with a non-functioning tumor. Following multidisciplinary consultation, the patient underwent open left adrenalectomy at 16 weeks’ gestation. Histopathological analysis confirmed ACC (Weiss score 8/9) without extra-adrenal extension. Surveillance MRI at 32 weeks demonstrated no recurrence or residual mass. At 40 weeks’ gestation, she delivered a healthy infant, and both mother and child remain well on follow-up. Conclusion Non-functioning ACC during pregnancy is rare and poses significant diagnostic challenges. Early imaging, comprehensive hormonal assessment, and timely surgical intervention during the second trimester are essential. Multidisciplinary management is crucial to optimizing maternal and fetal outcomes.
Female ; Pregnancy ; Heart Rate ; Neoplasms

BACKGROUND

Undernutrition remains a public health concern in the Philippines despite multitude of government efforts using different nutrition specific and sensitive interventions. Hence, the role civil society organizations play is important in augmenting the health and nutrition programs in the country. Community feedback is important as they are the receiving end of these programs.

OBJECTIVE

The study aimed to know the perceived impact and community insights on the implemented health and nutrition programs in the four selected sites in the Philippines.

METHODS

Qualitative program evaluation was used, and 50 discussants were recruited through purposive sampling. Semi-structured interview guide for focus group discussion was utilized to determine the perceived impact of the programs among the discussants, and thematic analysis was used to generate codes and themes.

RESULTS

The implemented health and nutrition programs were found to be a source of hope for the family and community and beyond basic necessities. However, there remain barriers in successful acquisition of new information such as a lack of resources and environmental influences. There are also learned opportunities such as continued support from the Civil Society Organization (CSO), and impact capacity building that are not sponsor-driven.

CONCLUSION

Overall, the participants see the health and nutrition programs as helpful for their children as these programs foster proper child rearing. The programs also empower the parents and the community through capacity building. However, there is a need to revisit implementing rules and guidelines to further maximize the benefits and resources of the programs.

Program Evaluation ; Public Health ; Play And Playthings ; Residence Characteristics ; Evaluation Studies As Topic ; Malnutrition ; Nutritional Status

INTRODUCTION

Hypertension is a serious public health issue that puts individuals at risk for various morbidity and mortality indicators. One of the most crucial factors in managing blood pressure and preventing complications is medication adherence which is linked to several determinants. This study explored the correlation between medication adherence among middle-aged hypertensive adults and the different domains of quality of life (QOL), which includes physical, psychological, social relationship and environment.

METHODS

This cross-sectional study involved 96 Filipino residents of Brgy. San Jose, Navotas City aged 35 to 65 years old diagnosed with hypertension and prescribed anti-hypertensive medications. Pearson’s correlation coefficient was used to calculate the correlation between different domains of QOL as well as the overall QOL score.

RESULTS

Results revealed a statistically significant but weak positive correlation between overall QOL and medication adherence (r = 0.336, p<0.001). Among the QOL domains, environmental domain had the strongest correlation with adherence (r = 0.446, p = 0.00), followed by physical health (r = 0.443, p = 0.01) and psychological well-being (r = 0.382, p = 0.01). The social relationship domain showed negligible correlation (r = 0.163, p = 0.4).

CONCLUSION

The study demonstrates that while medication adherence is modestly associated with better perceived QOL, especially in physical, psychological and environmental aspects, other factors likely influence both outcomes. These findings highlight the need for holistic, community-based interventions that address not only medication adherence but also environmental and psychosocial barriers to care in managing hypertension.

Human ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Quality Of Life ; Public Health ; Medication Adherence ; Antihypertensive Agents ; Blood Pressure ; Interpersonal Relations

INRODUCTION

The growing misuse of antibiotics and the escalating threat of antibiotic resistance in the Philippines pose significant public health concerns. While various Knowledge, Attitudes and Practices (KAP) questionnaires on personal antibiotic use have been employed in local studies, none have been fully validated and a standardized, culturally appropriate tool remains lacking.

OBJECTIVE

This study aims to develop a Filipino-translated and culturally adapted KAP questionnaire on personal antibiotic use (KAPQ-PAU-FIL) and evaluate its validity and reliability.

METHODOLOGY

The research consisted of two phases. The first phase is the translation and cross-cultural adaptation of the original questionnaire in collaboration with the UST Sentro sa Salin at Araling Salin. The second phase is the validity and reliability testing of the KAPQ-PAU-FIL using a sample of 176 Filipino adults. This included assessment of its face validity, content validity, construct validity, internal consistency, test-retest reliability and equivalent forms reliability.

RESULTS

Most items were translated without difficulty, though four items were modified to better fit the linguistic and cultural context. The KAPQ-PAU-FIL demonstrates strong psychometric properties, with face validity (SFVI/Ave = 0.99), content validity (SCVI/Ave = 0.99), construct validity (CFI = 0.92, RMSEA = 0.06, SRMR = 0.04; FL = 0.60-0.85; ITC = 0.58-0.71), test-retest reliability (ICC = 0.83), internal consistency (α = 0.929) and equivalent forms reliability (p>0.05; κ = 0.62-0.74).

CONCLUSION

The KAPQ-PAU-FIL is the first ever, Filipino-translated, culturally adapted questionnaire designed to assess KAPQ-PAU-FIL, demonstrating strong validity and reliability to support public health programs against antibiotic misuse.

Surveys And Questionnaires ; Public Health ; Knowledge ; Anti-bacterial Agents ; Philippines ; Program

OBJECTIVES

In Asia, younger individuals (below age 45) are diagnosed to have type 2 diabetes with increased rates of obesity defined by lower BMI yet with greater visceral adiposity (waist circumference and waisthip ratios). The prevalence data on type 1 diabetes is not well established, considered to be low, but is seen to be increasing as well. This changing phenotype therefore, presents a clinical dilemma in terms of correctly classifying diabetes and deciding on the consequent appropriate treatment. Distinguishing type 1 from type 2 diabetes has become more difficult with type 2 diabetes dramatically increasing in young adults and children. This study aims to define the characteristics of diabetes among young adults in the Philippines to provide a basis for appropriate management amidst changes in diabetes phenotypes seen globally.

METHODS

In this cross-sectional analytic study, we characterized the demographic, metabolic, and autoimmune features of diabetes among young adult Filipinos aged 18 to 45 years old consulting at a tertiary referral center in Manila, Philippines. Baseline serum A1c, FBS, 75-g oral glucose tolerance test, insulin, serum C-peptide, insulin autoantibodies, leptin, adiponectin, lipid profile, and thyroid function tests were obtained from the participants and analyzed. The homeostasis model assessment (HOMA) was used to estimate the insulin sensitivity.

RESULTS

A total of 348 patients with diabetes were included, with females comprising two-thirds of the participants. The mean age at diagnosis of diabetes was 35.9±7.22 years. The mean BMI was 28.12 kg/m2, with median waist to hip ratio (WHR) of 0·93. Metabolic syndrome was found in 60% of participants and 67.82% were obese by body mass index. The mean A1c was 9.07±2.52%. Good glucose control (A1c less than 7.0%) was seen in 23% of participants  while nearly half (48%) had HbA1c which was >9.0%. The median levels of fasting insulin and C-peptide were 12.62 (range 1.33–90.42) mIU/L and 0.78 ng/mL (range 0–16.2), respectively. 

Included participants were diagnosed with diabetes within a year and as such, majority did not have any micro- or macrovascular complications. The most common diabetes complication was sensory neuropathy detected by monofilament testing, which was found in 28% of participants, followed by non-proliferative diabetic retinopathy in 13%. A history of previous diabetic ketoacidosis was found in 10 patients (2.87%). Glutamic acid decarboxylase (GAD) and insulin auto-antibodies were found in 3.2% and 19.3% of participants, respectively. Approximately half (51.73%) of the participants were insulin resistant by HOMA-IR.

CONCLUSION

In contrast with Caucasians and other Asians, diabetes among young Filipino adults is associated with lower BMI but with a similarly high visceral adiposity as shown by an elevated WHR. Metabolic syndrome with insulin resistance as defined by a variety of indices is predominant. Type 1 diabetes with autoantibodies occur in only a small fraction of this population. Data derived from this work can provide a framework for cluster analysis towards personalized management specific to this population.

Human ; Acids ; Adiponectin ; Adiposity ; Adult ; Aged ; Antibodies ; Asia ; Asian ; Asian Continental Ancestry Group ; Autoantibodies ; Body Mass Index ; C-peptide ; Carboxy-lyases ; Child ; Cluster Analysis ; Demography ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Diabetic Ketoacidosis ; Diabetic Retinopathy ; Diagnosis ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Glutamate Decarboxylase ; Glutamic Acid ; Insulin ; Insulin Resistance ; Ketosis ; Leptin ; Lipids ; Metabolic Syndrome ; Obesity ; Patients ; Peptides ; Phenotype ; Philippines ; Population ; Prevalence ; Serum ; Therapeutics ; Thyroid Gland ; Thyroid Function Tests ; Young Adult

BACKGROUND AND OBJECTIVE

Evidence base on employment-related medical examinations is highly variable. The aim of this study is to build expert agreement on the appropriate medical and laboratory tests in major industries in Quezon City.

METHODS

An initial scoping review of local, national, and international policies on employment-related diagnostic testing was done. The determination of industries at the selected study site (Quezon City) was accomplished through Pareto analysis. Interviews of key informants and representatives, and a consensus-building process through an expert panel were carried out by the Philippine College of Occupational Medicine (PCOM) Quezon City Chapter. Data gathered was used in the study and analyzed. An initial list of medical tests and diagnostics was drafted and the Modified RAND appropriateness method was used as the choice of mixed methods consensus-building process by an expert panel.

RESULTS

Regulations often vary significantly within settings and implementers, particularly the scope, content, and procedures for medical examinations of workers. History taking (including occupational history) and physical examination are the cornerstones of the screening process. CBC and chest x-ray were deemed appropriate screening laboratory tests for asymptomatic preemployment examination, while only chest x-rays were used during periodic examinations. Additional tests for medical surveillance should be based on job demands and specific exposure. For specific chemical exposure, standard references for medical requirements, like from Occupational Safety and Health Administration (OSHA), can be referred to.

CONCLUSION

A shift in how occupational health and safety measures are implemented is needed, particularly in the pre-employment and periodic examination practices, for more relevant screening while preventing unnecessary and low-yield testing and reducing costs for the employer and the employee. An occupational screening checklist/questionnaire based on the results of the study that includes appropriate clinical history-taking, review of systems (ROS), physical examination, and laboratories must be devised, which is to be followed by training in the proper conduction of these medical assessments.

Occupational Medicine ; Occupational Health ; Public Health ; Preventive Medicine

BACKGROUND

The global impact of the COVID-19 pandemic has instigated a profound public health crisis, particularly affecting professionals like dentists who, due to their close interaction with saliva—a potential viral reservoir—and the aerosols generated during specific procedures, face elevated risks of infection. To mitigate this, the Centers for Disease Control and Prevention (CDC) and the Philippine Dental Association (PDA) have established guidelines for averting cross-infection in dental settings

OBJECTIVE

This study, conducted in an urbanized Metro Manila City, delves into the infection control practices of dentists amid the pandemic.

METHODS

Dentists from a Metro Manila city dental chapter were invited to participate in an online survey (Google Forms) consisting of participants' demographics, patient triage, engineering, administrative controls, disinfection personal hygiene, personal protective equipment (PPE), and waste management practices. Descriptive statistics, employing frequency distributions and percentages, summarized the dentists' adherence to infection control protocols.

RESULTS

Out of forty-nine respondents (49), the majority (92%) provided their teams' orientation on COVID-19 infection control protocols before reopening. Notably, 57% deferred elective procedures and 43% postponed aerosolgenerating procedures (AGPs). Only 39% utilized rubber dam isolation during AGPs. Most respondents reported full implementation of recommended administrative controls during the pandemic, with 92% isolating their treatment areas from other parts of the clinic. Most respondents adopted high-efficiency particulate air (HEPA) filtration units (82%) as one of their clinic’s engineering controls, and an extraoral vacuum machine, accounting for 71% of the respondents. The most common disinfection product used by the participants was alcohol, which was at 94%. Additionally, over 90% adhered to all recommended hand hygiene practices for both dental staff and patients. For the waste management protocols, only 55% of the respondents have their infectious waste collected by third-party Treatment Storage and Disposal (TSD) facilities.

CONCLUSION

The data shows that with the guidelines posted by both the PDA and CDC, the city’s dental practitioners could still provide services to the community in the safest manner at the time by being updated and following the infection control practices suggested by both organizations. Although some areas could have been improved, such as third-party waste management and the utilization of RT-PCR testing, some of these problems could have been attributed to the lack of availability in their areas.

Public Health ; Philippines ; Interprofessional Education ; World Health Organization ; Centers For Disease Control And Prevention, U.s. ; Centers For Disease Control And Prevention (u.s.)

BACKGROUND

The global impact of the COVID-19 pandemic has instigated a profound public health crisis, particularly affecting professionals like dentists who, due to their close interaction with saliva—a potential viral reservoir—and the aerosols generated during specific procedures, face elevated risks of infection. To mitigate this, the Centers for Disease Control and Prevention (CDC) and the Philippine Dental Association (PDA) have established guidelines for averting cross-infection in dental settings.

OBJECTIVE

This study, conducted in an urbanized Metro Manila City, delves into the infection control practices of dentists amid the pandemic.

METHODS

Dentists from a Metro Manila city dental chapter were invited to participate in an online survey (Google Forms) consisting of participants' demographics, patient triage, engineering, administrative controls, disinfection personal hygiene, personal protective equipment (PPE), and waste management practices. Descriptive statistics, employing frequency distributions and percentages, summarized the dentists' adherence to infection control protocols.

RESULTS

Out of forty-nine respondents (49), the majority (92%) provided their teams' orientation on COVID-19 infection control protocols before reopening. Notably, 57% deferred elective procedures and 43% postponed aerosolgenerating procedures (AGPs). Only 39% utilized rubber dam isolation during AGPs. Most respondents reported full implementation of recommended administrative controls during the pandemic, with 92% isolating their treatment areas from other parts of the clinic. Most respondents adopted high-efficiency particulate air (HEPA) filtration units (82%) as one of their clinic’s engineering controls, and an extraoral vacuum machine, accounting for 71% of the respondents. The most common disinfection product used by the participants was alcohol, which was at 94%. Additionally, over 90% adhered to all recommended hand hygiene practices for both dental staff and patients. For the waste management protocols, only 55% of the respondents have their infectious waste collected by third-party Treatment Storage and Disposal (TSD) facilities.

CONCLUSION

The data shows that with the guidelines posted by both the PDA and CDC, the city’s dental practitioners could still provide services to the community in the safest manner at the time by being updated and following the infection control practices suggested by both organizations. Although some areas could have been improved, such as third-party waste management and the utilization of RT-PCR testing, some of these problems could have been attributed to the lack of availability in their areas.

Human ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; World Health Organization ; Residence Characteristics ; Quarantine ; Public Health ; Centers For Disease Control And Prevention (u.s.) ; Covid-19 ; Centers For Disease Control And Prevention, U.s.

BACKGROUND

Stunting remains a major public health issue in Indonesia, particularly in regions like Pandeglang Regency, where prevalence rates are high. Understanding the contributing factors is essential for targeted interventions.

OBJECTIVE

This study aimed to analyze factors associated with stunting among toddlers using a mixed-methods approach.

METHODS

A cross-sectional mixed-methods study was conducted in two health centers in Banten Province from December 2021 to January 2022. Quantitative data were collected using a structured questionnaire and analyzed using chi-square tests (pRESULTS

There is a relationship between maternal knowledge, history of exclusive breastfeeding, history of supplementary feeding, support from health workers, and socio-economic status with the prevalence of stunting. However, the pattern of exclusive breastfeeding and seeking health services in the working areas of Bangkonol Health Center and Kaduhejo Health Center, Pandeglang Regency, is not good enough and needs to be improved. Health workers need to educate mothers with toddlers about patterns of providing complementary feeding, food preparation, and storage, and basic health practices to prevent stunting.

RESULTS

There is a relationship between maternal knowledge, history of exclusive breastfeeding, history of supplementary feeding, support from health workers, and socio-economic status with the prevalence of stunting. However, the pattern of exclusive breastfeeding and seeking health services in the working areas of Bangkonol Health Center and Kaduhejo Health Center, Pandeglang Regency, is not good enough and needs to be improved. Health workers need to educate mothers with toddlers about patterns of providing complementary feeding, food preparation, and storage, and basic health practices to prevent stunting.

Human ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Public Health ; Prevalence ; Methods ; Indonesia ; Health ; Growth Disorders ; Comprehension