Background: Given the shortage of medical professionals in the Philippines, Barangay HealthWorkers (BHWs) may play a role in providing postpartum healthcare services.However, as there are no reports regarding BHW activities in postpartumhealthcare, we conducted this study to understandpostpartum healthcare services and exploring the challenges and motivations ofmaternal health service providers. Methods: Focus group interview (FGI) of 13participants was conducted as Qualitative Research Methodology at Muntinlupa City. The results were analyzed according tothe interview guide. The proceedingsof the FGI were transcribed verbatim, and researchers read and coded thetranscripts. The codes were then used to construct a categories. Results: Four important activities were highlighted among 11 analysiscodes. These activities were “Assessment of postpartum women’s conditions,”“Recommendation to visit a health facility,” “Measurement of blood-pressure andvitamin intake,” and “Providing postpartum health information.” Among fiveanalysis codes, we identified three challenges that BHWs face, which were “Nocurrent information regarding postpartum care,” “Some postpartum women do notwant to receive healthcare services from BHW,” and “Too many assigned postpartumwomen.” Among five analysis codes, we identified two reasons for continuing BHWactivities, which were “Hospitality to help postpartum women and their familyin the community” and “Performance of mission in providing BHW services.” Conclusion: This study is the first to evaluate BHW activities in postpartumhealthcare services. Our results indicate that BHWs may play an important rolein evaluating postpartum women’s physical and mental conditions throughhome-visiting services. However, several difficulties adversely affected theiractivities, and these must be addressed to maximize the contributions of BHWsto the postpartum healthcare system.

Dengue virus (DENV) infection is a significant burden in Indonesia and other tropical countries. DENV infection have wide spectrum of clinical manifestations i.e. asymptomatic, dengue fever, dengue hemorrhagic fever and dengue shock syndrome. The difference of clinical manifestation may due to the deversity of genetic constitution of the host. The C-type lectin DC-SIGN (CD209) has been identified to be the major dengue receptor on human dendritic cells. There are at least five polymorphisms in exon  5 and 6 of DC-SIGN encoded gene which have been identified and recorded in dbSNP. The aim of this work is to measure the frequency of these polymorphisms among asymptomatic and hospitalized DENV infected patients. We enrolled 23 hospitalized and 73 asymptomatic DENV infected patients. Among those subject we performed PCR amplification and DNA direct seqencing for 23 hospitalized DENV infected patients and 24 asymptomatic DENV infected patients. The result showed that there were no polymorphic nucleotides in CD209 encoded gene found among the patients.

We encountered a probable case ofloiasis in a returned traveler from Central Africa. A 52-year-old Japanese womanpresented to our hospital complaining of discomfort in her eyes and skin. She reportedhaving frequently visited Central Africa over many years and having been extensivelyexposed to the rainforest climate and ecosystem. Although no microfilariae werefound in her blood, there was an elevated level of IgG antibodies against thecrude antigens of Brugia pahangi,which have cross-reactivity with Loa loa.She was treated with albendazole for 21 days, after which the antigen-specificIgG level decreased and no relapse occurred.

Organizationsworking for the elimination of Chlamydia triggered blindness (trachoma) followthe WHO SAFE (surgery of trichiasis, antibiotics, face washing andenvironmental changes) strategy with the aim to achieve a minimum of 80% ofchildren with clean faces in the endemic communities, mass treatment coveringthe whole district with trachoma rates of 10% or more and surveillance plans.Trachoma recurrence is common after implementing 3, 5 or even 7 times the SAFEstrategy, revealing that the cognitive processes that require assimilation andintegration of knowledge did not register with parents, care takers andchildren. Moreover, repeated awareness campaigns to improve hygiene did notsystematically produce irreversible changes of behavior in neglectedpopulations. Facing evidence, the rational supporting mass drug administrationas the mainstay of preventable blindness elimination requires a wider scopethan those of mathematical models. The inhibition to perceive disappointingoutcomes requiring repeated interventions may suggest from a sociologic pointof view that the strategies are product of those evaluating the activities ofthose that fund them and vice versa. In this field, similar articulationappears for reciprocal interactions of researchers with those judging thepertinence and quality of their work. So far, the lack of autocritic forcertain elimination strategy approaches may reveal inbred circles that did notclearly assess that antibiotics, trichiasis surgery and education limited toimprovement of hygiene are inefficient if not associated with long term basiceducational actions in schools.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease that is endemic in East Asia. The SFTS virus (SFTSV) is transmitted to other organisms by infected ticks and is endemic to Nagasaki in western Japan. However, epidemiological information regarding SFTSV in Nagasaki ticks has not been elucidated. In this study, we first examined the sensitivities of SFTSV gene detection by real-time RT-PCR and virus isolation in cultured cells and mice. These methods could detect SFTSV in the samples containing more than 4 × 10⁰ ffu. Next, we attempted to isolate SFTSV and to detect viral gene in 2,222 nymph and adult ticks collected from May to August 2013 among seven regions of Nagasaki. However, neither virus isolation nor viral gene detection were confirmed in those tick pools. SFTSV positivity rates are considered very low in ticks and viral loads in ticks are also very limited. Further investigation by increasing the number of ticks and including larval samples in the investigation, as well as improved detection methods, may be required to find SFTSV-positive ticks in this region.

Neurocysticercosis(NCC) is an important disease in central nervous system caused by infectionwith Taenia solium metacestodes. Inaddition to clinical findings and the imaging analysis, the results ofimmunological tests are informative to diagnose NCC. To compare the usefulnessof serum and cerebrospinal fluid (CSF) samples for antibody detection test,paired serum and CSF samples from NCC and other neurological disease patientswere examined by an enzyme-linked immunosorbent assay with low-molecular-weightantigens purified from T. solium cystfluid in a blinded fashion. Sensitivities of both serum and CSF samples were25.0% in inactive NCC cases (n = 4) and 90.9% in active NCC cases (n = 33) and specificitiesof serum and CSF were 100% and 95.8%, respectively. By the combination of serumand CSF samples, sensitivity for active NCC cases became 100%. There was nodifference in the test performance between serum and CSF samples. Based onthese results, we suggest the detection of specific antibodies in serum for thediagnosis of active NCC because of an easy collection of it. However, in caseof the antibody test negative, CSF should be used to confirm NCC and to ruleout other medical disorders of central nerve system. For diagnosis of suspectedinactive NCC cases, antibody detection test using either serum or CSF has alimited diagnostic value and cannot be recommended.

Background: Sepsis is one of themost common causes of neonatal hospital admissions and is estimated to cause26% of all neonatal deaths worldwide. While waiting for results of bloodculture, it is necessary to initiate an empirical choice of antibiotics basedon the epidemiology of causative agents and antibiotic sensitivity pattern in alocality. Objective: To determine the major causativeorganisms of neonatal sepsis at the Niger Delta University Teaching Hospital(NDUTH) as well as their antibiotic sensitivity pattern with the aim offormulating treatment protocols for neonates. Methods: Within a 27 month period (1stof October 2011 to the 31st of December 2013), results of bloodculture for all neonates screened for sepsis at the Special Care Baby Unit of thehospital were retrospectively studied. Results: Two hundred and thirty three(49.6%) of the 450 neonates admitted were screened for sepsis. Ninety seven(43.5%) of them were blood culture positive with 52 (53.6%) of the isolatedorganisms being Gram positive and 45 (46.4%) Gram negative. The commonestisolated organism was Staphylococcusaureus (51.5%) followed by Escherichiacoli (16.5%) and Klebsiellapneumoniae (14.4%). All isolated organisms demonstrated the highestsensitivity to the quinolones. Conclusion: Neonatal sepsis is asignificant cause of morbidity among neonates admitted at the NDUTH.  There is need for regular periodicsurveillance of the causative organisms of neonatal sepsis as well as theirantibiotic susceptibility pattern to inform empirical choice of antibioticprescription while awaiting blood culture results.

Leprosyleads to chronic granulomatous inflammation in skin and peripheral nerves thatcan lead to sensory, motor and autonomic impairments. Autonomic dysfunctions mayresult in dryness and cracking of the skin. In this study, we present the useof ozone provided by a high-frequency device to treat hand ulcers (wounds) inan 80-year-old man who was diagnosed asmultibacillary in 2007. In the first visit, the patient was evaluated andreceived verbal and written instructions about self-care. Treatment consistedof five sessions, once per week. The ozone provided by a high-frequency device seemed tobe useful in the treatment of ulcers, thus, contributing to the healingprocess. Research that investigates theuse of high frequencies in thetreatment of ulcers associated or not with other interventions (self-carestrategies, protective clothing, adaptedtools and footwear adaptation) is strongly recommended.

Congenital syphilis (CS) is a public health burden in both developing and developed countries. We report two cases of CS in premature neonates with severe clinical manifestations; Patient 1 (gestational age 31 weeks, birth weight 1423 g) had disseminated idiopathic coagulation (DIC) while Patient 2 (gestational age 34 weeks and 6 days, birth weight 2299 g) had refractory syphilitic meningitis. Their mothers were single and had neither received antenatal care nor undergone syphilis screening. Both neonates were delivered via an emergency cesarean section and had birth asphyxia and transient tachypnea of newborn. Physical examination revealed massive hepatosplenomegaly. Laboratory testing of maternal and neonatal blood showed increased rapid plasma reagin (RPR) titer and positive Treponema pallidum hemagglutination assay. Diagnosis of CS was further supported by a positive IgM fluorescent treponemal antibody absorption test and large amounts of T. pallidum spirochetes detected in the placenta. Each neonate was initially treated with ampicillin and cefotaxime for early bacterial sepsis/meningitis that coexisted with CS. Patient 1 received fresh frozen plasma and antithrombin III to treat DIC. Patient 2 experienced a relapse of CS during initial antibiotic treatment, necessitating parenteral penicillin G. Treatment was effective in both neonates, as shown by reductions in RPR. Monitoring of growth and neurological development through to age 4 showed no evidence of apparent delay or complications. Without adequate antenatal care and maternal screening tests for infection, CS is difficult for non-specialists to diagnose at birth, because the clinical manifestations are similar to those of neonatal sepsis and meningitis. Ampicillin was insufficient for treating CS and penicillin G was necessary.

Rotavirus is a leading cause of severe acutegastroenteritis in children worldwide, and globally licensed vaccines areavailable. To expedite the introduction of rotavirus vaccines in the nationalimmunisation programme, a simple, economical method to monitor changes in theburden of rotavirus disease may be of great help. Here, we report anapplication of a time-seriesanalysis on a publicly-available dataset in Japan on the weekly number oflaboratory-confirmed rotavirus-positive samples over the last 5 year period betweenthe 36th week of 2009 and the 35th week of 2014 during which rotavirus vaccines became marketed in Japan andpresumed to reach an uptake rate of at least 39% as a national average. Comparedwith the expected number of rotavirus detection based on the preceding four rotavirusseasons, the number of rotavirus detection during the 2013-2014 season was 43%(95% CI: 38.6, 47.8). This suggeststhat the use of rotavirus vaccine had a positive impact on reducing the burdenof rotavirus diarrhoea in Japan. This method, because of its simplicity andlittle cost, should be applicable to early detection of the impact of rotavirusvaccine even in resource-poor countries where the World Health Organizationfunded and implemented the sentinel surveillance programmes oflaboratory-confirmed rotavirus cases.