BACKGROUND: Dissemination of health communication materials is one of the most important strategies to increase awareness on the prevention and control of leptospirosis. One of the projects under the Program on the Prevention and Control of Leptospirosis in the Philippines (LepCon) is the dissemination of health communication materials.
OBJECTIVES: This study assessed the dissemination of health communication materials to 14 city and municipal health offices in the National Capital Region (NCR), Philippines. Specifically, this study determined: (1) how the health communication materials were disseminated by the city and municipal health offices; (2) the placement of the materials in the health facilities; and (3) the challenges encountered during the dissemination process.
RESULTS: The city/municipal health offices used different approaches in disseminating the health
communication materials and these are classified into distribution for public consumption, utilization as health education materials, and maintenance of supply by reproducing the materials in other forms. Eleven (11) out of the 14 city/municipal health offices (78.6%) still had leptospirosis posters. Seven (50%) of them posted the poster in the health facility. However, only four (28.6%) facilities placed the posters in locations where health facility clients can easily see and read them. Two of the 14 city/municipal health offices (14.3%) had an information, education and communication (IEC) display area where the LepCon fan is one of the health communication materials on display. The number of materials provided to the health offices was noted to be inadequate to reach the health facilities' target audiences. Finally, the monitoring and evaluation of health communication materials disseminated to facilities under health offices' jurisdiction was also a big challenge.
CONCLUSIONS: Different approaches were used in disseminating the posters and fans to the health facilities under the jurisdiction of the city/municipal health offices. It was also noted that the number of materials provided to the health offices was not adequate to reach the health facilities' target audiences. Although three-fourths of the health offices covered still have health communication materials in their facility, only less than 25% of these facilities have posters placed in strategic locations in the facility. A formal scheme of monitoring the dissemination of the materials was expressed by the informants.

Human ; Health Communication ; Health Education ; Teaching Materials ; Maintenance ; Health Facilities ; Leptospirosis

OBJECTIVES: Rats have been identified as primary sources of leptospires in the environment. This study aimed to characterize Leptospira species circulating among rats found in public markets in Iloilo City, Philippines.           METHODS: Dark-field microscopy was used to determine leptospire presence in tissue cultures. Isolates from the cultures were characterized via serotyping with monoclonal and polyclonal antibodies. To characterize the antibodies present in rat sera, the microscopic agglutination test (MAT) was used.                                                                            RESULTS: In this study, 19 rats were obtained from 7 markets in Iloilo City. Three(3) rats (15%.8) were found to harbor leptospires in the urinary bladder (2) and kidney (1). Serotyping of the isolates showed that they did not belong to previously reported common serovars in the Philippines such as Manilae, Losbanos, Javanica or Grippotyphosa. Using another panel of polyclonal antibodies, it was shown that the isolates belonged to serovar lcterohaemorrhagiae. The MAT results showed that 16 (84.2%) serum samples were positive for anti-Leptospira antibodies. The most common infecting serovars were Autumnails (47.4%), Pomona (42.1%) Copenhageni (36.8%), and Hebdomadis (31.6%) other infecting serovars identified were lcterohaemorrhagiae, Poi, Grippotyphosa, Patoc, and Pyrogenes.                                                                                                                                                      CONCLUSION: The results of the present study provide baseline data on the circulating leptospiral serovars in iloilo City. Results suggest the possible role of rats in disease transmission in the study areas.

Animal ; Leptospirosis ; Rats ; Antibodies, Monoclonal ; Serotyping ; Culture ; Agglutination

OBJECTIVE: This study assessed the knowledge, attitudes and practices of the community residents on the prevention and control of Leptospirosis in the National Capital Region, Philippines.
METHODS: In this cross-sectional study, four-stage random cluster sampling proportional to size was used to select the 413 respondents from 30 villages in the National Capital Region. The mother or any responsible adult served as the respondent for the community survey which yielded data on the knowledge, attitudes, domestic practices, and sources of information for the prevention and control of Leptospirosis. Encoding was done using Epi Info Version 6. Descriptive statistics was generated through Microsoft Excel.
RESULTS: Majority of the respondents were able to correctly identify that the causative agent of leptospirosis is bacteria (91%), that the disease is transmitted by the urine of infected of rats (89%) through skin abrasions (71%) and mucous membranes (57%). Most commonly identified signs and symptoms of the disease include acute febrile illness with myalgia (87%), difficulty of breathing and decreased urine output (72%). Majority identified the prevention and control measures correctly. Wearing of boots, maintaining a clean and orderly house and maintaining good sanitation were the top answers of the respondents. In terms of attitudes, respondents had positive attitudes towards the preventive practices of wearing boots or following health advisories of authorities (99%). Majority also believed that leptospirosis is curable if detected early (99%) and that it is a serious disease (98%). Similarly, more than 90% had positive attitude when it comes to health care. Wading in flood waters (93%), walking barefoot (85%) and conducting clearing activities after flood (63%) were the commonly believed forms of exposure to the disease. In terms of domestic practices, respondents usually clean their surroundings (40%), avoid wading in floodwaters (25%), wear boots (21%) to protect themselves from acquiring leptospirosis. Primary sources of information on leptospirosis were the mass media (46%), health workers (17%) and the health facilities (14%). The most common educational materials read by the respondents were flyers (9%), posters (8%), and leaflets (7%).
CONCLUSION: In general, majority of the respondents were knowledgeable on the causes, signs and symptoms, and modes of transmission of leptospirosis, and had favorable attitudes towards the prevention and control measures against leptospirosis. However, when it comes to domestic practices, less than 40% actually implement measures for the prevention and control of leptospirosis. Respondents' main source of information was the mass media and very few have read educational materials containing information about the prevention and control of leptospirosis. 

Human ; Animal ; Male ; Female ; Bacteria ; Rodentia ; Jaundice ; Leptospirosis ; Abnormalities, Multiple ; Cross-sectional Studies ; Floods ; Health Facilities ; Health Personnel ; Limb Deformities, Congenital ; Mucous Membrane ; Myalgia ; Philippines ; Rats ; Sanitation ; Surveys And Questionnaires ; Attitude ; Urine

OBJECTIVES: To determine the occurrence and antimicrobial resistance of pathogenic vibrios from green mussel, Perna viridis in bacoor bay cavite.

METHODS: Vibrios were isolated using TCBS agar and confirmed using API Identification kit. The relationship between the density of vibrios and environment parameters such as months, harvest sites and other physico-chemical parameters of water was determined. The isolated vibrios were subjected to antibiotic resistance testing to determine the resistance patterns.

RESULTS: Pathogenic vibrios were isolated in all of the 90 mussel samples. Of the 183 vibrio isolates, 75 strains were V. alginolyticus and 53 strains belonged to V. cholerae wherein 18 (34%) of these were V. cholerae serotype O1. Forty nine (49) strains belonged to V. parahaemolyticus and six were V. vulnificus. Using the regression analysis, salinity, water temperature and ph have significant correlation on the density of vibrios (p=0.0309), with regression model, total vibrios = -16990763 + 145858 Salinity + 186808 Temperature + 1037886 pH. In the antimicrobial resistance assay,ampicillin had the highest drug resistance (37.8%) followed by nalidixic acid (10.4%), tetracycline (10.4%) and co-trimoxazole (9.3%).

CONCLUSION: Pathogenic vibrios were isolated in mussel of Bacoor, Cavite and can be predicted using salinity, temperature and pH of the water. Thirty six percent (36%) of Vibrio isolates were resistance to ampicillin.

Animal ; Salinity ; Temperature ; Ampicillin ; Drug Resistance ; Nalidixic Acid ; Tetracycline ; Trimethoprim-sulfamethoxazole Combination

Introduction: Leptospirosis is one of the neglected reemerging zoonoses that is of public health concern globally. The need to discover novel therapeutic alternatives for leptospirosis through screening for and elucidating the mechanism/s of the anti-leptospiral activity of plant extracts is therefore necessary. This study analyzes the optimized tube dilution technique and the BiologTM sole carbon utilization phenotype microarray as screening tool for anti-leptospiral activity of plant extracts. Methods: The suitability of the optimized tube dilution technique was evaluated by determining the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and motility inhibition property of a plant extract and an antimicrobial control (pen G) against 4 dominantly circulating Leptospira serovars/serogroup in the Philippines. Likewise, the suitability of the BiologTM sole carbon utilization assay was evaluated using a plant extract and selected antimicrobials against L. interrogans serovar Manilae strain K64 and L. interrogans serovar Losbanos strain K37. Results: The MIC, MBC, and motility inhibition property of a plant extract and the antibiotic controls as well as its effect on the carbon utilization phenome of the Leptospira serovars gave consistent results, within and between several runs. With standard deviation = 0 for all serovars. The MIC and MBC of the antimicrobial control (pen G), the positive control, was 10 ug/ml. The growth control (leptospires without treatment), the negative control, showed presence of motile leptospires. The MIC and the MBC of the test plant extract was 250 ug/ml – 500 ug/ml. Results of the carbon utilization phenome or pattern of carbon utilization were consistent within the 3 replicates and between two runs. Conclusion The optimized tube dilution technique and the BiologTM sole carbon utilization assay is a potential in vitro screening tool for determining anti-leptospiral activity of plant extracts.
Leptospira ; Serogroup

Objectives: Probiotic supplementation often only leads to transient improvement in the gut microbiome. Potential prebiotics, such as the oligosaccharide-rich varieties of Dioscorea esculenta tubers, can potentially bridge the gap between supplementation and persistent colonization. Thus, this study aimed to assess the ability of D. esculenta tubers to promote the growth of probiotic Lactobacillus sp. in vitro selectively.

Methods: The prebiotic activity of the selected varieties of Dioscorea esculenta tubers was evaluated via compe titive growth assay, wherein the ratios of probiotic Lactobacillus sp. over enterotoxigenic Escherichia coli (ETEC) or "prebiotic ratios" were compared following treatment.

Results: Negative control (0.9% NaCl solution) produced a ratio of 0.88, Lowland and Highland varieties produced ratios of 1.26 and 1.29, respectively, and positive control (inulin) produced 1.54. The two varieties had comparable ratios to one another (p > 0.05), and significantly higher ratios than the negative control (p < 0.05). Both varieties have significant prebiotic activity. Compared to inulin, the two varieties' prebiotic activity was 84% as effective.

Conclusion: Overall, the tubers promoted the growth of Lactobacillus sp. over ETEC. The crude tuber samples, given their availability and affordability, can be easily integrated into the local diet to contribute to the improvement of the general population's health.

Enterotoxigenic Escherichia coli ; Inulin ; Lactobacillus ; Prebiotics

Objective: To study the distribution of human leptospirosis cases across the different geographic regions in the Philippines in 2015-2017 and to determine the relationship between the frequency of typhoon occurrence and human leptospirosis cases. Methods: Information on the frequency of leptospirosis cases and typhoon occurrence across the different regions in the Philippines from 2015 to 2017 was retrieved from the databases of the Department of Health and the Philippine Atmospheric, Geophysical, and Astronomical Services Administration, respectively. Descriptive measures on the prevalent cases and occurrence of typhoons across the different regions were summarized. Linear regression analysis was employed to establish the functional relationship between leptospirosis cases and typhoon occurrence. The distribution of human leptospirosis cases was assessed using the Poisson distribution. Results: The frequency of typhoon occurrence accounted for the significant linear variation in the geographic distribution of human leptospirosis cases in the Philippines (P<0.001). Moreover, the human leptospirosis cases obeyed a Poisson distribution (λ=6.89, P<0.001). Conclusions: The Philippines has frequently experienced severe weather perturbations such as typhoons resulting in flooding and subsequently increasing the risk of transmitting bacterial infections including leptospirosis. Information obtained regarding the determinants and distribution of human leptospirosis will provide better understanding of the disease propagation for subsequent design of optimal disease prevention measures, appropriate resource allocation, effective control strategies, and necessary public health programs.

OBJECTIVE: This paper presents the experiences of, and lessons learnt from, a seven-year government-academe-civil society collaboration in the development, implementation, and evaluation of a training program for Filipino physicians and rehabilitation practitioners on the management of drug dependence.

METHODS: Review of memoranda, records, and reports relevant to the initiation and implementation of the training activity. Where relevant, we also perused internal notes and minutes of meetings written by the authors, who are also members of the training team.

RESULTS: A tripartite collaboration between government, academe, and professional organizations developed a training program on the management of drug dependence for physicians and rehabilitation practitioners. Learner-centered approaches to education were adopted in the delivery of training content. Participation in the training is a prerequisite for government accreditation as rehabilitation professionals. A ladderized approach to the training was adapted, with participants first obtaining a broad introduction to the program, followed by in-depth focus on the assessment and management of drug dependency. This was done as a response to the perception that a single, two-week training program is insufficient to fully capacitate physicians and rehabilitation practitioners with the requisite knowledge and skills necessary to manage persons with drug dependence. Future plans include an executive course for established practitioners, and a course on community-based management of drug dependency.

CONCLUSION: The current perspective on drug use and dependence is transitioning from a politico-legal issue to a public health concern. Attaining the sustainable development goals in 2030 will necessitate the development of a cadre of professionals who are, among others, capable of assessing and treating persons who suffer from drug dependence. The Philippine experience may serve as a model for other countries struggling with the drug menace.

Human ; Substance-related Disorders ; Substance Abuse Treatment Centers ; Philippines

BACKGROUND: Domestic animals are known to be either maintenance or accidental hosts of Leptospira. Determination of seroprevalence of leptospirosis among these animals is of great importance due to their close association with humans, economic loss as well as the public and veterinary health problems caused by the said zoonosis.

OBJECTIVE: This study aimed to determine the seroprevalence of leptospirosis among water buffaloes, pigs, and dogs in selected areas in the Philippines.

METHODS: Microscopic agglutination test (MAT) was used to test for leptospirosis. Testing was done from January 2007 to August 2008.

RESULTS: With the cut-off titer set at 1:80, the MAT-positivity rates were 82%, 67%, and 79% for 190 water buffaloes, 45 pigs, and 106 dogs, respectively. The most common prevailing serovars detected were Hardjo, Tarassovi, and Hebdomadis for water buffaloes; Semaranga, Grippotyphosa, and Patoc for pigs; and, Manilae, Patoc, and Autumnalis for dogs. MAT-positivity rates among these animals in terms of age (except for water buffaloes), sex and sample collection sites were not statistically significant. No Leptospira was isolated from the blood, urine, and kidney samples of these animals.

CONCLUSION: Results indicate a high seroprevalence of leptospirosis among the animals studied and that several pathogenic leptospires are causing infection in these animals.

Animal ; Seroepidemiologic Studies ; Leptospirosis ; Swine ; Philippines