Background: Certain indigenous populations have been noted by the World Health Organization (WHO) to havethe highest prevalence ratesforchronicsuppurativeotitis media (CSOM), including the Australian Aborigines (28-43%), Greenlanders (2-10%) and Alaskan Eskimos (2-10%). Objectives: To determine the prevalence of common ear problems, particularly CSOM, among the indigenous Ati or Aeta community in Bolabog, Boracay, and to determine their hearing sensitivity using screening audiometry. Methods: Study Design - Descriptive cross-sectional study. Setting - A small Ati community in Bolabog, Boracay. Population - A total of 63 adults and children underwent medical interview and otoscopy. Additionally 24 had their hearing screened by audiometry. Results: About a quarter of the population participated in the study, including 41 children (40 percent of all children) and 22 adults (18 percent of all adults). Forty-six percent of children and 23 percent of adults who were examined had previous history of ear discharge, while 22 percent of children and 45 percent of adults who were examined had history of hearing loss. Seventeen percent of children had history of hearing loss in the family. CSOM was found in 18 (43.90 percent) children and 8 (36.36 percent) adults. Impacted cerumen was found in 17.1 percent of children. Eleven female children underwent screening audiometry. Of these, eight had normal hearing and three had abnormal findings. Thirteen adults were also tested, five of whom were male and had normal hearing bilaterally. Four of eight female adults had abnormal hearing, of which three were unilateral. Conclusions: The Ati population in Bolabog, Boracay belongs to a group with the highest prevalence rates for CSOM (27.0 percent). A bigger sample for screening audiometry is required for proper estimation of hearing loss prevalence. Both environmental and genetic factors may have increased the prevalence of CSOM in the Ati population of Boracay. (Author)
HEARING LOSS OTITIS MEDIA OTITIS MEDIA ; SUPPURATIVE

BACKGROUND: Various methods and equations are available to predict the basal metabolic rate (BMR). A published study comparing the Harris-Benedict Equation, Bioelectrical Impedance Analysis, and Indirect Calorimetry (IC), was done among Filipinos, and was able to obtain a novel formula for BMR. The purpose of this study is to validate this novel formula. METHODS: This is a multi-center, cross-sectional, validation study of the novel BMR equation, done among adult overweight and obese Filipinos, who were seen at St. Luke’s Medical Center and Providence Hospital in Quezon City, Outpatient Clinics from August 2019 to March 2020. Purposive sampling was done, and upon giving consent, subjects had undergone interview, anthropometrics measurement, and IC. RESULTS: 174 samples were enrolled. Mean age is 43 years old, majority are females. 27% have no co-morbidities; of those with co-morbidities, half have diabetes mellitus (DM). Mean weight is 74.30 kg; mean BMI is 29.78 kg/m2 . The mean computed BMR is 1174.70 kcal/day, which is 145.83 significantly lower than the BMR derived with calorimetry: 1320.53 kcal/day (P-value 0.000). However, the scatterplot reveals the linearity of positive direction for both values. 31% of the computed BMR fell within the +/-10% estimate of the actual BMR. Stratification of the results between those with DM and without, lowered the difference between the calculated and actual BMR to 46 kcal/day (from 145.83) among the DM subgroup, and increased the estimated accuracy to 38% falling within the +/- 10% estimate of the actual values. CONCLUSION: The novel BMR formula is linearly reflective of the basal metabolism of adult overweight and obese Filipinos, but the numerical values are lower compared to actual calorimetry results, yielding more accuracy when applied among patients with diabetes.
Calorimetry, Indirect ; Basal Metabolism ; Obesity Management

Objective: To calculate the accuracy, sensitivity, specificity and positive predictive values of the Siemens HearCheck™ Navigator in detecting hearing loss and to compare values of these parameters when the examination is done in a soundproof booth and in a quiet room. Methods: Design: Analytical, cross-sectional study Setting: Tertiary Public University Hospital Patients: Patients seen at the Ear Unit of a tertiary public university hospital from June 2009 to August 2010 were tested using the Siemens HearCheck™ Navigator and pure tone audiometry, inside a soundproof audiometry booth and in a quiet room with an ambient noise of 50dB, with a different investigator for each examination. Each ear was treated as a separate subject. Results obtained from the HearCheck™ Navigator were designated as observed values and were classified as “no hearing loss” for green light, and “with hearing loss” for yellow or red lights. Results were compared with pure tone air conduction averages designated as gold standard values. Normal hearing acuity (0-25 dB) was classified as no hearing loss. Pure tone air conduction averages of 26dB and above were classified as “with hearing loss” and were further stratified as mild hearing loss (26-40dB) and moderate or worse hearing loss (>41 dB). Observed and gold standard values were compared and tabulated in a 2x2 table for all levels of hearing loss, mild hearing loss, and moderate or worse hearing loss. Accuracy, sensitivity, specificity, positive and negative predictive values of the Siemens HearCheck™ Navigator inside a soundproof audiometry booth and in a quiet room were determined using pure tone audiometry as the gold standard. Results: 100 patients (200 ears) were tested, with a median age of 43 years old (range 15-75), and an almost equal number of male and female participants (52 males, 48 females). Accuracy rate of the Siemens HearCheck™ Navigator inside the soundproof audiometry booth and in a quiet room were 82.5% and 84% respectively for all levels of hearing loss. Sensitivity, specificity, positive and negative predictive values were similar whether the examination was done inside the soundproof audiometry booth or in a quiet room. These values were notably higher in patients with moderate or worse hearing loss compared to patients with mild hearing loss. Conclusion The Siemens HearCheck™ Navigator shows potential as an accurate, portable, easy-to-use tool to screen for hearing loss, especially for cases of moderate or worse hearing loss, without the need for soundproof audiometry booths or special training. It is recommended that further studies be done to differentiate degrees of hearing loss, and to evaluate its usefulness in other target populations, including school children and the elderly.
Hearing Loss

BACKGROUND: In 2000, the World Health Organization recommended implementation of universal hearing screening. The Philippines enacted this policy into law in 2009 as it was found to be cost-effective for the Philippines. The model at the time used a hospital-based approached to screening. This paper examines the cost-effectiveness and budget impact of implementing a community-based universal hearing screening program.
METHODS: A model was developed following a community-based hearing screening program. Parameters were obtained through literature review, secondary data analysis, and consultation with experts. Cost-effectiveness was assessed for a single birth cohort from a public payer and societal perspective.
RESULTS: A community-based universal hearing screening program was found to be cost-saving. One-way sensitivity analysis showed that results were sensitive only to treatment rate and follow-up rate. The program is also a high budget impact program.
CONCLUSION: A community-based hearing screening program is cost-saving for the Philippines. Ensuring treatment and good follow-up in testing will ensure cost-effectiveness.

Objective: Recent advances in epigenetic studies continue to reveal novel mechanisms of gene regulation and control, however little is known on the role of epigenetics in sensorineural hearing loss (SNHL) in humans. We aimed to investigate the methylation patterns of two regions, one in RB1 and another in GJB2 in Filipino patients with SNHL compared to hearing control individuals. Methods: We investigated an RB1 promoter region that was previously identified as differentially methylated in children with SNHL and lead exposure. Additionally, we investigated a sequence in an enhancer-like region within GJB2 that contains four CpGs in close proximity. Bisulfite conversion was performed on salivary DNA samples from 15 children with SNHL and 45 unrelated ethnically-matched individuals. We then performed methylation-specific real-time PCR analysis (qMSP) using TaqMan® probes to determine percentage methylation of the two regions. Results: Using qMSP, both our cases and controls had zero methylation at the targeted GJB2 and RB1 regions. Conclusion Our study showed no changes in methylation at the selected CpG regions in RB1 and GJB2 in the two comparison groups with or without SNHL. This may be due to a lack of environmental exposures to these target regions. Other epigenetic marks may be present around these regions as well as those of other HL-associated genes.
Hearing Loss ; Methylation