No abstract available.
Developing Countries

BACKGROUND AND OBJECTIVE: Road traffic injuries were the second leading cause of death due to injury in 2003 in the Philippines. In 2011, the Philippine Road Safety Action Plan (PRSAP) was instituted. Five years into the program, latest data showed that the death rate due to road injuries continue to increase despite the presence of key legislation supporting road safety. This study was aimed at identifying the gaps in addressing road safety in the Philippines.

METHODOLOGY: Literature review and key informant interviews of representatives of the different agencies including the Department of Transportation and Communications (DOTC), Department of Public Works and Highways (DPWH), Road Board, Philippine National Police (PNP), Metro Manila Development Authority (MMDA), and Land Transportation Office (LTO) were conducted to identify gaps in the program.

RESULTS AND CONCLUSION: Key gaps include: weak leadership at the national and local level, limited material and human resources for enforcement of laws, and fragmented information system. These gaps should be addressed to improve the road safety situation in the country.

Developed Countries ; Developing Countries ; Humans ; Maternal Mortality

No abstract available.
Biopsy* ; Developing Countries* ; Tuberculosis, Spinal*

Press freedom and worldwide internet access have opened ample opportunity for a staggering number of poor open access journals and junk publishers to emerge. Dubious publishers are abusing and camouflaging the golden open access model. In 2012, Jeffery Beall shed light on the predatory journals (as he preferred to call them) and the threat to open access scientific publication. Publishing in predatory journals is continuing to be a major threat for the development of science in developing countries. The authors of this article proposed solutions and outline a fresh perspective to help authors avoid publishing in predatory journals.
Developing Countries ; Freedom ; Internet ; Publications

No abstract available.
Biopsy* ; Developing Countries* ; Tuberculosis, Spinal*

Paper-based analytical devices are fluidic chips fabricated with extremely inexpensive materials, namely paper, thereby allowing their use as a zero-cost analytical device in third-world countries that lack access to expensive diagnostic infrastructures. The aim of this review is to discuss: (1) microfluidic paper-based analytical devices (microPADs) for quantitative analysis, (2) fabrication of two- or three-dimensional microPADs, (3) analytical methods of microPADs, and (4) our opinions regarding the future applications of microPADs for quantitative urinalysis.
Developing Countries ; Methods ; Microfluidics ; Urinalysis*

Smoking among school children is becoming a serious problem in developing countries, including Bangladesh. The early initiation of smoking needs urgent intervention to protect this vulnerable group and preventing them to be addicted. This study aims to determine the age at initiation of smoking and factors affecting it. A two-stage cluster sampling was used with a selection of schools on probability proportional to enrolment size followed by stratified random sampling of government and private schools and then a random start in classes VIII, IX and X of each school targeting the students aged 13 years and above. Data collected from secondary school students using self-administered structured questionnaire. All analyses were performed with SPSS version 20.0. Missing value was treated by multiple imputations. A total of 6877 data were analysed in which 84.7% were non-smoker, 9.5% were ever smoker and 5.8% were current smokers. Among the ever smoker (n=823), 38% were current smokers, 56.5% former and 5.5% were recent quitters. The mean (SD) age at initiation of smoking was 10.9 (0.2) years. Multinomial regression analysis revealed that class grade, peer pressure and offered free cigarette appeared to be significant predictors of smoking initiation (p<0.05). Parental smoking and type of schools appeared as significant factors for smoking initiation by bi-variate analysis, but regression analysis did not significantly influence (p>0.05). Promotion of smoking resistance skills among children and teens through comprehensive approaches designed to enhance general personal competence by teaching an array of personal and social life skills is recommended.
Smoking ; Schools ; Students ; Developing Countries

Introduction: Lung cancer is the leading malignancy metastatic to the central nervous system with approximately 20% to 44% of all cases developing brain metastasis. Immunotherapy using pembrolizumab, an anti-PD1monoclonal antibody, is a novel method in lung cancer treatment and has shown favorable results in patients with metastatic brain lesions from non-small cell lung carcinoma (NSCLC). However, the cost of the recommended treatment dose limits its use especially in developing countries like the Philippines. Case Presentation: The authors report two patients with lung cancer with brain metastasis upon diagnosis. The first patient is a 65-year-old male, non-smoker with PD-L1 expression of 60%. He was started on pembrolizumab 100 mg IV every three (3) weeks and a repeat CT scan after 11 cycles revealed a reduction of the two brain metastatic lesions and no fluoro-D-glucose (FDG) uptake on positron emission tomography (PET) scan even after one year into treatment. The second patient is a 67-year-old female, a previous smoker with PD-L1 expression of 50% with a metastatic solitary solid nodule in the cortex of the right cerebellum. After five cycles of pembrolizumab 100 mg IV every three weeks, there was noted complete resolution of brain metastasis on PET scan even after one year of treatment. Conclusion A lower dose of pembrolizumab (100 mg given every 3 weeks) was found to be effective in the management of advanced NSCLC with brain metastasis in the two patients. Further studies are recommended to investigate lower dose pembrolizumab as monotherapy without radiation therapy or surgery in patients with NSCLC with brain metastasis especially in the setting of a resource-limited country like the Philippines.
Immunotherapy ; Lung Neoplasms ; Developing Countries

At the start of the pandemic, the Philippines had to send swab samples to the Victorian Infectious Diseases Reference Laboratory in Melbourne, Australia for COVID-19 confirmation. With the increasing number of suspected cases needing confirmatory diagnostic testing, there was a demand to rapidly expand the capacity for widescale testing. Remarkably, within 200 days from announcement of the first confirmed COVID-19 case in the Philippines in January 30, 2020, the country has been able to expand its testing capacity from one national reference laboratory, the Research Institute for Tropical Medicine (RITM), to more than 100 licensed reverse transcription-polymerase chain reaction (RT-PCR) and cartridge-based PCR laboratories across the country. Due to the shortage of a trained clinical laboratory workforce, diagnostic centers are forced to hire additional personnel who have limited experience and technical knowledge and skills of molecular assays, especially in processing specimens, interpreting the results, identifying errors, and troubleshooting, in order to meet the demand of increased testing. Thus, the vulnerability to diagnostic errors, including cross-contamination, is increased and with the tendency for generating false positive results that can compromise the health of the patient and disrupt the efficacy of public health policies and public health response, surveillance programs, and restrictive measures for containing the outbreak. Hence, this review article aims to present the different sources of contamination in the laboratory setting where RT-PCR assays are conducted, as well as provide efficient, effective and feasible solutions to address these issues, most especially in low- and middle-income countries (LMICs) like the Philippines.
Developing Countries ; Quality Control ; Diagnosis