Background: Neonatal sepsis complicated with neutropenia increases risk of mortality by 50%. The immature neutrophil production of neonates is often overwhelmed by severe infection. Granulocyte colony stimulating factor (G-CSF), a naturally occurring cytokine used to support neutrophil recovery during chemotherapy, is a possible treatment that can improve outcomes of neonatal sepsis. Objectives: To determine the efficacy of G-CSF in decreasing mortality and morbidity in septic neonates. Methodology: Electronic searches were conducted on online journal databases. Unpublished or ongoing studies ere sought in training institutions accredited by the Philippine Pediatric Society. The investigators included randomized control trials using G-CSF on septic neonates. Results: Twenty-two trials were identified and thirteen were assessed to be eligible for review. The studies had a total of 530 participants, with the largest having 78 subjects. Relative risks (RR), mean differences (MD) and standard mean differences (SMD) with 95% confidence intervals (CI) using the fixed effect model and random effects model were reported in the results. There was a significant decrease in mortality (RR 0.69, 95% CI 0.48 to 0.99) with a greater reduction for preterm neonates, low birth weight neonates and neutropenic neonates. There was no significant reduction in morbidities caused by neonatal sepsis. Conclusions There is moderate quality evidence that suggests that G-CSF as an adjunct treatment for neonatal sepsis significantly decreases mortality with greater benefit to preterm neonates, low birth weight neonates and those with baseline neutropenia. The studies did not show any benefit in reducing sepsis-related morbidity.
Neonatal Sepsis ; Neutropenia

Objective: To describe patterns of feeding difficulties and behaviors of Filipino children diagnosed with Autism Spectrum Disorder (ASD). Methods: An electronic mealtime survey was administered to caregivers of 3- to 9-year-old children diagnosed with ASD in a Philippine tertiary government hospital. Descriptive statistics and correlation analyses between feeding difficulties measured as Mealtime Survey Score, sociodemographic data, and early feeding history were performed. The impact of the COVID-19 pandemic to these was analyzed through a binomial test. Results: All of the 115 study subjects reported at least one problematic feeding behavior, with picky eating being the most frequent (61.74%). Significantly, more feeding difficulties were observed among the children with reported early feeding difficulties during their 2nd and 3rd year of life. There were no documented statistically significant changes in feeding behaviors during the past six months of the COVID-19 pandemic. Conclusion There is a high prevalence of feeding difficulties and problematic feeding behavior among Filipino children with ASD, however no significant changes to these during the past six months of the COVID-19 pandemic were documented. Present feeding difficulties and behaviors were associated with history of early feeding difficulties, highlighting the need to include feeding difficulties in screening tools, and early training programs and interventions for children with ASD.
Autism Spectrum Disorder: Child ; Feeding Behavior ; COVID-19

Background. The increasing prevalence of autism has significantly impacted the health care spending of many families worldwide. To date, families from low to middle-income countries are burdened with out-of-pocket spending as their local health care systems have yet to incorporate autism-related services into the health care infrastructure.

Objectives. This study aimed to determine the direct costs of diagnosing and caring for children with autism and analyze its impact on the Filipino family.

Methods. The cross-sectional study consisted of a self-administered questionnaire that looked at parents' employment status, family income, and the direct costs for consultations, diagnostic tests, therapy, education, and medications. Study participants were parents living with their child diagnosed with autism, ages 2 to 6 years old at the time of the study.

Results. One hundred fifty-eight parents participated in the survey for the cost of care for children with autism. Sixty-seven (42.4%) of parents received government or subsidized medical services for their children's consultation and/ or intervention, while the rest went to private centers or hospitals. The total costs for all evaluations that confirmed the autism diagnosis ranged from ?1,356 to ?44,634 and averaged ?7,411.80 per child. Overall, the mean cost of interventions post-diagnosis, including therapy, education, medications, and developmental evaluations for the first year, was ?38,868 or ?3,239 per month (21% percent of the monthly expenditures for a household with an income of ?15,000/month). The total cost of care per child was closely related to the family's revenue in the sample population. Families with higher incomes also had higher expenditures for autism-related services.

Conclusion. Autism imposes a significant economic burden on Filipino families, particularly the minimum-wage household earners who spent a higher proportion of their budget (21%) on autism-related services. The wide range of total costs for the care of the children in the study may be explained by the wide variability of the expenses for the services, differences in access to services, socioeconomic status, and the wide variation in needs of children with autism due to the nature of the condition.