OBJECTIVE

This study aimed to estimate the incidence of hypertension and determine the risk factors for hypertension among apparently healthy adult Filipinos.

This observational prospective community-based study included apparently healthy adult individuals aged 20–50 years from the Life Course Study in Cardiovascular Disease Epidemiology (LIFECARE) Philippine cohort at baseline and followed-up after an average of four years. Sociodemographic data, psychosocial stress, and clinical and metabolic profiles were obtained and analyzed. Multivariable Cox regression analysis was performed to identify factors associated with the development of hypertension.

A total of 2,089 non-hypertensive participants were included, with 59% women and average age of 35 years (SD = 8.4). The incidence rate of hypertension was 38.1 per 1,000 person-years. The cumulative incidence of hypertension over a mean follow-up time of four years was 15.4% (95% CI = 13.9–17.0%). The risk of incident hypertension was higher among males (aHR=1.3, 95% CI: 1.0–1.8; p=0.044), ≥40 years old (aHR=3.9, 95% CI: 2.6–5.8; pCONCLUSION

The 4-year incidence rate of hypertension among apparently healthy adult Filipinos is high. Increased age, male sex, family history of hypertension, abdominal obesity, and high normal blood pressure were significantly associated with the development of hypertension.

OBJECTIVE: To assess the risk of aristolochic acid (AA)-associated cancer in patients with AA nephropathy (AAN). METHODS: A retrospective study was conducted on patients diagnosed with AAN at Peking University First Hospital from January 1997 to December 2014. Long-term surveillance and follow-up data were analyzed to investigate the influence of different factors on the prevalence of cancer. The primary endpoint was the incidence of liver cancer, and the secondary endpoint was the incidence of urinary cancer during 1 year after taking AA-containing medication to 2014. RESULTS: A total of 337 patients diagnosed with AAN were included in this study. From the initiation of taking AA to the termination of follow-up, 39 patients were diagnosed with cancer. No cases of liver cancer were observed throughout the entire follow-up period, with urinary cancer being the predominant type (34/39, 87.17%). Logistic regression analysis showed that age, follow-up period, and diabetes were potential risk factors, however, the dosage of the drug was not significantly associated with urinary cancer. CONCLUSIONS No cases of liver cancer were observed at the end of follow-up. However, a high prevalence of urinary cancer was observed in AAN patients. Establishing a direct causality between AA and HCC is challenging.
Humans ; Retrospective Studies ; Incidence ; Carcinoma, Hepatocellular ; Liver Neoplasms/epidemiology* ; Kidney Diseases/chemically induced* ; Aristolochic Acids/adverse effects*

BACKGROUND AND OBJECTIVE

Scabies is the second most common cause of disability due to skin disease in the Philippines. However, there were no cited studies in Global Burden of Disease 2019 and the disability-adjusted life years (DALY) computations were most likely based on statistical modelling. The Philippine Department of Health has embarked on a program to estimate the disease burden of priority diseases in the country, which include scabies. The last nationwide prevalence survey was 23 years ago. This systematic review aimed to estimate the prevalence or incidence of scabies in the Philippines.

We searched PubMed, Scopus, Herdin, and Philippine Health Research Registry (search date October 2022) for studies on prevalence/incidence (including systematic reviews, cross-sectional studies, cohort studies, case series, registry or census studies) of patients diagnosed with scabies in the Philippines. We excluded narrative reviews, commentaries, and conference proceedings or abstracts. Two reviewers independently screened titles and abstracts, assessed full text reports for eligibility, appraised the quality of included studies, and collected data using a pretested data extraction form. We did not pool studies due to clinical heterogeneity but plotted the individual studies in a forest plot with prevalence estimates and confidence intervals. We reported the median and interquartile range for entire group or relevant subgroups (age, setting) of studies. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of evidence.

We included nine studies (N=79,065). Most were clinic-based prevalence studies, retrospective chart reviews, conducted in dermatology outpatient clinics, Metro Manila area, and on pediatric populations. Prevalence of scabies was moderate (i.e., between 2 and 10%), ranging from 2.75% (national prevalence survey) to 6.8% (communitybased review), to high (> 10%) among pediatric patients in clinic-based retrospective chart reviews (29 to 36%) and institution-based surveys (39.0% to 45%), and a tertiary government university training hospital dermatology clinic (22.9%). The most affected age group was from 0 to 14 y/o, while males tended to have a higher prevalence than females. The cooler month of January had higher prevalence than the hotter month of June in one study.

Scabies is common in the Philippines, especially among children and elderly in institutional settings, and during the month of January. There is a need to do a national prevalence survey to identify high-risk areas and to monitor the prevalence of scabies, especially in crowded settings and vulnerable populations. This information can be used for estimating the burden of disease for scabies and guide appropriate health resource allocation.

Objective: This study aimed to estimate the incidence of hypertension and determine the risk factors for hypertension among apparently healthy adult Filipinos. Methods: This observational prospective community-based study included apparently healthy adult individuals aged 20–50 years from the Life Course Study in Cardiovascular Disease Epidemiology (LIFECARE) Philippine cohort at baseline and followed-up after an average of four years. Sociodemographic data, psychosocial stress, and clinical and metabolic profiles were obtained and analyzed. Multivariable Cox regression analysis was performed to identify factors associated with the development of hypertension. Results: A total of 2,089 non-hypertensive participants were included, with 59% women and average age of 35 years (SD = 8.4). The incidence rate of hypertension was 38.1 per 1,000 person-years. The cumulative incidence of hypertension over a mean follow-up time of four years was 15.4% (95% CI = 13.9–17.0%). The risk of incident hypertension was higher among males (aHR=1.3, 95% CI: 1.0–1.8; p=0.044), ≥40 years old (aHR=3.9, 95% CI: 2.6–5.8; p < 0.001), family history of hypertension (aHR=1.4, 95% CI: 1.1–1.7; p=0.007), abdominal obesity (aHR=1.4, 95% CI: 1.0–2.0; p=0.027), baseline systolic blood pressure (SBP) of at least 130 mm Hg or diastolic blood pressure (DBP) of at least 80 mm Hg (aHR=5.1, 95% CI: 3.8–6.8; p < 0.001). Conclusion The 4-year incidence rate of hypertension among apparently healthy adult Filipinos is high. Increased age, male sex, family history of hypertension, abdominal obesity, and high normal blood pressure were significantly associated with the development of hypertension.
Human ; hypertension ; incidence

Background: Due to the increasing number of elderly patients being referred to anesthesia for surgical procedures, there is a growing interest with regard to the incidence of postoperative delirium and its contributing factors. Objectives: The primary objective of this study is to determine the incidence of postoperative delirium in the charity elderly patients at the Philippine General Hospital (PGH). Methods: The incidence of postoperative delirium was assessed in an analytic prospective study conducted at the PGH among elderly patients undergoing elective surgeries. Through interviews and chart reviews, the collected data focused on baseline intellectual status, age, gender, ASA classification, level of education, comorbidities, vices, previous surgeries, maintenance medications, preoperative diagnostics, duration of surgery, duration of anesthesia, type of anesthetic technique, and pain scores at the recovery room and 24 hours postoperatively. Responses to the Short Portable Mental Status Questionnaire (SPMSQ), the Preoperative and Postoperative assessment forms and the Confusion Assessment Method (CAM) instrument were analyzed. Results: It was observed that there was a 2.5% incidence of postoperative delirium in the study population and among the risk factors assessed, polypharmacy and presence of moderate to severe pain scores on the first day following surgery were significant contributors in its occurrence. Conclusion In this preliminary study, the incidence of postoperative delirium as well as the significant contributing factors were described. In succeeding investigations, it is recommended to extend the observation and follow-up periods.
Emergence Delirium ; Aged ; Incidence

Background and Objective: Scabies is the second most common cause of disability due to skin disease in the Philippines. However, there were no cited studies in Global Burden of Disease 2019 and the disability-adjusted life years (DALY) computations were most likely based on statistical modelling. The Philippine Department of Health has embarked on a program to estimate the disease burden of priority diseases in the country, which include scabies. The last nationwide prevalence survey was 23 years ago. This systematic review aimed to estimate the prevalence or incidence of scabies in the Philippines. Methods: We searched PubMed, Scopus, Herdin, and Philippine Health Research Registry (search date October 2022) for studies on prevalence/incidence (including systematic reviews, cross-sectional studies, cohort studies, case series, registry or census studies) of patients diagnosed with scabies in the Philippines. We excluded narrative reviews, commentaries, and conference proceedings or abstracts. Two reviewers independently screened titles and abstracts, assessed full text reports for eligibility, appraised the quality of included studies, and collected data using a pretested data extraction form. We did not pool studies due to clinical heterogeneity but plotted the individual studies in a forest plot with prevalence estimates and confidence intervals. We reported the median and interquartile range for entire group or relevant subgroups (age, setting) of studies. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of evidence. Results: We included nine studies (N=79,065). Most were clinic-based prevalence studies, retrospective chart reviews, conducted in dermatology outpatient clinics, Metro Manila area, and on pediatric populations. Prevalence of scabies was moderate (i.e., between 2 and 10%), ranging from 2.75% (national prevalence survey) to 6.8% (communitybased review), to high (> 10%) among pediatric patients in clinic-based retrospective chart reviews (29 to 36%) and institution-based surveys (39.0% to 45%), and a tertiary government university training hospital dermatology clinic (22.9%). The most affected age group was from 0 to 14 y/o, while males tended to have a higher prevalence than females. The cooler month of January had higher prevalence than the hotter month of June in one study. Conclusion Scabies is common in the Philippines, especially among children and elderly in institutional settings, and during the month of January. There is a need to do a national prevalence survey to identify high-risk areas and to monitor the prevalence of scabies, especially in crowded settings and vulnerable populations. This information can be used for estimating the burden of disease for scabies and guide appropriate health resource allocation.
Scabies ; Philippines ; Epidemiology ; Prevalence ; Incidence

Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.
Adult ; Humans ; Adolescent ; Imatinib Mesylate/adverse effects* ; Incidence ; Antineoplastic Agents/adverse effects* ; Retrospective Studies ; Pyrimidines/adverse effects* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy* ; Treatment Outcome ; Benzamides/adverse effects* ; Leukemia, Myeloid, Chronic-Phase/drug therapy* ; Aminopyridines/therapeutic use* ; Protein Kinase Inhibitors/therapeutic use*

BACKGROUND: There is limited data to comprehensively evaluate the epidemiological characteristics of multiple myeloma (MM) in China; therefore, this study determined the characteristics of the disease burden of MM at national and provincial levels in China. METHODS: The burden of MM, including incidence, mortality, prevalence, and disability-adjusted life years (DALYs), with a 95% uncertainty interval (UI), was determined in China following the general analytical strategy used in the Global Burden of Disease, Injuries, and Risk Factors Study 2019. The trends in the burden of MM from 1990 to 2019 were also evaluated. RESULTS: There were an estimated 347.45 thousand DALYs with an age-standardized DALY rate of 17.05 (95% UI, 12.31-20.77) per 100,000 in 2019. The estimated number of incident case and deaths of MM were 18,793 and 13,421, with age-standardized incidence and mortality rates of 0.93 (95% UI, 0.67-1.15) and 0.67 (95% UI, 0.50-0.82) per 100,000, respectively. The age-specific DALY rates per 100,000 increased to more than 10.00 in the 40 to 44 years age group reaching a peak (93.82) in the 70 to 74 years age group. Males had a higher burden than females, with approximately 1.5- to 2.0-fold sex difference in age-specific DALY rates in all age groups. From 1990 to 2019, the DALYs of MM increased 134%, from 148,479 in 1990 to 347,453 in 2019. CONCLUSION The burden of MM has doubled over the last three decades, which highlights the need to establish effective disease prevention and control strategies at both the national and provincial levels.
Humans ; Male ; Female ; Adult ; Aged ; Global Burden of Disease ; Quality-Adjusted Life Years ; Multiple Myeloma/epidemiology* ; Global Health ; Incidence ; Prevalence ; Risk Factors ; China/epidemiology*

BACKGROUND: Primary malignant bone tumors are uncommon, and their epidemiological features are rarely reported. We aimed to study the incidence and death characteristics of bone tumors from 2000 to 2015. METHODS: Population-based cancer registries submitted registry data to National Central Cancer Registry of China (NCCRC). The data collected from 501 local cancer registries in China were assessed using NCCRC screening methods and criteria. Incidence and mortality rates of primary bone tumor were stratified by age group, gender, and area. Age-standardized incidence and mortality rates were adjusted using the Chinese standard population in 2000 and Segi's world population. The annual percentage change (APC) in rate was calculated using the Joinpoint Regression Program. RESULTS: Data from 368 registries met quality control criteria, of which 134 and 234 were from urban and rural areas, respectively. The data covered 309,553,499 persons. The crude incidence, age-standardized incidence, and crude mortality rates were 1.77, 1.35, and 1.31 per 100,000, respectively. Incidence and mortality rates were higher in males than those in females; they showed downward trends, with declines of 2.2% and 4.8% per year, respectively, and the rates in urban areas were lower than those in rural areas. Significant declining trends were observed in urban areas. Stable trends were seen in rural areas during 2000 to 2007, followed by downward trends. Age-specific incidence and mortality rates showed stable trends in the age group of 0 to 19 years, and downward trends in the age group elder than 19 years. CONCLUSIONS The incidence and mortality rates of primary malignant bone tumors in rural areas were higher compared to those in urban areas. Targeted prevention measures are required to monitor and control bone tumor incidence and improve the quality of life of affected patients. This research can provide a scientific basis for the prevention and control of bone tumors, as well as basic information for follow-up research.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Young Adult ; China/epidemiology* ; Incidence ; Quality of Life ; Bone Neoplasms/mortality* ; East Asian People

BACKGROUND: Atherosclerosis-related diseases represent significant health issues among adults globally. Despite their widespread impact, comprehensive data concerning the global and national burden and trends of these diseases remain sparse. Our objective is to examine the trends in the burden of atherosclerosis among adults from 1990 to 2019 at both global and national levels. METHODS: We reported the average annual percentage changes (AAPCs) in prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of atherosclerosis-related diseases (ischemic heart disease [IHD], ischemic stroke, and peripheral arterial disease [PAD]) at the global and national levels among individuals based on a trend analysis of the Global Burden of Diseases Study (GBD) 2019. We further analyzed these global trends as a function of age, gender, and the social development index. We also used joinpoint regression analysis to identify the year with the most substantial changes in global trends. RESULTS: Globally, the AAPC of IHD incidence rose from 1990 to 2019 (0.20; 95% confidence interval [CI], 0.12-0.28), with substantial surges in 1995, 2001, 2005, 2010, and 2017. Conversely, AAPC of IHD mortality rates exhibited a different trend until a rise in 2014. The AAPC of incidence rates of ischemic stroke and PAD also escalated during the same period, with respective 0.43 (95% CI, 0.39-0.48) and 0.13 (95% CI, 0.06-0.21). For ischemic stroke, both incidence and mortality soared in 2014, while PAD incidence declined in 1994 and 1998, then sharply climbed in 2016. Nationally, the Northern Mariana Islands experienced the steepest increase in IHD and PAD incidence and mortality between 1990 and 2019. China saw a significant rise in ischemic stroke incidence, whereas the highest mortality rate increase occurred in Timor-Leste. By sociodemographic index (SDI) quintile, low-middle-, middle-, and high-middle-SDI countries all showed upward trends in IHD, ischemic stroke, and PAD incidence. Simultaneously, IHD and ischemic stroke mortality rates, as well as DALYs, dropped in the low-, high-middle-, and high-SDI nations. However, PAD mortality rates and DALYs saw an uptick across all SDI quintiles. Regarding age demographics, a global decrease in the AAPC IHD incidence as noted in individuals above 55 years old, in contrast to an increase in the 20-55 age group during this period. AAPC of mortality rates for IHD, ischemic stroke, and PAD decreased across all ages. The AAPC showed an increase in IHD incidence in both genders. Conversely, IHD's DALYs saw a reduction in both males and females. Ischemic stroke patterns mirrored these trends, whereas all measures for PAD exhibited growth for both sexes. CONCLUSIONS From 1990 to 2019, there was an overall increasing trend in the global incidence of all three clinical manifestations of atherosclerosis. Between 1990 and 2019, both the mortality rate and DALYs for IHD and ischemic stroke declined across all age groups. Overall, the burden of atherosclerosis-related diseases has not significantly decreased and even shows signs of trending upward. These findings strongly suggest that despite some progress made, efforts to control atherosclerosis diseases globally need to be intensified.
Adult ; Humans ; Male ; Female ; Middle Aged ; Global Burden of Disease ; Quality-Adjusted Life Years ; Atherosclerosis/epidemiology* ; Myocardial Ischemia/epidemiology* ; Incidence ; Ischemic Stroke