BACKGROUND AND OBJECTIVES

The global pandemic caused by Coronavirus Disease 2019 (COVID-19) has affected millions, with growing evidence of the potential role of ocular tissues in viral transmission. At the time of writing, local data regarding the phenomenon was limited. This study investigated external ocular manifestations in patients with COVID-19 at a referral center in the Philippines, examined correlations between demographics, systemic manifestations, and laboratory results with ocular manifestations, and determined their timing relative to systemic symptoms.

METHODS

This single-center, descriptive cross-sectional study was carried out from December 8 to 18, 2020 at the adult COVID-19 wards of the Philippine General Hospital involving 72 participants. Data collection involved relevant clinical history taking and performing gross eye examination. The prevalence of ocular manifestations was described with 95% confidence intervals. Correlations between ocular manifestations and quantitative variables were analyzed with point-biserial correlation, and associations with qualitative variables were tested using chi-square or Fisher’s exact tests.

RESULTS

Among participants, 31.9% presented with ocular manifestations with foreign body sensation as the most prevalent ocular symptom (11.1%) and conjunctival hyperemia as the most prevalent ocular finding (19.4%). The median age of patients with ocular manifestations was 41 years old with a higher prevalence in the male population (73.9%, CI=95%, p=0.001). No significant correlation was observed between presence of external ocular manifestations and the different systemic and ocular co-morbidities as well as with COVID-19 clinical classification. Among those who experienced symptoms, majority (29.2%) of the patients experienced systemic symptoms prior to the onset of ocular symptoms. Ocular complaints may present as the sole manifestation (13.9%). Several laboratory parameters were measured and only temperature and AST levels showed a low positive correlation with the presence of ocular manifestations. 

CONCLUSION

Ocular manifestations occur in roughly one third of patients with COVID-19 based on this study population. With some individuals presenting with ocular signs or symptoms as the initial and sole manifestation, healthcare practitioners must exercise caution and remain vigilant in managing patients who present as such. At the time of writing, this is the first local study investigating the different external ocular manifestations in patients with COVID-19. There is a need to pursue more robust studies and conduct more local investigations which will guide both ophthalmologists and other practitioners in strengthening existing guidelines regarding precautionary practices, clinical diagnosis, and management of COVID-19 patients.

Human ; Sars-cov-2 ; Covid-19 ; Philippines ; Adult ; Association ; Classification ; Collection ; Confidence Intervals ; Coronavirus ; Cross-sectional Studies ; Data Collection ; Demography ; Diagnosis ; Disease ; Exercise ; Eye ; Foreign Bodies ; History ; Hospitals ; Hospitals, General ; Hyperemia ; Laboratories ; Male ; Morbidity ; Ophthalmologists ; Pandemics ; Patients ; Population ; Prevalence ; Referral And Consultation ; Role ; Sensation ; Temperature ; Time ; Tissues ; Volition ; World Health Organization ; Writing

Introduction: COVID-19 pandemic placed unprecedented strain on hospital resources and manpower. This study assesses the impact of Malaysia’s nationwide lockdown on the incidence, types, severity, and outcomes of emergency general surgery (EGS) cases at a tertiary care hospital. Methods: This retrospective cohort study analysed the data of patients who underwent EGS procedures for the period 2017 and 2021. Results: During the pandemic period, there was a 48.3% reduction in EGS cases (n=889) compared to the pre-pandemic period (n=1720). Significant reductions were observed in surgeries for appendicitis, soft tissue infection, colorectal, urology, peptic ulcer, and vascular disorders in the COVID period. Conversely, procedures for biliary disorders and hernia complications increased by 7.4% and 5.5%, respectively. Length of hospital stay increased by 57.8% for patients with small bowel disorders, while ICU/HDU admissions rose by 43.5% for colorectal cases (P < 0.05). There was no significant difference in mortality rates between the two periods. Conclusions The overall reduction in EGS procedures during the COVID-19 period was consistent with global trends. Despite the challenges posed by the pandemic, the outcomes related to duration of stay, ICU/HDU utilisation, and mortality remained comparable to the pre-pandemic period. These findings highlight the adaptability of healthcare professionals in maintaining continuity and quality of emergency surgical care during a crisis.
Acute Care Surgery ; COVID-19 ; Pandemics

BACKGROUND

Vaccine hesitancy among senior citizens remains common in many countries. This was significantly observed during the COVID-19 pandemic in Dauis, Bohol, Philippines. However, there is limited research on the factors influencing this hesitancy.

OBJECTIVE

This study aimed to identify the determinants associated with COVID-19 vaccine hesitancy among senior citizens in the municipality of Dauis, Bohol.

METHODS

This case-control study employed a modified survey questionnaire adapted from relevant literatures. A total of 497 registered senior citizens participated, of whom 331 were vaccinated against COVID-19 and 166 were unvaccinated. The study determined the socio-demographic factors, health status, and perceptions of COVID-19 vaccine safety. Bivariate and multivariable logistic regression analyses were used to identify factors associated with vaccine hesitancy.

RESULTS

The study found that respondents aged 84 and older were significantly more likely to exhibit vaccine hesitancy (p = 0.018, OR = 7.817). In contrast, factors associated with a reduced likelihood of hesitancy included having tertiary education (p = 0.012, OR = 0.239), a low income (p = 0.042, OR = 0.138), receiving an annual flu vaccine (p = 0.020, OR = 0.328), and perceiving the COVID-19 vaccine as safe (p = 0.000, OR = 0.032).

CONCLUSION

Age is a significant determinant of COVID-19 vaccine hesitancy. Educational attainment, monthly income, receipt of annual influenza vaccine and perception on vaccine safety were found to be influential determinants. These findings offer valuable insights for evidence-based interventions to enhance vaccine acceptance to this vulnerable population.

Human ; Vaccination Hesitancy ; Covid-19 ; Pandemics ; Vaccination

BACKGROUND AND OBJECTIVE

There are mixed reports on nurses’ satisfaction with electronic medical records (EMR) in literature, and facilitators and barriers to its adoption were reported frequently. A Philippine public tertiary hospital developed an EMR to facilitate remote access to patient charts outside its COVID-designated areas during the pandemic. This study aims to assess nurses’ satisfaction with EMR use in order to improve their user experience. The Delone and McLean Information System (D&M IS) Success Model was used as its framework. This offers a unique perspective to EMR adoption by accounting for the effects of the pandemic.

METHODS

A descriptive, cross-sectional, quantitatively driven, concurrent mixed-methods design was employed. Nurses from the hospital were recruited for the survey (n=353) and the focus group discussions (n=14). Ethical approval was obtained prior to its conduct. Analysis was done through descriptive statistics, multiple linear regression, and thematic analysis. Data were integrated to appreciate the differences in their experiences from the point of adoption up to their current experiences.

RESULTS

Nurses initially faced challenges with the EMR when it was introduced, but improvements and continuous use have led to their current high satisfaction. Despite mandatory use and high usage scores, some daily tasks are still done manually. Use, length of service, number of patients handled, designation, and area of assignment were found to be associated with satisfaction. Thematic analysis highlighted several adoption prerequisites in this setup, including assessment of user competence and experience, and the provision of training, structural necessities, and organizational support.

CONCLUSION

This study found high use and satisfaction scores, aligning with the D&M IS Success Model, despite initial adoption challenges. Recommendations include maintaining high EMR use and improving efficiency, communication, and collaboration. Emphasis was placed on the provisions of better training and continuous feedback gathering.

Human ; Electronic Health Records ; Health Information Systems ; Nurses ; Pandemics ; Philippines

Practice-based learning is the key objective of postgraduate education. COVID-19 has revealed that medical institutions may need to adopt adaptive strategies to guide their students. The aim of this study is to describe the perception of Philippine medical clerks towards their surgical preparedness with an Enriched Virtual Mode (EVM)-Hybrid Learning during the pandemic. A cross-sectional survey was conducted among 176 fourth-year students using a 21-item 4-point-Likert questionnaire. Descriptive analysis showed that students sustained a strong enthusiasm for surgery (composite mean = 2.83 ± 0.62), with the highest ratings given to skill-oriented subjects, such as practical minors (3.05 ± 0.82) and clinical surgery (3.03 ± 0.78). Preparedness was similarly high (3.17 ± 0.46): practice was regarded as essential (3.50 ± 0.68) and operating-room exposure useful (3.22 ± 0.68), though time for hands-on practice was adequate (2.84 ± 0.74). Preference scores revealed a desire for richer tactile experience (3.36 ± 0.37), with scrubbing, suturing and live surgery observation receiving most support (>3.50). Overall satisfaction reached a moderate-to-high level (2.99 ± 0.48) but lagged behind interest and preparedness, indicating that limited physical immersion tempered fuller contentment. These suggest that while a blended curriculum can preserve enthusiasm and sense of readiness, emphasis on protected skills laboratories and increased exposure to the operating room may be needed to translate conceptual competence into experiential fulfillment.

Human ; Male ; Female ; Young Adult: 19-24 Yrs Old ; Cross-sectional Studies ; Education ; Curriculum ; Perception ; Observation ; Schools, Medical ; Personal Satisfaction ; Learning ; Mental Competency ; Laboratories ; Pandemics

BACKGROUND

Coronavirus disease 2019 (COVID-19) infection is still a problem in our country for the past 2 years. The pandemic severely affected the immunocompromised and high-risk group of patients, such as the pregnant and lactating women. Research shows that this group has higher risk of being critically ill as well as dying. However, there are only a few studies on how COVID-19 vaccine is perceived among this vulnerable group. Hence, this study aims to assess the knowledge, attitude, and practices on COVID-19 vaccine among high-risk pregnant and lactating women. Moreover, the results will be used in crafting health policies that affect this specific group of patients.

METHODOLOGY

A prospective cross-sectional study was conducted on high-risk pregnant and lactating women who sought antenatal consults at the High-Risk Clinic in a tertiary training hospital for a 1-month period. Participants were asked to answer a validated questionnaire assessing their knowledge, attitudes, and practices on COVID-19 vaccine. They were also asked about their sociodemographic characteristics, co-morbidities, history of COVID-19 infection, and vaccination status, as well as the source of their information regarding the vaccine. Descriptive statistics was used to summarize in this study. In addition, frequency and proportion were used for nominal variables, median and range for ordinal variables, and mean and standard deviation for interval or ratio variables. MINITAB 20 was used for data analysis.

RESULTS

A total of 323 high-risk pregnant and lactating women were enrolled in the study with an average age of 29 years old. Socio-demographic characteristics of the participants showed that they were high-school graduate, single, mostly financially disadvantaged, and resides in Cavite, Laguna, Batangas, Rizal and Quezon area. The majority have diabetes mellitus as their co-morbidity, were not infected with COVID-19 and had already been vaccinated. The significant source of information of vaccine information was mainly from social media. The study presented that more than 90% were aware that COVID-19 vaccine was recommended by professional organizations, however, only 55%–59% only agree that it is safe during pregnancy and breastfeeding. The result also conveyed a positive attitude toward vaccination as the pregnancy progresses, as well as during lactation. As to practices, 80% of the participants were told by their health care providers to get vaccinated and 72% of them reported vaccine side effects. Furthermore, 58% of the participants would recommend vaccination during pregnancy while only 54% will recommend it while breastfeeding.

CONCLUSION

Assessment of knowledge, attitudes, and practices of COVID-19 vaccine among high-risk pregnant and lactating women gave an understanding on how a vulnerable population perceives vaccination. In general, this research study presented high percentage COVID-19 vaccine awareness and acceptance; however, it can also be seen that there is a mixed perception regarding vaccine safety during pregnancy and lactation. Strategies to improve health literacy which are evidenced based that can be carried out by a health care provider could be established to achieve maximum vaccination coverage among high-risk group of patients.

Human ; Female ; Coronavirus ; Covid-19 ; Vaccines ; Pandemics

OBJECTIVES

The study aims to identify the gaps and document the best practices in the response during the COVID-19 pandemic. The study also compared how urban and rural sites of local government units (LGUs) implement measures. Hence, the study was conducted to probe into the non-uniform implementation of COVID-19 protocols in two (2) rural and two (2) urban local government units (LGUs), and the best practices that can be done to remedy this gap in disaster risk management.

METHODS

A case study design was employed and analyzed using a triangulation approach to determine the gaps and best practices of the selected urban and rural LGUs in implementing COVID-19 protocols. The study adopted the WHO COVID-19 Strategic Preparedness and Response Plan (SPRP) Monitoring and Evaluation Framework (COVID-19) M&E Framework) in monitoring and tracking situations, containment efforts, and the response during the pandemic around the world. The study was tailored for both urban and rural LGUs in the Philippines to identify their approach in implementing their COVID-19 protocols.

RESULTS

Findings showed that best practices include strict border controls and granular lockdowns, conversion of existing buildings into isolation facilities, and extensive information dissemination. The gaps in implementation identified were the lack of human resources and necessary facilities to treat patients, no purpose-built isolation facilities, “inapplicability” of national protocols and ordinances in local settings, misinformation regarding the COVID-19 pandemic, and uncooperative behavior of the people.

CONCLUSION

Urban and rural communities are recommended to build risk communication and scenarios, establishing “Botika” and mobile vaccination, and extensive information dissemination as remedy to the misinformation regarding the virus, vaccine, and other pandemic-related information. Additionally, penalizing people who spread false information regarding the pandemic also be implemented. Finally, preventive health assistance should be provided to the first responders such as barangay hall personnel.

Human ; Covid-19 ; Pandemics

BACKGROUND

The relationship between pandemics and climate change has emerged as a critical area of study, particularly underscored by the COVID-19 pandemic, which exposed vulnerabilities in global health systems and environmental governance. Although direct evidence linking climate change to the spread of COVID-19 remains limited, rising global temperatures and ecosystem disruptions have intensified human–wildlife interactions, increasing the risk of zoonotic disease emergence.

AIMS AND OBJECTIVES:

This study aims to synthesize existing research on the interconnections between climate change and emerging infectious diseases, identify key knowledge gaps, and provide insights to guide integrated health and environmental policy development.

MATERIALS AND METHODS

A systematic literature review was conducted using peer-reviewed articles published within the past two decades. Relevant studies were identified through scientific databases, focusing on evidence linking climate variability, ecosystem shifts, and zoonotic transmission dynamics.

RESULTS

Findings indicate that climate-induced changes—such as rising temperatures, altered precipitation patterns, and habitat disruption—affect vector ecology and wildlife migration, facilitating conditions for pathogen spillover. However, existing research remains fragmented, with limited longitudinal analyses and region-specific data to quantify these associations.

CONCLUSION

The interconnectedness of human health, environmental health, and biodiversity underscores the need for a holistic One Health approach. Strengthening interdisciplinary collaboration and integrating climate resilience into public health strategies are vital to addressing the multifaceted challenges posed by climate change and emerging pandemics.

Human ; Climate ; Climate Change ; Literature ; Pandemics ; Review

INTRODUCTION

The suspension of face-to-face education across all public and private institutions in the Philippines during the COVID-19 pandemic prompted nationwide adoption of blended learning-a hybrid model combining online and modular instruction with limited in-person components, while blended learning became primary instructional approach during this period, the Dr. Jose Fabella Memorial Hospital School of Midwifery‘s specific implementation lacked formal evaluation. This study aimed to analyze students’ and instructors’ experiences, self-efficacy, and satisfaction with blended learning during the pandemic-era “new normal,” addressing a critical gap in assessing pedagogical effectiveness in specialized vocational training contexts.

METHODOLOGY

This study used mixed method approach to assess of DJFMH midwifery students and instructors’ experiences, self-efficacy, and satisfaction by using quantitative questionnaires and qualitative focus groups to explore deeper insights. This pattern enabled the researchers to evaluate the level of experiences, self-efficacy, and satisfaction but also the strengths and weaknesses of the program.

RESULTS

The findings revealed that the demographic profile predominantly consists of young, single, first-time midwifery students with no prior experience in information and communication technologies (ICT) literacy experience and limited professional background. This group was compared to a more experienced cohort of instructors, with both groups using PLDT as their internet service provider. Both students and instructors reported moderate agreement regarding blended learning experiences. In addition, the results indicated a positive correlation between experience and satisfaction. However, there was only a weak correlation between experience and self-efficacy. Instructors generally reported high self-efficacy, while students expressed mixed feelings about their preparedness and skill acquisition, especially in practical midwifery competencies. Overall, both groups demonstrated moderate levels of satisfaction with the blended learning approach. Instructors largely report higher self-efficacy, while students exhibit mixed feelings about their preparedness and skill acquisition, particularly regarding practical midwifery competencies. Both groups display moderate satisfaction with blended learning, especially appreciating its flexibility in time and location, as well as the fresh perspectives it brings to education. However, they also identify several challenges, including the pressure of expectations, limited adjustment to online platforms, technological issues, gaps in applying midwifery skills, disparities in learning resources, and environmental distractions. Despite recognizing the strengths of blended learning, there remains a strong preference among participants for in-person instruction.

DISCUSSION

The study highlighted the need for multifaceted approach to midwifery education that addresses the disparities in ICT literacy, preferences for in-person instructions, technological competencies, emotional wellbeing, and practice. Policymakers should focus on practical skill development of students and the professional development of instructors to create a more effective and supportive environment. Future studies should conduct longitudinal research to track the progress of students’ skills and confidence.

Human ; Personal Satisfaction ; Vocational Education ; Instructional Films And Videos ; Midwifery ; Pandemics

BACKGROUND

The Philippines has been significantly affected by the HIV epidemic in the Asia-Pacific region, with a notable increase in new cases over the past decade. Despite efforts to promote HIV testing, access to treatment, and awareness campaigns, progress has been slow, particularly among youths. Tangere, a market research application, conducted surveys during and after the COVID-19 pandemic to assess HIV knowledge among Filipinos.

OBJECTIVES

This study aimed to evaluate changes in HIV awareness among young Filipinos during and after the COVID-19 pandemic using data collected via Tangere’s surveys. Specifically, it sought to analyze demographic characteristics, sources of HIV information, and knowledge regarding HIV transmission, prevention, and stigma.

METHODS

Tangere collaborated with the investigators to develop a questionnaire assessing HIV knowledge among young Filipinos. Surveys were conducted during and after the COVID-19 pandemic, targeting subscribers aged 18-35 years, primarily from the National Capital Region and Luzon area. Data analysis involved calculating frequencies and percentages to summarize demographic characteristics and HIV knowledge. An Independent-Samples Proportions procedure was used to compare HIV knowledge during and after the pandemic.

RESULTS

The survey revealed that while respondents generally possessed reasonable knowledge about HIV, there were notable changes in the awareness during and after the pandemic. Social media and television were identified as primary sources of HIV information. Knowledge regarding HIV transmission and prevention increased postpandemic, particularly concerning preventive measures such as pre-exposure prophylaxis (PREP) and motherto-child transmission (MTCT). However, persistent misconceptions and stigma surrounding HIV remained, indicating the need for continued education and advocacy efforts.

CONCLUSION

The study underscores the importance of utilizing social media platforms for HIV awareness campaigns, especially among youths who are disproportionately affected by the epidemic. Despite improvements in knowledge, the Philippines has yet to achieve global HIV prevention goals. Continued efforts to enhance awareness, particularly regarding recent advancements in HIV prevention and treatment, are essential for curbing the epidemic and improving public health outcomes nationwide.

Human ; Knowledge ; Attitude ; Hiv ; Covid-19 ; Pandemics