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Pediatric Infectious Disease Society of the Philippines Journal.2017;18(1):2-. doi:https://doi.org/10.56964/pidspj20171801001

The editorship came in as a big, BIG surprise. This with a bang and the news that our dear EIC (over the last 15 years), Dr. Cecilia Maramba-Lazarte will relinquish her post. The whole gamut of human emotions came into play as if I were this character Riley from “Inside Out”(Disney). I felt overly surprised. There was sadness, disgust, even fear. Anger? Angst? There was no perfect word to describe what it felt to be tasked to carry on and bring further “THE PIDSP JOURNAL”.

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Association between breastfeeding and clinical outcomes of infants with very severe pneumonia

Cherrylyn R. Laguna-Cruz ; Gener T. Becina

Pediatric Infectious Disease Society of the Philippines Journal.2017;18(1):3-10. doi:https://doi.org/10.56964/pidspj20171801002

Objective: To determine the association of breastfeeding with the clinical outcomes of infants with very severe pneumonia. Methods: This retrospective study included intubated, full-term infants between one to six months of age admitted for very severe pneumonia at the critical care units of the National Children’s Hospital from 2005 to-2015. The 52 subjects per type of feeding (exclusively breastfed and non-exclusively breastfed) were selected using simple random sampling. We examined the association between the type of feeding with the length of ICU stay, ventilator days, health-care-associated infection (HAI) and mortality. Results: A total of 104 infants were included in the study. The exclusively breastfed (EBF) infants stayed for a shorter amount of time in the ICU than the non-exclusively breastfed (NEBF) infants (p-value = 0.0067). The EBF infants had shorter intubation period and mechanical ventilation use (p value=0.001), and less HAI (p-value = 0.015). There were more infants with very severe pneumonia who died from the NEBF group but no significant association (p-value = 0.076) was found between mortality and the type of feeding. Conclusion Exclusively breastfed infants who were admitted for very severe pneumonia at the critical care areas showed better outcomes in terms of shorter ICU stay and ventilator use, and lower incidence of HAI as compared to the NEBF infants. However, data showed no significant association between mortality and type of feeding.
Breast Feeding ; Pneumonia

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Effect of bovine colostrum on the absolute neutrophil counts of Acute Lymphocytic Leukemia patients undergoing chemotherapy: A double-blind randomized placebo-controlled study

Edith Cyrill L. Caysido ; Ferdinand Ganggangan ; Rainelda P. Runez

Pediatric Infectious Disease Society of the Philippines Journal.2017;18(1):11-17. doi:https://doi.org/10.56964/pidspj20171801003

Background: Changes in the blood cell counts, such as leukopenia and neutropenia, in patients with Acute Lymphoblastic Leukemia (ALL) are common events following chemotherapy. These commonly delay further administration of chemotherapeutic agents. Furthermore, the risk of infection rises correspondingly with the degree of neutropenia. Bovine colostrum is a rich source of immunoglobulins and other antimicrobial factors. These immunoglobulins are believed to improve the immune function and may be effective in the prevention of neutropenia following chemotherapy. Objective: To determine the efficacy of bovine colostrum in preventing neutropenia among ALL patients undergoing chemotherapy. Methods: This study included pediatric patients, aged 6 months to 18 years old diagnosed with ALL undergoing chemotherapy. Twenty-one subjects were randomly assigned to receive bovine colostrum or placebo that were taken twice a day for a week beginning from the first day of chemotherapy. Baseline complete blood count (CBC) and the absolute neutrophil count (ANC) were determined before and after 7 days of giving the colostrum or placebo. A ttest was applied to determine significant differences before and after the supplementation on each group. Results: Results showed that there was a significant increase in ANC of patients given bovine colostrum as compared to the placebo group with a pvalue of 0.007. There were also significant increases in the white blood cells and platelet counts in those who were given bovine colostrum, with p-values of Conclusion Exclusively breastfed infants who were admitted for very severe pneumonia at the critical care areas showed better outcomes in terms of shorter ICU stay and ventilator use, and lower incidence of HAI as compared to the NEBF infants. However, data showed no significant association between mortality and type of feeding.
Precursor Cell Lymphoblastic Leukemia-Lymphoma

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Predictive factors of treatment failure for pediatric community-acquired Pneumonia C And D In 2-To-59 months of age

Charisse R. Zuniga ; Robert Dennis Garcia ; Rozaida Villon

Pediatric Infectious Disease Society of the Philippines Journal.2017;18(1):18-26. doi:https://doi.org/10.56964/pidspj20171801004

Objective: To determine antibiotic treatment failure rate and predictors of treatment failure in children 2 to-59 months with Pediatric Community Acquired Pneumonia-C (PCAP-C) and PCAP-D admitted at Makati Medical Center. Methods: This prospective cohort study examined 100 children, 2-to-59 months with clinically diagnosed PCAP-C and PCAP-D. Baseline assessment was done on day 1 of hospital stay and follow-up assessments were done on days 3 and 7 or upon discharge for the outcomes of interest. Results: One hundred children were included in the study and 98% had PCAP-C. This study identified a treatment failure rate of 17% among children with PCAP-C. There was no mortality. Malnutrition and low oxygen saturation on admission were significant predictors of treatment failure. Conclusion Antibiotic treatment failure rate was 17%. Malnutrition and hypoxia were significant predictors of treatment failure in children with PCAPC.
Pneumonia ; Malnutrition ; Hypoxia

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Effect of a powerpoint lecture vs video presentation on the knowledge and attitude on HIV among grade 9 public school students

Anne Margarette Canapi ; Jenny Wong ; Kris Ian Mendoza

Pediatric Infectious Disease Society of the Philippines Journal.2017;18(1):27-35. doi:https://doi.org/10.56964/pidspj20171801005

Objective: This study aimed to compare the effect of a Powerpoint lecture versus video presentation on the knowledge and attitude on HIV among grades 9 students in a public school in Manila. Methods: GRADE 9 public school students were randomly assigned into one of two groups, video presentation or PowerPoint presentation. Pre- and post-tests were administered to assess the efficacy of an intervention. Student t-test was used to compare knowledge on HIV/AIDS before and after the intervention, as well as compare the results between the 2 groups. Chi-square was used to compare scores on attitude before and after the intervention, with the level of significance at p=0.05. Results: Two hundred fourteen students participated in the study, and majority (57%) are females. The mean age of participants is 14.2 years. The difference in scores before and after the intervention was found to be statistically significant (p<0.001) with an approximate increase by 16% and 24% after a video and Powerpoint presentation respectively. The difference between post-intervention scores is statistically significant (p <0.001; 95% confidence interval) in favor of the PowerPoint presentation. Conclusion A PowerPoint lecture is more effective than a video presentation in increasing knowledge and developing positive attitude towards HIV/AIDS.
HIV

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Fever of unknown origin in children: A five-year review

Ma. Fema A. Cabanalan-Rivera ; Ma. Liza M. Antoinette M. Gonzales

Pediatric Infectious Disease Society of the Philippines Journal.2017;18(1):36-44. doi:https://doi.org/10.56964/pidspj20171801006

Objective: The clinical presentation, outcome, and risk factors for mortality in children with Fever of Unknown Origin (FUO) were determined. Methods: Medical records of pediatric patients admitted for FUO from January 2009 to December 2013 were reviewed. Clinical manifestations, physical exam findings, diagnostic work-ups and final diagnosis were determined, as well as the relationship between final diagnosis and risk for mortality. Results: Fifty-seven patients with FUO were included. Weight loss, cough, colds, and rashes were common symptoms while pallor, lymphadenopathies, and hepatomegaly were common physical exam findings. All patients underwent Phase I evaluation for FUO, while 73.7% underwent further diagnostic tests. A specific etiology was established in 96.5% of cases: infectious, 43.9%, connective tissue disease, 38.6%, and hematologic/oncologic, 14%. Two cases remained to have no specific diagnosis. Majority of patients had a benign course and were discharged improved (84.2%). The mortality rate is 15.8% and was not associated with any disease category (p-value 0.204). Conclusion FUO in children occurs across all age groups. Its clinical presentations are varied and non-specific and common signs and symptoms are pallor, lymphadenopathies, weight loss, cough, colds. and joints pains. Infection is the most common cause of FUO in children, followed by connective tissue diseases and hematologic and oncologic diseases. The mortality rate from FUO is 15.8%.
Fever of Unknown Origin

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Chronic Granulomatous Disease: An unreported mutation

Melody O. Kiat ; Sté ; phanie Boisson-Dupuis ; Jean-Laurent Casanova ; Jacinta Bustamante ; Maria Beatriz P. Gepte ; Jaime A. Santos

Pediatric Infectious Disease Society of the Philippines Journal.2017;18(1):45-53. doi:https://doi.org/10.56964/pidspj20171801007

Chronic Granulomatous Disease (CGD) is caused by defects in the phagocyte NADPH oxidase and occurs in approximately 1:200,000 births worldwide. It presents with early onset of severe recurrent bacterial and fungal infections. This is a case of a 9-year old male with severe, recurrent bacterial infections since 3 weeks of age. Initial Nitroblue tetrazolium (NBT) reduction tests were normal but a DNA analysis revealed a previously unreported homozygous mutation in CYBB, p.S418Y. Dihydrorhodamine (DHR) test showed poor neutrophil oxidation consistent with X-linked CGD. Definitive microbiologic diagnosis is essential for directing therapy for recurrent bacterial and fungal infections. Treatment of infections should be aggressive. Lifelong bacterial and fungal prophylaxis is necessary for prolonged survival. We report a case of confirmed CGD with the previously unreported mutation.
Granulomatous Disease

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Clinical profile and treatment outcomes of childhood extra-pulmonary tuberculosis in a Children’s Medical Center

Melody O. Kiat

Pediatric Infectious Disease Society of the Philippines Journal.2017;18(2):3-15. doi:https://doi.org/10.56964/pidspj20171802002

Background: Extra-pulmonary tuberculosis comprises 1.1% of all tuberculosis (TB) cases notified in the Philippines.34 Its diagnosis poses a challenge for clinicians due to the protean ways in which the disease presents. Monitoring its treatment outcome is essential to evaluate the effectiveness of the intervention. Objective: This study aims to determine the clinical profile and treatment outcomes of children with extra-pulmonary tuberculosis in a children’s medical center. Methods: This is a retrospective cross-sectional study conducted in a children’s medical center. The medical records of children less than 15 years with extrapulmonary tuberculosis from 2010 to 2014 were reviewed. Demographic, clinical data and treatment outcome were noted. Results: A total of 140 charts were reviewed. Male to female ratio is 2.3:1. The most common age group was 0-4 years and central nervous system (CNS) was the most predominant site. New cases were 96.4% and 97.1% were clinically diagnosed. History of TB contact was elicited in 36.4% and tuberculin skin test was positive only in 39.3%. The most common presenting symptoms were in association with the site of infection. Results of the different diagnostic modalities used have contributed significantly in establishing the diagnosis. Treatment outcome was favorable at 79.3% while deaths were seen in 11.4% of cases. Conclusion The study has shown that proportion of patients with extra-pulmonary tuberculosis was 3%. Treatment outcome was satisfactory at 79.3% but was not significantly associated with the site of infection.
Child

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A meta-analysis on GeneXpert using stool samples in diagnosing pediatric pulmonary tuberculosis

Othella Mary Ann S. Cacayorin

Pediatric Infectious Disease Society of the Philippines Journal.2017;18(2):16-22. doi:https://doi.org/10.56964/pidspj20171802003

Objectives: To find an alternative specimen for GeneXpert assay in the diagnosis of pediatric pulmonary tuberculosis (PTB). To determine the sensitivity and specificity of using stool samples as an alternative to sputum for GeneXpert assay. Methods: A systematic search was done using an electronic database (e.g. Pubmed). Using the keywords “GeneXpert”, “tuberculosis”, “Stool samples”. QUADAS-2 checklist was used in assessing the studies gathered. Revman 5.3 was used to determine the sensitivity and specificity of the study included in this meta-analysis. Results: A total of 185 stool samples were included in this review, which showed a median sensitivity of 77% (IQR 0.63-0.87) and median specificity of 98% (IQR 0.95-1.0). Conclusion Despite the heterogeneous sensitivity, GeneXpert has a high specificity, which enabled rapid diagnosis of pulmonary tuberculosis promoting timely initiation of appropriate therapy.
Stool ; Tuberculosis, Pulmonary

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A retrospective study on sensitivity, specificity, negative predictive value, positive predictive value of TB PCR versus TB Culture in diagnosing tuberculosis in Filipino children aged 3 months to 18 years at a tertiary care center

Jesanel B. Ancheta ; Robert Dennis J. Garcia

Pediatric Infectious Disease Society of the Philippines Journal.2017;18(2):23-35. doi:https://doi.org/10.56964/pidspj20171802004

Objectives: This study aimed to establish the accuracy of TB PCR versus TB culture and rifampicin resistance detection by PCR versus conventional susceptibility testing of body fluids in diagnosing tuberculosis in pediatric patients 3 months to 18 years with suspected tuberculous disease at a tertiary care center. Methods: This is a retrospective analytical study of patients seen between January 1, 2012 to May 31, 2017, with clinical and radiographic features suggestive of tuberculosis, who had diagnostic testing of body fluids for TB PCR and TB culture. Results: Among 159 patients suspected of TB, 46 (28%) tested positive by PCR, of which one was rifampicin-resistant. The sensitivity, specificity, positive predictive value and negative predictive values of TB PCR, using TB culture as the gold standard were 90%, 91.6%, 78.3%, and 96.5% respectively. The sensitivity, specificity, positive predictive value, and negative predictive values of TB PCR for detecting rifampicin resistance, using TB culture and sensitivity as the gold standard, were 33%, 100%, 100%, and 95%, respectively. Overall, the accuracy of TB PCR in detecting TB disease is 91.2% and the accuracy of TB PCR in detecting rifampicin resistance is 95%. Conclusion Findings in our study suggest that TB PCR play an important role in TB disease diagnosis, but clinical and radiological assessment continue to be essential in the diagnosis of childhood tuberculosis. The accuracy of TB PCR in detecting TB disease in children is 91.2% and the accuracy of TB PCR in detecting Rifampicin resistance is 95%.
Tuberculosis ; Pediatrics

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