The 1961 cholera epidemic in Manila, Republic of the Philippines

A pandemic of El-Tor-type cholera began in south-east Asia during 1961. Many members of the medical profession, as well as government officials and the public, were confused by the relationship between the disease caused by the El Tor organism and classic Asiatic cholera. The authors observed large numbers of cholera patients admitted to San Lazaro Hospital, Manila, early in the Philippine epidemic, and in the present communication they draw attention to certain clinical and epidemiological features of so-called El Tor cholera. The paper not only describes the patients and the epidemic, but also suggests some of the treatment needs during such an epidemic. No indication was found that the disease caused by the classic cholera vibrio is different from that which is designated the El Tor variant.     

Organic Contaminants in the Marine Environment of Manila Bay,Philippines

Organochlorine pesticides (OCs) and polychlorobiphenyls (PCBs) were determined in sediments and oysters’ soft tissues (Cassostrea gigas) collected in selected sites of Manila Bay. Overall, the concentration levels were very low. In sediments, PCBs were the compounds present in higher concentrations, with Σ13PCB congeners averaging 0.69 ± 0.46 ng/g (dry weight), followed by ΣDDT averaging 0.53 ± 0.28 ng/g and Σchlordane with 0.26 ± 0.28 ng/g. Concentrations measured in oysters averaged 20 ± 17 ng/g (dry weight) for Σ13PCB and were higher than ΣDDT, with 9.5 ± 2.4 ng/g, and Σchlordane, with 3.8 ± 3.1 ng/g. No dissolved residues of polar compounds, such as herbicides, and organophosphorous and organochlorine pesticides were found in the bay water. In general, results showed that concentrations of organochlorine pesticide residues, such as DDT, hexachlorocyclohexane, chlordane, lindane, endosulfan, and heptachlor in sediments and oysters were low in comparison with other coastal areas in Asia, although PCB concentrations in oysters were relatively high in some zones of Manila Bay and indicative of loose control of industrial chemical waste discharges into the bay. Nevertheless, current concentrations of persistent organochlorine contaminants in sediments were under threshold effect levels (TELs) and chronic toxic effects are, thus, unlikely to generate impairment of marine biota in Manila Bay.     

HBsAG and HBeAG markers among pregnant women in Manila, Philippines

The sera of 5,684 pregnant women were tested for HBsAG and 432 (7.6%) were found positive. Positive HBsAG sera were then tested for the e antigen and of 413 tested, 115 or 27.8% were positive. The over-all prevalence rate of e antigen was 2.03%. All women were asymptomatic. Six of 13 HBsAG-HBeAg-positive mothers delivered infants who became HBsAg-positive within two years of age for a rate of 46%. The findings support earlier studies on the importance of the e antigen as an index of perinatal transmission. Also, they support evidence of unusually high rates of transmission among Asian ethnic groups.     

PCBs in sediments and oysters of Manila Bay,the Philippines

Polychlorinated biphenyls (PCBs) were analyzed in sediment and oyster samples from coastal sites inside Manila Bay. Concentrations for 13 individual PCB congeners and total PCBs are reported herein. Median ΣPCB concentration in sediments was 0.46 ng g^?1 dry weight (range 0.10–1.5 ng g^?1) and in oysters it was 15 ng g^?1 dry weight (range 7–73 ng g^?1). The most contaminated areas of the bay were the coastal zones of Metropolitan Manila and Bulacan province. A significant correlation (p < 0.01) was found between ΣPCB concentrations in oysters and in sediments. PCB concentrations measured in the bay sediments were below acute toxic levels to marine biota. Nevertheless, consumption of oysters by human population living around the bay might originate ΣPCB intake rates estimated at about 2.5 times lower than the tolerance limit. Further environmental surveillance is recommended in order to prevent public health risks that may be posed by these chemicals.     

Postpartum IUD - the suture loop

Postabortal IUD insertion has been well researched and successfully used throughout the world with a wide range of IUDs. Postpartum IUD insertion would be equally successful except that this timing has been associated with high expulsion rates. Extensive IUD design research over more than 10 years has not produced a device superior to the original Lippes Loop. This focuses current research on the conditions under which IUDs are inserted instead of on changes and improvements in design. The International Fertility Research Program (IFRP) in North Carolina is conducting research with a modified Lippes Loop with a view to postpartum insertion. Initial trials with the device have been successful and extended trials are under way. This IUD can be placed by hand or with a simple inserter after expulsion of the placenta. After more experience with the device, it is thought that nonmedical personnel can be trained to insert it.     

Diagnosis and management of tuberculosis by private practitioners in Manila, Philippines

SETTING: Private for-profit health care providers are prominent in the health system of the Philippines. OBJECTIVES: To examine the practices of the private practitioners in Malabon, Metropolitan Manila, Philippines, concerning diagnosis and treatment of tuberculosis (TB). DESIGN: Forty-five private practitioners of Malabon who treat adult TB patients were interviewed. RESULTS: For diagnosis, most private practitioners relied on the clinical presentation and result of an X-ray. Only 13% of the respondents routinely also asked for sputum examination. Ninety-six percent used X-ray as a tool to monitor treatment. Sixty percent of the respondents prescribed a regimen consisting of isoniazid, rifampicin, pyrazinamide, and ethambutol. Except for rifampicin, over-dosage was common. For re-treatment cases, none prescribed the WHO-recommended re-treatment regimen. The private practitioners perceived the main reasons for patient non-adherence to be the patients' lack of finances to buy drugs and patients' perceived well being after a certain period of treatment. Patients' lack of money was seen as the main obstacle to compliance. The only case holding mechanism mentioned was occasional clinic appointments of the TB patients. CONCLUSION: Private practices for diagnosis and treatment of TB typically deviate from guidelines. The quality of care among private practitioners needs improvement. Innovative strategies are required.     

Cemetery vase breeding of dengue vectors in Manila, Republic of the Philippines

Aedes albopictus and Ae. aegypti were found breeding abundantly in cement vases within cemeteries in Manila. Aedes albopictus dominated in cemeteries containing vegetation which provided both shade and plant debris for the vase water. The highest larval densities for both species were found from August to December, which is from mid-to-late rainy season. Aedes albopictus is unable to compete successfully with Ae. aegypti in residential areas with sparce vegetation and thus is very limited in its distribution within the city. Biting activity of both species is similar, with peaks occurring between 0530-0600 h and 1730-1800 h.     

School climate for the internally displaced children (IDPs) in Manila,Philippines

ABSTRACT

The article aims to examine the spheres which help create positive school climate suitable for the integration of internally displaced children (IDPs). The paper looks at how the experience of IDP children affects their overall school life as perceived by their own teachers. Data from this study were taken from nine (9) elementary school teachers who participated in the focus group discussion (FGD). The participants, all from a particular school in Manila, handled the IDP students as they continued their studies after displacement. Results suggest that the spheres of safety, supportive and inclusive environment have created a positive school climate for the IDP students. The paper argues that school integration of IDP children requires the positive fulfillment of these spheres. Feeling secured, being surrounded with supportive social network, and learning in inclusive environment are all non-negotiable features of a school climate that facilitates successful school integration. Results of this study provide insights as to what components have to be improved and focused on by host schools when receiving IDP school children.     

A study of diarrhoea-enteritis deaths in infants in Manila, Philippines: Report of a Joint Study Group of the Institute of Hygiene, University of the Philippines, and the Manila Health Department

In view of the high mortality caused by diarrhoea-enteritis among children under two years of age in the Philippines, a study was conducted to determine, first, the accuracy of death certificates ascribing death to this cause and, secondly, the relative importance of certain preventable factors in such death.     

Breast feeding and nutritional status in depressed urban areas of Greater Manila,Philippines

Marasmic infants, weaned from the breast earlier than nutritionally normal infants, were found in depressed areas of Greater Manila, Philippines. Bottle feeding was not a statistically significant cause of malnutrition in a sample of 513 6 to 48 month old children. Other significant variables were mother's education, birth order, morbidity, parental employment, and family stability. The mean weight for age of those bottle fed or weaned for 2 months was slightly greater than for those still breast fed. Both groups were severely malnourished. Incidence of bottle feeding was highest in depressed neighborhoods where the nutritional status of infants was the highest. If poor Filipina mothers, with an average sixth grade education, bottle feed as adequately as they breast feed they would be better off breast feeding, and spending the saved money on weaning foods. The positive correlation between the nutritional status of the infant and the mother's education suggest that education for girls in school could have a beneficial effect on infants' nutrition.     

Occurrence and Sources of Bromate in Chlorinated Tap Drinking Water in Metropolitan Manila, Philippines

Significant levels of potentially carcinogenic bromate were measured in chlorinated tap drinking water in Metropolitan Manila, Philippines, using an optimized ion-chromatographic method. This method can quantify bromate in water down to 4.5 μg l⁻¹ by employing a postcolumn reaction with acidic fuchsin and subsequent spectrophotometric detection. The concentration of bromate in tap drinking water samples collected from 21 locations in cities and municipalities within the 9-month study period ranged from 7 to 138 μg l⁻¹. The average bromate concentration of all tap drinking water samples was 66 μg l⁻¹ (n = 567), almost seven times greater than the current regulatory limit in the country. The levels of bromate in other water types were also determined to identify the sources of bromate found in the distribution lines and to further uncover contaminated sites. The concentration of bromate in water sourced from two rivers and two water treatment plants ranged from 15 to 80 and 12 to 101 μg l⁻¹, respectively. Rainwater did not contribute bromate in rivers but decreased bromate level by dilution. Groundwater and wastewater samples showed bromate concentrations as high as 246 and 342 μg l⁻¹, respectively. Bromate presence in tap drinking water can be linked to pollution in natural water bodies and the practice of using hypochlorite chemicals in addition to gaseous chlorine for water disinfection. This study established the levels, occurrence, and possible sources of bromate in local drinking water supplies.     

Exposure of preschoolers to lead in the Makati area of Metro Manila, the Philippines

A study was conducted in the Makati area of Metro Manila, the Philippines. The study evaluated the significance of playground soil lead intake to the total daily lead burden in preschool children. The lead concentration was measured in residential playground soils, food, water, and hair samples by atomic absorption spectrometer and the data were used to draw conclusions. All of the playground soils were contaminated with lead levels ranging from a minimum of 34.54 microg/g to a maximum of 283.13 microg/g in comparison to the naturally occurring lead level of 15 microg/g in soils. Further, the study conducted a lead analysis on the hair of the study population to determine the accumulated lead intake. Ingestion of 25 mg/day of soil contributed to 4% of the total lead intake per day by children exposed to the study sites. Food (83%) was found to be the major source of lead compared to other sources. The study also includes economic valuation and cost benefit analysis from reducing lead in gasoline.     

Factors associated with health-related quality of life among pulmonary tuberculosis patients in Manila,the Philippines

Purpose

Health-related quality of life (HRQOL) among pulmonary tuberculosis (PTB) patients has not been investigated in the Philippines. This study aimed to describe HRQOL among PTB patients and to determine factors that are associated with HRQOL.

Methods

A cross-sectional survey was conducted at 10 public health centers and 2 non-government organization clinics in District I, Tondo, Manila. Face-to-face interviews using a structured questionnaire including Short Form-8, Duke-UNC Functional Social Support Questionnaire, and Medical Research Council (MRC) dyspnea scale were performed with 561 PTB patients from September to November 2012.

Results

HRQOL among PTB patients was generally impaired. Factors associated with lower physical component summary were exposure to secondhand smoke (SHS) (P = 0.038), positive sputum smear result (P = 0.027), not working (P = 0.038), lower education level (P < 0.01), number of symptoms (P < 0.01), number of adverse drug reactions (ADRs) (P < 0.01), higher score on the MRC dyspnea scale (P < 0.01), and low perceived social support (P = 0.027). Lower body mass index (P = 0.016), non-SHS exposure (P = 0.033), number of symptoms (P < 0.01), number of ADRs (P < 0.01), low perceived social support (P < 0.01), and negative perception for waiting time in the clinic (P = 0.026) were identified to be factors significantly associated with lower mental component summary.

Conclusion

Socioeconomic status including SHS exposure and low perceived social support, in addition to clinical factors, may be associated with poor HRQOL. Further study would be needed to assess our findings.