2009 Journals

Vol.10 No.1 Jan-Dec 2009
PNEUMOCOCCAL SEROTYPES AMONG FILIPINO CHILDREN ADMITTED IN A TERTIARY CARE CENTER FOR INFECTIOUS DISEASES FROM 2000 TO 2005
MRZ Capeding, LT Sombrero, GA Esparar, MU Mondoy
Keywords: streptococcus pneumoniae, pneumococcal serotypes, invasive pneumococcal disease *Research Institute for Tropical Medicine, Muntinlupa City, Metro Manila, Philippines
Abstract:
Streptococcus pneumoniae (SP) infections cause substantial morbidity and mortality especially in young children; therefore, prevention is of importance. Knowledge of the prevailing pneumococcal serotypes is necessary to formulate recommendations regarding use of pneumococcal conjugate vaccine. Fifty four invasive isolates from patients admitted to the Research Institute for Tropical Medicine, one of the tertiary care centers for infectious diseases of the Department of Health, during the years January 2000 to August 2005 were serotyped. Hospital medical records of children with invasive SP infections were reviewed.
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FREQUENCY OF HELICOBACTER PYLORI INFECTION USING THE HELICOBACTER PYLORI STOOL ANTIGEN TEST (HPSAT) AMONG CHILDREN DIAGNOSED WITH DYSPEPSIA
Sharon Casio Uy, M.D.*
Keywords: H. pylori, helicobacter infections, dyspepsia, HPSAT *Chong Hua Hospital
Abstract
Objective: To determine the frequency of Helicobacter pylori infection using the Helicobacter Stool Antigen Test among children diagnosed with dyspepsia.
Study Design: Cross-sectional Study
Setting: Chong Hua Hospital and Clinics of participating pediatricians.
Study Population: Pediatric patients aged 5 to 18 years presented with abdominal pain, with or without vomiting seen at Chong Hua Hospital who consented to participate in the study were included.
Method: The HpSAT was performed in all patients and the socio-demographic and clinical profiles of children were correlated using the Spearman’s rho method.
Results: HpSAT positive was seen in 10.53% (n=4) out of the 38 children who had signs and symptoms of dyspepsia. Using Spearman’s rho test, statistically significant correlation were seen between HpSAT positive children and MCWD as the water source (p value=.019), intake of fruit juice (p value=.003) and history of dyspepsia in the family (p value=.050). The following had no statistical significant correlation with HpSAT positive subjects: Staying in a household of ≥ 5 members (p=.743), diet type (p=.092), effect of food intake (p=.380), acuteness of signs and symptoms (p=.576), family history of peptic ulcer disease (p=.482) and vomiting (p=.914).
Conclusion: HpSAT was positive in 10.53% of children with dyspepsia. The risk factors identified in the study that were significantly associated with H. pylori infection in children were: source of water, intake of juice and history of dyspepsia in the family. The different gastrointestinal symptomatology, particularly abdominal pain—whether acute or chronic, and its relationship to food intake and vomiting had no association in H. pylori infection. Because symptoms alone were not useful in distinguishing between causes, all aspects of the patient’s evaluation–including the medical history, physical examination and laboratory review, had been essential in the diagnosis.
Keywords: H. pylori, helicobacter infections, dyspepsia, HPSAT  *Chong Hua Hospital 
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THE PREVALENCE OF TB INFECTION AND DISEASE AMONG CHILDREN WITH ACUTE LEUKEMIA
Ma. Ysabel Lesaca-Medina, MD and Cecilia Maramba-Lazarte, MD
Keywords: Acute Leukemia, Tuberculosis in children *Philippine General Hospital
Abstract:
Objective: Immunocompromised patients, such as those diagnosed with leukemia and are on chemotherapy, are at increased risk of developing tuberculosis (TB). This study aims to determine the prevalence of TB infection and disease among children with acute leukemia on maintenance phase of chemotherapy.
Methodology: The study was conducted at the Philippine General Hospital. Patients included were children aged one to 18 years, with Acute Leukemia (ALL or AML) while on maintenance chemotherapy or at least one year from the last dose of chemotherapy. Chart reviews, interviews and physical examinations were performed. Patients were then screened with tuberculin test, Candida and Tetanus antigen to determine TB infection rates and presence of anergy. Chest xrays were performed when necessary. The prevalence of TB infection and TB disease was then determined.
Results: A total of 29 patients were included in the study. Forty five percent (13 patients) had TB infection. But none of the patients proved to have active TB disease. No demographic factors correlated with either result. Anergy was present in only one patient.
Conclusion: There was a high rate of TB infection but a low rate of TB disease in this population of patients. Tuberculin testing remains a useful test in this population, as indicated by the low rate of anergy in this study. Annual tuberculin skin testing is recommended for patients with continuous exposure to TB and isoniazid preventive therapy should be considered for these patients who are recent converters. A follow-up study should be done for this population to determine their TB status thru time. Larger sample studies involving several institutions to determine prevalence of TB infection and disease should be performed. To explain the low rate of TB disease in this population, investigations into possible antimycobacterial activities of chemotherapeutic drugs should be looked into.Keywords: Acute Leukemia, Tuberculosis in children *Philippine General Hospital 
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A DESCRIPTIVE STUDY OF THE KNOWLEDGE, ATTITUDES AND PRACTICES ON TUBERCULOSIS AMONG TREATMENT PARTNERS OF PEDIATRIC PATIENTS IN TARLAC CITY
Maria Christina N. Bacay-Domingo, M.D.*, Anna Lisa Ong-Lim, M.D.
Keywords: tuberculosis, treatment partners, pediatric patients, KAP *University of the Philippines College of Medicine- Philippine General Hospital
Abstract:
Objectives: This study aims to describe the knowledge, attitudes and practices towards tuberculosis (TB) among treatment partners of the pediatric patients seen at the out-patient department (OPD) of the Tarlac Provincial Hospital from August to October 2005.
Methods: A questionnaire-based survey was conducted to investigate the knowledge, attitudes and practices towards TB among treatment partners of pediatric patients (0 to18 years old) seen at the OPD of Tarlac Provincial Hospital from August to October 2005. A pre-validated questionnaire, which consisted of 12 questions, was distributed to treatment partners of these patients. The chi-square test was used to compare different proportions and to test the association between the variables.
Results: Out of the 62 respondents, 35 (57%) scored “good” in their overall knowledge on TB. Sixty-one percent of the respondents had acceptable attitudes and practices toward the disease. Ninety-six percent of the respondents knew that TBs was a highly-infectious disease, but was curable. The main source of information about tuberculosis was the mass media (newspapers, television and radio) in 41% of the respondents. As regards the consequences of interrupted treatment, 69% of the respondents believed that complications would ensue, while 13% believed that patients would die from nonadherence to the TB medication. There was no significant difference in the proportion with good knowledge between sexes, different levels of education and economic strata.
Keywords: tuberculosis, treatment partners, pediatric patients, KAP *University of the Philippines College of Medicine- Philippine General Hospital
Conclusion: The treatment partners of the patients with TB at the OPD of the Tarlac Provincial Hospital showed good knowledge of the disease and its presenting symptoms (57%) and acceptable attitudes and practices towards it (61%). There is still a need to strengthen the educational activities on TB through mass media; they are excellent venues for information-dissemination, thus, leading to better case detection.
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BELIEFS AND PRACTICES OF PARENTS ON THE USE OF ANTIBIOTICS FOR THEIR CHILDREN WITH UPPER RESPIRATORY TRACT INFECTION
Micheline Joyce C. Salonga, M.D.
Keywords: respiratory tract infection, antibiotics, URTI *Philippine General Hospital
Abstract:
Overuse of antibiotics in the treatment of upper respiratory tract infections among children is becoming a major contributor to the emergence of antibiotic resistance. It is but appropriate to conduct a survey that will provide data on the knowledge and practices of parents regarding appropriate use of antibiotic for their children with symptoms of upper respiratory tract infection (URTI).
Objectives: This study describes the beliefs and practices of parents on the use of antibiotics in the treatment of upper respiratory tract infections among their children.
Methods: A survey questionnaire on the beliefs and practices in the use of antibiotics were distributed to the respondents—parents, who brought their children with upper respiratory tract infection (URTI) symptoms for consult at a local health center The respondents were classified based on their sex, age and educational background. A total of 96 questionnaires were distributed in five days. Data collected were tallied and analyzed.
Results: Majority of the respondents (66/96,88%) were females and within the age range of 18 to 30 years old, while 62% were high school (HS)graduates, predominantly living within the vicinity of the local health center. Overall, the majority of the respondents correctly answered questions on common antibiotic beliefs. Among the respondents who were in the HS level, 90% responded in complete disagreement to the common belief that antibiotics cure all infections, while 86% of those from the College level group responded in complete disagreement to this common belief. Among those in the primary school level group, 68% believed that antibiotics could cure all infections. As to respondents’ practices towards antibiotic usage, 38% demanded antibiotics for their child with URTI, while 42% decided to self medicate using antibiotics. Most of the respondents, however, are compliant to giving antibiotics to their children with URTI.
Keywords: respiratory tract infection, antibiotics, URTI *Philippine General Hospital
Conclusion and Recommendations: In conclusion, a high percentage of the respondents from the local health center, particularly those in the primary education group, had poor understanding of the appropriate antibiotic usage for their children with URTI. Most of the respondents from the aforementioned group kept on with the use of antibiotics for their children presenting with symptoms of URTI, regardless of etiology. Also, a significant number would give antibiotics to their children even without a prescription. In turn, these beliefs and practices may be one of the contributory factors in the development of resistance to antibiotic. It is recommended that effective dissemination of information on the appropriate use of antibiotic be provided for the community, with the aim of changing the attitudes of parents on the judicious use of antibiotics.
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Candida parapsilosis Shunt Infection: A case report
Mercy Jeane Uy-Aragon, M.D.*, Cecilia Maramba, M.D.*
Keywords: Shunt infection, Candida, Candida parasilopsis *Philippine General Hospital
Abstract:
Shunt infections are common complications of ventriculoperitoneal shunt (VPS) placement; its incidence varies from 0.3% to 40%. Bacterial infections are still the most common etiology of shunt infections, while fungal cases remain to be rare causes. Because of the latter, fungi are usually not considered in the initial diagnosis of shunt infections. Moreover, shunt infections have non-specific manifestations and have insidious nature, which make diagnosis difficult to render. Physicians who are not experienced in the management of fungal infections may lack the proper knowledge in handling shunt infection cases, which in turn leads to a delay in the administration of appropriate treatment and increase in patient morbidity. We report a case of fungal shunt infection caused by Candida parapsilosis.
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