Consistency of Ever Reported Risky and Sensitive Behaviors Among Early Adolescents in a Nationally Representative Longitudinal Study: Results From the First 2 Waves of the Longitudinal Cohort Study of the Filipino Child, 2016 to 2018

Background: An ongoing cohort study on adolescents in the Philippines presents a unique opportunity to update current literature by measuring the level of reporting consistency on these behaviors and determine predictors of reporting inconsistency. Methods: This study was a secondary analysis of the first 2 waves of the Longitudinal Cohort Study on the Filipino Child (LCSFC), a nationally representative cohort of Filipino adolescents throughout the Sustainable Development Goals (SDGs) implementation period, that is, age 10 in 2015 until age 24 in 2030, to measure the impact of SDG-oriented policies on the country’s future economic and health outcomes. This study focused on the index child self-administered surveys, specifically risky and sensitive behaviors spanning the child’s lifetime, that is, ever reported behaviors, asked on both waves and calculated retraction and apparent initiation rates, and assessed possible factors for retraction. Results: On most of the 17 risky and sensitive behaviors, majority of index children were inconsistent with reporting life-time behaviors. On most of the 17 risky and sensitive behaviors, majority of index children were inconsistent with reporting life-time behaviors. On many behaviors, sex of the index child was a significant predictor of retraction. Conclusion: This study seems to provide evidence against the use of self-administered questionnaires on risky and sensitive behaviors for early adolescents. Future rounds of this survey should consider alternative methods in collecting these types of information from young respondents

Previous and active tuberculosis increases risk of death and prolongs recovery in patients with COVID-19

Background: There is a growing literature on the association of SARS-CoV-2 and other chronic conditions, such as noncommunicable diseases. However, little is known about the impact of coinfection with tuberculosis. We aimed to compare the risk of death and recovery, as well as time-to-death and time-to-recovery, in COVID-19 patients with and without tuberculosis. Methods: We created a 4:1 propensity score matched sample of COVID-19 patients without and with tuberculosis, using COVID-19 surveillance data in the Philippines. We conducted a longitudinal cohort analysis of matched COVID-19 patients as of May 17, 2020, following them until June 15, 2020. The primary analysis estimated the risk ratios of death and recovery in patients with and without tuberculosis. Kaplan–Meier curves described time-to-death and time-to-recovery stratified by tuberculosis status, and differences in survival were assessed using the Wilcoxon test. Results: The risk of death in COVID-19 patients with tuberculosis was 2.17 times higher than in those without (95% CI: 1.40-3.37). The risk of recovery in COVID-19 patients with tuberculosis was 25% lower than in those without (RR ¼ 0.75,05% CI 0.63-0.91). Similarly, time-to-death was significantly shorter (p ¼ .0031) and time-to-recovery significantly longer in patients with tuberculosis (p ¼ .0046). Conclusions: Our findings show that coinfection with tuberculosis increased morbidity and mortality in COVID-19 patients. Our findings highlight the need to prioritize routine and testing services for tuberculosis, although health systems are disrupted by the heavy burden of the SARS-CoV-2 pandemic

Epidemiological profile and transmission dynamics of COVID-19 in the Philippines

The Philippines confirmed local transmission of COVID-19 on 7 March 2020. We described the characteristics and epidemiological time-to-event distributions for laboratory-confirmed cases in the Philippines recorded up to 29 April 2020 and followed until 22 May 2020. The median age of 8212 cases was 46 years (IQR 32–61), with 46.2% being female and 68.8% living in the National Capital Region. Health care workers represented 24.7% of all detected infections. Mean length of hospitalisation for those who were discharged or died were 16.00 days (95% CI 15.48–16.54) and 7.27 days (95% CI 6.59–8.24). Mean duration of illness was 26.66 days (95% CI 26.06–27.28) and 12.61 days (95% CI 11.88–13.37) for those who recovered or died. Mean serial interval was 6.90 days (95% CI 5.81–8.41). Epidemic doubling time prior to the enhanced community quarantine (ECQ; 11 February and 19 March) was 4.86 days (95% CI 4.67–5.07) and the reproductive number was 2.41 (95% CI 2.33–2.48). During the ECQ (20 March to 9 April), doubling time was 12.97 days (95% CI 12.57–13.39) and the reproductive number was 0.89 (95% CI 0.78–1.02)

A cross-sectional study on the burden and impact of migraine on work productivity and quality of life in selected workplaces in the Philippines

Background Migraine imposes a substantial personal and economic burden to many working age individuals. This study aimed to evaluate the burden and impact of migraine on work productivity in selected workplaces in the Philippines. Methods A cross-sectional survey was conducted among employees suspected or diagnosed with migraine February to May 2020. Volunteer employees were screened for migraine using the ID-Migraine™ test. Eligible employees were tested for migraine severity and impact on work productivity using the Migraine Disability Assessment (MIDAS) questionnaire. Quality of life was measured using the Short Form-36 (SF-36) questionnaire and additional questions on triggers, coping mechanisms, workplace assistance, and health care utilization were asked. Multiple logistic regression was used to identify significant predictors of migraine disability (high – MIDAS Grade III/IV vs. low – MIDAS Grade I/II). Differences in quality of life scores by migraine disability were measured using multiple linear regression. Productivity costs lost to migraine disability were calculated as the number of days lost to migraine multiplied by the self-reported wage rate, and costs according to migraine severity were measured using a two-part generalized linear model. Results From around 24,000 employees who were invited to participate in the survey, 954 respondents provided consent and attempted to respond to the survey resulting to a response rate of around 4.1%. A total of 511 positive migraine screens were included in the final sample. Females comprised two-thirds of all positive migraine screens and were more likely to have high migraine disability (odds ratio: 1.60, 95% CI: 1.03–2.49) than males. Those with high migraine disability scored lower on role limitations compared to those with low migraine disability. Stress and looking at computer screens were cited as the top trigger for migraine, while sleeping enough hours and getting a massage were cited as top coping mechanisms. Three in four (77%) visited their company clinic within the past 3 months, which meant that most doctors seen for migraine-related symptoms were general practitioners. Five in six (85%) took medication for migraine, almost all of which were over-the-counter medications. Mean annual productivity costs lost due to migraine disability were PHP27 794 (USD556) per person. Conclusion Migraine poses a significant threat to work productivity in the Philippines. Many opportunities, such as disease management and introduction of alternative options for migraine treatment, may be introduced to help address these issues. Introduction Migraine is a neurological disorder recognized as one of the leading causes of disability in the world, estimated to impact anywhere between one in ten [1] and one in six individuals [2]. While several population-level studies on migraine have been conducted in the past few years, there remain countries with little information on the burden of migraine, specifically in the Asia-Pacific region [2]. A systematic review and meta-analysis on chronic migraine found only seven population-level studies in the Asia-Pacific region estimating chronic migraine prevalence to be approximately 6–17 people per 1000 population [3]. In the Philippines, the last known national-level migraine prevalence survey was in 2003, which found that 7.9% of the population screened positive for migraine [4]. However, in 2017, the Institute for Health Metrics and Evaluation (IHME) reports that headache disorders which include migraine has a prevalence estimate of about 17.3% [5]. Migraine is associated with significant impact on daily living, such as work, school, and personal activities [6]. Migraine patients consistently report poorer quality of life scores than healthy individuals on aspects of physical well-being, while chronic migraine patients consistently report poorer quality of life scores than episodic migraine patients on aspects of emotional well-being [7]. Additionally, the expectation of worry on the next migraine attack is in itself negatively affecting work productivity and quality of life [8]. Sex and age are significantly associated with migraine burden, with females at least twice as likely to report having migraine [1] and working-age individuals more likely to report having migraine than younger or older individuals [9]. This implies that migraine poses a significant economic burden and various studies in the past have tried to quantify the economic impacts of migraine. The European Eurolight project estimated that more than 90% of economic losses associated with migraine were attributable to indirect costs such as sick days and reduced work productivity as compared to less than 10% of direct costs such as medicines and outpatient consultation [10]. A systematic review from the United States found that on average around 2 to 3 workdays per month were lost due to migraine, with women reporting twice more workdays affected than men [11]. A Malaysian study found similar results with mean days affected by migraine being 5.6 days over the past 3 months among banking sector employees, with monetary losses potentially reaching as much as USD3000 annually for those with the most severe forms of migraine [12]. In a literature search, this was the only published study found to present data on the burden of migraine in the Asia Pacific region. Given this, the present study assessed the burden and impact of migraine and work productivity and daily activities in selected workplaces in the Philippines. Focusing on those having migraine, this study explored the migraine patient journey regarding the frequency and severity of migraine attacks, triggers in the workplace, workplace assistance programs, availability and utilization of health care services, and quality of life. Finally, this study also measured monetary estimates on lost productivity

Inequalities and impacts on poverty incidence of tobacco, alcohol, and health out-of-pocket expenditures in the Philippines, 2012–2018

The Philippines increased taxes for tobacco and alcohol products and expanded population coverage under the national social health insurance scheme from 2012 to 2018. This paper examines inequalities in tobacco, alcohol, and health out-of-pocket (OOP) expenditures in the Philippines using the Family Income and Expenditure Survey 2012, 2015, and 2018. Fewer households reported spending on tobacco and alcohol, and the amount decreased among poor households over time, resulting in a decrease in impoverishment. Tobacco and alcohol spending was regressive, with the magnitude of regressivity decreasing between 2015 and 2018. Health OOP expenditures decreased between 2015 and 2018, with the magnitude of progressivity unchanged across time. Early evidence from this study suggests that the Philippines may have made some gains in reducing the inequitable effects of tobacco and alcohol spending on poorer households because of these policy reforms. Further analyses may be conducted to confirm whether these changes are affected by universal health coverage (UHC) policy reforms

Association of SHI Coverage and Level of Healthcare Utilization and Costs in the Philippines: A 10-Year Pooled Analysis

BackgroundThe Philippine Health Insurance Corporation (PhilHealth), which manages the Philippine national health insurance program, is a critical actor in the country’s strategy for universal health coverage. Over the past decade, PhilHealth has passed significant coverage, benefits and payment reforms to contain costs and improve the affordability care for high-cost diseases, inpatient care and select outpatient services. MethodsWe studied the association of PhilHealth with health care utilization and health care costs using three rounds of the Philippine Demographic and Health Survey with data on individual outpatient and inpatient visits from 2008 to 2017. ResultsPhilHealth membership was associated with 42% greater odds of outpatient utilization and 47–100% greater odds inpatient utilization depending on survey year. Depending on facility type, use of PhilHealth to pay for care was associated with higher average health care costs of 244–865% for outpatient care and 135–206% for inpatient care. ConclusionsPhilHealth has likely decreased barriers to health care utilization but may have inadvertently driven up health care costs in the country. Results align with past studies that suggest that reforms in the prior decade have done little to contain health care costs for Filipinos