Pub Date : 2023-04-03DOI: 10.56964/pidspj20232401005
Marimel Reyes-Pagcatipunan, M. A. Madrid, C. Borja-Tabora, C. S. Tan-Lim, I. Cabaluna, Reginald Balmeo
This Clinical Practice Guideline for the Periodic Health Examination (Pediatric Immunization) is an output from the joint undertaking of the Department of Health and National Institutes of Health-Institute of Clinical Epidemiology. This clinical practice guideline is a systematic synthesis of scientific evidence on immunization for the prevention of human papilloma virus (HPV) infection, influenza, typhoid fever, Japanese encephalitis, poliomyelitis, meningococcal infection, and Hepatitis A in the pediatric population. The CPG provides nine (9) recommendations on prioritized questions regarding the relevant vaccines for preventing these seven (7) diseases. Recommendations are based on the appraisal of the best available evidence on each of the eight identified clinical questions. The CPG is intended to be used by general practitioners and specialists in the primary care setting, policy makers, employers and administrators, allied health practitioners and even patients. The guideline development process followed the widely accepted Grading of Recommendations, Assessment, Development, and Evaluation or the GRADE approach including GRADE Adolopment, a systematic process of adapting evidence summaries and the GRADE Evidence to Decision (EtD) framework. , It includes 1) identification of critical questions and critical outcomes, 2) retrieval of current evidence, 3) assessment and synthesis of the evidence base for these critical questions, 4) formulation of draft recommendations, 5) convening of a multisectoral stakeholder panel to discuss values and preferences and assess the strength of the recommendations, and 6) planning for dissemination, implementation, impact evaluation and updating. The recommendations in this CPG shall hold and will be updated after 3 years or when new evidence arise.
{"title":"PHILIPPINE GUIDELINES ON PERIODIC HEALTH EXAMINATION: PEDIATRIC IMMUNIZATION","authors":"Marimel Reyes-Pagcatipunan, M. A. Madrid, C. Borja-Tabora, C. S. Tan-Lim, I. Cabaluna, Reginald Balmeo","doi":"10.56964/pidspj20232401005","DOIUrl":"https://doi.org/10.56964/pidspj20232401005","url":null,"abstract":"This Clinical Practice Guideline for the Periodic Health Examination (Pediatric Immunization) is an output from the joint undertaking of the Department of Health and National Institutes of Health-Institute of Clinical Epidemiology. This clinical practice guideline is a systematic synthesis of scientific evidence on immunization for the prevention of human papilloma virus (HPV) infection, influenza, typhoid fever, Japanese encephalitis, poliomyelitis, meningococcal infection, and Hepatitis A in the pediatric population. The CPG provides nine (9) recommendations on prioritized questions regarding the relevant vaccines for preventing these seven (7) diseases. Recommendations are based on the appraisal of the best available evidence on each of the eight identified clinical questions. The CPG is intended to be used by general practitioners and specialists in the primary care setting, policy makers, employers and administrators, allied health practitioners and even patients. The guideline development process followed the widely accepted Grading of Recommendations, Assessment, Development, and Evaluation or the GRADE approach including GRADE Adolopment, a systematic process of adapting evidence summaries and the GRADE Evidence to Decision (EtD) framework. , It includes 1) identification of critical questions and critical outcomes, 2) retrieval of current evidence, 3) assessment and synthesis of the evidence base for these critical questions, 4) formulation of draft recommendations, 5) convening of a multisectoral stakeholder panel to discuss values and preferences and assess the strength of the recommendations, and 6) planning for dissemination, implementation, impact evaluation and updating. The recommendations in this CPG shall hold and will be updated after 3 years or when new evidence arise.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125800345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-03DOI: 10.56964/pidspj20232401003
L. Dans, A. Ong-Lim, Rosemarie Arciaga, Donna Isabel Capili, Arnel Gerald Q. Jiao, J. Rogacion
The Coronavirus disease 2019 (COVID-19) pandemic has triggered a global crisis and has affected millions of people worldwide. With the evolution of the different variants of concern, the incidence of COVID-19 in the pediatric population has risen. The Surveillance and Analysis of COVID-19 in Children Nationwide (SALVACION) Registry, developed by the Pediatric Infectious Disease Society of the Philippines (PIDSP) and the Philippine Pediatric Society (PPS), has reported 3,221 cases as of March 31, 2022, with 90.4% requiring hospitalization and 36.2% with moderate to critical disease severity. Given the magnitude of the impact of COVID-19, with most of the clinical recommendations available designed towards adult patients, there was an urgent need for clinicians, public health officials and the government to also prioritize evidence-based clinical practice guidelines for the pediatric population. Hence, the development of the Philippine Pediatric COVID-19 Living Clinical Practice Guidelines was conceptualized. This independent project, funded and supported by the PPS and PIDSP, aimed to formulate up-to-date, evidence-based recommendations on the treatment, diagnosis, infection prevention and control of COVID-19 in children. Following the standard CPG development process outlined in the DOH Manual for CPG Development and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology, 15 evidence summaries and 24 recommendations were generated by 12 consensus panelists representing their specific health organizations and institutions.
{"title":"\"PHILIPPINE PEDIATRIC COVID-19 LIVING CLINICAL PRACTICE GUIDELINES as of March 2022\"","authors":"L. Dans, A. Ong-Lim, Rosemarie Arciaga, Donna Isabel Capili, Arnel Gerald Q. Jiao, J. Rogacion","doi":"10.56964/pidspj20232401003","DOIUrl":"https://doi.org/10.56964/pidspj20232401003","url":null,"abstract":"The Coronavirus disease 2019 (COVID-19) pandemic has triggered a global crisis and has affected millions of people worldwide. With the evolution of the different variants of concern, the incidence of COVID-19 in the pediatric population has risen. The Surveillance and Analysis of COVID-19 in Children Nationwide (SALVACION) Registry, developed by the Pediatric Infectious Disease Society of the Philippines (PIDSP) and the Philippine Pediatric Society (PPS), has reported 3,221 cases as of March 31, 2022, with 90.4% requiring hospitalization and 36.2% with moderate to critical disease severity. Given the magnitude of the impact of COVID-19, with most of the clinical recommendations available designed towards adult patients, there was an urgent need for clinicians, public health officials and the government to also prioritize evidence-based clinical practice guidelines for the pediatric population. Hence, the development of the Philippine Pediatric COVID-19 Living Clinical Practice Guidelines was conceptualized. This independent project, funded and supported by the PPS and PIDSP, aimed to formulate up-to-date, evidence-based recommendations on the treatment, diagnosis, infection prevention and control of COVID-19 in children. Following the standard CPG development process outlined in the DOH Manual for CPG Development and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology, 15 evidence summaries and 24 recommendations were generated by 12 consensus panelists representing their specific health organizations and institutions.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"147 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126140952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-23DOI: 10.56964/pidspj20222302009
Kiara Natalie Roble, Robert Tagocon
Background: Studies comparing hematocrit values, disease severity, and discharge status between well-nourished and undernourished pediatric dengue patients are limited. Objective: This study compared the mean hematocrit values, disease severity and discharge status of undernourished vs. well-nourished pediatric dengue patients admitted in a tertiary government hospital. Methodology: A retrospective cohort study involving 114 pediatric dengue patients, with comparison groups of well-nourished and undernourished children matched according to age, phase of illness and sex was done. Main outcomes measured were mean hematocrit values, disease severity and discharge status. Results: There was a significantly lower mean pre-resuscitation hematocrit in the wasted (M=39.67%, SD=3.78) compared to the well-nourished group (M=43.68%, SD=4.72), p=0.006, among children >6 to 12 years old in the febrile phase. There were no significant differences in disease severity and discharge status between wasted and well-nourished children. In those >2 to 6 years old in the febrile phase, the severely wasted had significantly higher pre-resuscitation hematocrit (M=43.28%, SD=4.77) compared to well-nourished children (M=39.11%, SD=5.34), p=0.041. More severe dengue, worse discharge status and an earlier time to demise was seen among severely wasted children. Conclusion: Wasted participants had significantly lower mean hematocrit values with no difference in disease severity and discharge status when compared to well-nourished participants. Severely wasted children had significantly higher hematocrit values, severe dengue, and worse discharge status.
{"title":"Mean Hematocrit Values, Disease Severity, and Discharge Status of Undernourished Versus Well-Nourished Children with Dengue Infection in a Tertiary Government Hospital","authors":"Kiara Natalie Roble, Robert Tagocon","doi":"10.56964/pidspj20222302009","DOIUrl":"https://doi.org/10.56964/pidspj20222302009","url":null,"abstract":"Background: Studies comparing hematocrit values, disease severity, and discharge status between well-nourished and undernourished pediatric dengue patients are limited. Objective: This study compared the mean hematocrit values, disease severity and discharge status of undernourished vs. well-nourished pediatric dengue patients admitted in a tertiary government hospital. Methodology: A retrospective cohort study involving 114 pediatric dengue patients, with comparison groups of well-nourished and undernourished children matched according to age, phase of illness and sex was done. Main outcomes measured were mean hematocrit values, disease severity and discharge status. Results: There was a significantly lower mean pre-resuscitation hematocrit in the wasted (M=39.67%, SD=3.78) compared to the well-nourished group (M=43.68%, SD=4.72), p=0.006, among children >6 to 12 years old in the febrile phase. There were no significant differences in disease severity and discharge status between wasted and well-nourished children. In those >2 to 6 years old in the febrile phase, the severely wasted had significantly higher pre-resuscitation hematocrit (M=43.28%, SD=4.77) compared to well-nourished children (M=39.11%, SD=5.34), p=0.041. More severe dengue, worse discharge status and an earlier time to demise was seen among severely wasted children. Conclusion: Wasted participants had significantly lower mean hematocrit values with no difference in disease severity and discharge status when compared to well-nourished participants. Severely wasted children had significantly higher hematocrit values, severe dengue, and worse discharge status.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116654622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-23DOI: 10.56964/pidspj20222302005
Meg Tuazon, Mary Crist Delos Santos-Jamora, Sabrina Florendo-Villanueva, Rainelda Panlilio-Runez
Objectives: This case series aims to present three cases of pediatric cancer – two acute leukemia and one solid tumor with active COVID-19 infection who underwent chemotherapy Methodology: Three cases of pediatric cancer who tested positive for SARS-CoV2 are presented. All proceeded with scheduled chemotherapy despite active COVID-19 infection. Two had no post-chemotherapy complications, while one had febrile neutropenia and hospital-acquired pneumonia. Results: In this case series, COVID-19 infection in pediatric patients with cancer does not appear to be more severe compared with the general population. The severity of signs and symptoms can be attributed to a lower Cycle Threshold (CT) value and a co-infection. COVID-19 infection did not change the course and post-chemotherapy complications in all cases. Conclusion: Patient demographics, comorbidities and type of malignancy played an essential role in the pre- and post-chemotherapy outcome. Individual patient factors including CT values, comorbidities, co-infections, COVID19 disease severity classification, and blood count picture are also instrumental in the management and outcome of these cases. Pediatric cancer treatment should be a priority during active COVID-19 infection.
{"title":"Cancer and Chemotherapy in Pediatric COVID-19: A Case Series","authors":"Meg Tuazon, Mary Crist Delos Santos-Jamora, Sabrina Florendo-Villanueva, Rainelda Panlilio-Runez","doi":"10.56964/pidspj20222302005","DOIUrl":"https://doi.org/10.56964/pidspj20222302005","url":null,"abstract":"Objectives: This case series aims to present three cases of pediatric cancer – two acute leukemia and one solid tumor with active COVID-19 infection who underwent chemotherapy Methodology: Three cases of pediatric cancer who tested positive for SARS-CoV2 are presented. All proceeded with scheduled chemotherapy despite active COVID-19 infection. Two had no post-chemotherapy complications, while one had febrile neutropenia and hospital-acquired pneumonia. Results: In this case series, COVID-19 infection in pediatric patients with cancer does not appear to be more severe compared with the general population. The severity of signs and symptoms can be attributed to a lower Cycle Threshold (CT) value and a co-infection. COVID-19 infection did not change the course and post-chemotherapy complications in all cases. Conclusion: Patient demographics, comorbidities and type of malignancy played an essential role in the pre- and post-chemotherapy outcome. Individual patient factors including CT values, comorbidities, co-infections, COVID19 disease severity classification, and blood count picture are also instrumental in the management and outcome of these cases. Pediatric cancer treatment should be a priority during active COVID-19 infection.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114850376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-23DOI: 10.56964/pidspj20222302002
Arlene Dy-Co
This is the second time we are releasing a joint editorial from journals all over the world in the call for action to address climate change. The COVID-19 pandemic has caught the world unaware despite the progress in science; majority did not take the warnings of a looming pandemic. With climate change, its impact on infectious diseases will not be any gentler as the hazards are too numerous. From increased transmission of infections, expansion of infections to other geographic areas and emergence of new infectious diseases. This would be gargantuan compared to a pandemic as this would not only involve one infectious disease but numerous and would impact every aspect of the world we know. Joining this call for action is a baby step, but no action is too small in whatever way we can to help ensure a better Earth for our younger generation. Our giant stride for this issue comes with the news that our published articles will now have digital object identifier (DOI). The Pediatric Infectious Disease Society of the Philippines Journal is proud to announce as we join the more than 10,000 organizations that assigns DOI names. The DOI is a unique alphanumeric string assigned by an international registration agency and will provide persistent identification of our articles. This will make our published articles easy to find, cite, link, assess and reuse, thus making scholarly communications more effective. Likewise, this increases opportunities for transparency in scholarly works. Technology has changed publishing dramatically and keeping up with this from the local forefront is not easy. We believe that we will be closer to the realization of making our local publications more visible and discoverable by a wider audience with this giant stride.
{"title":"Baby Steps, Giant Strides","authors":"Arlene Dy-Co","doi":"10.56964/pidspj20222302002","DOIUrl":"https://doi.org/10.56964/pidspj20222302002","url":null,"abstract":"This is the second time we are releasing a joint editorial from journals all over the world in the call for action to address climate change. The COVID-19 pandemic has caught the world unaware despite the progress in science; majority did not take the warnings of a looming pandemic. With climate change, its impact on infectious diseases will not be any gentler as the hazards are too numerous. From increased transmission of infections, expansion of infections to other geographic areas and emergence of new infectious diseases. This would be gargantuan compared to a pandemic as this would not only involve one infectious disease but numerous and would impact every aspect of the world we know. Joining this call for action is a baby step, but no action is too small in whatever way we can to help ensure a better Earth for our younger generation. Our giant stride for this issue comes with the news that our published articles will now have digital object identifier (DOI). The Pediatric Infectious Disease Society of the Philippines Journal is proud to announce as we join the more than 10,000 organizations that assigns DOI names. The DOI is a unique alphanumeric string assigned by an international registration agency and will provide persistent identification of our articles. This will make our published articles easy to find, cite, link, assess and reuse, thus making scholarly communications more effective. Likewise, this increases opportunities for transparency in scholarly works. Technology has changed publishing dramatically and keeping up with this from the local forefront is not easy. We believe that we will be closer to the realization of making our local publications more visible and discoverable by a wider audience with this giant stride.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"75 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128063131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-23DOI: 10.56964/pidspj20222302007
Robert Garcia
Introduction: The scarce local data on the etiology of childhood pneumonia admitted in a hospital has come from a few urban and rural government hospitals. There is no data from private hospitals. Knowing the most likely etiology of pneumonia is of outmost importance as this has implications on the diagnostic modalities requested and the institution of therapy. Objectives: The purpose of this study is to identify clinical and microbiologic diagnoses of clinically- and radiographically-confirmed pediatric pneumonia cases admitted in a private hospital. Secondarily, a discussion of specific etiologies is made. Methodology: Each consecutive, inpatient, pneumonia referral/admission in either one of two private, urban, tertiary hospitals, of a child 18 years and below from 1993 to 2021 was logged into a computer daily by a single pediatric infectious disease specialist. Clinical, epidemiologic, diagnostic and therapeutic data were recorded. All pneumonia cases, except those seen in newborns before their discharge from the nursery, were included. Results: Of the 496 cases, there was a clinical and/or microbiologic etiology in 43% of cases. The bacteremia rate was 6.3%. The most common identifiable etiologies were Mycoplasma pneumoniae (11.9%), Mycobacterium tuberculosis (5.2%), and Staphylococcus aureus (4.2%), while bronchiolitis (5.5%) and measles (4.8%) were the most common clinical diagnoses. There were several cases of ventilator-associated pneumonia and Pneumocystis jirovecii pneumonia. Conclusions: Mycoplasma pneumoniae, tuberculosis, Staphylococcus aureus and Pneumocystis jirovecii are important pneumonia etiologies that have not been widely considered locally. The data presented here mirrors the practice of one pediatric infectious disease doctor in two hospitals where diagnostic and treatment options are readily available and utilized.
{"title":"The Etiology of Childhood Inpatient Pneumonias in Two Private, Tertiary, Metro Manila Hospitals from 1993-2021 Seen By One Pediatric Infectious Disease Specialist","authors":"Robert Garcia","doi":"10.56964/pidspj20222302007","DOIUrl":"https://doi.org/10.56964/pidspj20222302007","url":null,"abstract":"Introduction: The scarce local data on the etiology of childhood pneumonia admitted in a hospital has come from a few urban and rural government hospitals. There is no data from private hospitals. Knowing the most likely etiology of pneumonia is of outmost importance as this has implications on the diagnostic modalities requested and the institution of therapy. Objectives: The purpose of this study is to identify clinical and microbiologic diagnoses of clinically- and radiographically-confirmed pediatric pneumonia cases admitted in a private hospital. Secondarily, a discussion of specific etiologies is made. Methodology: Each consecutive, inpatient, pneumonia referral/admission in either one of two private, urban, tertiary hospitals, of a child 18 years and below from 1993 to 2021 was logged into a computer daily by a single pediatric infectious disease specialist. Clinical, epidemiologic, diagnostic and therapeutic data were recorded. All pneumonia cases, except those seen in newborns before their discharge from the nursery, were included. Results: Of the 496 cases, there was a clinical and/or microbiologic etiology in 43% of cases. The bacteremia rate was 6.3%. The most common identifiable etiologies were Mycoplasma pneumoniae (11.9%), Mycobacterium tuberculosis (5.2%), and Staphylococcus aureus (4.2%), while bronchiolitis (5.5%) and measles (4.8%) were the most common clinical diagnoses. There were several cases of ventilator-associated pneumonia and Pneumocystis jirovecii pneumonia. Conclusions: Mycoplasma pneumoniae, tuberculosis, Staphylococcus aureus and Pneumocystis jirovecii are important pneumonia etiologies that have not been widely considered locally. The data presented here mirrors the practice of one pediatric infectious disease doctor in two hospitals where diagnostic and treatment options are readily available and utilized.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"497 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123565266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-23DOI: 10.56964/pidspj20222302006
Abigail Ruiz Rivera, Francesca Mae T. Pantig, Cecilia Maramba-Lazarte, Arlene Dy-Co, Venus Oliva Rosales, R. Sarmiento, Allyne Aguelo, Mary Crist Delos Santos-Jamora, Imelda Luna, Jay Ron Padua, Cleo Anna Marie Pasco, Anna Soleil Cheshia Tan-Figueras, Pia Catrina Torres
Background: The COVID-19 pandemic continues to afflict nations worldwide. The Philippines is no exception which has recorded more than 3 million cases as of December 2021 with children comprising 12% of total cases. Since the start of the pandemic, the Pediatric Infectious Disease Society of the Philippines (PIDSP) has been collecting data nationwide, through an online pediatric COVID-19 registry (SALVACION registry), to provide a better understanding of COVID-19 in children in the local setting. Methods: This was an ambispective cohort study of pediatric COVID-19 cases in the Philippines reported from March 2020 to December 2021. Data on clinical features, laboratory findings, disease severity, and treatment outcomes were voluntarily reported by physicians across the country. This study was approved by the Department of Health Single Joint Research Ethics Board. Results: As of December 30, 2021, there were 2,127 cases reported in the registry, with a median age of 5 years (interquartile range: 1-13 years) and mostly mild (41.9%) or moderate (24.5%) in severity. The top symptoms reported were fever (57.9%), cough (42.7%), coryza/colds (29.4%), anorexia (25.2%), and difficulty of breathing (23.1%). The most common comorbidities were hematologic-oncologic diseases (7.4%), neurologic diseases (7.0%) and surgical conditions (4.4%), while the most common coinfections were sepsis (6.3%), dengue fever (4.8%) and healthcare-associated pneumonia (2.1%). Significantly higher median CRP, procalcitonin, D-dimer, ferritin, transaminases and lactate dehydrogenase were seen among severe/critical cases compared to non-severe cases. There was a high frequency of antibiotic use (58%). Most cases recovered, although 172 deaths were reported with an 8.6% case fatality rate. The most common comorbidities in those who died were neurologic (15.7%), cardiac (12.8%) and hematologic (11.6%) diseases. Conclusion: Children across all age groups are susceptible to COVID-19 and most cases are mild or moderate in severity. Among severe and critical cases, the most common comorbidities were neurologic, hematologic-oncologic and cardiac diseases. Most patients recovered with supportive management.
{"title":"SARS-CoV-2 Infection in Filipino Children: An Interim Report from the SALVACION Registry","authors":"Abigail Ruiz Rivera, Francesca Mae T. Pantig, Cecilia Maramba-Lazarte, Arlene Dy-Co, Venus Oliva Rosales, R. Sarmiento, Allyne Aguelo, Mary Crist Delos Santos-Jamora, Imelda Luna, Jay Ron Padua, Cleo Anna Marie Pasco, Anna Soleil Cheshia Tan-Figueras, Pia Catrina Torres","doi":"10.56964/pidspj20222302006","DOIUrl":"https://doi.org/10.56964/pidspj20222302006","url":null,"abstract":"Background: The COVID-19 pandemic continues to afflict nations worldwide. The Philippines is no exception which has recorded more than 3 million cases as of December 2021 with children comprising 12% of total cases. Since the start of the pandemic, the Pediatric Infectious Disease Society of the Philippines (PIDSP) has been collecting data nationwide, through an online pediatric COVID-19 registry (SALVACION registry), to provide a better understanding of COVID-19 in children in the local setting. Methods: This was an ambispective cohort study of pediatric COVID-19 cases in the Philippines reported from March 2020 to December 2021. Data on clinical features, laboratory findings, disease severity, and treatment outcomes were voluntarily reported by physicians across the country. This study was approved by the Department of Health Single Joint Research Ethics Board. Results: As of December 30, 2021, there were 2,127 cases reported in the registry, with a median age of 5 years (interquartile range: 1-13 years) and mostly mild (41.9%) or moderate (24.5%) in severity. The top symptoms reported were fever (57.9%), cough (42.7%), coryza/colds (29.4%), anorexia (25.2%), and difficulty of breathing (23.1%). The most common comorbidities were hematologic-oncologic diseases (7.4%), neurologic diseases (7.0%) and surgical conditions (4.4%), while the most common coinfections were sepsis (6.3%), dengue fever (4.8%) and healthcare-associated pneumonia (2.1%). Significantly higher median CRP, procalcitonin, D-dimer, ferritin, transaminases and lactate dehydrogenase were seen among severe/critical cases compared to non-severe cases. There was a high frequency of antibiotic use (58%). Most cases recovered, although 172 deaths were reported with an 8.6% case fatality rate. The most common comorbidities in those who died were neurologic (15.7%), cardiac (12.8%) and hematologic (11.6%) diseases. Conclusion: Children across all age groups are susceptible to COVID-19 and most cases are mild or moderate in severity. Among severe and critical cases, the most common comorbidities were neurologic, hematologic-oncologic and cardiac diseases. Most patients recovered with supportive management.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133498346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-23DOI: 10.56964/pidspj20222302010
Kathleen Joyce Del Carmen, A. Du, K.J.N. Kimseng
Background: Early-onset sepsis (EOS) is a leading cause of morbidity and mortality among neonates. Diagnosis of EOS can be difficult as clinical signs are subtle. The use of the Neonatal EOS Calculator (NEOSC) may help screen high-risk neonates for EOS and may result in a significant reduction in unnecessary antibiotic use. Objective: To determine the diagnostic accuracy of the NEOSC in screening for EOS in neonates more than 35 weeks age of gestation. Methodology: This was a retrospective, case-control study where 245 septic (cases) and 245 non-septic (controls) neonatal and maternal medical records were reviewed. The EOS risk classification from the NEOSC was compared with the actual clinical outcome. An online statistical software (medcalc.org) was used to compute for the sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and accuracy of the NEOSC. Results: Based on the NEOSC, only 64 of 245 clinically septic neonates were truly positive for sepsis while 181 were falsely negative for sepsis. Of the 245 non-septic neonates, 3 were falsely positive for sepsis, while 242 were truly negative for sepsis. With a 95% confidence interval, the computed variables showed a Sn 26.12%, Sp 98.78%, PPV 76.12%, NPV 89.95%, PLR 21.33, and NLR 0.75. The accuracy of the NEOSC is 89.33%. Conclusion: The NEOSC had poor sensitivity and is not recommended in screening for EOS in neonates more than 35 weeks age of gestation. It may be used as an adjunct in EOS diagnosis due to its high specificity and accuracy.
{"title":"Diagnostic Accuracy of the Neonatal Early Onset Sepsis Calculator in Screening for Early Onset Sepsis in Neonates More Than 35 Weeks Age of Gestation","authors":"Kathleen Joyce Del Carmen, A. Du, K.J.N. Kimseng","doi":"10.56964/pidspj20222302010","DOIUrl":"https://doi.org/10.56964/pidspj20222302010","url":null,"abstract":"Background: Early-onset sepsis (EOS) is a leading cause of morbidity and mortality among neonates. Diagnosis of EOS can be difficult as clinical signs are subtle. The use of the Neonatal EOS Calculator (NEOSC) may help screen high-risk neonates for EOS and may result in a significant reduction in unnecessary antibiotic use. Objective: To determine the diagnostic accuracy of the NEOSC in screening for EOS in neonates more than 35 weeks age of gestation. Methodology: This was a retrospective, case-control study where 245 septic (cases) and 245 non-septic (controls) neonatal and maternal medical records were reviewed. The EOS risk classification from the NEOSC was compared with the actual clinical outcome. An online statistical software (medcalc.org) was used to compute for the sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and accuracy of the NEOSC. Results: Based on the NEOSC, only 64 of 245 clinically septic neonates were truly positive for sepsis while 181 were falsely negative for sepsis. Of the 245 non-septic neonates, 3 were falsely positive for sepsis, while 242 were truly negative for sepsis. With a 95% confidence interval, the computed variables showed a Sn 26.12%, Sp 98.78%, PPV 76.12%, NPV 89.95%, PLR 21.33, and NLR 0.75. The accuracy of the NEOSC is 89.33%. Conclusion: The NEOSC had poor sensitivity and is not recommended in screening for EOS in neonates more than 35 weeks age of gestation. It may be used as an adjunct in EOS diagnosis due to its high specificity and accuracy.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126403596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-23DOI: 10.56964/pidspj20222302004
Catherine Cano, Lynard Anthony Ignacio, E. Rodríguez, Froilan Vicente Vinuya, Robert Garcia, J. Regalado
Background: Since the start of SARS-CoV-2 pandemic, a post-infection hyperinflammatory process in children with features similar to Kawasaki disease, termed multisystem inflammatory syndrome in children (MIS-C),1 was identified. Thousands of MIS-C cases have already been reported worldwide.2 As possible cases of MIS-C in neonates were increasingly identified, multisystem inflammatory syndrome in neonates (MIS-N) as a distinct entity was proposed as neonates may not manifest all the typical features described in older children. Case Presentation: We describe the case of a previously well term neonate with sudden signs of bowel obstruction who later had multisystem involvement (cardiac, gastrointestinal, and hematologic). The baby was born to a 23-yearold multigravida with an unremarkable prenatal history except for COVID-19 infection during her 34th week age of gestation. The mother presented with mild respiratory symptoms and resolved with supportive management. Our patient was born stable, then had sudden manifestations of feeding intolerance on the 16th day of life and upon work-up had moderate anemia, elevated inflammatory and cardiac markers, ileus, and dilatation of proximal left coronary artery. RT-PCR for SARS-CoV2 was negative. The baby was managed with intravenous immunoglobulin (IVIG) and steroids, with rapid clinical and laboratory parameters improvement thereafter. Conclusion: MIS-N is still evolving as a disease entity with no clear, directed guidance yet on diagnosis and management. Management is extrapolated from treatment of MIS-C. Additional case reports and series are warranted to increase awareness and enable better understanding of the disease pathology among clinicians for timely investigation, diagnosis, and management.
{"title":"Multi-System Inflammatory Syndrome in Neonate (MIS-N) Presenting as Bowel Obstruction: A Case Report","authors":"Catherine Cano, Lynard Anthony Ignacio, E. Rodríguez, Froilan Vicente Vinuya, Robert Garcia, J. Regalado","doi":"10.56964/pidspj20222302004","DOIUrl":"https://doi.org/10.56964/pidspj20222302004","url":null,"abstract":"Background: Since the start of SARS-CoV-2 pandemic, a post-infection hyperinflammatory process in children with features similar to Kawasaki disease, termed multisystem inflammatory syndrome in children (MIS-C),1 was identified. Thousands of MIS-C cases have already been reported worldwide.2 As possible cases of MIS-C in neonates were increasingly identified, multisystem inflammatory syndrome in neonates (MIS-N) as a distinct entity was proposed as neonates may not manifest all the typical features described in older children. Case Presentation: We describe the case of a previously well term neonate with sudden signs of bowel obstruction who later had multisystem involvement (cardiac, gastrointestinal, and hematologic). The baby was born to a 23-yearold multigravida with an unremarkable prenatal history except for COVID-19 infection during her 34th week age of gestation. The mother presented with mild respiratory symptoms and resolved with supportive management. Our patient was born stable, then had sudden manifestations of feeding intolerance on the 16th day of life and upon work-up had moderate anemia, elevated inflammatory and cardiac markers, ileus, and dilatation of proximal left coronary artery. RT-PCR for SARS-CoV2 was negative. The baby was managed with intravenous immunoglobulin (IVIG) and steroids, with rapid clinical and laboratory parameters improvement thereafter. Conclusion: MIS-N is still evolving as a disease entity with no clear, directed guidance yet on diagnosis and management. Management is extrapolated from treatment of MIS-C. Additional case reports and series are warranted to increase awareness and enable better understanding of the disease pathology among clinicians for timely investigation, diagnosis, and management.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"357 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114758124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-23DOI: 10.56964/pidspj20222302008
Janine Malimban, Robert Garcia, Maria Ronella Francisco-Mallari
Introduction: Kawasaki disease (KD) is the leading cause of acquired heart disease in childhood, but its diagnosis remains challenging since a significant number of cases do not meet the diagnostic criteria (Incomplete KD). This may delay the diagnosis and initiation of treatment, and increase the risk of morbidity from coronary artery complications. Objectives: This study compared the clinical profile and treatment outcomes of children with complete and incomplete KD. Methods: This is a cross-sectional, retrospective study of pediatric patients diagnosed with KD and admitted in a tertiary hospital from January 1, 2010 to December 31, 2020. Demographics, clinical manifestations, laboratories, 2D echocardiography (2DE) findings and treatment outcomes were obtained by review of medical records and analyzed using descriptive statistics. Results: Among 135 patients studied, 71% were classified as Incomplete Kawasaki Disease. Majority (89%) were children more than 1 year old and predominantly male (55%). Five classic features, other than fever, were more frequent in complete KD – bilateral bulbar conjunctivitis, mucosal changes in the lip and oral cavity, polymorphous exanthem, changes in extremities, and cervical lymphadenopathy. Fever (100%), conjunctivitis (100%), rashes (97%) and oral changes (90%) were the most common findings in complete KD, while fever (100%), rashes (56%), conjunctivitis (46%) and oral changes (35%) were noted in incomplete KD. Higher CRP (167 mg/L vs. 100 mg/L) and lower albumin levels (30 g/L vs. 38 g/L) were seen in complete KD. Coronary artery dilatation (56% vs. 48%) was frequently detected in both complete and incomplete KD. Majority (96%) of cases received only one dose of IVIG and 4% needed additional treatment with methylprednisone. Conclusion: The five principal features of KD other than fever, elevated CRP and lower albumin levels were significantly more common in complete cases. No significant differences in the demographics and 2DE findings of children with complete and incomplete KD were observed.
川崎病(KD)是儿童获得性心脏病的主要原因，但其诊断仍然具有挑战性，因为大量病例不符合诊断标准(不完全KD)。这可能会延迟诊断和开始治疗，并增加冠状动脉并发症的发病风险。目的:本研究比较了完全性和不完全性KD患儿的临床特征和治疗结果。方法:对2010年1月1日至2020年12月31日在某三级医院确诊为KD的儿科患者进行横断面回顾性研究。通过查阅医疗记录获得人口统计学、临床表现、实验室、二维超声心动图(2DE)结果和治疗结果，并使用描述性统计进行分析。结果:135例患者中71%为不完全川崎病。大多数(89%)是1岁以上的儿童，主要是男性(55%)。除发热外，在完全性KD中更常见的五个典型特征是:双侧球结膜炎、唇部和口腔粘膜改变、多形性渗漏、四肢改变和颈部淋巴结病。完全性KD患者最常见的表现为发热(100%)、结膜炎(100%)、皮疹(97%)和口腔改变(90%)，而完全性KD患者最常见的表现为发热(100%)、皮疹(56%)、结膜炎(46%)和口腔改变(35%)。完全KD患者CRP水平较高(167 mg/L vs 100 mg/L)，白蛋白水平较低(30 g/L vs 38 g/L)。冠状动脉扩张(56% vs. 48%)在完全KD和不完全KD中都很常见。大多数(96%)病例仅接受一剂IVIG, 4%需要额外的甲基强的松治疗。结论:除了发热、CRP升高和白蛋白水平降低外，KD的五个主要特征在完全病例中更为常见。完全KD和不完全KD患儿的人口统计学和2DE结果没有显著差异。
{"title":"A Comparative Study of Pediatric Patients with Complete vs. Incomplete Kawasaki Disease in a Tertiary Hospital: An Eleven Year Review","authors":"Janine Malimban, Robert Garcia, Maria Ronella Francisco-Mallari","doi":"10.56964/pidspj20222302008","DOIUrl":"https://doi.org/10.56964/pidspj20222302008","url":null,"abstract":"Introduction: Kawasaki disease (KD) is the leading cause of acquired heart disease in childhood, but its diagnosis remains challenging since a significant number of cases do not meet the diagnostic criteria (Incomplete KD). This may delay the diagnosis and initiation of treatment, and increase the risk of morbidity from coronary artery complications. Objectives: This study compared the clinical profile and treatment outcomes of children with complete and incomplete KD. Methods: This is a cross-sectional, retrospective study of pediatric patients diagnosed with KD and admitted in a tertiary hospital from January 1, 2010 to December 31, 2020. Demographics, clinical manifestations, laboratories, 2D echocardiography (2DE) findings and treatment outcomes were obtained by review of medical records and analyzed using descriptive statistics. Results: Among 135 patients studied, 71% were classified as Incomplete Kawasaki Disease. Majority (89%) were children more than 1 year old and predominantly male (55%). Five classic features, other than fever, were more frequent in complete KD – bilateral bulbar conjunctivitis, mucosal changes in the lip and oral cavity, polymorphous exanthem, changes in extremities, and cervical lymphadenopathy. Fever (100%), conjunctivitis (100%), rashes (97%) and oral changes (90%) were the most common findings in complete KD, while fever (100%), rashes (56%), conjunctivitis (46%) and oral changes (35%) were noted in incomplete KD. Higher CRP (167 mg/L vs. 100 mg/L) and lower albumin levels (30 g/L vs. 38 g/L) were seen in complete KD. Coronary artery dilatation (56% vs. 48%) was frequently detected in both complete and incomplete KD. Majority (96%) of cases received only one dose of IVIG and 4% needed additional treatment with methylprednisone. Conclusion: The five principal features of KD other than fever, elevated CRP and lower albumin levels were significantly more common in complete cases. No significant differences in the demographics and 2DE findings of children with complete and incomplete KD were observed.","PeriodicalId":117545,"journal":{"name":"Pediatric Infectious Disease Society of the Philippines Journal","volume":"223 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133049835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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