An Assessment of the Philippine Hospital Resources as Predictors of the Case Fatality Rate of COVID – 19

In the heightened effects of the pandemic, health resources have been in constant limbo as supplies and availability of hospital resources take a toll as COVID-19 cases surge, resulting in shortages. Thus, health systems are overwhelmed, resulting in a higher fatality rate since the capacity to provide medical attention is diminished. In this paper, hospital resources refer to mechanical ventilators, ICU, isolation, and ward beds which are the critical factors of the case fatality rate (CFR) of COVID-19 in the Philippines. Data were retrieved from the Department of Health (DOH) Case Bulletins from October 26, 2020, to June 30, 2021, with 248 total observations. This research used the Ordinary Least Squares (OLS) Multiple Regression to determine if hospital resources are the predictors of the case fatality rate of COVID-19. Furthermore, the results show a significant relationship between the hospital resources and the case fatality rate of COVID-19 in the Philippines. This study can become a framework for further research concerned about hospital resources as the predictors of case fatality rates of different diseases in a pandemic.

Diphtheria resurgence in Sada'a-Yemen, 2017–2020

Background Diphtheria is a contagious vaccine-preventable disease that contributes to the high morbidity and mortality among under 5 children, especially in Yemen. As a consequence of war and collapse of the health system, a fatal epidemic occurred at the end of 2017. This study aims to describe the epidemiology of diphtheria by time, place, and person and vaccination status of affected children. Methods A study was conducted in Sada'a governorate by using accumulative line list of diphtheria from November 2017 to September 2020 at electronic Integrated Disease Early Warning System (eIDEWS). The case definition of WHO was adopted. Data was analyzed by Microsoft Excel and Epi info- version 7.2 and multivariable logistic analysis used for identifying significant associated factors. Results 747 cases were met of WHO case definition. The annual peak of cases started during week 31 and weak 49. Males were slightly more than females (51% vs 49%) and about 35% of cases involved children aged 10 to < 15 years. The overall incidence of diphtheria and case fatality rate (CFR) were 69/ 100,000 and 6.4%, respectively. The highest CFR was among age groups under 5 years 11% (P < 0.001) and among females was 8%. Dysphagia and swollen lymph nodes were the predominant symptoms 98%, 92%, respectively. Based on the Vaccination status, the percentage of unvaccinated and unknown were 53% and 41% respectively, with CFR 11% among cases who received one dose. Furthermore, the most case were from Sahar 40% with case fatality rate 8% and the highest CFR was significantly higher among cases in border and ongoing conflict district (P < 0.05). Conclusions The findings highlight that diphtheria is still an ongoing cause of morbidity and mortality among under 5 children in Sada'a that is rising with the low diphtheria immunization coverage. Therefore, concomitant efforts should now focus on improving and monitoring routine immunization across all age groups and healthcare services, especially in borders and continuing conflict districts.

Omicron Impact in India: An Early Analysis of the Ongoing COVID-19 Third Wave

India is currently experiencing the third wave of COVID-19, which began on around 28 Dec. 2021. Although genome sequencing data of a sufficiently large sample is not yet available, the rapid growth in the daily number of cases, comparable to South Africa, United Kingdom, suggests that the current wave is primarily driven by the Omicron variant. The logarithmic regression suggests the growth rate of the infections during the early days in this wave is nearly four times than that in the second wave. Another notable difference in this wave is the relatively concurrent arrival of outbreaks in all the states; the effective reproduction number (Rt) although has significant variations among them. The test positivity rate (TPR) also displays a rapid growth in the last 10 days in several states. Preliminary estimates with the SIR model suggest that the peak to occur in late January 2022 with peak caseload exceeding that in the second wave. Although the Omicron trends in several countries suggest a decline in case fatality rate and hospitalizations compared to Delta, a sudden surge in active caseload can temporarily choke the already stressed healthcare India is currently experiencing the third wave of COVID-19, which began on around 28 Dec. 2021. Although genome sequencing data of a sufficiently large sample is not yet available, the rapid growth in the daily number of cases, comparable to South Africa, United Kingdom, suggests that the current wave is primarily driven by the Omicron variant. The logarithmic regression suggests the growth rate of the infections during the early days in this wave is nearly four times than that in the second wave. Another notable difference in this wave is the relatively concurrent arrival of outbreaks in all the states; the effective reproduction number (Rt) although has significant variations among them. The test positivity rate (TPR) also displays a rapid growth in the last 10 days in several states. Preliminary estimates with the SIR model suggest that the peak to occur in late January 2022 with peak caseload exceeding that in the second wave. Although the Omicron trends in several countries suggest a decline in case fatality rate and hospitalizations compared to Delta, a sudden surge in active caseload can temporarily choke the already stressed healthcare infrastructure. Therefore, it is advisable to strictly adhere to COVID-19 appropriate behavior for the next few weeks to mitigate an explosion in the number of infections.

Estimated incidence and case fatality rate of traumatic brain injury among children (0–18 years) in Sub-Saharan Africa. A systematic review and meta-analysis

Introduction Studies from Sub-Saharan Africa (SSA) countries have reported on the incidence and case fatality rate of children with Traumatic Brain Injury (TBI). However, there is lack of a general epidemiologic description of the phenomenon in this sub-region underpinning the need for an accurate and reliable estimate of incidence and outcome of children (0–18 years) with TBI. This study therefore, extensively reviewed data to reliably estimate incidence, case fatality rate of children with TBI and its mechanism of injury in SSA. Methods Electronic databases were systematically searched in English via Medline (PubMed), Google Scholar, and Africa Journal Online (AJOL). Two independent authors performed an initial screening of studies based on the details found in their titles and abstracts. Studies were assessed for quality/risk of bias using the modified Newcastle-Ottawa Scale (NOS). The pooled case fatality rate and incidence were estimated using DerSimonian and Laird random-effects model (REM). A sub-group and sensitivity analyses were performed. Publication bias was checked by the funnel plot and Egger’s test. Furthermore, trim and fill analysis was used to adjust for publication bias using Duval and Tweedie’s method. Results Thirteen (13) hospital-based articles involving a total of 40685 participants met the inclusion criteria. The pooled case fatality rate for all the included studies in SSA was 8.0%; [95% CI: 3.0%-13.0%], and the approximate case fatality rate was adjusted to 8.2%, [95% CI:3.4%-13.0%], after the trim-and-fill analysis was used to correct for publication bias. A sub-group analysis of sub-region revealed that case fatality rate was 8% [95% CI: 2.0%-13.0%] in East Africa, 1.0% [95% CI: 0.1% -3.0%] in Southern Africa and 18.0% [95% CI: 6.0%-29.0%] in west Africa. The pooled incidence proportion of TBI was 18% [95% CI: 2.0%-33.0%]. The current review showed that Road Traffic Accident (RTA) was the predominant cause of children’s TBI in SSA. It ranged from 19.1% in South Africa to 79.1% in Togo. Conclusion TBI affects 18% of children aged 0 to 18 years, with almost one-tenth dying in SSA. The most common causes of TBI among this population in SSA were RTA and falls. TBI incidence and case fatality rate of people aged 0–18 years could be significantly reduced if novel policies focusing on reducing RTA and falls are introduced and implemented in SSA.

Analisis Indikator Entomologi dan Sebaran Jentik Aedes aegypti pada Daerah Stratifi kasi Endemisitas Demam Berdarah Dengue di Kota Jayapura

The incidence rate (IR) of Dengue Hemorrhagic Fever in Papua Province in 2017 was8.04 per 100,000 population, with a case fatality rate (CFR) of 1.12%. In 2016, the Health Offi ce ofJayapura City declared six urban villages as high endemic areas, four urban villages as high sporadicareas, and ten villages as DHF-free areas from a total of 39 urban villages in Jayapura. This studyaims to analyze larval by House index [HI], Container index [CI], Breateu index (BI), and Maya index[MI] as well as the distribution of vector Ae. aegypti in endemic, sporadic and DHF-free areas inJayapura City. The design of this study was a cross-sectional study. This research was conducted fromJanuary to March 2019. Subjects (375 houses) were surveyed according to WHO guidelines basedon its endemicity stratifi cation. Observations of mosquitos’ larvae were done using visual and singlelarvae methods. The result of this research showed that endemic areas had their HI, CI and BI as muchas 43.3%, 16.5%, and 90.0%, respectively, with density fi gure is six. Sporadic areas had their HI,CI and BI as much as 35.4%, 10.9%, and 57.5%, respectively, with density fi gure is fi ve. DHF-freeareas had their HI, CI, and BI as much as 14.8%, 5.7%, and 35.2%, respectively, with density fi gureis fi ve. The Maya index for endemic and sporadic areas was categorized as moderate, while DHF-freeareas were low.

Analisis Kesintasan Gejala Gastrointestinal dengan Luaran Pasien Anak Terkonfirmasi Covid-19

Latar belakang. Data nasional menunjukkan proporsi kasus konfirmasi Covid-19 pada usia 0-18 tahun mencapai 12,5% yang artinya 1 dari 8 kasus konfirmasi Covid-19 adalah anak. Data IDAI menunjukkan Case Fatality Rate akibat Covid-19 pada anak mencapai 3-5%. Gejala gastrointestinal pada Covid-19 dapat terjadi tanpa didahului oleh gejala pernapasan. Anak lebih sering menunjukkan gejala gastrointestinal dibandingkan orang dewasa.Tujuan. Untuk mengetahui gejala gastrointestinal terhadap luaran pasien anak terkonfirmasi Covid-19.Metode. Penelitian ini merupakan kohort retrospektif di ruang isolasi Covid-19 RSUP Dr. M. Djamil Padang. Penelitian dilakukan selama bulan Mei 2020-Mei 2021. Populasi penelitian adalah semua pasien anak yang terkonfirmasi Covid-19 di RSUP M. Djamil yang memenuhi kriteria inklusi dan ekslusi. Teknik pengambilan sampel diambil dari data rekam medik dengan minimal 24 sampel.Hasil. Berdasarkan gejala gastrointestinal ditemukan bahwa konstipasi, diare, nyeri perut dan perdarahan saluran cerna tidak berhubungan dengan luaran pasien Covid-19 anak yang dirawat (p>0,05). Namun terdapat hubungan muntah dengan luaran pasien Covid-19 anak yang dirawat (p<0,05). Selain itu, ditemukan bahwa tidak terdapat perbedaan rerata lama rawatan dengan luaran pasien Covid-19 anak yang dirawat (p>0,05).Kesimpulan. Pada penelitian ini, pasien dengan gejala gastrointestinal terbukti sebagai prediktor terjadinya prognosis buruk dari pasien anak Covid- 19 yang dirawat.

Konseling WhatsApp Gateway untuk Meningkatkan Kesiapsiagaan Masyarakat dalam Menghadapi Covid-19

Sampai 31 Maret 2020, Indonesia melaporkan 1.528 kasus terkonfirmasi C dengan 136 kematian dan tingkat kematian (case fatality rate) 8,9%. Pandemi Covid-19 membuat aktifitas menjadi serba terbatas, tidak terkecuali dengan penyebaran informasi sehingga edukasi intensif dibutuhkan untuk membentuk kesiapsiagaan masyarakat. Tujuan penelitian ini adalah untuk mengetahui pengaruh konseling melalui WhatsApp terhadap kesiapsiagaan masyarakat Villa Pamulang Depok dalam menghadapi Covid-19. Penelitian ini menggunakan metode quasi experiment yang bersifat analitik dan one group pretest-posttest design. Sampel dalam penelitian ini berjumlah 44 orang yang diperoleh dengan teknik proportional sample. Responden diberikan edukasi melalui WhatsApp selama 14 hari. Pengaruh penyebaran informasi melalui WhatsApp diukur dengan menggunakan paired sampel t-test. Hasil penelitian menunjukkan adanya hubungan antara penyebaran informasi Covid-19 melalui WhatsApp terhadap kesiapsiagaan masyarakat Villa Pamulang Depok dalam mengahadapi Covid-19 dengan p-value=0,004. Hasil penelitian juga menunjukkan perbedaan kesiapsiagaan Covid-19 sebelum dan sesudah pemberian informasi Covid-19 melalui WhatsApp. Penelitian ini diharapkan dapat menambahkan pengetahuan terhadap kesiapsiaagan masyarakat sebagai upaya pencegahan Covid-19.

Diagnosis and Treatment of Fournier Gangrene in Secondary Hospital; A Report of Two Cases

Fournier Gangrene (FG) is a specific form of necrotizing fasciitis that localized on genital and perianal, although it is rare but it is progressively fast and potentially fatal. The incidence of FG is 1.6 cases per 100,000 males, with a case fatality rate of 7.5%. Proper diagnosis and management are very important to avoid serious complications. Early debridement, broad-spectrum antibiotics and immediate supportive therapy, can reduce mortality. The objective is reporting two cases of FG who were admitted to a secondary hospital and what is the best management based on our setting. The method is qualitative observational study. The material collected through direct interview and from medical record. The best management for our setting was rapid diagnosis and followed by prompt debridement.