Health research as a national concern
The NIH presents results of studies that have public-health consequences
In celebration of their seventh year of founding, the National Institutes of Health (NIH) joined the University of the Philippines Manila in holding the third Science and Technology Week on February 7 to 11. Carrying the theme, Shaping Our Future through Science and Technology, the weeklong celebration gathered the academic units of the UP Manila campus to promote the importance of health-science research, and at the same time make these lead to improvements in the lives of Filipinos.
During the opening ceremonies, Dr. Perla Santos Ocampo, former UP Manila chancellor, took note of the significant gains in health-science research made with the help of the NIH. "The NIH has come a long way in cutting-edge health, technology, and research since its foundation. I take personal pride because in several ways the NIH is the fruit of our shared vision and efforts."
The UP College of Nursing, meanwhile, unveiled three of its latest achievements. Prof. Josefina Tuazon, College of Nursing dean, announced the College's redesigation as a World Health Organization (WHO) Collaborating Center for Leadership in Nursing Development. As a WHO collaborating center, the College will coordinate with various academic and regulatory institutions in coming up with ways to help improve the profession. She also introduced the publication of the Department of Health-WHO-supported project, Integrating Prevention on Control of Smoking/Tobacco Use in the Nursing Profession. Lastly, she announced that the College had recently received a grant to develop a Nursing and Midwifery Information System.
For his part, Dr. Jaime Galvez Tan, NIH executive director, reported on the memorandum of agreement signed by the NIH, National Economic Development Authority, and the National Statistics Office that details their respective roles in assessing the performance of the Philippine Health Insurance Company. This way, the PHIC can see which directions to take toward improving itself and its service to Filipinos.
Medical and social impact
The whole week of the celebrations highlighted the research activities of the different academic units of the campus. The College of Dentistry presented separate studies on the stress profile and the oral-health impact-profile score of the College's students. Meanwhile, the College of Nursing conducted a workshop on evidence-based practice in nursing, with special attention given to the appraisal of metaanalyses.
As for the NIH, research fellows presented three studies that "address national concerns"--studies that have significant impact on public health.
Dr. Fe Marilyn Lorenzo, a professor at the College of Public Health, presented a country case study on the migration of Filipino health workers. Funded by the International Labor Organization, the study aimed to give "in-depth information" on the phenomenon as well as understand its "impact on the individual migrant, his family, the profession, and the nation as whole."
The study, aside from relying on documents that detailed health-worker-migration patterns, made use of interviews with "potential" migrants as well as those "who chose to stay behind." The 257 respondents included nurses, doctors, pharmacists, midwives, physical therapists, and occupational therapists. They came from five cities--Manila, Cebu, Davao, Laoag, and Valenzuela.
Lorenzo said that the Philippines is now one of the largest providers of health professionals all over the world, "supplying about 25 percent" of the total overseas health-care work force. With the migration of Pinoy nurses being one of the most noticeable phenomena of the past years, the study found that their most common destination is Saudi Arabia (57 percent), the United States (14 percent), and the United Kingdom (12 percent). She added: "The prediction is that the UK will soon overtake Saudi Arabia as the top destination because of the volume of the demand."
Meanwhile, Dr. Corazon Ngelangel of the Department of Clinical Epidemiology pre-sented a study on the use of acetic acid for cervical-cancer screening. The study was published in the International Journal of Gynecologic Oncology, which also gave it a research prize.
Cervical cancer has remained one of the most common--and deadly--cancers among women in the Philippines over the years. Only about 25 percent of women with the disease live beyond five years from the time of diagnosis. Early detection is believed to help patients greatly in surviving the disease.
Unfortunately the government cannot subsidize routine Pap smears because of the expense involved. With the results of the study led by Ngelangel, acetic-acid-guided visual inspection can be advocated for routine screening. The study proved that the method could be as accurate as a Pap smear. In addition, it could yield a "higher net benefit" than Pap smear--about US$21 million per 100,000 women, as opposed to US$7 million per 100,000 with the Pap smear.
Lastly, Dr. Enrique Ostrea, visiting professor from Wayne State University, gave an update on a study he is currently leading, which is about maternal exposures to environmental toxicants and their outcomes in Filipino children.
Ostrea stressed that maternal/fetal exposure to environmental toxicants is "not only a national but international concern." With this study, Ostrea and other researchers with NIH are concerned with maternal exposure and potential effects of the exposure to fetuses and infants.
This study is supported by grants from the US National Institutes of Health, National Institute of Child and Human Development, and US Environmental Protection Agency. Participants to the study were recruited from Malolos, Bulacan, and Tagum, Davao, and are being followed up and assessed on the effects of common household and farm pesticides, as well as heavy metals.
J.P. de Guzman
Screening for life
"A drop of blood can save babies from mental retardation and death"
Shelling out an extra PhP550 immediately after giving birth to a child could save him or her from mental retardation--or even death.
So said Dr. Carmencita Padilla, director of the National Institutes of Health-Institute of Human Genetics. At a media forum held during the University of the Philippines Manila Science and Technology Week in February, Padilla discussed the importance of screening newborns for five serious metabolic disorders: congenital hypothyroidism, congenital adrenal hyperplasia, galactosemia, phenylketonuria, and glucose-6-phosphate-dehydrogenase deficiency.
She said that in most developed countries, newborn screening is an "integral part of routine newborn care." She added that if fully implemented in the country, newborn screening can save as many as 33,000 infants every year.
In newborn screening, the hospital takes a blood sample from an infant's heel and blots it onto a special paper. If the child is delivered at home, he or she must be brought to a facility that offers the service. The sample is then sent to a centralized testing center at the NIH building in UP Manila. The results are usually made available within seven working days, but in case of a positive screen, the hospital coordinator or attending physician is informed immediately about it. Either way the parents must be informed of the results of the screen. A child who screens positive must then be referred to a specialist for confirmatory testing or for possible medical management.
When newborn screening was introduced in the country in 1996, parents could only avail themselves of the service in 18 private and six government hospitals. With the signing of Republic Act 9288 or the "Newborn Screening Act of 2004" in April last year, together with the approval of its implementing rules, a number of improvements could be seen in the program. As of January this year 396 hospitals in the country offer newborn screening; by next year all 1,700 hospitals in the country must offer the service.
Padilla said that one of the reservations parents have with newborn screening is that they still find the cost steep. But she said that it is, in fact, more expensive to care for a child with severe disability. For instance, a child who ends up having severe mental retardation because of congenital hypothyroidism will require at least PhP195 every day for treatment. On the other hand, congenital hypothyroidism detected early with the help of newborn screening will only require PhP1.58 daily for thyroid hormone.
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