The World Health Organization recently revised their recommendations and considered healthy children and adolescents as low priority group for COVID-19 vaccine. This review comprehensively assessed existing clinical evidence on COVID-19 vaccine in 12-17 years old. Included in this review were any type of study that investigated the efficacy, immunogenicity, safety, and effectiveness of COVID-19 vaccine on protection against SARS-COV-2 infection in 12-17 years old. Various electronic databases were searched up to March 15, 2023. Studies were screened, data extracted, risk of bias appraised, and certainty of evidence was judged using GRADE. Review Manager 5.4 was used to estimate pooled effects. Difference between the two groups was described as mean difference for continuous variables and as relative risk or odds ratio for categorical variables. There were six randomized controlled trials and 16 effectiveness studies (8 cohorts and 8 case control). Low certainty evidence showed that BNT162b2 (Pfizer) was effective, immunogenic, and safe in healthy adolescents. There were 15 effectiveness studies on BNT162b2 (Pfizer) in healthy adolescent and one on immunocompromised patients. It was protective against infection with any of the variants, with higher protection against Delta than Omicron. BNT162b2 is protective against hospitalization and emergency and urgent care (high certainty); and critical care and MIS-C (low). Very low certainty evidence noted that BNT 162b2 was also immunogenic in 12-21 years old with rheumatic diseases while on immunomodulatory treatment but with possible increased exacerbation of illness. Low certainty evidence demonstrated that mRNA-1273 (Moderna) was effective, immunogenic, and safe. Low to very low certainty evidence were noted on the safety and immunogenicity of two vector base vaccines (ChAdOx1-19 and Ad5 vector COVID vaccine) and two inactivated vaccines (CoronaVac and BBIBP CorV). There is presently low certainty evidence on the use of RNA vaccines in 12-17 years old. The recommendation on its use is weak. There is presently insufficient evidence for the use of inactivated and vector-based COVID-19 vaccines. Different countries should consider whether to vaccinate healthy adolescent without comprising the other recommended immunization and health priorities that are crucial for this age group. Other factors including cost-effectiveness of vaccination and disease burden should be accounted.

On December 31, 2019, a cluster of severe pneumonia infection of uncertain etiology was reported in Wuhan, China which later was determined to be due to a novel coronavirus and was termed the SARS-CoV-2 causing COVID-19 infection. In a media briefing by WHO Director General Dr. Tedros Adhanom Ghebreyesus on the 11th of March 2020, he acknowledged the increasing number of cases of COVID-19 outside of China which had increased 13-fold and the number of affected countries had tripled. With approximately 118,000 cases identified in 114 countries and 4,291 people who lost their lives from this virus, WHO declared COVID-19 a pandemic.1 In the Philippines, as of the 2nd day of March 2020, there were 43 admitted cases classified as “persons under investigation” (PUI) with no confirmed cases. By the 15th of March 2020, with the hope of controlling the spread of the infection, Metro Manila and several provinces were placed in community “lockdowns” and international travel coming in and going out of the Philippines was curtailed. By the 20th of March 2020, there were already 230 confirmed cases and 18 deaths nationwide.2 The Philippine General Hospital (PGH) was designated as the COVID 19-referral hospital for the National Capital Region. The medical and surgical wards were retrofitted in preparation for the first group of patients diagnosed with COVID-19 to be admitted. By the first day of April 2020, PGH officially began operating as the COVID-19 referral center. However, by this time, the country has lost several medical practitioners who were either affiliated with the Philippine General Hospital and/or were University of the Philippines-College of Medicine alumni – adult cardiologists Dr. Francisco Lukban and Dr. Raul Jara, anesthesiologist Dr. Greg Macasaet, pediatric surgeon Dr. Leandro Resurreccion, and pediatrician and then current Philippine Pediatric Society President Dr. Salvacion Gatchalian. In the neurosciences, the Division of Pediatric Neurology, one of the busiest divisions of the Department of Pediatrics, had to adapt to the COVID-19 pandemic in service delivery, teaching, and research. Figures 1-3 show the comparison of 2019 to 2020 census of inpatient admissions/referrals to the Neurology Service and outpatient consultations. To give way for the creation of a COVID Pediatric team of residents for COVID-related admissions, the 15 Pediatric Neurology Service beds were dissolved and were put under the General Pediatrics Service. There was a 61.7%drop in inpatient cases from 193 patients in 2019 to 74 patients in 2020 with a maximum of 208 inpatients in the month of January to a minimum of 23 inpatients in the month of June.3,4

Synovial sarcoma of the hypopharynx is an uncommon malignancy, with less than 100 cases reported in available journals. We report a case of a 22-year-old female presenting with dysphagia and enlarging hypopharyngeal mass, clinically diagnosed as hypopharyngeal malignancy, right, at least stage III. Histopathologic examination including immunohistochemistry study with TLE1 and SS18 Fluorescence In Situ Hybridization (FISH) confirm the diagnosis of synovial sarcoma. This is the first reported case of synovial sarcoma of the hypopharynx in the Philippines confirmed by SS18 FISH. Due to the size of the mass, chemoradiotherapy followed by surgery is the current plan of management for this patient.

Medicinal plants are widely used for healthcare needs, including oral health. In the Philippines, garlic, guava, tsaang-gubat, and hierba buena, although primarily recognized as plants used for the treatment of systemic diseases, are indicated as analgesics for dental pain, treatment of gingival inflammation, and oral health maintenance. Despite studies focusing on the effectiveness of these plants for oral health, there is little to no research on the populace's knowledge, attitude, and practices on these medicinal plants. The study aimed to determine the knowledge, attitude, and practices of Oral Medicine patients from a dental college in Manila on four medicinal plants (garlic, guava, tsaang-gubat, and hierba buena) for oral health. A descriptive study design was used. Oral Medicine patients (694) were invited to participate in the study through daily text messages containing brief research details. The link to the three-part online questionnaire (Google Forms) was sent via text and Facebook messages, and was answerable within 15-20 minutes. Two hundred fourteen (214) Oral Medicine patients participated, with 147 (68.69%) having knowledge on using medicinal plants for oral health which they mostly knew through friends and acquaintances. Most participants had a generally positive attitude toward medicinal plants for oral health and believed they were beneficial (177, 82.71%), safe, effective, and cheaper than conventional medicine (175, 81.78%), and accessible (171, 79.91%). Only 64 (29.91%) personally used medicinal plants to address their oral health conditions. Garlic (144, 97.96%) was the most widely known and used, followed by guava (52, 35.37%), hierba buena (12, 8.16%), and tsaang-gubat (4, 2.72%). Most participants were knowledgeable with a generally positive attitude toward the four medicinal plants for oral health but did not use these to address their oral health problems.

In the Philippines, the prevalence of food insecurity increased during the COVID-19 pandemic, affecting the nutritional status of communities nationwide. Urban areas in particular are vulnerable to the harmful effects of food insecurity, and the effects are extended and magnified when it comes to children. This study aims to evaluate the coping strategies of households with children aged 0-10 years old in an urban poor community in Quezon City. In particular, the study will determine Coping Strategies Index (CSI) scores and the frequency of specific coping strategies used. A descriptive cross-sectional study was conducted to assess the coping strategies of 405 households with children in the community during the pandemic. Mothers or caregivers were given a survey inquiring about the sociodemographic data and CSI. Sociodemographic profiling showed that the households generally belonged to class D and E (PhP 15,000 and below) income households (73.8%). The majority of the household heads (52.6%) have their highest educational attainment at the high school level.The majority (77.5%) of the households were categorized as having low CSI classification (90%CI: 73.9, 80.8). This could indicate that relief operations conducted in the community may have helped ease their food insecurity. Coping strategies that were most frequently employed by the households were depending on less preferred or more affordable food (74.8%), rationing money for prepared food (69.1%), and purchasing food on credit (58.5%). Low CSI classification was noted, which may be due to increased adaptation to persistent food insecurity and the utilization of coping strategies not indicated in the questionnaire. Common coping strategies used by households include reliance on less favored or less costly food items, rationing resources for prepared food, and food on credit. It is recommended that the results collected be used to target food availability and accessibility interventions in the community.

The Philippine Primary Care Studies (PPCS) is a network of pilot studies that developed, implemented, and tested strategies to strengthen primary care in the country. These pilot studies were implemented in an urban, rural, and remote setting. The aim is to use the findings to guide the policies of the national health insurance program (PhilHealth), the main payor for individualized healthcare services in the country. The objective of this report is to compare baseline outpatient benefit utilization, hospitalization, and health spending, including out-of-pocket (OOP) expenses, in three health settings (urban, rural, and remote). These findings were used to contextualize strategies to strengthen primary care in these three settings. Cross-sectional surveys were carried out using an interviewer-assisted questionnaire on a random sample of families in the urban site, and a stratified random sample of households in the rural and remote sites. The questionnaire asked for out-patient and hospitalization utilization and spending, including the OOP expenses. A total of 787 families/households were sampled across the three sites. For outpatient benefits, utilization was low in all sites. The remote site had the lowest utilization at only 15%. Unexpectedly, the average annual OOP expenses for outpatient consults in the remote site was PhP 571.92/per capita. This is 40% higher than expenses shouldered by families in the rural area, but similar with the urban site.For hospital benefits, utilization was lowest in the remote site (55.7%) compared to 75.0% and 78.1% for the urban and rural sites, respectively. OOP expenses per year were highest in the remote site at PhP 2204.44 per capita, probably because of delay in access to healthcare and consequently more severe conditions. Surprisingly, annual expenses per year for families in the rural sites (PhP 672.03 per capita) were less than half of what families in the urban sites spent (PhP 1783.38 per capita). Compared to families in the urban site and households in the rural sites, households in remote areas have higher disease rates and consequently, increased need for outpatient and inpatient health services. When they do get sick, access to care is more difficult. This leads to lower rates of benefit utilization and higher out-of-pocket expenses. Thus, provision of "equal" benefits can inadvertently lead to "inequitable" healthcare, pushing disadvantaged populations into a greater disadvantage. These results imply that health benefits need to be allocated according to need. Families in poorer and more remote areas may require greater subsidies.

Primary care nurses serve as the gatekeeper of the health system. They could be psychologically affected in times of health crisis such as the COVID-19 pandemic. This study aimed to assess their perceived anxiety, depression, and resilience while working in the rural health units in Samar Province. A cross-sectional design was employed involving 188 primary care nurses who were working in rural health units (RHUs) in Samar province. They were selected through stratified random sampling technique. Anxiety and depression levels were assessed using the 21-item Depression Anxiety Stress Scale (DASS-21). Resilience level was assessed using 18-item Resilience Scale. Pearson's r moment correlation and logistic regression analysis were used to determine associated factors with mental health. Twenty (20) nurses experienced anxiety and five of them reported depression. Work experience is associated with depression [Exp(B) = 3.753; 95% CI (1.121 - 12.563)]. Overall, nurses reported high resilience level. Anxiety and depression are significantly and negatively associated with resilience. Primary care nurses experience depression and anxiety during COVID-19 pandemic. Work experience is associated to their levels of depression. Moreover, nurses reported high levels of resilience. The higher the levels of anxiety and depression, the lower is their resilience.

The adoption of electronic medical records (EMRs) in the Philippines has been initiated and adjusted since the last decade through the Philippine eHealth Agenda framework. EMRs are known to improve clinical management and have been widely adopted in advanced economies. However, empirical research on EMR implementation remains limited. This study aims to determine how public primary health care facilities in the country interacted with EMRs before and during the COVID-19 pandemic to understand EMR adoption. More than 270,000 records generated from EMR usage logs in six rural primary health facilities in Western Visayas were analyzed. Average time of EMR use during work hours was estimated and compared before and during the pandemic. EMR adoption based on specific EMR features used was also determined. In 2020, EMR use ranged from less than one hour to more than eight hours in selected rural health units (RHUs). There was a statistical increase and decrease in use of features during the pandemic. Some EMR users had efficient use indicated by complete adoption of EMR features although such features were not as frequently used as those pertaining to basic adoption. This study demonstrates that for EMR use in rural settings, progressive use from basic to complete may vary among users. Public health emergencies such as a pandemic may also affect EMR use. Future research directions should explore other mechanisms which affect user behavior and encourage full adoption of technology such as use of games or non-monetary incentives.

Occupational therapy (OT) can be part of mental health and psychosocial support (MHPSS) in the university setting. Numerous studies worldwide have highlighted the negative impact of COVID-19 on mental health due to isolation and restrictions. In the Philippines, these issues were exacerbated among students, whose abrupt shift to remote learning negatively affected their mental well-being. As universities reopened, there is an opportunity for OT to support students' mental health. This study presents the findings of an online group discussion and an online forum that explored the role of OT in MHPSS in the Philippine university setting. Moreover, this study aimed to (1) describe the perceptions of Filipino OT practitioners (OTPs) on their role in the university setting, and (2) describe thoughts of Filipino OTPs on being part of MHPSS services. Using a qualitative exploratory design, data was gathered through an online discussion and an online forum. Thirty-five Filipino OTPs with a background in mental health practice served as the participants. Data was analysed using constant comparison. Analyses of data generated four themes: (1) awareness of the importance of MHPSS as student support, (2) mental health and occupation-focused support in the education setting, (3) role of OT in MHPSS, and (4) potential for interprofessional services. Need for OT in MHPSS is justified by rising issues in anxiety, depression, trauma, and stress that can be addressed using an occupation-focused approach. OTPs can provide non-specialized services like PFA, or specialized individual or group-based interventions. However, OTPs think that they need to know more about MHPSS to contribute across all levels of MHPSS.

This study assessed the level of health system responsiveness of Rural Health Units (RHUs) in Cagayan Valley Region along seven domains of responsiveness namely dignity, autonomy, confidentiality, choice of provider, prompt attention, communication, and quality of basic amenities, and five core components of the health system namely health governance, health human resource, health information system, access to medicines and technology, and service delivery. A cross-sectional research design was adopted using survey as the primary means of data collection using a researcher-developed questionnaire. The study was conducted in RHUs of 15 identified municipalities in the region. The municipalities were chosen based on their low performance in the LGU health score cards for 2019. A total of 618 clients and 235 health workers were included in the study. Frequency, percentage, and mean were used to analyze the profile and level of health system responsiveness. T-test and one-way ANOVA were used to test significant differences. The results showed that the RHUs included in the study have very good level of health system responsiveness, with overall percentage scores ranging from 73.55 to 88.08, in all domains assessed. However, choice of providers within the facilities (62.71%) and access to medicine and technology (77.45%) were the least responsive among all the identified domains. Significant differences in the clients' assessment of the responsiveness of the RHUs were seen when grouped according to their sex, age, educational attainment, income level, overall level of health, frequency of visits, and distance of home to facility. The RHUs' location, whether in an urban or rural area, number of staff, and number of barangays catered also were found to determine the level of health system responsiveness. Moreover, not all RHUs were able to comply with basic requirements of the Department of Health specifically along the services offered. It can be concluded therefore that the RHUs, despite the limitations in certain aspects are still able to meet the expectations of the clients and health workers in the delivery of health services. However, in order to maximize responsiveness of these facilities, DOH requirements for these facilities should be met.