Leading causes of Mortality and Morbidity

y Eight of the ten leading causes of morbidity in the

country are caused by infections. They are: acute lower respiratory tract infection and pneumonia; acute watery diarrhoea; bronchitis/bronchiolitis; influenza; tuberculosis; malaria, acute febrile illness; and dengue fever. Among these communicable diseases, pneumonia and tuberculosis continue to be among the 10 leading causes of mortality, causing a significant number of deaths across the country.

y At the same time as deaths due to preventable diseases

have been in a decline, life-style diseases have begun to dominate in the leading causes of death, particularly heart diseases; vascular system diseases; malignant neoplasm; diabetes mellitus; chronic lower respiratory diseases. However, certain conditions originating in the perinatal period are also among the 10 leading causes of mortality, further illustrating the vulnerability of the newborn child.

y Accidents and injuries, other leading causes of death,

and are also among the neglected disease conditions of public health importance. The mortality rate from accidents gradually increased from 18.7 deaths per 100 000 populations in 1980 to 23 per 100 000 in 1996. An abrupt increase has been observed since then, reaching a level of 41.3 per 100 000 in 2004, almost double the 1996 rate. Among the causes, 36% are assaults, followed by deaths from transport accidents, at 25%.

Maternal, child and infant diseases

The Philippines is one of 55 countries accounting for 94% of all maternal deaths in the world and is statistically off-track for achievement of MDG 5 by 2015. Maternal deaths are closely linked with neonatal deaths. Nearly half of all pregnancies every year are unintended, resulting in women having one-third more children than they desire, one-third being born less than two years apart, and 15% ending in abortion. For completed pregnancies, the majority (60%) of deliveries are home-based, two-thirds of them attended by an unskilled attendant.

The vast majority of maternal deaths are due to haemorrhage, hypertensive diseases, sepsis, obstructed labour and problems related to abortion. These conditions are treatable if deliveries are attended by skilled health workers able to identify and treat them. They would also be less prevalent; if mothers had only their desired number of children, spaced by at least two years. For every maternal death, there are 20 neonatal, infant and child deaths. While the probability of reducing the under-five mortality by two thirds by 2015 has been adjudged highly probable, it may not be realized unless deaths during the first 28 days (neonatal period) are dealt with, as 40% of deaths among the under-fives (17 per 1000 live births) occur within 28 days of delivery. In fact, half of neonatal deaths occur during the first two days of life. Progress to curtail neonatal deaths is dismal, with death rates among this age group showing only the barest decline over the past 20 years.

As mentioned, conditions originating in the perinatal period is among the leading cause of mortality; the top cause of death being pneumonia, followed by bacterial sepsis. Other causes of mortality are related to pregnancy, events during delivery and congenital malformations. Undernutrition remains a challenge in the country. Only 68% of children under five have the normal weight for age using the National Center for Health Statistics/WHO Standards. In 2005, the prevalence of underweight preschool children (0-5 years) was 24.6%, 26.3% were stunted, 4.8% were wasted and 2.0% were overweight. In itsState of the world s children 2004. The United Nations Children s Fund (UNICEF) reported that 20% of infants have a low birth weight, while according to the 2003 NDHS, 13% are babies of low birth weight.

Exclusive breast-feeding is on the decline, with only 33.5% of children exclusively breast-fed up to the age of six months. Other nutritional challenges faced by the Filipino child include: y anaemia with prevalence rates among children aged 6-12 months and 6-11 years of age still increasing, and presently at the high levels of 66% and 37.4%, respectively; y vitamin A deficiency the level among children aged six months to five years increased from 35% in 1993 to 40% in 2003; y iodine deficiency there are an estimated 1.5 million schoolchildren aged 6-12 years who are at risk of mental retardation due to iodine deficiency.

Burden of Disease
Tuberculosis is still among the leading causes of morbidity and mortality in the Philippines; the country as has the 8th highest TB incidence in the world and the 3rd highest in the Western Pacific Region. The burden of disease of TB is disproportionately high for the poor, elderly and male population, although death is highest among older persons. Since TB principally affects the productive age group, it is estimated that the country loses some Php 26 billion (US$ 540 million annually due to premature deaths from TB.

Environmental-related health risks have been cited as a significant problem, with air pollution, water pollution, sanitation and unhygienic practices contributing to an estimated 22% of the reported disease cases and nearly 6% of reported deaths, costing Php 14.3 billion (US$ 287 million) per year in lost income and medical expenses.

Ligtas Tigdas Pinas

The Department of Health (DOH) today launched its month-long, nationwide, door-to-door measles vaccination campaign dubbed Iligtas sa Tigdas ang Pinas which is targeting about 18 million children nine months to below 8 years old. The main objective of the campaign is to reduce the number of susceptible children that have piled up since we last conducted a nationwide campaign last 2004, Health Secretary Enrique T. Ona explained, adding that vaccination is the best way to prevent Measles and German measles.

From April 4 to May 4, 2011, expect vaccination teams or Bakunadoors to be knocking at your door to give free Meales and German Measles vaccines to children aged 9 months to below 8 years old. The health department advises that parents submit eligible children for vaccination even if they have previous measles vaccinations or if they have already suffered from measles. Aside from vaccines, some local governments will also be giving out free capsules of Vitamin A which is an important micronutrient for good eyesight, strong bones, and a healthy immune system. From January to March 19 of this year, there were 2,075 measles cases nationwide recorded by the DOH National Epidemiology Center. There have already been five deaths recorded. Ages of cases ranged from 8 days to 85 years old.

Most of the cases came from the National Capital Region (311), Central Luzon (298), Bicol Region (277),CALABARZON (238), Davao Region (197), Ilocos Region (174), and Zamboanga Peninsula (163).At the National Capital Region, most cases came from Manila (101), Quezon City (50), and Caloocan (36). Nationwide mass immunization campaigns such as this have enjoyed a better coverage rate than regular implementation of the Expanded Program of Immunization. Previous measles campaigns conducted in 2004 and 2007 both reached 95% coverage, a level never achieved by the regular programs. This prompted the DOH to implement the nationwide door-to-door strategy to fight off the threat of measles.

Food Imports from Japan

In a joint meeting on 22 March 2011 initiated by DOST-PNRI and attended by FDA and agencies of the Department of Agriculture(Bureau of Animal Industry, Bureau of Fisheries and Aquatic Resources, Bureau of Plant Industry), there was briefing was on the nuclear crisis arising from the earthquake-tsunami disaster that affected the Fukushima Daiichi nuclear plant in Japan.

Although results of radioactivity measurements done by the Philippine Nuclear Research Institute (PNRI) on imported food products from Japan collected by the FDA from the local market showed that these products were safe, it was decided that the agencies with jurisdiction over food products do random sampling of food products arriving after 21 March 2011 for testing by the PNRI to ensure that the food reaching the Philippine market will be free from radiation contamination. Priority is placed on milk products and seafoods.

On March 23, FDA in cooperation with PNRI, conducted a technical briefing for 18 importers of processed food from Japan and to discuss the proposed random sampling of food products including the procedures in the collection of testing of the samples. The importers were not only cooperative but many were also willing to subject their products to voluntary testing. The PNRI will carry out the testing and the food importers will be responsible for the payment of testing fees. The Department of Health is assuring the public that it is taking all necessary steps to prevent the entry of any radioactive substances in the country and will be issuing updates as the need arises

Food Products from Japan being Monitored

Food and Drug Administration (FDA) Director Suzette H. Lazo, MD today assured the public that food products and food additives imported from Taiwan are being monitored after the Taipei Economic and Cultural Office (TECO) informed the Philippine government of possible contamination of Di (2-ethylhexyl) phthalate (DEHP).

Widely used as a plasticizer in the manufacturing of articles such as intravenous bags and tubings, blood bags and infusion tubings and nasogastric tubes, DEHP was found to be illegally added to a food product raw material intended for emulsification. While low doses of DEHP are generally safe, high doses or prolonged exposure can have harmful effects. Children are especially prone to the harmful effects of high doses of DEHP or to repeated exposure which can lead to testicular effects, fertility problems and toxicity to kidneys.

The Taiwan government has informed the Department of Health that a company may have imported food products containing additives contaminated by DEHP to the Philippines. Efforts to trace local counterpart of this company are currently in progress.

June is Dengue Awareness Month

The Department of Health (DOH) today reported a total of 22,903 dengue cases nationwide from January to May 7 this year as it prepares to observe June as Dengue Awareness Month . The total number of dengue cases is 8% higher compared to the same period last year. There were 141 deaths recorded (Case FatalityRate-0.62%).

Most of the cases came from the National Capital Region (6,732), Central Luzon (4,181), andCALABARZON (3,555). At the National Capital Region, Quezon City had the most (1,694) number of cases followed by Manila(824), Kalookan City (775), Pasig (592), Valenzuela (466), and Paranaque City (407). Ages of cases ranged from less than a month to 89 years old. Majority (53%) of the cases were males. Most (39.9%) affected cases belonged to the 1-10 years age group.

Increasing Number of AIDS Victim

Human Immunodeficiency Virus or HIV continues to be a potent threat to the health of our countrymen. Countries across the globe are facing this dreaded disease and its disastrous effects on individuals, their families, the health care delivery system, and society in general. Towards the end of 2008, an estimated total number of 33.4 million people were infected with HIV globally.

Locally, there are now a total of 5,729 HIV positive cases in the country. This represents less than one percent of our total population which means that the country is still on track to meet our MDG target of halting the spread of HIV/AIDS by 2015.