Although infectious diseases are no longer the leading cause of deaths in the country, they remain a major reason of morbidity and hospitalization; hence, infectious diseases still impose a huge socio-economic burden in the country. Experts have to address challenges like antimicrobial abuse, folk remedies delaying effective treatment, and simply lack of proper knowledge on basic ways to prevent infections
By Baby Ann Melinda Velonta
Recent data from the Department of Health (DOH) show that among the top 10 infectious diseases in the Philippines, acute upper respiratory infections top the list with more than one million recorded cases.
Pneumonia comes in second followed by urinary tract infection, bronchitis, influenza, acute watery diarrhea, pulmonary tuberculosis, dengue fever and other forms of tuberculosis in the top 10 list.
With advances in antimicrobial treatment, most infectious diseases are now treatable and patients survive their infections, but among the top 10 leading causes of deaths, pneumonia remains in the top five, with pulmonary tuberculosis among the top 10.
Infectious Disease (ID) specialists are the experts in the diagnosis and treatment of diseases caused by microorganisms. They’re knowledgeable and skilled at making a critical assessment of patients with infections, identifying the microorganism causing the infection and determining the antimicrobial that would eradicate the causative organism.
Not all patients with infections are referred to the ID specialists in actual clinical practice. Most uncomplicated cases are usually managed by their primary physicians, or another medical specialists who may be treating the patient for another medical problem. More complicated cases, particularly those who need confinement, are generally referred to the ID specialist for more accurate and definitive treatment.
The birth of PSMID
Recognizing the importance of a collegial body of experts in infectious diseases, 12 ID experts bonded together in 1970 to organize the Philippine Society of Microbiology and Infectious Diseases (PSMID). The pioneers realized that ID was still an evolving and dynamically growing specialty which required a continuing medical education and other means of professional development. Its first president was Dr. Elpidio Gamboa, and on May 23, 1972, PSMID’s charter was signed by 11 people namely Doctors Elpidio Gamboa, Rodolfo Jao, Benjamin Limson, Pedro Chanco, Thelma Tupasi, Lourdes Campos, Ernesto Valdez, Cesar Uylangco, Virginia Sevilla, Joaquin Sumpaico, and Antonio Gonzaga.
Among the Society’s initial efforts were the regular publication of the Philippine Journal of Microbiology and Infectious Diseases, its official scientific publication which remains up to this time.
Initial collaboration with other local medical societies was done in 1974 under the leadership of the second president, Dr. Cesar Uylangco (1974-1975). It was also then that the distinction between fellows and regular members were set as the members grew in number.
To this day, PSMID pursues dynamism in its professional and medical standards while remaining true to its ethical values. The 500 plus members of the Society comprising its three chapters in Cebu, Negros Oriental and Mindanao work towards the ultimate vision of safeguarding the health and wellness of the Filipino community by preventing infections.
Education is key
The Society’s primary goal is to educate its members, other medical practitioners, healthcare professionals, nurses and technologists on the proper ways of addressing infectious diseases. It is also the Society’s objective to update the public with basic but essential information on how to prevent and deal with common infections prevalent especially during certain seasons, such as flu, dengue, typhoid fever, malaria, leptospirosis, hepatitis and pulmonary tuberculosis. Educating the public on HIV/AIDS is also a major thrust by the Society.
According to Dr. Mario Panaligan, current PSMID president, they are now being invited to certain programs by the DOH to actively collaborate with them in raising the public’s awareness about the preventive and precautionary measures for the various IDs.
The PSMID is promoting basic preventive programs such as Respiratory Etiquette of covering one’s mouth when coughing or sneezing, and Cough Love, consisting of quickly covering one’s mouth and nose with one’s sleeves when coughing or sneezing. Most importantly and the simplest of all, frequent hand washing is still one of the best ways to prevent the transmission of infectious agents.
Antibiotic abuse, folk remedies
Most people think that all febrile infections require antibiotics. Some even self-medicate without seeing their physician. “Many people think that antibiotics work but not all infections can be cured by antibiotics,” says Dr. Panaligan.
He adds that specific kinds of antibiotics are needed for specific kinds of infection. To be able to target only the microorganism causing the infection, we need to properly identify the antibiotic where the microorganism is susceptible.
The PSMID has embarked on a continuing advocacy to educate the public to minimize, if not eliminate misuse, overuse, underuse—or any form of abuse of antibiotics. Dr. Panaligan defines antibiotic misuse as the incorrect or inadequate prescription of the dose of antibiotic or the prescription of incorrect antibiotic from the very start. On the other hand, he defines antibiotic overuse as the use of broad spectrum (very strong) antibiotics that can kill many organisms, even the good ones needed by the body to function properly.
Both the public and even some medical practitioners tend to think that the longer antibiotics are taken in, the better is the outcome and the more effective would be the cure. Some would also think that for faster cure of infection, broad spectrum antibiotics should be preferred.
He says that some doctors, on some occasions, use antibiotics for longer periods without relying on culture and sensitivity studies, which determines if specific microorganisms are susceptible to the antibiotic or not.
Prolonging the duration would kill practically all organisms in the body and this may cause collateral damage or what Dr. Panaligan explains as killing all susceptible organisms, but could later cause resistant organisms to come out and start another infection.
This is the reason why PSMID now highlights a program they termed as Antimicrobial Stewardship. This is in collaboration with the DOH and is now being implemented in different hospitals nationwide.
“We help the DOH in terms of educating the different hospitals because antimicrobial stewardship is training, or is actually a scheme to help clinicians use antibiotics properly,” he explains.
This program educates health professionals, clinicians and medical practitioners of different hospitals on the rational use of antibiotics. This program could hopefully address the alarming increase in antibiotic resistance in the country.
In this modern day and age, many of our countrymen, especially in the provinces, are still relying too much on alternative medicine or folk remedies like herbal medicines. That includes the treatment of infections. It’s only when the infection becomes complicated that the patient is brought to the physician for treatment.
Educating thru social media
Since many of our countrymen are active in social media, PSMID recently launched its social medicine arm, to raise the public’s awareness about specific infectious diseases as well as give practical tips and pointers on the prevention and treatment of these diseases, and when to see a physician should they develop infections.
The ID Talk is an interactive way of disseminating information and answering queries from medical professionals and ordinary people alike. Right now, it is also being promoted in Facebook, Twitter and Instagram to cater to a wider public audience.
Under Dr. Panaligan’s leadership, PSMID is really harnessing digital technology to raise public awareness about infectious diseases. Dr. Panaligan believes that a more dynamic website and an active social media arm are the best way of reaching out to the public. He hopes to make this his legacy to the Society.
Vaccination is still one of the best modes for prevention of infections, not only for children, but for adults, too. There are vaccines for flu, pneumonia, hepatitis and other infections which should be administered to kids and adults—especially those with compromised immune systems.
Despite some shortcomings of some vaccines, Dr. Panaligan explains that vaccines are still the most cost-effective agents in preventing infections. PSMID is working with the Philippine Foundation on Vaccination to advocate on the importance of receiving vaccination as well as to continuously develop vaccines that would protect the people from the threats of infectious diseases.
In addition to this, PSMID also collaborates with the DOH on addressing emerging and re-emerging infectious diseases. PSMID holds a regular annual convention every November to discuss recent researches, studies and guidelines on the prevention and cure of infectious diseases. In this regard, the PSMID has been organizing international conferences, like a forthcoming conference in April of next year to collaborate with other foreign societies in the exchange of best practices and other ideas for jointly battling prevalent infectious diseases.
“We help the Department of Health in terms of educating different hospitals on antimicrobial stewardship, which guides clinicians to use antibiotics properly”
Nov 2018 Health and Lifestyle