Publications by authors named "Hilton Y Lam"

4 Publications

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The Community Health Assessment Program in the Philippines (CHAP-P) diabetes health promotion program for low- to middle-income countries: study protocol for a cluster randomized controlled trial.

BMC Public Health 2019 Jun 3;19(1):682. Epub 2019 Jun 3.

School of Medicine, Ateneo de Zamboanga University, La Purisima St, 7000, Zamboanga City, Philippines.

Background: Type 2 diabetes is increasing globally, with the highest burden in low- to middle-income countries (LMICs) such as the Philippines. Developing effective interventions could improve detection, prevention, and treatment of diabetes. The Cardiovascular Health Awareness Program (CHAP), an evidence-based Canadian intervention, may be an appropriate model for LMICs due to its low cost, ease of implementation, and focus on health promotion and disease prevention. The primary aim of this study is to adapt the CHAP model to a Philippine context as the Community Health Assessment Program in the Philippines (CHAP-P) and evaluate the effect of CHAP-P on glycated hemoglobin (HbA1c) compared to a random sample of community residents in control communities.

Methods: Six-month, 26-community (13 intervention, 13 control) parallel cluster randomized controlled trial in Zamboanga Peninsula, an Administrative Region in the southern Philippines. Criteria for community selection include: adequate political stability, connection with local champions, travel feasibility, and refrigerated space for materials. The community-based intervention, CHAP-P sessions, are volunteer-led group sessions with chronic condition assessment, blood pressure monitoring, and health education. Three participant groups will be involved: 1) Random sample of community participants aged 40 or older, 100 per community (1300 control, 1300 intervention participants total); 2) Community members aged 40 years or older who attended at least one CHAP-P session; 3) Community health workers and staff facilitating sessions.

Primary Outcome: mean difference in HbA1c at 6 months in intervention group individuals compared to control.

Secondary Outcomes: modifiable risk factors, health utilization and access (individual); diabetes detection and management (cluster). Evaluation also includes community process evaluation and cost-effectiveness analysis.

Discussion: CHAP has been shown to be effective in a Canadian setting. Individual components of CHAP-P have been piloted locally and shown to be acceptable and feasible. This study will improve understanding of how best to adapt this model to an LMIC setting, in order to maximize prevention, detection, and management of diabetes. Results may inform policy and practice in the Philippines and have the potential to be applied to other LMICs.

Trial Registration: ClinicalTrials.gov ( NCT03481335 ), registered March 29, 2018.
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http://dx.doi.org/10.1186/s12889-019-6974-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547510PMC
June 2019

Economic burden of hospitalisation for congestive heart failure among adults in the Philippines.

Heart Asia 2018 10;10(2):e011039. Epub 2018 Oct 10.

Institute of Health Policy Development, National Institutes of Health, University of the Philippines, Manila, Philippines.

Objectives: Hospitalisation for congestive heart failure (CHF) was reported to be 1648 cases for every 100 000 patient claims in 2014 in the Philippines; however, there are no data regarding its economic impact. This study determined CHF hospitalisation cost and its total economic burden. It compared the healthcare-related hospitalisation cost from the societal perspective with the payer's perspective, the Philippine Health Insurance Corporation (PhilHealth).

Methods: This is a cost analysis study. Data were obtained from representative government/private hospitals and a drugstore in all regions of the country. Healthcare costs included cost of diagnostics/treatment, professional fees and other CHF-related hospital charges, while non-healthcare costs included production losses, transportation and food expenses.

Results: The overall mean healthcare-related cost for CHF hospitalisation (class III) in government hospitals in the Philippines in 2014 was PHP19 340-PHP28 220 (US$436-US$636). In private hospitals, it was PHP28 370-PHP41 800 (US$639-US$941). In comparison, PhilHealth's coverage/CHF case rate payment is PHP15 700 (US$354). The mean non-healthcare cost was PHP10 700-PHP14 600 (US$241-US$329). Using PhilHealth's case rate payment and the prevalence of CHF hospitalisation in 2014, the total economic burden was PHP691 522 200 (US$15 574 824). Using the study results on healthcare-related cost meant that the total economic burden for CHF hospitalisation would instead be PHP851 850 000-PHP1 841 563 000 (US$19 185 811-US$41 476 644).

Conclusions: The calculated healthcare-related hospitalisation cost for CHF in the Philippines in 2014 demonstrates the disparity between the actual cost and PhilHealth's coverage. This implies a need for policymakers to review its coverage to make healthcare delivery affordable.
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http://dx.doi.org/10.1136/heartasia-2018-011039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203040PMC
October 2018

Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.

Authors:
Nicholas Kassebaum Hmwe Hmwe Kyu Leo Zoeckler Helen Elizabeth Olsen Katie Thomas Christine Pinho Zulfiqar A Bhutta Lalit Dandona Alize Ferrari Tsegaye Tewelde Ghiwot Simon I Hay Yohannes Kinfu Xiaofeng Liang Alan Lopez Deborah Carvalho Malta Ali H Mokdad Mohsen Naghavi George C Patton Joshua Salomon Benn Sartorius Roman Topor-Madry Stein Emil Vollset Andrea Werdecker Harvey A Whiteford Kalkidan Hasen Abate Kaja Abbas Solomon Abrha Damtew Muktar Beshir Ahmed Nadia Akseer Rajaa Al-Raddadi Mulubirhan Assefa Alemayohu Khalid Altirkawi Amanuel Alemu Abajobir Azmeraw T Amare Carl A T Antonio Johan Arnlov Al Artaman Hamid Asayesh Euripide Frinel G Arthur Avokpaho Ashish Awasthi Beatriz Paulina Ayala Quintanilla Umar Bacha Balem Demtsu Betsu Aleksandra Barac Till Winfried Bärnighausen Estifanos Baye Neeraj Bedi Isabela M Bensenor Adugnaw Berhane Eduardo Bernabe Oscar Alberto Bernal Addisu Shunu Beyene Sibhatu Biadgilign Boris Bikbov Cheryl Anne Boyce Alexandra Brazinova Gessessew Bugssa Hailu Austin Carter Carlos A Castañeda-Orjuela Ferrán Catalá-López Fiona J Charlson Abdulaal A Chitheer Jee-Young Jasmine Choi Liliana G Ciobanu John Crump Rakhi Dandona Robert P Dellavalle Amare Deribew Gabrielle deVeber Daniel Dicker Eric L Ding Manisha Dubey Amanuel Yesuf Endries Holly E Erskine Emerito Jose Aquino Faraon Andre Faro Farshad Farzadfar Joao C Fernandes Daniel Obadare Fijabi Christina Fitzmaurice Thomas D Fleming Luisa Sorio Flor Kyle J Foreman Richard C Franklin Maya S Fraser Joseph J Frostad Nancy Fullman Gebremedhin Berhe Gebregergs Alemseged Aregay Gebru Johanna M Geleijnse Katherine B Gibney Mahari Gidey Yihdego Ibrahim Abdelmageem Mohamed Ginawi Melkamu Dedefo Gishu Tessema Assefa Gizachew Elizabeth Glaser Audra L Gold Ellen Goldberg Philimon Gona Atsushi Goto Harish Chander Gugnani Guohong Jiang Rajeev Gupta Fisaha Haile Tesfay Graeme J Hankey Rasmus Havmoeller Martha Hijar Masako Horino H Dean Hosgood Guoqing Hu Kathryn H Jacobsen Mihajlo B Jakovljevic Sudha P Jayaraman Vivekanand Jha Tariku Jibat Catherine O Johnson Jost Jonas Amir Kasaeian Norito Kawakami Peter N Keiyoro Ibrahim Khalil Young-Ho Khang Jagdish Khubchandani Aliasghar A Ahmad Kiadaliri Christian Kieling Daniel Kim Niranjan Kissoon Luke D Knibbs Ai Koyanagi Kristopher J Krohn Barthelemy Kuate Defo Burcu Kucuk Bicer Rachel Kulikoff G Anil Kumar Dharmesh Kumar Lal Hilton Y Lam Heidi J Larson Anders Larsson Dennis Odai Laryea Janni Leung Stephen S Lim Loon-Tzian Lo Warren D Lo Katharine J Looker Paulo A Lotufo Hassan Magdy Abd El Razek Reza Malekzadeh Desalegn Markos Shifti Mohsen Mazidi Peter A Meaney Kidanu Gebremariam Meles Peter Memiah Walter Mendoza Mubarek Abera Mengistie Gebremichael Welday Mengistu George A Mensah Ted R Miller Charles Mock Alireza Mohammadi Shafiu Mohammed Lorenzo Monasta Ulrich Mueller Chie Nagata Aliya Naheed Grant Nguyen Quyen Le Nguyen Elaine Nsoesie In-Hwan Oh Anselm Okoro Jacob Olusegun Olusanya Bolajoko O Olusanya Alberto Ortiz Deepak Paudel David M Pereira Norberto Perico Max Petzold Michael Robert Phillips Guilherme V Polanczyk Farshad Pourmalek Mostafa Qorbani Anwar Rafay Vafa Rahimi-Movaghar Mahfuzar Rahman Rajesh Kumar Rai Usha Ram Zane Rankin Giuseppe Remuzzi Andre M N Renzaho Hirbo Shore Roba David Rojas-Rueda Luca Ronfani Rajesh Sagar Juan Ramon Sanabria Muktar Sano Kedir Mohammed Itamar S Santos Maheswar Satpathy Monika Sawhney Ben Schöttker David C Schwebel James G Scott Sadaf G Sepanlou Amira Shaheen Masood Ali Shaikh June She Rahman Shiri Ivy Shiue Inga Dora Sigfusdottir Jasvinder Singh Naris Silpakit Alison Smith Chandrashekhar Sreeramareddy Jeffrey D Stanaway Dan J Stein Caitlyn Steiner Muawiyyah Babale Sufiyan Soumya Swaminathan Rafael Tabarés-Seisdedos Karen M Tabb Fentaw Tadese Mohammad Tavakkoli Bineyam Taye Stephanie Teeple Teketo Kassaw Tegegne Girma Temam Shifa Abdullah Sulieman Terkawi Bernadette Thomas Alan J Thomson Ruoyan Tobe-Gai Marcello Tonelli Bach Xuan Tran Christopher Troeger Kingsley N Ukwaja Olalekan Uthman Tommi Vasankari Narayanaswamy Venketasubramanian Vasiliy Victorovich Vlassov Elisabete Weiderpass Robert Weintraub Solomon Weldemariam Gebrehiwot Ronny Westerman Hywel C Williams Charles D A Wolfe Rachel Woodbrook Yuichiro Yano Naohiro Yonemoto Seok-Jun Yoon Mustafa Z Younis Chuanhua Yu Maysaa El Sayed Zaki Elias Asfaw Zegeye Liesl Joanna Zuhlke Christopher J L Murray Theo Vos

JAMA Pediatr 2017 06;171(6):573-592

Institute for Health Metrics and Evaluation, University of Washington, Seattle.

Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.

Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.

Evidence Review: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss.

Findings: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries.

Conclusions And Relevance: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.
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http://dx.doi.org/10.1001/jamapediatrics.2017.0250DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540012PMC
June 2017

Assessing the residual risk for transfusion-transmitted infections in the Philippine blood supply.

Yale J Biol Med 2014 Sep 3;87(3):299-306. Epub 2014 Sep 3.

Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila.

Due to a USAID-funded study on blood banks, a national policy was instituted in 1994 that set standards for Philippine blood services, promoted voluntary donation, and led to a ban on commercial blood banks. In this follow-up study, we assess the safety of the supply by determining the residual risk for transfusion-transmitted infections (syphilis, hepatitis B and C, HIV). We also identified unsafe facility practices and generated policy recommendations. A 1992 study found that transfusion-ready blood was not safe using the LQAS method (P > 0.05). We found that the 2012 residual risk became 0 to 0.9 percent attributable to the national policy. We noted poor to fair adherence to this policy. We identified unsafe practices such as use of rapid tests and lack of random blood retesting. Training and use of regional networks may improve safety. Despite improvement in safety, facilities complain of funding and logistical issues regarding compliance with the policy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144284PMC
September 2014