03 July 2007

Philippines' Top Ten Causes of Mortality

It is interesting to see what are the leading diseases and health conditions that kill Filipinos everyday and ponder why they continue to do so. The chronology I have below came from the Department of Health's Health Statistics website (now a dead link), and is said to have been updated sometime last January 2007.

Heart diseases are varied and may include coronary, ischemic, valvular, inflammatory, hypertensive, hereditary, and infectious causes. Sadly, I can't find recent online data that points specifically to the breakdown of specific heart diseases' contribution to the overall mortality rate. The resources just say it is number one, and for the past several years beginning in the early 90s, the complex group of heart diseases has been the Philippines' top killer. From 1942 to the 1980s, infectious diseases used to be the Philippines' top killer. A 1984 study identifies rheumatic heart disease, ischemic and hypertensive heart diseases as the major types involved. Another study blames cigarette smoking, the easy accessibility of cigarettes even to adolescents, and the usual suspects of increasing fat intake, increasing diabetes cases, and high cholesterol levels as predisposing factors.

Closely related to number 1 above, these are the diseases that affect the circulatory system (blood vessels) and may include peripheral artery disease, all types of aneurysms and dissections, atherosclerosis, Buerger’s Disease, Raynaud’s phenomenon, and arterial embolism and thrombosis. A frequent diet of fatty and salty food, lack of exercise, no periodic medical consultations, and increasing cost of hospitalization all contribute to the existence of this number two killer.

In order of killing contribution, cancers of the lung, breast, cervix, liver, colon and rectum, prostate, stomach, oral cavity, ovary and leukemia are the specific leading cancer killers in the Philippines today. Why the lung? Because Filipinos love to smoke, the innocent and unwary get to inhale all the second-hand smoke they can get, and the air pollution is terrible especially in cities found in Metro Manila. Why breast cancer? Read this. Why the liver? Perhaps alcohol consumption and unidentified but increasing incidence of both overt and subclinical hepatitis infections are to blame. For the rest, feel free to share your theories. As with the heart and vascular diseases, there is low cancer prevention consciousness. Currently, 75 percent of all cancers occur after age 50 years, and only about 3 percent occur at age 14 years and below. Also, cancer survival rates here are relatively low. Most Filipinos seek medical help only when their cancer conditions are in the advanced stage. By that time, it is too late. They spend most of their money with radio- and chemotherapy sessions just to extend their lives for a couple of months.

Safety and prevention are two of the frequently ignored concepts by most Filipinos. It is not therefore surprising to find that accidents is the fourth killer. I am not talking about merely driving accidents, but all types of accidents including occupational and otherwise. It is a common sight seeing construction workers not wearing safety harnesses or hard hats. In fact, I have not seen a worker operating a jack hammer wearing any ear protection --- only in the Philippines! Construction in streets and roads are done with a scarcity of signs making both motorists and pedestrians suffer from accidents like colliding with big blocks of stone and falling in open manholes. Also, since we are a disaster-prone country, typhoons, landslides, flash-floods, volcanic eruptions, and earthquakes all contribute to the other causes of accidents here.

You would think that in the light of modern medical treatment and wide availability of antibiotics, Pneumonia would no longer kill us, right? Wrong! For adults, this occurs mainly as a complication of other chronic diseases like lung cancer, COPD, tuberculosis, and other debilitating illnesses that leave them bedridden most of the time. For children, this remains to be a major killer, either as a sole disease beginning with a respiratory infection, or as a complication of measles. This recent study from Cebu City concludes that most physicians do not adhere to the local guidelines in treating community-acquired pneumonia. Also, there's the other form of more fatal pneumonia --- the hospital-acquired type. This is the pneumonia you get when your length of stay in the hospital is long, and the antibiotics used to treat are the higher generations.

The joke is that you are not a Filipino if you do not have TB. It might sound amusing but it gives you a glimpse of how prevalent this disease is. In the late 1990s, the Philippines was fourth in the world for the number of cases of tuberculosis, and had the highest number of cases per head in South East Asia. Today, there has been some improvement but a lot still need to be done. Among the 22 countries in the world accounting for 80 percent of TB worldwide, the Philippines is now ranked number 9. Almost 75 Filipinos die everyday because TB. Almost everyone gets vaccinated with BCG as a child, and yet, this does not ensure that you will not develop TB later. Is the direct-observed treatment strategy (DOTS) working? To a certain extent yes, and only if those with symptoms consult immediately. The problem is that most Filipinos ignore their symptoms, continue to roam around and spread the infection, and consult only when there is blood coming out when they cough. Also, over the years, no one has developed a better vaccine and a better class of drugs against this infection. Meanwhile, the multi-drug resistance capability of the organism due to mutation continues to progress.

This number 7 killer confuses me, and much as I have tried to research on it, I can't find what are the specific details about it. What does this mean? Abnormal signs and symptoms? Are these mysterious diseases? If NEC means necrotizing enterocolitis, then this should be looked into and investigated more. In the UK, confirmed cases of necrotizing enterocolitis occurred in three times as many infants who received no breast milk as in those who received both breast milk and formula.

These are all smoking-related diseases and includes emphysema, chronic bronchitis, and COPD. The Philippines has a law against smoking, but very few establishments and people enforce and follow it.

Extrapolated prevalence figures show that there are more than 5 million Filipinos with diabetes today. Central obesity, which means big and bigger tummies, predispose to developing type 2 diabetes. The lack of physical activity amd love of sugar-laden food and beverages predispose to metabolic abnormalities which later on give rise to diabetes. Most consultations are made because of symptoms arising from diabetic complications like diabetic retinopathy (leading to vision loss and blindness), diabetic neuropathy (decreased sensation in the limbs, fingers, often leading to diabetic foot and amputation), and diabetic nephropathy (kidney damage resulting in chronic dialysis).

Infant mortality rate in the Philippines is higher compared to its southeast Asian neighbors. Currently, the infant mortality rate is 22.12 deaths per 1,000 live births. Identified causes include sepsis, prematurity, jaundice, entangled umbilical cord leading to asphyxia, diarrhea, and congenital malformations. Improved prenatal care can possibly decrease the mortality rates even more.

22 reactions:

may said...

it is sad that tuberculosis is still up there. the sad thing is, a lot of people think that all coughs are the same, so they ignore it. worse, even when they know for a fact it is something serious, they still ignore it because they have no money to get treated. poverty is a pain.

Anonymous said...

Offhand, I would say that cancer, diabetes and heart diseases are the three highest in Malaysia. Generally the people here consume far too much sugar and carbohydrates.

Anonymous said...

thank you for some information.. it help me in my report tomorrow about the mortality rate.. keep up updating news here in the philippines...

Anonymous said...

hi dr. emer! do u mind stating your source in the chronology of the top cancers that cause death locally? thank you!

Dr. Emer said...

ANONYMOUS - are you the doctor-blogger I know? just follow the breast cancer link above and you will know my source.

Anonymous said...

Thanks for having this list. Really helped alot. Hope it will be constantly updated. Best regards.

Anonymous said...

good day Dr Emer! thanks for the list.. now, we already have our presentation about this in our healthcare suubject.. Thanks again!

Anonymous said...

well, what really is the seventh causes of morality?

Anonymous said...

Tubercullis is as old as when corruption era started in the Philippines... it can only be cured if the DOH annuall budget increase more than triple of our millitary budget. Further upgrading and genuine health program implementation is a kind of war we Filipinos haven't won. Ultimately health for all is the pricelless prize at stake...Lets all wake up from the deep sleep of corruption and win the battle... MABUHAY

Anonymous said...

can you please specify the scientific names of each disease. Well i just want to make a wider research about this topic. Thank you

Anonymous said...

thanks for the info..it helped me.can u post another page for the newly discovered or diagnosed diseases,just like this..I want to update myself to it.. thanks again.

Anonymous said...

Thanks for the info Doc. I'm just wondering how the high-sodium content of our food affects the occurence of these diseases. And what can we do to raise awareness. More power to you!

Anonymous said...

What is the percentage of deaths amongst children with pnemonia? Can you tell me more about this and how it has really affected children? What about their access to nebulizers? What is the cost for that? Please email me at daisy.ludwig@yahoo.com

Unknown said...

WOW,thank you for the very relevant info,you complete my research work,thank u so much...

TEAcheer said...

Adobo and heart disease are almost synonymous!

Anonymous said...

That information somehow completed my research.. great! rock on


MARJ RN MAN

wound infections said...

hello friends I really liked this information, a few days ago I read something similar, I would like to receive updates on this issue, as it is very interesting, thanks!

Anonymous said...

good day~! sir, may I know your name?? please, this information is what we need in our investigatory project! please response =3 thank you!!

bea v. oyong said...

well that's the fact that tuberculosis is still in the list..let's face the reality,then find a SOLUTION..SAKIT NA NG MAHIHIRAP ANG TUBERCULOSIS...AT DAHIL DUN LUMALAKI NA ANG POPULASYON NG NAGKAKAROON NG SAKIT NA ITO..

Anonymous said...

I am an Australian and I have been to the Philippines 5 times in 3 years because I have a wife there living in the provinces, 2 hours drive out of Manila. The last 3 times that I have been to the Philippines i have got really sick, severe coughing and having difficulty breathing. I have returned to Australia really sick each time. I am still not 100% even after being back in Australia for 6 months. My wife is having a Sputum test for TB, so after reading all of this, I think that it is time that I will also get this test done. Thanks for the advice! And next time, if there is a next time, I will only be staying in a 5 star hotel in Manila. I have never felt so bad! and never coughed liked that ever before! I hope that I don't have TB!

Anonymous said...

accidents should be considered as diseases. if heart disease and cancer kill you fast, accidents kill you faster

jhyena said...

,..thanks for the info,..it helps a lot for my research paper,but can I ask you then,according to your lifes experiences as a doctor what are the filipino lifestyles that may trigger cancer?the 3rd ranked in your leading cause of mortality,.thanks