Worldwide, one of the leading causes of death and injuries are motor vehicle accidents. This study was conducted to explore motor vehicle accident victims’ experiences after vehicular accident in an attempt to further understand the phenomenon. It is important to know the effects of the accident to the life of survivors in order to make a specific intervention to their specific needs. A qualitative phenomenological design is used, using semi-structured, in depth face to face interviews to elicit accounts of vehicular accident survivors. Findings revealed that driving under influence of alcohol, over speeding, slippery road, and first time driving are some of the causes of accident. Five of the respondents had experienced disturbing thoughts, and some of them had dreams of the accident were happening again. Six of the respondents were afraid that it will happen again when something or someone reminded them of the accident or when seeing the place where they experienced the accident. The result of this study will help and assist health professionals in developing a plan of care to victims of vehicular accidents regardless of severity to have psychological assistance to avoid future problems such as recurrent thoughts, sleep disturbances and others. Keyword: vehicular accident; victim
Background: Children aged 5-14 years who are household contacts of index pulmonary TB cases have limited coverage for TB preventive therapy (TPT) due to variable uptake of the national guideline recommendations in the Philippines. We conducted a cost effectiveness analysis evaluating the expansion of latent TB testing and treatment among pediatric (5-14 years) household contacts of index TB patients in the Philippines. Methods: Using a Markov state transition model, eligible household contacts (HHCs) age 5-14 years are screened for latent TB infection (LTBI) with either the tuberculin skin test (TST) or interferon gamma release assay (IGRA). Those who test positive are then simulated to receive one of the following TPT strategies: 6 months of daily isoniazid (6H), 3 months of weekly isoniazid and rifapentine (3HP), 3 months of daily isoniazid plus rifampicin (3HR) and the current practice of no testing or treatment for LTBI (NTT). The analysis assesses the projected cost and quality-adjusted life years (QALY) gained for every strategy from the perspective of the Philippines public healthcare system over a time horizon of 20 years. The total cost and gain in QALYs are presented as an incremental cost-effectiveness ratio (ICER) comparing cost per QALY gained for each strategy over NTT. Results: Our model estimates that expanding TPT coverage to HHCs aged 5-14 years would be cost effective with incremental cost-effectiveness ratios (ICERs) ranging from 1,024 $/QALY gained when using TST and 6H (Uncertainty range: 497 - 2,334) to 2,293 $/QALY gained when IGRA and 3HR are used (Uncertainty range: 1,140 – 5,203). IGRA cost would have to drop to $5.50 to achieve similar results to strategies using TST. These findings were robust to sensitivity analyses over a wide range of parameter values. Conclusion: Expanding TPT coverage to HHCs aged 5-14 years is cost effective when using TST and 6H closely followed by a strategy combining TST and 3HP. IGRA cost will require significant reduction to achieve results similar to TST.
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