I
nte
rna
t
io
na
l J
o
urna
l o
f
P
u
bli
c
H
ea
lt
h Science
(
I
J
P
H
S)
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
,
p
p
.
997
~
1
007
I
SS
N:
2252
-
8
8
0
6
,
DOI
: 1
0
.
1
1
5
9
1
/ijp
h
s
.
v
1
4
i
2
.
2
4
9
6
0
997
J
o
ur
na
l ho
m
ep
a
g
e
:
h
ttp
:
//
ijp
h
s
.
ia
esco
r
e.
co
m
Phys
icia
n
a
ccepta
bility o
f
o
ra
l iver
mectin versus
per
methrin
in
sca
bies
t
reatme
nt
Ro
wena
F
.
G
enuin
o
1
,
M
a
ria
Chris
t
ina
F
ilo
m
ena
R.
B
a
t
a
c
2
,
Alena
M
a
rie
B
.
M
a
ria
no
3
,
B
elen
L
.
Do
f
it
a
s
2
,
F
ra
ncis
R.
Ca
pu
le
4
,
F
er
na
nd
o
B
.
G
a
rc
ia
J
r.
5
,
M
a
ry
Ann J
.
L
a
dia
6
,
M
a
la
y
a
P
.
Sa
nto
s
7
,
Aily
n M
.
Ya
bes
8
,
M
a
ria
Ste
ph
a
nie F
a
y
S.
Ca
g
a
y
a
n
8
1
D
e
p
a
r
t
me
n
t
o
f
A
n
a
t
o
my
,
C
o
l
l
e
g
e
o
f
M
e
d
i
c
i
n
e
,
U
n
i
v
e
r
si
t
y
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
s
M
a
n
i
l
a
,
M
a
n
i
l
a
,
P
h
i
l
i
p
p
i
n
e
s
2
D
e
p
a
r
t
me
n
t
o
f
D
e
r
ma
t
o
l
o
g
y
,
P
h
i
l
i
p
p
i
n
e
G
e
n
e
r
a
l
H
o
s
p
i
t
a
l
,
U
n
i
v
e
r
si
t
y
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
s
M
a
n
i
l
a
,
M
a
n
i
l
a
,
P
h
i
l
i
p
p
i
n
e
s
3
D
e
p
a
r
t
me
n
t
o
f
O
t
o
r
h
i
n
o
l
a
r
y
n
g
o
l
o
g
y
,
Ea
st
A
v
e
n
u
e
M
e
d
i
c
a
l
C
e
n
t
e
r
,
Q
u
e
z
o
n
C
i
t
y
,
P
h
i
l
i
p
p
i
n
e
s
4
D
e
p
a
r
t
me
n
t
o
f
C
l
i
n
i
c
a
l
,
S
o
c
i
a
l
a
n
d
A
d
mi
n
i
s
t
r
a
t
i
v
e
P
h
a
r
mac
y
,
C
o
l
l
e
g
e
o
f
P
h
a
r
ma
c
y
,
U
n
i
v
e
r
s
i
t
y
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
s M
a
n
i
l
a
,
M
a
n
i
l
a
,
P
h
i
l
i
p
p
i
n
e
s
5
D
e
p
a
r
t
me
n
t
o
f
H
e
a
l
t
h
P
o
l
i
c
y
a
n
d
A
d
mi
n
i
st
r
a
t
i
o
n
,
C
o
l
l
e
g
e
o
f
P
u
b
l
i
c
H
e
a
l
t
h
,
U
n
i
v
e
r
si
t
y
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
s
M
a
n
i
l
a
,
M
a
n
i
l
a
,
P
h
i
l
i
p
p
i
n
e
s
6
I
n
st
i
t
u
t
e
o
f
C
l
i
n
i
c
a
l
E
p
i
d
e
mi
o
l
o
g
y
,
N
a
t
i
o
n
a
l
I
n
st
i
t
u
t
e
s
o
f
H
e
a
l
t
h
-
U
n
i
v
e
r
si
t
y
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
s
M
a
n
i
l
a
,
M
a
n
i
l
a
,
P
h
i
l
i
p
p
i
n
e
s
7
S
c
h
o
o
l
o
f
H
e
a
l
t
h
S
c
i
e
n
c
e
s
,
M
a
p
u
a
U
n
i
v
e
r
s
i
t
y
,
M
a
k
a
t
i
,
P
h
i
l
i
p
p
i
n
e
s
8
D
e
p
a
r
t
me
n
t
o
f
P
h
a
r
mac
o
l
o
g
y
a
n
d
T
o
x
i
c
o
l
o
g
y
,
C
o
l
l
e
g
e
o
f
M
e
d
i
c
i
n
e
,
U
n
i
v
e
r
si
t
y
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
s
M
a
n
i
l
a
,
M
a
n
i
l
a
,
P
h
i
l
i
p
p
i
n
e
s
Art
icle
I
nfo
AB
S
T
RAC
T
A
r
ticle
his
to
r
y:
R
ec
eiv
ed
Ma
y
2
,
2
0
2
4
R
ev
is
ed
J
u
l 2
2
,
2
0
2
4
Acc
ep
ted
J
u
l 3
0
,
2
0
2
4
Ora
l
iv
e
rm
e
c
ti
n
m
a
y
b
e
a
c
h
e
a
p
e
r
a
n
d
m
o
re
c
o
n
v
e
n
ien
t
a
l
tern
a
ti
v
e
to
t
o
p
ica
l
p
e
rm
e
th
rin
fo
r
c
las
sic
sc
a
b
ies
b
u
t
it
s
a
c
c
e
p
tab
il
it
y
a
m
o
n
g
p
h
y
sic
i
a
n
s
in
t
h
e
P
h
il
i
p
p
i
n
e
s
is
u
n
d
e
re
x
p
l
o
re
d
.
T
h
is
q
u
a
li
tati
v
e
stu
d
y
a
ime
d
to
i
n
v
e
stig
a
te
p
h
y
sic
ia
n
s’
e
x
p
e
rien
c
e
s
a
n
d
p
e
rc
e
p
ti
o
n
s
re
g
a
rd
i
n
g
o
ra
l
i
v
e
rm
e
c
ti
n
,
a
lo
n
e
o
r
in
c
o
m
b
in
a
ti
o
n
with
p
e
rm
e
th
ri
n
,
a
n
d
o
n
ly
p
e
rm
e
th
ri
n
i
n
t
h
e
tre
a
tme
n
t
o
f
c
las
sic
s
c
a
b
ies
.
We
in
terv
iew
e
d
1
5
p
u
r
p
o
si
v
e
ly
sa
m
p
led
F
il
ip
i
n
o
p
h
y
sic
ian
s:
n
in
e
h
a
v
e
p
re
sc
rib
e
d
o
n
l
y
p
e
rm
e
th
rin
,
o
n
e
h
a
s
p
re
sc
rib
e
d
e
it
h
e
r
o
ra
l
iv
e
rm
e
c
ti
n
o
r
p
e
rm
e
th
ri
n
a
l
o
n
e
,
a
n
d
fi
v
e
h
a
v
e
p
re
sc
rib
e
d
a
ll
t
h
re
e
re
g
ime
n
s
fo
r
sc
a
b
ies
.
In
ter
v
iew
d
a
ta
we
re
a
n
a
ly
z
e
d
a
n
d
th
e
m
a
ti
c
a
ll
y
o
rg
a
n
i
z
e
d
u
sin
g
th
e
th
e
o
re
ti
c
a
l
fra
m
e
wo
rk
o
f
a
c
c
e
p
tab
il
i
ty
(TF
A)
.
O
u
r
fin
d
in
g
s
re
v
e
a
l
m
ix
e
d
a
wa
re
n
e
ss
a
n
d
e
x
p
e
rien
c
e
with
iv
e
rm
e
c
ti
n
a
m
o
n
g
F
il
i
p
i
n
o
p
h
y
sic
ian
s:
wh
il
e
m
o
st
we
re
g
e
n
e
ra
ll
y
c
o
n
fid
e
n
t
in
p
e
rm
e
th
rin
a
s
th
e
sta
n
d
a
rd
c
a
re
,
c
o
m
b
in
a
ti
o
n
th
e
ra
p
y
wa
s
re
se
rv
e
d
a
s
a
las
t
re
so
rt.
Th
e
se
i
n
sig
h
ts
h
i
g
h
li
g
h
t
t
h
e
n
e
e
d
fo
r
o
n
g
o
i
n
g
e
d
u
c
a
ti
o
n
,
c
lea
re
r
g
u
id
e
li
n
e
s,
a
n
d
fu
r
th
e
r
re
se
a
rc
h
to
imp
ro
v
e
th
e
e
ffica
c
y
a
n
d
a
c
c
e
ss
ib
il
it
y
o
f
sc
a
b
ies
trea
tme
n
ts
wh
il
e
a
d
d
re
ss
in
g
p
h
y
sic
ian
s'
v
a
ry
in
g
p
e
rc
e
p
ti
o
n
s a
n
d
se
lf
-
e
ffica
c
y
in
a
lt
e
rn
a
ti
v
e
trea
tme
n
ts.
K
ey
w
o
r
d
s
:
Acc
ep
tab
ilit
y
I
v
er
m
ec
tin
Per
m
eth
r
in
Ph
y
s
ician
Qu
alitativ
e
s
tu
d
y
Scab
ies
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
R
o
wen
a
F.
Gen
u
in
o
Dep
ar
tm
en
t o
f
An
ato
m
y
,
C
o
lleg
e
o
f
Me
d
ici
n
e,
Un
iv
er
s
ity
o
f
th
e
Ph
ilip
p
in
es M
an
ila
Ma
n
ila,
Ph
ilip
p
in
es
E
m
ail: r
f
g
en
u
i
n
o
@
u
p
.
ed
u
.
p
h
1.
I
NT
RO
D
UCT
I
O
N
Scab
ies,
a
h
ig
h
ly
in
f
ec
tio
u
s
p
a
r
asit
ic
s
k
in
in
f
estatio
n
,
is
a
g
lo
b
al
p
u
b
lic
h
ea
lth
is
s
u
e
th
at
s
ig
n
if
ican
tly
im
p
ac
ts
h
ea
lth
a
n
d
q
u
ality
o
f
life
,
p
o
s
es
an
ec
o
n
o
m
ic
b
u
r
d
en
,
an
d
p
er
p
etu
ates
p
o
v
er
t
y
in
r
eso
u
r
ce
-
p
o
o
r
co
u
n
tr
ies
lik
e
th
e
Ph
ilip
p
in
es.
Or
al
iv
er
m
ec
t
in
is
r
ec
o
m
m
e
n
d
ed
as
a
n
alter
n
ativ
e
f
ir
s
t
-
lin
e
ag
en
t
to
to
p
ical
n
eu
r
o
to
x
ic
s
ca
b
icid
es
s
u
ch
as
p
er
m
eth
r
in
o
r
p
h
e
n
o
th
r
i
n
b
y
th
e
Un
ited
States
C
en
ter
s
f
o
r
Dis
ea
s
e
C
o
n
tr
o
l
-
Sex
u
ally
T
r
an
s
m
itted
I
n
f
ec
ti
o
n
s
(
US
C
DC
-
STI
)
[
1
]
,
E
u
r
o
p
ea
n
[
2
]
,
an
d
J
ap
an
ese
s
ca
b
ies
g
u
id
elin
es
[
3
]
.
Ho
wev
er
,
in
th
e
Ph
ilip
p
in
es,
i
n
ter
im
g
u
id
a
n
ce
f
r
o
m
t
h
e
Dep
ar
tm
en
t
o
f
Hea
lth
(
DOH)
s
tates
th
at
th
e
u
s
e
o
f
o
r
al
iv
er
m
ec
tin
is
o
f
f
-
la
b
el
an
d
m
a
y
b
e
co
n
s
id
er
ed
f
o
r
th
o
s
e
with
tr
ea
tm
en
t
f
ailu
r
e
o
r
co
n
tr
ain
d
icatio
n
with
t
o
p
ical
p
er
m
eth
r
in
,
im
m
u
n
o
co
m
p
r
o
m
is
e
o
r
cr
u
s
ted
s
ca
b
ies,
o
r
o
u
tb
r
ea
k
s
in
clo
s
ed
s
ettin
g
s
wh
er
e
th
er
e
ar
e
lo
g
is
tical
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
9
9
7
-
1
0
0
7
998
d
if
f
icu
lties
with
to
p
ical
tr
ea
tm
en
t
[
4
]
.
I
t
is
n
o
t
r
ec
o
m
m
e
n
d
e
d
f
o
r
p
r
eg
n
an
t
wo
m
en
an
d
c
h
ild
r
en
b
elo
w
1
5
k
g
.
I
v
er
m
ec
tin
was
r
eg
is
ter
ed
wit
h
th
e
Ph
ilip
p
in
e
Fo
o
d
a
n
d
Dr
u
g
Ad
m
i
n
is
tr
atio
n
in
Ma
y
2
0
2
1
to
tr
ea
t
h
u
m
an
n
em
ato
d
e
in
f
ec
tio
n
s
d
u
e
to
p
u
b
lic
d
em
a
n
d
d
u
r
i
n
g
t
h
e
C
OVI
D
-
19
pa
n
d
e
m
ic
[
5
]
b
u
t
it
is
n
o
t
lab
elled
f
o
r
u
s
e
in
s
ca
b
ies.
Desp
ite
th
e
ex
p
ir
ati
o
n
o
f
th
is
r
eg
is
tr
atio
n
in
N
o
v
em
b
er
2
0
2
2
[
6
]
,
o
r
al
iv
e
r
m
ec
tin
h
as
b
ee
n
r
ec
o
m
m
en
d
ed
b
y
th
e
Ph
ilip
p
i
n
e
DOH
f
o
r
tr
ea
tin
g
f
ilar
iasi
s
in
2
0
2
1
[
7
]
.
Or
al
iv
er
m
ec
tin
m
a
y
h
av
e
c
o
m
p
ar
ab
le
ef
f
icac
y
a
n
d
s
af
et
y
to
p
e
r
m
eth
r
in
b
ased
o
n
tw
o
p
r
ev
i
o
u
s
s
y
s
tem
atic
r
ev
iews
[
8
]
,
[
9
]
.
B
o
th
o
r
al
iv
er
m
ec
tin
an
d
to
p
ica
l
p
er
m
eth
r
in
h
a
v
e
f
ew,
m
o
s
tly
m
in
o
r
an
d
tr
an
s
ien
t
ad
v
er
s
e
ef
f
ec
ts
.
Patien
ts
g
iv
en
o
r
al
iv
er
m
ec
tin
h
a
v
e
r
e
p
o
r
ted
itch
in
g
,
s
ec
o
n
d
ar
y
b
ac
ter
ial
in
f
ec
tio
n
s
,
as we
ll a
s
s
y
s
tem
ic
s
id
e
ef
f
ec
ts
s
u
ch
as
h
ea
d
ac
h
e
an
d
n
au
s
ea
[
8
]
.
W
h
en
co
m
b
in
ed
with
ce
r
tain
d
r
u
g
s
o
r
ch
em
icals,
iv
er
m
ec
tin
ca
n
lead
to
h
a
r
m
f
u
l
d
r
u
g
in
ter
ac
ti
o
n
s
o
r
to
x
ic
ef
f
ec
ts
s
u
ch
as
h
em
ato
m
as
an
d
en
ce
p
alo
p
ath
y
[
1
0
]
–
[
1
2
]
.
T
h
e
m
ec
h
an
is
m
s
m
ay
in
v
o
lv
e
in
h
i
b
itio
n
o
f
clo
ttin
g
f
ac
to
r
s
,
c
y
to
ch
r
o
m
e
P
4
5
0
3
A
4
m
etab
o
lic
en
zy
m
e
o
r
b
l
o
o
d
-
b
r
ain
b
ar
r
ier
tr
an
s
p
o
r
ter
s
lik
e
m
u
ltid
r
u
g
r
esi
s
tan
ce
1
(
MD
R
1
)
,
b
r
ea
s
t
ca
n
ce
r
r
esis
tan
ce
p
r
o
tein
(
B
C
R
P),
o
r
m
u
ltid
r
u
g
r
esis
tan
ce
-
ass
o
ciate
d
p
r
o
tein
(
MRP
)
,
o
r
th
e
p
r
esen
ce
o
f
g
en
e
v
ar
iatio
n
s
o
f
th
ese
p
r
o
tein
s
.
C
o
m
m
o
n
r
ep
o
r
ted
ad
v
e
r
s
e
ef
f
ec
ts
o
f
p
er
m
eth
r
in
ar
e
m
o
s
tly
lim
ited
to
s
k
in
an
d
in
clu
d
e
m
ild
an
d
tr
an
s
ien
t
itch
in
g
,
b
u
r
n
in
g
,
s
tin
g
in
g
,
n
u
m
b
n
ess
,
tin
g
lin
g
,
r
ash
,
e
r
y
th
e
m
a,
ec
ze
m
a,
a
n
d
l
o
ca
lized
ed
em
a
[
8
]
,
b
u
t
a
r
a
r
e
t
r
an
s
ien
t
d
y
s
to
n
ic
r
ea
cti
o
n
wa
s
r
ep
o
r
ted
[
1
3
]
.
T
h
e
co
m
b
in
at
io
n
o
f
to
p
ical
p
er
m
eth
r
i
n
an
d
o
r
al
iv
er
m
ec
tin
h
as
b
ee
n
r
ep
o
r
ted
to
ca
u
s
e
tr
an
s
ie
n
t
b
u
r
n
i
n
g
s
en
s
atio
n
o
f
th
e
s
k
i
n
an
d
m
ild
h
ea
d
ac
h
e
[
1
4
]
,
[
1
5
]
.
T
h
e
ac
ce
p
tab
ilit
y
o
f
o
r
al
iv
er
m
ec
tin
am
o
n
g
p
h
y
s
ician
s
in
th
e
Ph
ilip
p
in
es
is
n
o
t
well
d
o
c
u
m
en
ted
,
alth
o
u
g
h
it
m
ay
o
f
f
er
co
m
p
ar
ab
le
ef
f
icac
y
a
n
d
s
af
et
y
to
p
er
m
eth
r
in
[
8
]
,
[
9
]
.
T
o
p
ical
p
er
m
eth
r
in
alo
n
e
(
2
-
d
o
s
e)
(
2
6
0
Ph
p
,
6
0
m
l
o
f
5
%
lo
tio
n
)
is
m
o
r
e
ex
p
e
n
s
iv
e
th
an
o
r
al
iv
er
m
ec
tin
al
o
n
e
(
2
0
0
u
g
/k
g
;
2
-
d
o
s
e)
(
4
4
Ph
p
,
t
wo
1
2
-
m
g
ta
b
lets
)
.
C
o
m
b
in
atio
n
r
eg
im
e
n
m
ay
b
e
ch
ea
p
er
(
1
5
2
Ph
p
f
o
r
a
s
in
g
le
d
o
s
e
o
f
o
r
al
iv
er
m
ec
tin
a
n
d
to
p
ical
p
e
r
m
eth
r
in
)
o
r
m
o
r
e
ex
p
en
s
iv
e
(
3
0
4
Ph
p
f
o
r
t
wo
d
o
s
es o
f
ea
ch
d
r
u
g
(
lead
i
n
g
Ph
ilip
p
in
e
d
r
u
g
s
to
r
e,
as o
f
J
u
n
e
2
0
2
3
)
.
Un
d
er
s
tan
d
in
g
p
h
y
s
ician
s
'
ex
p
er
ien
ce
s
an
d
p
er
ce
p
tio
n
s
r
eg
ar
d
in
g
s
ca
b
ies tr
ea
tm
e
n
t
o
p
tio
n
s
is
cr
u
cial
f
o
r
im
p
r
o
v
in
g
p
atien
t
o
u
tco
m
es
an
d
tr
ea
tm
e
n
t
ad
h
er
en
ce
.
W
ith
o
u
t
th
is
k
n
o
wled
g
e,
it
is
d
if
f
icu
lt
to
a
d
d
r
ess
p
o
ten
tial
b
ar
r
ier
s
to
th
e
ad
o
p
tio
n
o
f
o
r
al
iv
er
m
ec
tin
an
d
to
p
r
o
v
id
e
th
e
n
ec
ess
ar
y
s
u
p
p
o
r
t
f
o
r
its
u
s
e
in
clin
ical
p
r
ac
tice.
T
h
is
s
tu
d
y
aim
ed
to
ex
p
lo
r
e
th
e
e
x
p
er
ien
ce
s
an
d
p
er
ce
p
tio
n
s
o
f
a
s
m
all
s
elec
ted
g
r
o
u
p
o
f
Fil
ip
in
o
p
h
y
s
ician
s
r
eg
ar
d
in
g
th
e
u
s
e
o
f
o
r
al
iv
er
m
ec
tin
,
to
p
ical
p
er
m
eth
r
in
an
d
th
eir
co
m
b
in
atio
n
to
tr
ea
t scab
ies.
2.
M
E
T
H
O
D
2
.
1
.
Desig
n
A
q
u
alitativ
e
s
t
u
d
y
d
e
s
i
g
n
u
s
in
g
a
c
o
n
s
t
r
u
c
ti
v
is
t
/
i
n
t
e
r
p
r
e
t
i
v
is
t
p
a
r
a
d
i
g
m
wa
s
e
m
p
l
o
y
e
d
.
W
e
s
o
u
g
h
t
t
o
u
n
d
e
r
s
t
a
n
d
t
h
e
‘
m
e
a
n
i
n
g
’
o
f
p
h
y
s
i
c
i
a
n
e
x
p
e
r
ie
n
c
e
s
a
n
d
p
e
r
c
e
p
t
i
o
n
s
u
n
d
e
r
l
y
i
n
g
t
r
e
a
t
m
e
n
t
a
c
c
ep
t
a
b
i
l
i
t
y
.
T
h
e
s
t
u
d
y
p
r
o
t
o
c
o
l
w
a
s
a
p
p
r
o
v
e
d
b
y
t
h
e
U
n
i
v
e
r
s
it
y
o
f
t
h
e
P
h
i
li
p
p
i
n
e
s
M
a
n
i
l
a
R
e
s
e
a
r
c
h
E
t
h
i
cs
B
o
a
r
d
(
U
P
M
-
R
E
B
)
(
2
0
2
2
-
0055
-
0
1
)
.
2
.
2
.
Set
t
ing
a
nd
du
ra
t
io
n,
a
nd
s
a
m
pli
ng
T
h
e
s
tu
d
y
was
co
n
d
u
cted
in
th
e
Ph
ilip
p
in
es
b
etwe
en
Octo
b
er
2
0
2
2
to
J
an
u
ar
y
2
0
2
3
.
W
e
u
s
ed
p
u
r
p
o
s
iv
e
an
d
s
n
o
wb
all
s
am
p
l
in
g
to
r
ec
r
u
it 1
5
to
2
0
Fil
ip
in
o
p
r
im
ar
y
ca
r
e
p
h
y
s
ician
s
an
d
d
er
m
ato
lo
g
is
ts
with
at
least th
r
ee
y
ea
r
s
clin
ical
e
x
p
er
ien
ce
in
m
an
a
g
in
g
s
ca
b
ies an
d
o
t
h
er
s
k
in
n
eg
lecte
d
tr
o
p
ical
d
is
ea
s
es (
NT
Ds),
an
d
wh
o
h
av
e
p
r
escr
ib
ed
eith
er
o
r
al
iv
er
m
ec
tin
,
p
er
m
eth
r
in
,
o
r
th
eir
co
m
b
in
atio
n
f
o
r
cl
ass
ic
s
ca
b
ies.
W
e
in
v
ited
p
h
y
s
ician
s
th
r
o
u
g
h
th
r
ee
s
p
ec
i
alty
s
o
cieties a
n
d
m
ed
ical
o
r
g
an
izatio
n
s
: th
e
Ph
ilip
p
in
e
Der
m
ato
lo
g
ical
So
ciety
(
PDS),
th
e
Ph
ilip
p
in
e
Aca
d
em
y
o
f
Fam
ily
Ph
y
s
ician
s
(
PAFP
)
,
an
d
th
e
Ass
o
ciatio
n
o
f
Mu
n
icip
al
Hea
lth
Of
f
icer
s
o
f
t
h
e
Ph
ili
p
p
in
es
(
A
MH
OP)
.
W
e
ex
clu
d
ed
p
h
y
s
ici
an
s
with
co
n
f
lict
o
f
in
ter
est
(
i.
e.
,
f
in
a
n
cial,
s
o
cial,
an
d
r
esear
ch
)
.
2
.
3
.
Sa
m
ple
W
e
i
n
t
e
r
v
i
ew
e
d
1
5
p
h
y
s
ician
s
:
s
ev
en
d
er
m
ato
lo
g
is
ts
,
f
o
u
r
f
am
ily
/co
m
m
u
n
ity
m
e
d
icin
e,
an
d
f
o
u
r
g
en
er
al
p
r
ac
tice.
Me
d
ian
ag
e
was
4
6
y
ea
r
s
(
r
an
g
e,
2
7
to
6
7
)
an
d
m
e
d
ian
d
u
r
atio
n
o
f
p
r
ac
tice
was
1
6
y
ea
r
s
(
r
an
g
e,
4
to
3
8
)
.
Ma
jo
r
ity
wer
e
f
em
ale
(
1
2
/1
5
)
,
an
d
p
r
ac
tice
d
in
th
e
Natio
n
al
C
ap
ital
R
eg
i
o
n
(
NC
R
)
(
1
0
/1
5
)
.
Ov
er
all,
f
iv
e
p
h
y
s
ician
s
(
d
e
r
m
ato
lo
g
is
ts
)
p
r
escr
ib
e
d
all
th
r
ee
r
e
g
im
en
s
(
P/I/C
)
,
o
n
e
(
f
am
ily
m
ed
ici
n
e)
p
r
escr
ib
ed
p
e
r
m
eth
r
in
-
alo
n
e
an
d
iv
er
m
ec
tin
-
alo
n
e
(
P/I)
,
wh
ile
n
in
e
o
n
l
y
p
r
escr
ib
e
d
p
er
m
eth
r
in
-
alo
n
e
(P
-
o
n
ly
)
(
m
ix
ed
s
p
ec
ialties
)
as sh
o
wn
in
Fig
u
r
e
1
.
2
.
4
.
Da
t
a
c
o
llect
io
n
W
e
co
n
d
u
cted
one
-
t
i
m
e
i
n
-
d
e
p
t
h
i
n
t
e
r
v
i
e
ws
u
s
i
n
g
a
v
a
l
i
d
a
te
d
a
n
d
p
r
e
t
e
s
t
e
d
s
e
m
i
-
s
t
r
u
c
t
u
r
e
d
E
n
g
l
i
s
h
i
n
t
e
r
v
i
e
w
g
u
i
d
e
[
1
6
]
,
[
1
7
]
.
C
o
n
t
e
n
t
a
n
d
f
a
c
e
v
a
l
i
d
it
y
w
as
e
n
s
u
r
e
d
b
y
a
n
e
x
p
e
r
t
p
a
n
e
l
c
o
n
s
is
ti
n
g
o
f
d
e
r
m
a
t
o
l
o
g
i
s
t
s
w
i
t
h
p
u
b
l
i
c
h
e
a
lt
h
a
n
d
e
p
i
d
e
m
io
l
o
g
y
b
a
c
k
g
r
o
u
n
d
.
W
e
a
ls
o
p
r
e
t
e
s
t
e
d
t
h
e
i
n
t
e
r
v
i
ew
g
u
i
d
e
a
m
o
n
g
t
h
e
t
a
r
g
e
t
s
t
u
d
y
p
o
p
u
l
a
t
i
o
n
p
r
i
o
r
t
o
u
s
e
.
A
f
te
r
o
b
t
a
i
n
i
n
g
w
r
i
tt
e
n
c
o
n
s
e
n
t
f
o
r
m
s
,
p
h
y
s
i
ci
a
n
s
w
e
r
e
i
n
t
e
r
v
i
ewe
d
v
i
r
t
u
a
l
l
y
(
t
h
r
o
u
g
h
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
h
ysicia
n
a
cc
ep
ta
b
ilit
y
o
f o
r
a
l iv
ermectin
ve
r
s
u
s
p
er
meth
r
in
in
s
ca
b
ies tr
ea
tmen
t
(
R
o
w
en
a
F
.
Gen
u
in
o
)
999
Z
o
o
m
)
o
r
f
a
c
e
-
to
-
f
a
c
e
.
T
h
e
i
n
t
e
r
v
i
e
ws
w
e
r
e
c
o
n
d
u
c
t
e
d
b
y
th
e
p
r
i
m
a
r
y
i
n
v
e
s
t
i
g
a
t
o
r
w
h
i
l
e
a
c
o
-
i
n
v
e
s
ti
g
a
t
o
r
o
r
r
e
s
e
a
r
c
h
as
s
is
t
a
n
t
t
o
o
k
d
o
w
n
f
i
e
l
d
n
o
t
e
s
.
I
n
t
e
r
v
ie
w
s
r
ec
o
r
d
i
n
g
s
w
e
r
e
t
r
a
n
s
c
r
i
b
e
d
v
e
r
b
a
t
i
m
b
y
t
r
a
i
n
e
d
r
e
s
e
a
r
c
h
a
s
s
i
s
t
a
n
ts
,
i
n
c
l
u
d
i
n
g
n
o
n
v
e
r
b
a
l
i
n
f
o
r
m
a
t
i
o
n
s
u
c
h
a
s
v
o
c
al
i
n
f
l
e
ct
i
o
n
s
,
u
t
te
r
a
n
c
e
s
,
a
n
d
g
e
s
t
u
r
es
.
T
r
a
n
s
c
r
i
p
t
i
o
n
s
w
e
r
e
a
n
o
n
y
m
i
z
e
d
(
i
.
e
.
,
l
a
b
e
l
l
e
d
as
P
1
a
n
d
P
2
)
a
n
d
c
o
n
f
i
d
e
n
t
i
a
l
i
ty
w
a
s
e
n
s
u
r
e
d
b
y
s
t
o
r
i
n
g
p
e
r
s
o
n
a
l
i
n
f
o
r
m
a
t
i
o
n
,
r
e
c
o
r
d
i
n
g
s
,
a
n
d
t
r
a
n
s
c
r
i
p
t
i
o
n
s
in
a
s
e
c
u
r
e
s
t
o
r
a
g
e
.
T
r
a
n
s
c
r
i
p
t
s
w
e
r
e
n
o
t
r
e
t
u
r
n
e
d
t
o
i
n
f
o
r
m
a
n
t
s
f
o
r
c
o
m
m
e
n
t
a
n
d
/
o
r
c
o
r
r
e
c
t
i
o
n
.
N
o
t
e
:
A
,
D
e
rm
a
t
o
l
o
g
i
s
t
s;
B
,
F
a
m
i
l
y
Me
d
i
c
i
n
e
;
C
,
G
e
n
e
ra
l
p
r
a
c
t
i
t
i
o
n
e
rs
Fig
u
r
e
1
.
Dr
u
g
s
p
r
escr
ib
e
d
b
y
in
ter
v
iewe
d
p
h
y
s
ician
in
f
o
r
m
a
n
ts
2
.
5
.
Da
t
a
a
na
ly
s
is
W
e
u
s
e
d
th
e
th
eo
r
etica
l
f
r
am
e
wo
r
k
o
f
ac
ce
p
ta
b
ilit
y
(
T
FA)
[
1
8
]
to
g
u
i
d
e
d
ata
an
aly
s
is
.
T
h
e
T
FA
was
d
ev
elo
p
e
d
to
ass
es
s
th
e
ac
c
ep
tab
ilit
y
o
f
h
ea
lth
ca
r
e
in
ter
v
en
tio
n
s
to
u
s
er
s
(
e.
g
.
,
p
atie
n
ts
)
an
d
p
r
o
v
i
d
er
s
(
e.
g
.
,
p
h
y
s
ician
p
r
escr
ib
er
s
)
[
1
8
]
.
T
h
e
T
FA
th
eo
r
izes
th
at
a
cc
ep
tab
ilit
y
co
n
s
is
ts
o
f
s
ev
en
d
o
m
ain
s
:
af
f
ec
tiv
e
attitu
d
e,
b
u
r
d
en
,
eth
icality
,
in
ter
v
en
tio
n
c
o
h
er
e
n
ce
,
o
p
p
o
r
tu
n
ity
co
s
t,
p
er
ce
i
v
ed
ef
f
ec
tiv
en
ess
,
an
d
s
elf
-
ef
f
icac
y
as
p
r
esen
ted
in
T
ab
le
1
.
I
n
th
is
s
tu
d
y
,
we
m
o
d
if
ied
th
is
f
r
am
ewo
r
k
b
y
ad
d
i
n
g
an
eig
h
th
d
o
m
ain
,
ac
ce
s
s
ib
ilit
y
,
co
n
s
id
er
in
g
th
at
h
ea
lth
ca
r
e
s
er
v
ices
s
h
o
u
ld
b
e
p
h
y
s
ically
an
d
f
in
an
cially
ac
ce
s
s
ib
le
to
p
atien
ts
[
1
9
]
,
[
2
0
]
.
All th
ese
d
o
m
ai
n
s
m
ay
af
f
ec
t th
e
p
h
y
s
ician
’
s
d
ec
is
io
n
-
m
ak
in
g
a
n
d
p
r
escr
ib
in
g
p
r
ef
er
en
ce
.
T
a
b
l
e
1
.
M
o
d
i
f
i
e
d
T
FA
D
o
ma
i
n
D
e
f
i
n
i
t
i
o
n
1
A
f
f
e
c
t
i
v
e
a
t
t
i
t
u
d
e
F
e
e
l
i
n
g
s
a
b
o
u
t
t
h
e
i
n
t
e
r
v
e
n
t
i
o
n
o
r
d
r
u
g
.
2
.
B
u
r
d
e
n
Ef
f
o
r
t
n
e
e
d
e
d
t
o
p
r
e
scr
i
b
e
t
h
e
d
r
u
g
3
.
Et
h
i
c
a
l
i
t
y
H
o
w
p
r
e
scri
b
i
n
g
t
h
e
d
r
u
g
f
i
t
s w
i
t
h
t
h
e
p
h
y
s
i
c
i
a
n
’
s
v
a
l
u
e
s
4
.
I
n
t
e
r
v
e
n
t
i
o
n
c
o
h
e
r
e
n
c
e
U
n
d
e
r
st
a
n
d
i
n
g
h
o
w
t
h
e
d
r
u
g
w
o
r
k
s
5
.
O
p
p
o
r
t
u
n
i
t
y
c
o
st
W
h
a
t
t
h
e
p
h
y
si
c
i
a
n
mu
st
g
i
v
e
u
p
i
n
o
r
d
e
r
t
o
p
r
e
scri
b
e
t
h
e
d
r
u
g
6
.
P
e
r
c
e
i
v
e
d
e
f
f
e
c
t
i
v
e
n
e
ss
H
o
w
w
e
l
l
t
h
e
d
r
u
g
i
s
l
i
k
e
l
y
t
o
w
o
r
k
7
.
S
e
l
f
-
e
f
f
i
c
a
c
y
C
o
n
f
i
d
e
n
c
e
i
n
p
r
e
s
c
r
i
b
i
n
g
t
h
e
d
r
u
g
8
.
A
c
c
e
s
si
b
i
l
i
t
y
*
B
e
i
n
g
a
f
f
o
r
d
a
b
l
e
a
n
d
e
a
s
i
l
y
a
v
a
i
l
a
b
l
e
f
o
r
p
u
r
c
h
a
s
e
w
h
e
n
p
r
e
scr
i
b
e
d
*
A
d
d
e
d
d
o
ma
i
n
A
r
e
f
l
e
x
i
v
e
i
t
e
r
a
ti
v
e
t
h
e
m
at
i
c
a
n
a
l
y
s
is
w
as
f
o
ll
o
w
e
d
[
2
1
]
,
wi
t
h
t
h
e
p
r
i
n
c
i
p
al
i
n
v
es
t
i
g
at
o
r
-
in
t
e
r
v
i
e
w
e
r
(
R
G
)
a
n
d
a
c
o
-
i
n
v
es
ti
g
a
t
o
r
(
A
M
o
r
M
B
)
i
n
d
e
p
e
n
d
e
n
t
l
y
co
d
i
n
g
t
h
e
d
a
t
a
a
f
t
e
r
r
e
a
d
i
n
g
th
e
m
t
h
o
r
o
u
g
h
l
y
,
a
n
d
r
e
g
u
l
a
r
l
y
m
e
e
t
i
n
g
t
o
d
is
c
u
s
s
a
n
d
a
g
r
e
e
o
n
c
o
d
e
s
.
C
o
d
es
w
e
r
e
o
r
g
a
n
i
z
e
d
b
y
d
o
m
a
i
n
s
o
f
t
h
e
m
o
d
i
f
i
e
d
T
F
A
a
n
d
l
a
t
e
r
g
r
o
u
p
e
d
i
n
t
o
t
h
e
m
e
s
,
u
s
i
n
g
a
d
e
d
u
c
t
i
v
e
-
i
n
d
u
c
t
i
v
e
a
p
p
r
o
a
c
h
.
T
h
e
p
r
e
d
o
m
i
n
a
n
t
t
h
e
m
e
s
f
o
r
ea
c
h
p
r
e
s
c
r
i
b
e
d
d
r
u
g
a
n
d
t
h
e
i
r
m
o
s
t
r
e
p
r
e
s
e
n
t
a
ti
v
e
q
u
o
t
e
s
w
e
r
e
i
d
e
n
t
i
f
i
e
d
.
T
r
u
s
t
w
o
r
t
h
i
n
e
s
s
a
n
d
c
r
e
d
i
b
i
l
i
t
y
w
e
r
e
en
s
u
r
e
d
b
y
m
e
m
o
i
n
g
,
b
r
a
c
k
e
t
i
n
g
,
a
n
d
k
e
e
p
i
n
g
a
n
a
u
d
i
t
t
r
a
il
[
2
2
]
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
T
h
e
r
e
w
e
r
e
t
h
r
e
e
p
r
e
d
o
m
i
n
a
n
t
t
h
e
m
e
s
f
o
r
e
a
c
h
p
r
es
c
r
i
b
e
d
d
r
u
g
a
n
d
a
r
e
l
i
s
te
d
i
n
T
a
b
l
e
2
.
I
v
e
r
m
e
c
t
i
n
e
l
i
c
it
e
d
m
i
x
e
d
a
w
a
r
e
n
ess
a
n
d
e
x
p
e
r
i
e
n
c
e
w
i
t
h
it
s
u
s
e
s
a
n
d
s
a
f
et
y
b
u
t
i
t
s
p
r
es
c
r
i
b
i
n
g
p
r
a
c
ti
c
e
s
e
e
m
e
d
t
o
b
e
b
a
c
k
e
d
b
y
e
v
i
d
e
n
c
e
.
T
h
e
c
o
m
b
i
n
a
t
i
o
n
i
v
e
r
m
e
c
t
i
n
a
n
d
p
e
r
m
e
t
h
r
i
n
r
e
g
i
m
e
n
w
a
s
n
o
t
e
d
t
o
h
a
v
e
d
i
s
t
i
n
c
t
a
d
v
a
n
t
a
g
e
s
b
u
t
s
t
i
ll
w
a
s
v
i
ew
e
d
w
it
h
s
o
m
e
r
es
e
r
v
a
ti
o
n
.
O
n
t
h
e
o
t
h
e
r
h
a
n
d
,
p
e
r
m
e
t
h
r
i
n
w
a
s
p
e
r
c
ei
v
e
d
t
o
b
e
t
h
e
s
t
a
n
d
a
r
d
o
f
c
a
r
e
d
e
s
p
i
t
e
i
s
s
u
e
s
wi
t
h
p
a
ti
e
n
t
c
o
m
p
l
i
a
n
ce
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
9
9
7
-
1
0
0
7
1000
T
ab
le
2
.
Pre
d
o
m
in
an
t t
h
em
es f
o
r
ea
ch
p
r
escr
ib
ed
d
r
u
g
I
n
t
e
r
v
e
n
t
i
o
n
P
r
e
d
o
mi
n
a
n
t
t
h
e
m
e
s
I
v
e
r
mec
t
i
n
1
.
M
i
x
e
d
a
w
a
r
e
n
e
ss a
n
d
e
x
p
e
r
i
e
n
c
e
w
i
t
h
i
v
e
r
m
e
c
t
i
n
2
.
M
i
x
e
d
p
e
r
c
e
p
t
i
o
n
s
o
n
i
v
e
r
me
c
t
i
n
sa
f
e
t
y
3
.
Ev
i
d
e
n
c
e
-
b
a
s
e
d
a
p
p
r
o
a
c
h
i
n
p
r
e
scr
i
b
i
n
g
i
v
e
r
m
e
c
t
i
n
C
o
m
b
i
n
a
t
i
o
n
i
v
e
r
mec
t
i
n
/
P
e
r
me
t
h
r
i
n
1
.
C
o
mb
i
n
a
t
i
o
n
t
r
e
a
t
m
e
n
t
g
e
n
e
r
a
l
l
y
r
e
serv
e
d
a
s
l
a
s
t
o
p
t
i
o
n
2
.
C
o
mb
i
n
a
t
i
o
n
t
r
e
a
t
m
e
n
t
e
n
s
u
r
e
s f
a
st
a
n
d
a
d
e
q
u
a
t
e
c
u
r
e
3
.
C
o
mb
i
n
a
t
i
o
n
t
r
e
a
t
m
e
n
t
p
r
o
v
i
d
e
s
m
u
l
t
i
-
f
a
c
e
t
e
d
a
d
v
a
n
t
a
g
e
s
P
e
r
met
h
r
i
n
1
.
C
o
n
f
i
d
e
n
c
e
i
n
p
r
e
scri
b
i
n
g
p
e
r
m
e
t
h
r
i
n
a
s s
t
a
n
d
a
r
d
o
f
c
a
r
e
2
.
D
i
f
f
i
c
u
l
t
y
i
n
e
n
s
u
r
i
n
g
p
a
t
i
e
n
t
c
o
m
p
l
i
a
n
c
e
w
i
t
h
p
e
r
me
t
h
r
i
n
3
.
P
e
r
c
e
i
v
e
d
e
f
f
i
c
a
c
y
o
f
p
e
r
m
e
t
h
r
i
n
3
.
1
.
I
v
er
m
ec
t
in
3
.
1
.
1
.
M
ix
ed
a
wa
re
nes
s
a
nd
ex
perience
wit
h iv
er
m
ec
t
in
T
w
o
o
f
s
ix
iv
er
m
ec
tin
p
r
escr
i
b
er
s
n
o
te
d
th
at
am
o
n
g
c
o
lleag
u
es,
iv
er
m
ec
tin
was r
ar
ely
p
r
e
s
cr
ib
ed
an
d
with
r
eser
v
atio
n
s
:
“
Th
ere
w
ere
n
o
t
a
lo
t
o
f
d
er
ma
to
lo
g
is
ts
u
s
in
g
it.
S
o
,
I
[
th
o
u
g
h
t]
mig
h
t
fin
d
m
y
s
elf
in
h
o
t
w
a
ters
if
[
I
p
r
escr
ib
e
it]
.
”
(
P4
,
6
7
/F,
d
e
r
m
ato
lo
g
is
t)
On
e
n
o
n
-
p
r
escr
ib
e
r
ju
s
t o
p
ted
to
s
tick
with
wh
at’
s
‘
in
th
e
b
o
o
k’
s
in
ce
s
h
e
was n
o
t a
b
le
t
o
c
o
n
f
er
with
o
th
er
p
h
y
s
ician
s
o
n
th
eir
ex
p
er
ien
ce
with
iv
er
m
ec
tin
in
th
eir
p
atien
ts
with
s
ca
b
ies
(
P8
,
2
7
/F,
g
en
e
r
al
p
r
ac
titi
o
n
er
,
P
-
o
n
ly
)
.
Sev
en
n
o
n
-
p
r
escr
ib
er
s
,
d
esp
ite
b
ec
o
m
in
g
awa
r
e
o
f
it
d
u
e
to
th
e
C
OVI
D
-
1
9
p
an
d
em
ic
(
2
/7
)
an
d
f
r
o
m
m
ed
ical
tr
ai
n
in
g
(
3
/7
)
,
wer
e
u
n
f
am
iliar
with
iv
er
m
ec
tin
’
s
o
r
al
p
r
ep
a
r
atio
n
f
o
r
h
u
m
a
n
s
,
av
ailab
ilit
y
,
an
d
in
d
icatio
n
an
d
d
o
s
in
g
f
o
r
s
ca
b
ies.
On
e
n
o
n
-
p
r
escr
ib
er
was
cu
r
io
u
s
ab
o
u
t
iv
er
m
ec
tin
b
u
t
wan
ted
to
s
tu
d
y
it m
o
r
e:
“On
ly
w
h
en
I
kn
o
w
mo
r
e
a
b
o
u
t
ivermec
tin
w
ill I
p
r
esc
r
ib
e
it.”
(
P9
,
4
2
/F,
f
am
ily
m
ed
icin
e
)
On
e
o
th
er
n
o
n
-
p
r
escr
ib
er
wo
u
ld
p
r
ef
er
to
g
iv
e
iv
er
m
ec
ti
n
f
ir
s
t
to
ad
u
lts
s
in
ce
h
e
m
ay
m
ak
e
m
is
tak
es
in
p
ed
iatr
ic
d
o
s
in
g
:
On
e
n
o
n
-
p
r
escr
ib
er
f
ea
r
e
d
:
“
D
o
in
g
mo
r
e
h
a
r
m
th
a
n
g
o
o
d
”
s
in
ce
s
h
e
was
n
o
t
co
n
f
id
e
n
t
with
s
elf
-
r
esear
ch
.
(
P8
,
2
7
/
F,
g
en
er
al
p
r
ac
titi
o
n
er
)
3
.
1
.
2
.
M
ix
ed
perc
ept
io
ns
o
n i
v
er
m
ec
t
in s
a
f
et
y
Fo
u
r
o
u
t
o
f
s
ix
p
r
escr
ib
er
s
co
n
s
id
er
ed
iv
er
m
ec
tin
s
af
e.
T
w
o
p
r
escr
ib
er
s
h
i
g
h
lig
h
ted
its
estab
lis
h
ed
s
af
ety
in
m
ass
d
r
u
g
a
d
m
in
is
tr
a
tio
n
f
o
r
s
ca
b
ies an
d
o
th
e
r
p
ar
a
s
itic d
is
ea
s
e
s
.
P1
r
em
ar
k
ed
:
“
Lo
o
k
a
t
a
ll
th
e
lite
r
a
tu
r
e.
I
t’
s
r
ea
lly
b
ee
n
g
iven
w
h
a
t,
fo
r
th
e
p
a
s
t
5
0
ye
a
r
s
g
iven
w
o
r
ld
w
i
d
e,
o
ve
r
5
0
millio
n
p
eo
p
le
in
A
fr
ica
.
.
.
min
ima
l
s
id
e
effec
ts
,
m
in
ima
l
A
DR
s
.
N
o
r
en
a
l
co
mp
lica
tio
n
s
,
n
o
h
ep
a
tic
co
mp
lica
tio
n
s
.
”
(
P1
,
5
0
/F,
d
er
m
ato
lo
g
is
t)
Fo
r
th
r
ee
p
r
escr
ib
e
r
s
,
th
eir
p
atien
ts
ex
p
er
ien
ce
d
eith
e
r
n
o
s
id
e
ef
f
ec
ts
o
r
o
n
l
y
m
ild
o
n
es.
On
e
p
r
escr
ib
er
ev
e
n
ex
p
r
ess
ed
th
at
s
h
e
was
:
“
C
o
n
fid
en
t
en
o
u
g
h
[
th
a
t
ivermec
tin
]
is
n
o
t
g
o
in
g
to
h
u
r
t
[
p
a
tien
ts
]
”
ev
en
w
ith
r
ep
e
at
d
o
s
es
.
(
P1
0
,
5
4
/F,
d
er
m
ato
lo
g
is
t)
Sh
e
s
tr
ess
ed
th
at
s
m
aller
d
o
s
es
wer
e
g
iv
en
f
o
r
s
ca
b
ies,
u
n
lik
e
f
o
r
C
OVI
D
-
1
9
.
Ho
w
ev
er
,
f
i
v
e
p
r
escr
ib
er
s
ex
p
r
ess
ed
ca
u
tio
n
ab
o
u
t self
-
m
ed
icatio
n
:
“
[
I
ve
r
mec
tin
]
ma
y
b
e
a
b
u
s
ed
.
P
eo
p
le
mig
h
t
th
in
k
s
in
ce
it's
o
n
ly
o
n
e
d
o
s
e,
t
h
ey
ca
n
s
elf
-
me
d
ica
te.
.
.
I
t's
s
ca
r
y
b
ec
a
u
s
e
w
ith
C
OV
I
D,
th
ey
ca
n
g
et
ivermec
tin
left a
n
d
r
ig
h
t
.
”
(
P1
4
,
4
6
/F,
f
am
ily
m
e
d
icin
e)
T
wo
n
o
n
-
p
r
escr
ib
er
s
wer
e
co
n
ce
r
n
ed
ab
o
u
t
s
ev
er
e
n
e
u
r
o
lo
g
ical
s
id
e
ef
f
ec
ts
d
u
e
to
t
h
e
p
an
d
em
ic
-
in
d
u
ce
d
m
e
d
ia
h
y
p
e
b
u
t
ac
k
n
o
wled
g
ed
th
at
th
ey
h
av
e
n
o
t h
e
ar
d
o
f
d
ea
th
s
o
r
s
er
io
u
s
ef
f
ec
ts
d
u
e
to
iv
e
r
m
ec
tin
.
I
n
ad
d
itio
n
,
o
n
e
P
-
o
n
l
y
p
r
escr
i
b
er
was c
o
n
ce
r
n
ed
with
th
e
i
r
r
ev
er
s
ib
ilit
y
o
f
s
y
s
tem
ic
s
id
e
ef
f
ec
ts
:
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
h
ysicia
n
a
cc
ep
ta
b
ilit
y
o
f o
r
a
l iv
ermectin
ve
r
s
u
s
p
er
meth
r
in
in
s
ca
b
ies tr
ea
tmen
t
(
R
o
w
en
a
F
.
Gen
u
in
o
)
1001
“
B
ec
a
u
s
e
if
yo
u
g
ive
s
o
meth
in
g
th
a
t's
s
ystemic,
yo
u
ca
n
't
ta
ke
it
b
a
c
k.
Un
like
w
i
th
to
p
ica
l
med
ica
tio
n
,
w
h
ere
s
id
e
effec
ts
a
r
e
lo
ca
liz
ed
,
yo
u
c
a
n
ju
s
t
w
a
s
h
it
o
ff
”
(
P3
,
6
7
/F,
d
er
m
ato
lo
g
is
t,
P
-
o
n
ly
)
3
.
1
.
3
.
E
v
idence
-
ba
s
ed
a
pp
ro
a
ch
wit
h iv
er
m
ec
t
in
Fiv
e
p
r
escr
ib
er
s
ju
s
tifie
d
th
e
u
s
e
o
f
iv
er
m
ec
tin
d
u
e
to
its
p
r
o
v
en
ef
f
icac
y
b
ased
o
n
p
u
b
lis
h
ed
liter
atu
r
e
in
o
th
er
co
u
n
tr
ies
an
d
W
HO
-
r
ec
o
m
m
en
d
ed
u
s
e
in
m
ass
d
r
u
g
ad
m
in
is
tr
atio
n
.
P1
5
(
5
2
/F,
d
er
m
ato
lo
g
is
t)
,
a
p
r
escr
ib
er
,
was c
o
n
f
id
en
t th
at
:
“
T
h
is
is
n
o
t a
co
n
tr
o
ve
r
s
ia
l d
r
u
g
if u
s
ed
p
r
o
p
erly”
an
d
is
”li
fesa
vin
g
in
ma
n
y
p
a
r
a
s
itic c
o
n
d
itio
n
s
.
”
Ho
wev
er
,
3
o
u
t
o
f
5
p
r
escr
ib
e
r
s
s
till
ac
k
n
o
wled
g
e
th
e
n
ee
d
f
o
r
m
o
r
e
e
v
id
en
ce
,
f
o
o
d
a
n
d
d
r
u
g
a
d
m
in
is
tr
atio
n
ap
p
r
o
v
al
an
d
f
o
r
m
u
lar
y
in
clu
s
io
n
b
y
Dep
ar
tm
en
t
o
f
Hea
lth
(
DOH
)
to
m
ak
e
iv
er
m
ec
tin
an
ac
ce
p
ted
alter
n
ativ
e
f
o
r
s
ca
b
ies
tr
ea
tm
en
t.
On
t
h
e
o
th
er
h
a
n
d
,
ev
en
n
o
n
-
p
r
escr
ib
er
s
wo
u
ld
s
ee
k
m
o
r
e
g
u
i
d
an
ce
f
r
o
m
lo
ca
l
p
r
ac
tice
g
u
id
elin
es,
ex
p
e
r
t le
ctu
r
es,
an
d
en
d
o
r
s
em
en
t b
y
th
e
DOH,
c
o
lleag
u
es,
an
d
t
h
e
lo
ca
l d
e
r
m
a
to
lo
g
ical
s
o
ciety
.
“
T
o
a
lla
y
th
e
fea
r
s
o
f p
r
escr
ib
in
g
ivermec
tin
.
”
(
P8
,
2
7
/F,
g
e
n
er
al
p
r
ac
titi
o
n
e
r
)
3
.
2
.
Co
m
bin
a
t
io
n iv
er
m
ec
t
i
n/p
er
m
et
hrin t
re
a
t
m
ent
3
.
2
.
1
.
Co
m
bin
a
t
io
n t
re
a
t
m
ent
g
ener
a
lly
re
s
er
v
ed
a
s
la
s
t
o
ptio
n
Fo
u
r
o
u
t
o
f
f
i
v
e
co
m
b
in
atio
n
tr
ea
tm
en
t
p
r
escr
ib
er
s
wer
e
h
esit
an
t
to
g
iv
e
th
is
r
eg
im
en
as
f
ir
s
t
-
lin
e
an
d
r
ese
r
v
ed
it f
o
r
s
elec
t p
atien
t p
o
p
u
latio
n
s
o
r
as a
last
o
p
tio
n
f
o
r
tr
ea
tm
en
t f
ailu
r
e
o
r
r
ec
u
r
r
e
n
ce
af
ter
p
er
m
et
h
r
in
u
s
e.
T
wo
p
r
escr
ib
er
s
g
a
v
e
it
as
an
alter
n
ativ
e
f
ir
s
t
-
lin
e
tr
ea
tm
en
t
f
o
r
th
o
s
e
with
d
if
f
ic
u
lties
with
to
p
ical
ap
p
licatio
n
an
d
h
av
e
p
o
o
r
q
u
ality
o
f
life
,
wh
ile
th
r
ee
n
o
n
-
p
r
es
cr
ib
er
s
wo
u
ld
co
n
s
id
er
g
iv
in
g
i
t
f
o
r
s
ev
er
e
s
ca
b
ies
o
r
“tech
n
ica
lly
d
iffi
cu
lt
ca
s
es"
(
P3
,
6
7
/F,
d
er
m
ato
lo
g
is
t)
.
D
esp
ite
b
ein
g
a
p
r
escr
ib
er
,
P1
5
was
u
n
ea
s
y
u
s
in
g
co
m
b
in
atio
n
tr
ea
tm
en
t a
s
f
ir
s
t
-
lin
e,
esp
ec
ially
f
o
r
n
ew
p
atie
n
ts
:
“
Yo
u
a
lw
a
ys
g
o
w
i
th
s
ta
n
d
a
r
d
o
f
ca
r
e.
S
o
,
I
w
o
u
ld
ju
s
t
g
ive
p
la
in
p
ermeth
r
in
…
A
n
d
if
th
ey
d
o
n
't
d
o
w
ell
th
en
w
e
ca
n
ta
lk
a
b
o
u
t so
meth
in
g
like
ivermec
tin
.
”
(
P1
5
,
5
2
/F,
d
e
r
m
ato
lo
g
is
t)
T
wo
n
o
n
-
p
r
escr
ib
er
s
an
d
o
n
e
p
r
escr
ib
er
wer
e
c
o
n
ce
r
n
ed
with
th
e
a
d
d
itio
n
al
ex
p
e
n
s
es,
y
et
n
o
p
er
ce
iv
ed
s
ig
n
if
ica
n
t in
cr
ea
s
e
in
ef
f
icac
y
:
“
I
f
p
ermeth
r
in
is
9
0
–
9
5
%
[
e
ffective
]
,
h
o
w
mu
ch
mo
r
e
is
th
e
co
mb
in
a
tio
n
?
I
t's
ju
s
t
a
d
d
ed
co
s
t.
[
I
’
ll g
ive
it fo
r
]
h
a
r
d
to
tr
ea
t a
n
d
tech
n
ic
a
lly
d
iffi
cu
lt c
a
s
es.
”
(
P3
,
6
7
/F,
d
er
m
ato
lo
g
is
t)
Ad
d
itio
n
ally
,
o
n
e
n
o
n
-
p
r
escr
i
b
er
f
o
u
n
d
it
c
h
allen
g
in
g
th
at
co
m
b
in
atio
n
iv
er
m
ec
tin
/p
er
m
eth
r
in
is
a
non
-
f
o
r
m
u
lar
y
m
e
d
icatio
n
:
“
I
n
th
e
h
o
s
p
ita
l,
w
h
en
w
e
p
r
escr
ib
e
med
ica
tio
n
s
to
o
u
r
p
a
tie
n
ts
,
w
h
en
w
e
w
a
n
t
o
u
r
p
a
tien
ts
to
b
e
co
ve
r
ed
b
y
P
h
ilHea
lth
,
th
e
m
ed
ica
tio
n
h
a
s
to
b
e
w
ith
in
th
e
p
r
escr
ip
tio
n
o
f
Dep
a
r
tmen
t
o
f
Hea
lth
(
DOH
)
”
(
P9
,
4
2
/F,
f
am
ily
m
e
d
icin
e)
3
.
2
.
2
.
Co
m
bin
a
t
io
n t
re
a
t
m
ent
ens
ures f
a
s
t
a
nd
a
dequ
a
t
e
cure
Fo
r
th
r
ee
p
r
escr
ib
er
s
,
co
m
b
i
n
atio
n
tr
ea
tm
e
n
t
en
s
u
r
e
d
f
ast
an
d
d
ef
in
ite
c
u
r
e.
T
h
e
a
d
d
it
io
n
al
o
r
al
iv
er
m
ec
tin
in
co
m
b
in
atio
n
tr
ea
tm
en
t
was
p
er
ce
iv
ed
b
y
P6
(
6
5
/F,
d
er
m
ato
lo
g
is
t)
,
a
p
r
escr
ib
er
,
as
wo
r
th
th
e
ex
tr
a
co
s
t,
esp
ec
ially
:
“if
yo
u
s
ee
a
p
a
tien
t
w
h
o
s
e
q
u
a
lity
o
f
life
is
s
o
a
ffected
.
”
E
v
en
o
n
e
n
o
n
-
p
r
escr
ib
er
s
h
ar
ed
th
at
"if
I
w
o
u
ld
w
a
n
t
to
r
eme
d
y
th
e
p
r
o
b
lem
fa
s
ter,
th
en
I
w
o
u
l
d
d
o
a
co
mb
in
a
tio
n
o
f
b
o
th
to
p
ica
l
a
n
d
o
r
a
l."
(
P1
3
,
4
5
/F,
f
am
ily
m
e
d
icin
e)
3
.
2
.
3
.
Co
m
bin
a
t
io
n t
re
a
t
m
ent
pro
v
ides
m
ulti
-
f
a
ce
t
ed
a
dv
a
nta
g
es
T
wo
p
r
escr
ib
er
s
esp
o
u
s
ed
t
h
e
p
o
ten
tial
ad
v
a
n
tag
es
o
f
co
m
b
in
atio
n
tr
ea
tm
e
n
t.
On
e
p
r
escr
ib
er
co
n
s
id
er
ed
th
e
b
en
ef
its
o
f
co
m
p
lem
en
tar
y
r
o
u
tes o
f
ad
m
in
is
tr
atio
n
an
d
less
r
is
k
o
f
d
ev
el
o
p
in
g
r
esis
tan
ce
:
"I
f
th
ey
ca
n
't
a
p
p
ly
t
h
e
p
erme
th
r
in
[
p
r
o
p
erly]
,
ta
kin
g
iv
ermectin
mig
h
t
ma
ke
u
p
fo
r
it..
.
Ma
yb
e
yo
u
s
h
o
u
ld
co
m
b
in
e,
less
ch
a
n
c
e
to
d
ev
elo
p
r
esis
ta
n
ce
to
p
ermeth
r
in
.
I
t
s
ee
ms
like
a
tw
o
-
d
r
u
g
co
mb
in
a
tio
n
,
a
lth
o
u
g
h
I
h
a
ve
n
o
p
r
o
o
f.
I
w
a
s
th
in
kin
g
like
h
o
w
w
e
tr
ea
t
lep
r
o
s
y
o
r
TB,
r
ig
h
t?
"
(
P1
0
,
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
9
9
7
-
1
0
0
7
1002
5
4
/F,
d
e
r
m
ato
lo
g
is
t)
.
E
v
e
n
o
n
e
n
o
n
-
p
r
escr
ib
e
r
w
o
u
ld
co
n
s
id
e
r
g
iv
i
n
g
iv
er
m
ec
tin
in
b
etwe
en
two
d
o
s
es
o
f
p
er
m
eth
r
in
“to
b
o
o
s
t th
e
eff
ec
t.”
(
P2
,
4
5
/F,
d
er
m
ato
lo
g
is
t)
3
.
3
.
P
er
m
et
hrin
3
.
3
.
1
.
Co
nfidence
in prescri
b
ing
perm
et
hrin a
s
s
t
a
nd
a
rd
o
f
ca
re
T
h
e
m
ajo
r
ity
o
f
p
r
escr
ib
er
s
(
1
3
/1
5
)
ex
p
r
ess
ed
co
n
f
id
en
ce
with
p
er
m
eth
r
in
s
in
ce
it
was
s
tan
d
ar
d
o
f
ca
r
e.
Sev
en
p
er
m
eth
r
in
p
r
escr
i
b
er
s
wer
e
f
am
iliar
with
p
er
m
et
h
r
in
f
r
o
m
m
ed
ical
t
r
ain
in
g
wh
i
le
f
o
u
r
p
r
escr
ib
er
s
tr
u
s
ted
th
e
r
ec
o
m
m
en
d
atio
n
s
i
n
tex
tb
o
o
k
s
,
m
o
d
u
le
s
,
a
n
d
jo
u
r
n
al
r
ep
o
r
ts
.
Desp
ite
n
o
t
b
ein
g
u
p
d
ated
with
t
h
e
latest p
r
ac
tice
g
u
id
elin
es,
o
n
e
p
r
escr
ib
er
s
till
r
elied
o
n
p
er
m
e
th
r
in
,
“T
h
a
t
w
a
s
h
o
w
I
w
a
s
ta
u
g
h
t
in
P
h
ilip
p
in
e
Gen
era
l
Ho
s
p
ita
l
(
P
GH
)
.
N
o
t
s
u
r
e
if
th
ere
a
r
e
n
ew
g
u
id
elin
es b
u
t [p
ermeth
r
in
]
s
ee
ms
to
w
o
r
k
fo
r
me
s
ti
ll.”
(
P1
0
,
5
4
/F,
d
e
r
m
ato
lo
g
is
t)
On
e
p
r
escr
ib
e
r
h
i
g
h
lig
h
ted
th
at
it
is
a
Ph
ilip
p
in
e
FDA
-
r
eg
is
ter
ed
s
ca
b
icid
e,
wh
ile
an
o
th
er
p
r
escr
ib
er
co
n
s
id
er
ed
p
e
r
m
eth
r
in
h
is
“g
o
-
to
tr
ea
tmen
t.”
(
P1
1
,
3
2
/M,
g
e
n
er
al
p
r
ac
titi
o
n
er
)
.
Sev
en
p
r
es
cr
ib
er
s
u
n
d
er
s
to
o
d
p
er
m
eth
r
in
’
s
u
n
iq
u
e
o
v
icid
al
a
ctio
n
:
“T
h
a
t’
s
w
h
y
it
is
a
d
r
u
g
o
f
ch
o
ice
co
mp
a
r
ed
to
o
t
h
ers
,
w
h
ich
a
r
e
o
n
ly
fo
r
a
d
u
lt
[
mites]
.
”
P6
(
6
5
/F,
d
er
m
ato
lo
g
is
t)
.
3
.
3
.
2
.
Dif
f
iculty
in ens
uring
pa
t
ient
co
m
pli
a
nce
wit
h per
m
et
hrin
E
n
s
u
r
in
g
co
m
p
lian
ce
with
p
e
r
m
eth
r
in
was
ch
allen
g
in
g
f
o
r
n
i
n
e
p
r
escr
ib
er
s
,
n
ec
ess
itatin
g
s
tr
ict
f
o
llo
w
-
u
p
m
ea
s
u
r
es
f
o
r
two
p
r
escr
ib
e
r
s
.
On
e
p
r
escr
ib
er
r
eso
r
ted
t
o
s
ca
r
in
g
th
e
p
atien
t
ab
o
u
t
th
e
r
is
k
o
f
r
ein
f
estatio
n
if
th
ey
wer
e
p
o
o
r
l
y
co
m
p
lian
t.
T
h
r
ee
p
r
escr
ib
er
s
f
o
u
n
d
ap
p
l
y
in
g
p
er
m
et
h
r
in
in
lar
g
e
h
o
u
s
eh
o
ld
s
b
u
r
d
e
n
s
o
m
e,
s
in
ce
it wa
s
co
s
tly
an
d
ted
io
u
s
.
As P1
0
,
5
4
/F,
d
e
r
m
ato
lo
g
is
t,
n
o
ted
:
“
I
d
o
n
't
r
ea
lly
tr
u
s
t th
a
t p
a
tien
ts
a
s
k
a
ll th
eir h
o
u
s
eh
o
ld
me
mb
ers
to
d
o
th
e
s
a
me.
”
Ho
wev
er
,
f
iv
e
p
r
escr
ib
er
s
f
o
u
n
d
th
at
p
atien
ts
w
er
e
g
e
n
er
ally
co
m
p
lian
t
with
p
e
r
m
eth
r
in
.
T
wo
o
f
th
e
f
iv
e
p
r
escr
ib
er
s
b
eliev
ed
it
w
as
d
u
e
to
th
e
ea
s
e
o
f
th
e
“o
n
e
-
d
a
y
a
p
p
r
o
a
ch
”
(
P2
,
4
5
/F,
d
er
m
ato
lo
g
is
t)
.
Six
p
r
escr
ib
er
s
f
o
u
n
d
it
n
ec
ess
ar
y
to
p
r
o
v
id
e
d
etailed
in
s
tr
u
ctio
n
s
f
o
r
p
er
m
eth
r
in
u
s
e.
P8
(
2
7
/
F,
g
en
e
r
al
p
r
ac
tice)
g
av
e
wr
itten
i
n
s
tr
u
ctio
n
s
in
t
h
e
v
er
n
ac
u
lar
w
h
ile
P1
1
(
3
2
/
M,
g
en
er
al
p
r
ac
titi
o
n
er
)
g
a
v
e
a
“o
n
e
-
s
h
o
t
d
ea
l”
ed
u
ca
tio
n
f
o
r
th
o
s
e
i
n
r
em
o
te
co
m
m
u
n
ities
wh
o
wer
e
u
n
lik
e
ly
to
f
o
llo
w
-
u
p
.
I
n
a
d
d
itio
n
,
s
o
u
r
cin
g
p
er
m
eth
r
i
n
o
r
ex
p
lain
i
n
g
its
p
r
o
p
er
u
s
e
th
r
o
u
g
h
d
etailed
in
s
tr
u
ctio
n
s
in
ter
f
er
ed
with
clin
ic
r
o
u
tin
es o
f
th
r
ee
p
r
escr
ib
er
s
:
“It’
s
a
ma
tter
o
f
ex
p
la
in
in
g
to
yo
u
r
p
a
tien
t…
I
f
yo
u
o
n
ly
h
a
ve
five
min
u
tes
fo
r
yo
u
r
p
a
tien
ts
,
th
a
t’
s
n
o
th
in
g
.
Go
o
d
b
ye
.
N
o
.
I
t’
s
n
o
t
en
o
u
g
h
.
”
(
P6
,
6
5
/F,
d
er
m
ato
l
o
g
is
t)
.
E
ig
h
t o
u
t
o
f
1
5
p
r
escr
i
b
er
s
f
o
u
n
d
p
er
m
eth
r
in
g
e
n
er
ally
n
o
t a
f
f
o
r
d
ab
le,
“T
h
e
c
h
a
llen
g
e
is
if th
e
y
ca
n
b
u
y
en
o
u
g
h
to
co
ve
r
th
e
en
tir
ety
o
f
th
e
b
o
d
y
s
u
r
fa
ce
a
r
ea
”
(
P1
1
,
3
2
/M,
g
en
er
al
p
r
ac
titi
o
n
er
)
,
with
two
p
h
y
s
ician
s
co
n
ce
r
n
ed
with
p
o
s
s
ib
le
s
k
im
p
in
g
an
d
p
o
o
r
ad
h
er
en
ce
.
3
.
3
.
3
.
P
er
ce
iv
ed
ef
f
ica
c
y
o
f
perm
et
hrin
Ma
jo
r
ity
o
f
p
er
m
eth
r
in
p
r
escr
ib
er
s
(
1
2
/1
5
)
c
o
n
s
id
er
ed
p
e
r
m
eth
r
in
h
ig
h
l
y
ef
f
ec
tiv
e
in
cl
ea
r
in
g
s
k
in
lesi
o
n
s
(
3
/1
2
)
,
with
n
o
o
r
f
ew
tr
ea
tm
en
t
f
ailu
r
es
(
7
/1
2
)
,
with
tr
ea
tm
en
t
f
ailu
r
es
u
s
u
ally
attr
ib
u
ted
to
m
is
d
iag
n
o
s
is
(
2
/1
2
)
s
in
ce
r
esis
tan
ce
was
r
ar
e
(
1
/1
2
)
(
h
ig
h
p
er
ce
iv
ed
ef
f
ec
tiv
e
n
ess
)
.
Oth
er
p
o
s
s
ib
le
ca
u
s
es
o
f
tr
ea
tm
en
t f
ailu
r
e,
ac
co
r
d
in
g
to
5
/1
2
p
r
escr
ib
e
r
s
,
ar
e
m
is
s
ed
s
p
o
ts
o
n
ap
p
licatio
n
,
p
o
o
r
co
m
p
lian
ce
,
an
d
lack
o
f
en
v
ir
o
n
m
en
tal
co
n
t
r
o
l.
Patien
ts
with
o
u
t
f
o
llo
w
-
u
p
s
wer
e
r
eg
ar
d
e
d
as
cu
r
ed
ac
co
r
d
in
g
to
5
/1
2
p
r
escr
ib
er
s
,
r
ar
el
y
r
eq
u
ir
i
n
g
s
ec
o
n
d
-
lin
e
d
r
u
g
s
.
Pre
s
cr
ib
er
s
ad
v
is
ed
p
atien
ts
th
at
p
e
r
s
is
ten
t
itch
in
g
was
n
o
r
m
al,
an
d
ab
s
e
n
ce
o
f
n
ew
lesi
o
n
s
was m
o
r
e
im
p
o
r
ta
n
t.
P1
4
(
4
6
/
F,
f
am
ily
m
ed
ic
in
e)
ex
p
lain
e
d
th
at
p
atien
ts
h
ig
h
ly
r
eg
ar
d
ed
p
er
m
eth
r
in
:
“
I
g
u
ess
th
e
p
a
tien
ts
ca
n
s
ee
…
th
e
r
esp
o
n
s
e
s
o
I
g
u
ess
th
ey
feel
th
a
t
a
'wo
n
d
er
d
r
u
g
'
w
a
s
u
s
ed
o
n
th
em
[
la
u
g
h
s
]
th
a
t
is
to
p
ica
l
b
ec
a
u
s
e
mo
s
t
o
f
th
em
ex
p
ec
t
to
d
r
in
k
it..
.
b
u
t
th
is
is
d
iffer
en
t,
th
is
i
s
s
o
meth
in
g
th
a
t th
ey
a
p
p
ly.
”
Sev
en
p
r
escr
ib
er
s
u
n
d
er
s
to
o
d
p
er
m
eth
r
in
’
s
s
ca
b
icid
al
ac
tio
n
,
co
r
r
ec
t
d
o
s
in
g
,
an
d
n
ee
d
f
o
r
ad
ju
n
ctiv
e
tr
ea
tm
en
t.
P6
(
6
5
/F,
d
er
m
ato
l
o
g
is
t)
r
ec
o
g
n
ized
p
e
r
m
eth
r
in
'
s
u
n
iq
u
e
o
v
icid
al
a
n
d
lar
v
ici
d
al
p
r
o
p
e
r
ties
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
h
ysicia
n
a
cc
ep
ta
b
ilit
y
o
f o
r
a
l iv
ermectin
ve
r
s
u
s
p
er
meth
r
in
in
s
ca
b
ies tr
ea
tmen
t
(
R
o
w
en
a
F
.
Gen
u
in
o
)
1003
I
v
er
m
ec
tin
’
s
e
f
f
i
ca
cy
,
s
af
ety
,
tr
ac
k
r
ec
o
r
d
(
in
n
e
g
lecte
d
t
r
o
p
ical
d
is
ea
s
e
(
NT
D
)
p
r
o
g
r
am
s
)
,
an
d
s
er
en
d
ip
ito
u
s
av
ailab
ilit
y
(
d
u
e
to
th
e
C
OVI
D
-
1
9
p
an
d
em
ic)
led
to
its
u
s
e
b
y
a
f
ew
p
h
y
s
ici
an
s
in
o
u
r
s
tu
d
y
in
tr
ea
tin
g
Fil
ip
in
o
p
atien
ts
with
s
ca
b
ies.
T
h
ese
p
h
y
s
ician
s
h
ad
m
ix
ed
awa
r
en
ess
an
d
f
am
iliar
ity
with
iv
er
m
ec
tin
an
d
y
et
wer
e
o
p
e
n
to
an
ev
id
e
n
ce
-
b
ased
ap
p
r
o
ac
h
.
C
o
m
b
in
a
tio
n
iv
er
m
ec
tin
a
n
d
p
er
m
eth
r
i
n
tr
ea
tm
en
t,
d
esp
ite
f
ast an
d
ass
u
r
ed
cu
r
e
,
was c
o
n
s
id
er
ed
as a
last
o
p
tio
n
.
Var
iab
le
awa
r
en
ess
an
d
f
am
i
liar
ity
with
iv
er
m
ec
tin
s
u
g
g
e
s
t
th
e
o
v
er
all
lack
o
f
k
n
o
wled
g
e
an
d
ex
p
er
ien
ce
in
t
h
e
u
s
e
o
f
iv
er
m
ec
tin
,
alo
n
e
o
r
in
co
m
b
in
atio
n
with
p
er
m
eth
r
in
,
in
s
ca
b
ies.
W
h
ile
o
r
al
iv
er
m
ec
tin
was
in
clu
d
ed
in
th
e
Ph
ilip
p
in
e
Natio
n
al
Fo
r
m
u
lar
y
(
1
9
9
3
)
a
n
d
r
ec
o
m
m
e
n
d
ed
f
o
r
u
s
e
in
th
e
DOH’
s
ly
m
p
h
atic
f
ilar
iasi
s
co
n
tr
o
l
p
r
o
g
r
am
in
2
0
2
1
,
th
e
Ph
ilip
p
in
e
FDA
war
n
ed
“a
g
ain
s
t
th
e
p
u
r
ch
ase
an
d
u
s
e
o
f
iv
er
m
ec
tin
v
eter
in
ar
y
p
r
o
d
u
cts
ag
ain
s
t
C
OVI
D
-
19”
[
2
3
]
.
T
h
e
Ph
ilip
p
in
e
FDA
f
u
r
th
er
s
tated
th
at
th
e
“r
eg
is
ter
ed
iv
er
m
ec
tin
p
r
o
d
u
cts
in
th
e
co
u
n
t
r
y
f
o
r
h
u
m
an
u
s
e
ar
e
in
to
p
ical
f
o
r
m
u
latio
n
s
u
n
d
er
p
r
escr
ip
tio
n
u
s
e
o
n
ly
”
f
o
r
tr
ea
tin
g
ec
to
p
ar
asit
es
s
u
ch
as
h
ea
d
lice
an
d
r
o
s
ac
ea
.
I
n
a
s
im
ilar
v
ein
,
th
e
PDS
d
is
co
u
r
ag
e
d
th
e
u
s
e
o
f
o
r
al
iv
e
r
m
ec
tin
f
o
r
C
OVI
D
-
1
9
[
2
4
]
.
W
h
ile
m
i
s
in
f
o
r
m
atio
n
an
d
co
n
tr
o
v
er
s
y
ab
o
u
t
o
r
al
iv
er
m
ec
tin
f
lo
u
r
is
h
ed
,
a
u
th
o
r
ities
co
u
ld
h
av
e
em
p
h
asized
its
p
r
o
v
e
n
r
o
le
in
h
u
m
an
p
ar
asit
ic
d
is
ea
s
e
s
s
u
ch
as
s
ca
b
ies,
an
d
NT
Ds
[
2
5
]
.
Alth
o
u
g
h
o
r
a
l
iv
er
m
ec
tin
was
later
r
eg
is
ter
e
d
as
an
an
ti
-
n
e
m
ato
d
al
b
y
th
e
Ph
ilip
p
in
e
FDA
in
m
id
-
2
0
2
1
,
its
ex
p
er
im
en
tal
u
s
e
in
C
OVI
D
-
1
9
i
n
itially
r
eq
u
ir
e
d
a
co
m
p
ass
io
n
ate
s
p
ec
ial
p
er
m
it
an
d
a
p
r
escr
ip
tio
n
f
r
o
m
a
p
h
y
s
ician
th
at
was
co
m
p
o
u
n
d
e
d
b
y
a
p
h
a
r
m
ac
is
t
[
2
6
]
.
Un
f
o
r
tu
n
ately
,
th
e
em
er
g
en
cy
au
th
o
r
izatio
n
f
o
r
o
r
al
iv
er
m
ec
tin
ex
p
ir
ed
in
No
v
em
b
er
2
0
2
2
an
d
th
e
d
r
u
g
was o
n
ly
av
ailab
le
in
a
f
ew
Ph
ilip
p
in
e
d
r
u
g
s
to
r
es a
s
o
f
Sep
te
m
b
er
2
0
2
3
.
No
n
-
p
r
escr
ib
e
r
s
in
o
u
r
s
tu
d
y
cited
th
e
lack
o
f
lo
ca
l
g
u
id
e
lin
es
as
th
eir
m
ain
r
ea
s
o
n
f
o
r
av
o
id
in
g
iv
er
m
ec
ti
n
.
E
v
id
en
ce
-
b
ased
p
r
ac
tice
g
u
id
elin
es
ar
e
co
n
s
id
e
r
ed
b
y
m
an
y
as
th
e
h
i
g
h
est
f
o
r
m
o
f
e
v
id
en
ce
f
o
r
d
ec
is
io
n
-
m
ak
in
g
[
2
7
]
,
[
2
8
]
.
T
h
is
is
s
im
ilar
to
Au
s
tr
alian
Ab
o
r
ig
in
al
co
m
m
u
n
ities
wh
er
e
all
in
ter
v
iewe
d
h
ea
lth
ca
r
e
p
r
o
v
i
d
er
s
(
HC
Ps
)
r
ef
er
r
ed
to
t
h
e
lo
ca
l
g
u
id
elin
e
f
o
r
th
e
d
iag
n
o
s
is
an
d
tr
ea
t
m
en
t
o
f
lo
ca
l
s
k
in
in
f
ec
tio
n
s
[
2
9
]
.
A
f
ew
m
o
n
th
s
af
ter
o
u
r
s
tu
d
y
en
d
e
d
,
th
e
DOH
r
elea
s
ed
th
e
in
ter
im
g
u
i
d
an
c
e
o
n
s
ca
b
ies
s
tatin
g
th
e
in
d
icatio
n
s
f
o
r
o
f
f
-
lab
el
u
s
e
o
f
i
v
er
m
ec
tin
; th
is
m
a
y
p
o
te
n
ti
ally
ch
an
g
e
th
e
p
r
escr
ib
in
g
p
r
ac
tice
o
f
th
e
n
o
n
-
p
r
escr
ib
er
s
in
o
u
r
s
tu
d
y
[
4
]
.
Fu
tu
r
e
FDA
ap
p
r
o
v
al
o
f
o
r
al
iv
er
m
ec
tin
f
o
r
s
ca
b
ies
wo
u
ld
p
av
e
th
e
way
f
o
r
its
o
n
-
lab
el
u
s
e
f
o
r
s
ca
b
ies an
d
m
ay
also
en
co
u
r
a
g
e
its
r
atio
n
al
u
s
e
am
o
n
g
p
h
y
s
ician
s
.
Mo
s
t
o
f
th
e
iv
er
m
ec
tin
p
r
escr
ib
er
s
in
o
u
r
s
tu
d
y
wer
e
d
er
m
ato
lo
g
is
ts
.
No
n
-
d
er
m
ato
lo
g
is
ts
m
ay
h
esit
ate
to
p
r
escr
ib
e
o
r
al
iv
e
r
m
ec
tin
d
u
e
to
u
n
f
a
m
iliar
ity
an
d
lack
o
f
FDA
lab
ellin
g
.
I
n
co
n
t
r
a
s
t,
o
f
f
-
lab
el
u
s
e
is
co
m
m
o
n
p
lace
in
d
er
m
ato
lo
g
y
p
r
ac
tice
an
d
is
co
n
s
id
er
e
d
a
r
at
io
n
al
ap
p
r
o
ac
h
,
g
iv
en
th
e
d
iv
er
s
e
p
ath
o
p
h
y
s
io
lo
g
y
o
f
s
k
in
d
is
o
r
d
er
s
[
3
0
]
.
So
m
e
d
r
u
g
s
r
em
ain
o
f
f
-
lab
el
f
o
r
s
k
in
co
n
d
itio
n
s
d
esp
ite
ev
id
en
ce
o
n
ef
f
icac
y
an
d
s
af
ety
d
u
e
to
t
h
e
p
r
o
tr
ac
te
d
p
r
o
ce
s
s
o
f
clin
ical
tr
ials
f
o
r
n
ew
i
n
d
icatio
n
s
o
f
p
r
ev
io
u
s
ly
ap
p
r
o
v
ed
d
r
u
g
s
,
wh
ich
d
is
co
u
r
ag
es
m
ar
k
etin
g
au
th
o
r
i
za
tio
n
h
o
ld
er
s
in
a
p
p
ly
in
g
f
o
r
n
ew
in
d
icatio
n
s
[
3
1
]
.
C
o
n
s
eq
u
en
tly
,
m
an
d
atin
g
on
-
lab
el
u
s
e
o
f
d
r
u
g
s
in
g
u
id
elin
es
o
r
r
eim
b
u
r
s
em
en
t
s
ch
e
m
es
m
ay
lim
it
ef
f
ec
tiv
e
tr
ea
tm
en
t,
esp
ec
ially
f
o
r
ch
ild
r
en
an
d
p
r
eg
n
an
t
wo
m
e
n
[
3
2
]
,
[
3
3
]
.
T
h
e
d
ev
el
o
p
m
en
t
o
f
lo
ca
l
p
r
ac
tice
g
u
id
elin
es
co
u
ld
f
ac
ilit
ate
th
e
in
clu
s
io
n
o
f
s
ca
b
ies
as
a
r
eg
is
t
er
ed
in
d
icatio
n
f
o
r
o
r
al
iv
er
m
ec
tin
b
y
th
e
Ph
ilip
p
in
e
FDA,
alig
n
in
g
with
W
HO
r
ec
o
m
m
en
d
atio
n
s
[
3
4
]
.
Ph
y
s
ician
ed
u
ca
tio
n
,
esp
ec
ially
in
v
o
lv
in
g
p
r
im
ar
y
ca
r
e
p
h
y
s
ician
s
,
will
h
elp
p
r
o
m
o
te
th
e
r
atio
n
al
tr
ea
tm
en
t
o
f
s
ca
b
ie
s
as
p
ar
t
o
f
th
e
u
n
iv
e
r
s
al
h
ea
lth
ca
r
e
p
r
o
g
r
am
o
f
th
e
Ph
ilip
p
in
es
th
at
en
s
u
r
es
th
at
all
Fil
ip
in
o
s
ar
e
g
u
ar
an
tee
d
eq
u
itab
le
ac
ce
s
s
to
q
u
al
ity
an
d
a
f
f
o
r
d
a
b
le
h
ea
lth
ca
r
e
[
3
5
]
.
C
o
m
b
in
atio
n
tr
ea
tm
e
n
t
is
u
s
ed
in
o
th
e
r
s
k
in
d
is
ea
s
es
s
u
ch
as
ac
n
e,
ato
p
ic
d
er
m
atitis
,
an
d
p
s
o
r
iasi
s
to
h
ar
n
ess
th
er
ap
eu
tic
s
y
n
er
g
y
,
p
o
ten
tially
m
in
im
ize
ad
v
er
s
e
ef
f
ec
ts
,
an
d
r
ed
u
ce
th
e
d
e
v
elo
p
m
en
t
o
f
d
r
u
g
r
esis
tan
ce
[
3
6
]
.
Ho
wev
er
,
p
h
y
s
ician
s
h
esit
ate
to
p
r
escr
ib
e
c
o
m
b
in
atio
n
with
o
u
t
k
n
o
win
g
th
e
o
p
tim
al
d
o
s
in
g
r
eg
im
en
s
o
r
r
ec
eiv
in
g
r
ec
o
m
m
en
d
atio
n
s
f
o
r
its
u
s
e
as
a
f
ir
s
t
lin
e
tr
ea
tm
en
t
f
o
r
p
atien
ts
with
class
ic
s
ca
b
ie
s
.
Mo
s
t
p
r
escr
ib
er
s
in
o
u
r
s
tu
d
y
r
eser
v
e
th
is
tr
ea
tm
e
n
t
f
o
r
p
atien
ts
with
s
ev
er
e
s
ca
b
ies,
p
o
o
r
q
u
ality
o
f
life
,
o
r
a
h
is
to
r
y
o
f
f
ailed
m
o
n
o
th
er
ap
y
.
T
h
e
J
ap
an
ese
s
ca
b
ies
g
u
id
elin
es
also
s
u
g
g
ested
lim
it
in
g
its
u
s
e
o
n
ly
in
class
ic
s
ca
b
ies
in
im
m
u
n
o
co
m
p
r
o
m
is
ed
in
d
iv
id
u
als
an
d
eld
er
l
y
p
atien
ts
with
in
tact
liv
er
f
u
n
ctio
n
.
I
t
also
r
ec
o
m
m
en
d
ed
f
u
r
t
h
er
s
tu
d
y
o
n
th
e
d
r
u
g
in
ter
ac
tio
n
s
,
an
d
e
f
f
i
ca
cy
an
d
s
af
ety
o
f
th
e
co
m
b
in
a
tio
n
tr
ea
tm
en
t
with
o
r
al
iv
er
m
ec
tin
a
n
d
p
h
en
o
th
r
i
n
[
3
]
.
Ph
y
s
ician
s
in
o
u
r
s
tu
d
y
wer
e
also
co
n
ce
r
n
ed
ab
o
u
t
t
h
e
ad
d
e
d
ex
p
e
n
s
e;
co
m
b
in
atio
n
o
r
al
iv
er
m
e
ctin
a
n
d
p
er
m
et
h
r
in
(
s
in
g
le
d
o
s
e
o
f
ea
ch
d
r
u
g
)
was
th
e
m
o
s
t
ex
p
e
n
s
iv
e
tr
ea
tm
en
t
an
d
ar
o
u
n
d
f
iv
e
tim
es
co
s
tlier
p
er
o
n
e
s
ca
b
ies
ca
s
e
cu
r
ed
th
an
a
s
in
g
le
d
o
s
e
o
f
iv
er
m
ec
tin
,
a
lth
o
u
g
h
o
n
ly
a
litt
le
h
ig
h
er
th
a
n
a
s
in
g
le
d
o
s
e
o
f
p
e
r
m
eth
r
in
[
1
5
]
.
Per
m
eth
r
in
was
th
e
m
o
s
t
ac
ce
p
tab
le
tr
ea
tm
en
t
p
r
escr
ib
e
d
b
y
all
p
h
y
s
ician
in
f
o
r
m
an
ts
in
th
is
s
tu
d
y
,
d
esp
ite
th
e
ch
allen
g
es
in
e
n
s
u
r
in
g
c
o
m
p
lian
ce
.
T
h
e
r
ea
s
o
n
s
f
o
r
th
e
p
er
ce
iv
e
d
p
o
o
r
c
o
m
p
lian
ce
wer
e
co
s
t,
in
co
n
v
e
n
ien
ce
o
f
wh
o
le
-
b
o
d
y
ap
p
lica
tio
n
,
a
n
d
d
if
f
icu
lty
i
n
co
n
v
in
cin
g
asy
m
p
to
m
atic
c
o
n
tacts
to
u
n
d
e
r
g
o
tr
ea
tm
en
t.
C
o
n
s
id
er
in
g
th
at
t
h
e
av
er
ag
e
h
o
u
s
eh
o
l
d
o
u
t
-
of
-
p
o
ck
et
p
ay
m
e
n
t
o
f
Fil
ip
in
o
s
ac
co
u
n
ts
f
o
r
4
1
.
5
%
o
f
th
e
h
ea
lth
e
x
p
en
d
itu
r
e,
p
er
m
et
h
r
in
m
a
y
b
e
u
n
af
f
o
r
d
ab
le
f
o
r
m
o
s
t
[
3
7
]
.
T
h
ese
ex
p
er
ie
n
ce
s
wer
e
also
m
ir
r
o
r
ed
in
an
o
b
s
er
v
atio
n
al
s
tu
d
y
o
f
4
0
h
o
u
s
eh
o
ld
s
in
two
s
ca
b
ies
-
en
d
em
ic
Ab
o
r
ig
i
n
al
co
m
m
u
n
ities
in
n
o
r
th
er
n
Au
s
tr
ali
a
with
a
co
m
m
u
n
ity
-
b
ased
s
k
in
h
ea
lth
p
r
o
g
r
am
[
3
8
]
.
Alth
o
u
g
h
th
er
e
was
g
o
o
d
ad
h
er
en
ce
to
to
p
ical
p
er
m
eth
r
in
t
r
ea
tm
en
t
in
3
2
/4
0
ch
ild
r
en
(
8
0
%),
m
o
s
t
(
2
4
7
/
4
4
0
,
5
6
%)
h
o
u
s
eh
o
ld
m
em
b
er
s
,
m
o
s
tly
m
ales
an
d
asy
m
p
to
m
atic
in
d
iv
id
u
als,
d
i
d
n
o
t
c
o
m
p
ly
with
tr
ea
tm
en
t.
I
n
an
o
th
er
q
u
alitativ
e
s
tu
d
y
in
f
o
u
r
r
em
o
te
Ab
o
r
ig
in
al
c
o
m
m
u
n
ities
with
a
s
ca
b
ies
p
r
ev
alen
ce
o
f
1
5
%,
p
o
ten
tial
b
ar
r
ier
s
to
p
e
r
m
eth
r
i
n
u
s
e
elicited
f
r
o
m
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
9
9
7
-
1
0
0
7
1004
p
ar
en
ts
/car
er
s
in
clu
d
ed
co
n
f
u
s
io
n
in
p
r
o
p
er
a
p
p
licatio
n
o
f
cr
ea
m
,
u
n
p
leasan
t
s
m
ell
an
d
tex
tu
r
e,
th
e
d
elay
i
n
h
ea
lin
g
o
f
th
e
s
k
in
i
n
f
ec
tio
n
a
f
ter
tr
ea
tm
en
t,
u
n
willi
n
g
n
ess
o
f
asy
m
p
to
m
atic
h
o
u
s
eh
o
ld
m
em
b
er
s
to
ap
p
ly
th
e
cr
ea
m
,
an
d
th
e
f
ast
tu
r
n
o
v
er
o
f
h
o
u
s
eh
o
ld
r
esid
en
ts
wh
o
m
o
v
e
b
etwe
en
h
o
u
s
es
[
2
9
]
.
Alth
o
u
g
h
all
h
ea
lt
h
ca
r
e
p
r
o
v
id
e
r
s
in
th
is
p
r
ev
io
u
s
s
tu
d
y
h
av
e
p
r
escr
ib
e
d
p
er
m
eth
r
i
n
f
o
r
ch
ild
r
en
with
s
ca
b
ies,
th
ey
o
f
ten
p
r
escr
ib
ed
lo
ca
lized
“sp
o
t”
tr
ea
tm
e
n
t,
an
d
n
o
t
wh
o
le
-
b
o
d
y
ap
p
licatio
n
as
s
tated
in
th
e
lo
ca
l
g
u
id
elin
e
.
I
n
ad
d
itio
n
,
o
n
ly
a
f
ew
ad
v
is
ed
tr
ea
tin
g
th
e
en
tire
h
o
u
s
eh
o
ld
d
u
e
to
th
e
h
ig
h
co
s
t
an
d
f
ast
tu
r
n
o
v
er
o
f
h
o
u
s
eh
o
ld
m
em
b
er
s
.
Similar
ly
,
th
e
u
s
e
o
f
p
e
r
m
eth
r
i
n
cr
ea
m
f
o
r
s
ca
b
ies
was
d
ir
ec
ted
b
y
n
u
r
s
es
in
a
Fij
i
co
m
m
u
n
ity
to
b
e
ap
p
lied
o
n
af
f
ec
ted
ch
ild
r
e
n
o
n
ly
a
n
d
r
ar
ely
ad
v
is
ed
its
s
im
u
ltan
eo
u
s
u
s
e
o
n
all
clo
s
e
co
n
tacts
[
3
9
]
.
L
ik
ewise
,
o
u
r
s
tu
d
y
s
h
o
wed
th
at
p
h
y
s
ician
s
d
o
u
b
ted
wh
eth
er
p
atien
ts
f
o
llo
wed
m
ed
ical
ad
v
ice
an
d
co
m
p
lied
with
th
e
in
s
t
r
u
ctio
n
s
an
d
f
ea
r
e
d
s
k
im
p
in
g
d
u
e
to
b
u
d
g
et
co
n
s
tr
ain
ts
.
T
h
e
s
tr
en
g
th
s
o
f
th
is
s
tu
d
y
in
c
lu
d
e
th
e
d
iv
er
s
ity
o
f
in
f
o
r
m
a
n
t
s
(
f
r
o
m
b
o
th
p
r
im
ar
y
ca
r
e
p
r
o
v
id
er
s
an
d
s
p
ec
ialis
t
s
)
,
an
d
th
e
r
esear
c
h
team
’
s
u
n
i
q
u
e
c
o
m
b
in
atio
n
o
f
an
aly
tic
ex
p
er
tis
e
(
d
er
m
ato
lo
g
is
t/clin
ical
ep
id
em
io
lo
g
is
t,
d
er
m
ato
lo
g
i
s
t/p
u
b
lic
h
ea
lth
/co
m
m
u
n
ity
m
ed
icin
e,
g
en
er
al
p
r
ac
t
itio
n
er
/p
s
y
ch
o
lo
g
y
)
.
L
im
itatio
n
s
in
clu
d
ed
v
ar
iab
l
e
iv
er
m
ec
tin
av
ailab
ilit
y
,
im
p
ac
tin
g
p
h
y
s
ician
s
’
ab
ilit
y
to
p
r
escr
ib
e
it
an
d
r
estrictin
g
p
ar
ticip
an
t
r
ec
r
u
it
m
en
t.
Ou
r
f
in
d
in
g
s
m
ay
b
e
ap
p
licab
le
o
n
ly
to
co
u
n
tr
ies
wh
e
r
e
o
r
al
iv
e
r
m
ec
tin
is
n
o
t
ap
p
r
o
v
e
d
f
o
r
s
ca
b
ies,
an
d
s
ca
b
ies
is
n
o
t
p
ar
t
o
f
a
n
atio
n
al
p
u
b
lic
h
ea
lth
co
n
tr
o
l
p
r
o
g
r
a
m
,
o
r
r
eim
b
u
r
s
ab
le
in
th
e
n
atio
n
al
h
ea
lth
in
s
u
r
a
n
c
e
p
r
o
g
r
am
.
4.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
h
as
s
h
o
wn
th
at
s
elec
ted
Fil
ip
in
o
p
h
y
s
ician
s
h
ad
m
ix
ed
awa
r
en
ess
an
d
e
x
p
er
ien
ce
o
n
iv
er
m
ec
tin
,
r
eser
v
ed
c
o
m
b
in
atio
n
iv
er
m
ec
tin
/
p
er
m
eth
r
i
n
tr
ea
tm
en
t
as
a
last
r
eso
r
t,
a
n
d
wer
e
g
en
e
r
ally
co
n
f
id
en
t
with
p
er
m
eth
r
in
as
s
tan
d
ar
d
o
f
ca
r
e
f
o
r
s
ca
b
ies
tr
ea
tm
en
t.
T
h
er
e
is
a
n
e
ed
f
o
r
o
n
g
o
in
g
p
h
y
s
ician
ed
u
ca
tio
n
,
clea
r
g
u
i
d
elin
es,
an
d
f
u
r
th
er
r
esear
ch
to
en
h
an
ce
t
h
e
ef
f
icac
y
an
d
ac
ce
s
s
ib
ilit
y
o
f
s
ca
b
ies
tr
ea
tm
en
ts
wh
ile
ad
d
r
ess
in
g
p
h
y
s
ician
s
'
v
ar
y
in
g
p
er
ce
p
tio
n
s
an
d
s
elf
-
ef
f
icac
y
in
u
tili
zin
g
t
h
ese
tr
ea
t
m
en
ts
.
Ou
r
f
in
d
in
g
s
m
ay
b
e
f
u
r
th
er
v
e
r
if
ied
am
o
n
g
a
b
ig
g
er
s
am
p
le
s
ize
o
f
p
h
y
s
ician
s
,
esp
ec
ially
am
o
n
g
th
o
s
e
wh
o
h
av
e
u
s
ed
iv
er
m
ec
tin
,
alo
n
e
o
r
in
co
m
b
i
n
atio
n
with
p
er
m
eth
r
in
.
Oth
er
s
tak
eh
o
ld
er
s
lik
e
p
u
b
lic
h
ea
lth
p
r
o
g
r
a
m
m
an
ag
e
r
s
an
d
p
atien
t
s
u
p
p
o
r
t
g
r
o
u
p
s
ca
n
also
b
e
in
ter
v
iewe
d
to
o
b
tai
n
a
b
r
o
a
d
er
p
er
s
p
ec
tiv
e
o
n
ac
ce
p
tab
ilit
y
.
L
ar
g
e
-
s
ca
le
p
h
y
s
ician
s
u
r
v
ey
s
m
ay
b
e
co
n
d
u
cted
to
g
ain
m
o
r
e
g
en
e
r
aliza
b
le
f
in
d
in
g
s
.
ACK
NO
WL
E
DG
E
M
E
NT
S
W
e
ac
k
n
o
wled
g
e
th
e
Ph
ilip
p
in
e
Der
m
ato
lo
g
ical
So
ciety
,
Ph
ilip
p
in
e
Aca
d
em
y
o
f
Fam
ily
Ph
y
s
ician
s
,
an
d
th
e
Ass
o
ciatio
n
o
f
Mu
n
icip
al
Hea
lth
Of
f
icer
s
o
f
th
e
Ph
ili
p
p
in
es
f
o
r
th
eir
p
ar
ticip
atio
n
in
th
is
s
tu
d
y
.
W
e
ar
e
g
r
atef
u
l
f
o
r
f
u
n
d
in
g
f
r
o
m
:
Un
iv
er
s
ity
o
f
th
e
Ph
ilip
p
in
es
Ma
n
ila
-
Natio
n
al
I
n
s
titu
tes
o
f
Hea
lth
(
UPM
-
NI
H
R
esear
ch
Fu
n
d
2
0
2
2
)
;
Pu
s
h
On
e
UPC
M
C
la
s
s
1
9
6
7
P
o
s
tg
r
ad
u
ate
Stu
d
ies
Pro
g
r
am
m
e
Gr
an
t;
an
d
UPM
-
Natio
n
al
Gr
ad
u
ate
Of
f
ice
f
o
r
Hea
lth
Scien
ce
s
(
T
h
esis
/Di
s
s
e
r
tatio
n
Gr
an
t)
.
RE
F
E
R
E
NC
E
S
[
1
]
K
.
A
.
W
o
r
k
o
w
s
k
i
e
t
a
l
.
,
“
S
e
x
u
a
l
l
y
t
r
a
n
sm
i
t
t
e
d
i
n
f
e
c
t
i
o
n
s
t
r
e
a
t
m
e
n
t
g
u
i
d
e
l
i
n
e
s,
2
0
2
1
,
”
M
MW
R
R
e
c
o
m
m
e
n
d
a
t
i
o
n
s
a
n
d
Re
p
o
rt
s
,
v
o
l
.
7
0
,
n
o
.
4
,
p
p
.
1
–
1
8
7
,
Ju
l
.
2
0
2
1
,
d
o
i
:
1
0
.
1
5
5
8
5
/
mm
w
r
.
r
r
7
0
0
4
a
1
.
[
2
]
C
.
M
.
S
a
l
a
v
a
st
r
u
,
O
.
C
h
o
si
d
o
w
,
M
.
J
.
B
o
f
f
a
,
M
.
Ja
n
i
e
r
,
a
n
d
G
.
S
.
T
i
p
l
i
c
a
,
“
Eu
r
o
p
e
a
n
g
u
i
d
e
l
i
n
e
f
o
r
t
h
e
ma
n
a
g
e
men
t
o
f
sc
a
b
i
e
s,
”
J
o
u
rn
a
l
o
f
t
h
e
E
u
r
o
p
e
a
n
Ac
a
d
e
m
y
o
f
D
e
rm
a
t
o
l
o
g
y
a
n
d
Ve
n
e
r
e
o
l
o
g
y
,
v
o
l
.
3
1
,
n
o
.
8
,
p
p
.
1
2
4
8
–
1
2
5
3
,
A
u
g
.
2
0
1
7
,
d
o
i
:
1
0
.
1
1
1
1
/
j
d
v
.
1
4
3
5
1
.
[
3
]
N
.
I
sh
i
i
e
t
a
l
.
,
“
G
u
i
d
e
l
i
n
e
f
o
r
t
h
e
d
i
a
g
n
o
s
i
s
a
n
d
t
r
e
a
t
m
e
n
t
o
f
s
c
a
b
i
e
s
i
n
Ja
p
a
n
(
t
h
i
r
d
e
d
i
t
i
o
n
)
:
Ex
e
c
u
t
i
v
e
c
o
mm
i
t
t
e
e
o
f
g
u
i
d
e
l
i
n
e
f
o
r
t
h
e
d
i
a
g
n
o
si
s
a
n
d
t
r
e
a
t
me
n
t
o
f
S
c
a
b
i
e
s,”
J
o
u
r
n
a
l
o
f
D
e
rm
a
t
o
l
o
g
y
,
v
o
l
.
4
4
,
n
o
.
9
,
p
p
.
9
9
1
–
1
0
1
4
,
S
e
p
.
2
0
1
7
,
d
o
i
:
1
0
.
1
1
1
1
/
1
3
4
6
-
8
1
3
8
.
1
3
8
9
6
.
[
4
]
P
.
D
e
p
a
r
t
me
n
t
o
f
H
e
a
l
t
h
,
“
I
n
t
e
r
i
m
g
u
i
d
a
n
c
e
f
o
r
t
h
e
d
i
a
g
n
o
si
s
a
n
d
m
a
n
a
g
e
me
n
t
o
f
sca
b
i
e
s
(
D
e
p
a
r
t
m
e
n
t
C
i
r
c
u
l
a
r
2
0
2
3
-
0
1
9
5
)
.
”
A
c
c
e
ss
e
d
:
O
c
t
.
2
0
2
4
.
(
O
n
l
i
n
e
)
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
d
r
i
v
e
.
g
o
o
g
l
e
.
c
o
m
/
f
i
l
e
/
d
/
1
N
X
Z
i
9
g
Ey
W
S
y
R
A
X
H
mU
g
f
w
S
6
C
W
F
LM
g
p
M
G
u
/
v
i
e
w
.”
[
5
]
J.
a
n
d
C
.
P
.
A
u
r
e
l
i
o
,
“
I
v
e
r
me
c
t
i
n
g
e
t
s
F
D
A
n
o
d
f
o
r
h
u
ma
n
c
o
n
s
u
m
p
t
i
o
n
,
”
P
h
i
l
i
p
p
i
n
e
D
a
i
l
y
I
n
q
u
i
r
e
r
.
M
a
y
2
0
2
1
.
A
c
c
e
ss
e
d
:
J
u
n
.
1
5
,
2
0
2
2
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
n
e
w
si
n
f
o
.
i
n
q
u
i
r
e
r
.
n
e
t
/
1
4
2
8
8
0
8
/
i
v
e
r
me
c
t
i
n
-
g
e
t
s
-
f
d
a
-
n
o
d
-
f
o
r
-
h
u
m
a
n
-
c
o
n
s
u
mp
t
i
o
n
.
[
6
]
P
h
i
l
i
p
p
i
n
e
F
o
o
d
a
n
d
D
r
u
g
A
d
m
i
n
i
s
t
r
a
t
i
o
n
,
“
F
D
A
V
e
r
i
f
i
c
a
t
i
o
n
P
o
r
t
a
l
:
I
v
e
r
m
e
c
t
i
n
,
”
F
o
o
d
a
n
d
D
r
u
g
A
d
mi
n
i
s
t
r
a
t
i
o
n
.
A
c
c
e
sse
d
:
S
e
p
.
3
0
,
2
0
2
4
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
v
e
r
i
f
i
c
a
t
i
o
n
.
f
d
a
.
g
o
v
.
p
h
/
d
r
u
g
_
p
r
o
d
u
c
t
s
l
i
st
.
p
h
p
.
[
7
]
P
.
D
e
p
a
r
t
me
n
t
o
f
H
e
a
l
t
h
,
G
u
i
d
e
l
i
n
e
s
i
n
t
h
e
u
se
o
f
I
v
e
rm
e
c
t
i
n
a
s
a
n
a
l
t
e
r
n
a
t
i
v
e
M
a
ss
D
ru
g
a
d
m
i
n
i
st
r
a
t
i
o
n
i
n
_
C
o
m
b
i
n
a
t
i
o
n
w
i
t
h
D
i
e
t
h
y
l
c
a
r
b
a
m
a
zi
n
e
C
i
t
r
a
t
e
(
D
EC
)
a
n
d
_
Al
b
e
n
d
a
z
o
l
e
(
ALB)
f
o
r
t
h
e
t
re
a
t
m
e
n
t
o
f
l
y
m
p
h
a
t
i
c
f
i
l
a
r
i
a
s
i
s
(
L
F)
.
2
0
2
1
,
p
p
.
1
–
4
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s:
/
/
l
a
w
.
u
p
d
.
e
d
u
.
p
h
/
w
p
-
c
o
n
t
e
n
t
/
u
p
l
o
a
d
s/
2
0
2
1
/
0
4
/
D
O
H
-
A
d
m
i
n
i
s
t
r
a
t
i
v
e
-
O
r
d
e
r
-
No
-
2
0
2
1
-
0
0
0
1
.
p
d
f
[
8
]
S
.
R
o
s
u
mec
k
,
A
.
N
a
st
,
a
n
d
C
.
D
r
e
ss
l
e
r
,
“
I
v
e
r
me
c
t
i
n
a
n
d
p
e
r
me
t
h
r
i
n
f
o
r
t
r
e
a
t
i
n
g
sc
a
b
i
e
s,
”
C
o
c
h
ra
n
e
D
a
t
a
b
a
se
o
f
S
y
st
e
m
a
t
i
c
R
e
v
i
e
w
s
,
v
o
l
.
2
0
1
8
,
n
o
.
4
,
A
p
r
.
2
0
1
8
,
d
o
i
:
1
0
.
1
0
0
2
/
1
4
6
5
1
8
5
8
.
C
D
0
1
2
9
9
4
.
[
9
]
K
.
T
h
a
d
a
n
i
p
o
n
,
T
.
A
n
o
t
h
a
i
s
i
n
t
a
w
e
e
,
S
.
R
a
t
t
a
n
a
s
i
r
i
,
A
.
Th
a
k
k
i
n
s
t
i
a
n
,
a
n
d
J
.
A
t
t
i
a
,
“
Ef
f
i
c
a
c
y
a
n
d
safe
t
y
o
f
a
n
t
i
s
c
a
b
i
e
t
i
c
a
g
e
n
t
s:
A
sy
st
e
ma
t
i
c
r
e
v
i
e
w
a
n
d
n
e
t
w
o
r
k
m
e
t
a
-
a
n
a
l
y
si
s
o
f
r
a
n
d
o
mi
z
e
d
c
o
n
t
r
o
l
l
e
d
t
r
i
a
l
s,”
J
o
u
r
n
a
l
o
f
t
h
e
Am
e
ri
c
a
n
A
c
a
d
e
m
y
o
f
D
e
rm
a
t
o
l
o
g
y
,
v
o
l
.
8
0
,
n
o
.
5
,
p
p
.
1
4
3
5
–
1
4
4
4
,
M
a
y
2
0
1
9
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
j
a
a
d
.
2
0
1
9
.
0
1
.
0
0
4
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
h
ysicia
n
a
cc
ep
ta
b
ilit
y
o
f o
r
a
l iv
ermectin
ve
r
s
u
s
p
er
meth
r
in
in
s
ca
b
ies tr
ea
tmen
t
(
R
o
w
en
a
F
.
Gen
u
in
o
)
1005
[
1
0
]
S
.
P
.
R
e
n
d
i
c
,
“
M
e
t
a
b
o
l
i
sm
a
n
d
i
n
t
e
r
a
c
t
i
o
n
s
o
f
I
v
e
r
mec
t
i
n
w
i
t
h
h
u
ma
n
c
y
t
o
c
h
r
o
me
P
4
5
0
e
n
z
y
m
e
s
a
n
d
d
r
u
g
t
r
a
n
s
p
o
r
t
e
r
s,
p
o
ssi
b
l
e
a
d
v
e
r
se
a
n
d
t
o
x
i
c
e
f
f
e
c
t
s
,
”
Arc
h
i
v
e
s
o
f
T
o
x
i
c
o
l
o
g
y
,
v
o
l
.
9
5
,
n
o
.
5
,
p
p
.
1
5
3
5
–
1
5
4
6
,
M
a
y
2
0
2
1
,
d
o
i
:
1
0
.
1
0
0
7
/
s
0
0
2
0
4
-
0
2
1
-
0
3
0
2
5
-
z.
[
1
1
]
B
.
W
.
G
i
l
b
e
r
t
a
n
d
J.
S
l
e
c
h
t
a
,
“
A
c
a
s
e
o
f
i
v
e
r
m
e
c
t
i
n
-
i
n
d
u
c
e
d
W
a
r
f
a
r
i
n
t
o
x
i
c
i
t
y
:
F
i
r
s
t
p
u
b
l
i
s
h
e
d
r
e
p
o
r
t
,
”
H
o
sp
i
t
a
l
P
h
a
rm
a
c
y
,
v
o
l
.
5
3
,
n
o
.
6
,
p
p
.
3
9
3
–
3
9
4
,
D
e
c
.
2
0
1
8
,
d
o
i
:
1
0
.
1
1
7
7
/
0
0
1
8
5
7
8
7
1
8
7
5
8
9
7
2
.
[
1
2
]
E.
B
a
u
d
o
u
e
t
a
l
.
,
“
S
e
r
i
o
u
s
i
v
e
r
me
c
t
i
n
t
o
x
i
c
i
t
y
a
n
d
h
u
ma
n
A
B
C
B
1
N
o
n
s
e
n
s
e
m
u
t
a
t
i
o
n
s,
”
N
e
w
En
g
l
a
n
d
J
o
u
r
n
a
l
o
f
Me
d
i
c
i
n
e
,
v
o
l
.
3
8
3
,
n
o
.
8
,
p
p
.
7
8
7
–
7
8
9
,
A
u
g
.
2
0
2
0
,
d
o
i
:
1
0
.
1
0
5
6
/
n
e
j
mc
1
9
1
7
3
4
4
.
[
1
3
]
C
.
I
.
C
o
l
e
m
a
n
,
E
.
L.
G
i
l
l
e
s
p
i
e
,
a
n
d
C
.
M
.
W
h
i
t
e
,
“
P
r
o
b
a
b
l
e
t
o
p
i
c
a
l
p
e
r
me
t
h
r
i
n
-
i
n
d
u
c
e
d
n
e
c
k
d
y
st
o
n
i
a
,
”
P
h
a
rm
a
c
o
t
h
e
ra
p
y
,
v
o
l
.
2
5
,
n
o
.
3
,
p
p
.
4
4
8
–
4
5
0
,
M
a
r
.
2
0
0
5
,
d
o
i
:
1
0
.
1
5
9
2
/
p
h
c
o
.
2
5
.
3
.
4
4
8
.
6
1
5
9
6
.
[
1
4
]
S
.
D
e
y
,
S
.
A
g
a
r
w
a
l
,
a
n
d
S
a
g
a
r
,
“
C
o
m
p
a
r
i
s
o
n
o
f
t
h
e
e
f
f
e
c
t
s
o
f
i
v
e
r
me
c
t
i
n
,
p
e
r
met
h
r
i
n
,
a
n
d
g
a
mm
a
b
e
n
z
e
n
e
h
e
x
a
c
h
l
o
r
i
d
e
a
l
o
n
e
a
n
d
w
i
t
h
t
h
a
t
o
f
c
o
m
b
i
n
a
t
i
o
n
t
h
e
r
a
p
y
f
o
r
t
h
e
m
a
n
a
g
e
me
n
t
o
f
s
c
a
b
i
e
s,”
J
o
u
r
n
a
l
o
f
Po
p
u
l
a
t
i
o
n
T
h
e
r
a
p
e
u
t
i
c
s
a
n
d
C
l
i
n
i
c
a
l
Ph
a
rm
a
c
o
l
o
g
y
,
v
o
l
.
2
9
,
n
o
.
1
,
p
p
.
e
8
7
–
e
9
6
,
Ja
n
.
2
0
2
2
,
d
o
i
:
1
0
.
4
7
7
5
0
/
j
p
t
c
p
.
2
0
2
2
.
8
4
5
.
[
1
5
]
W
.
P
r
a
b
o
d
h
,
T
.
S
B
,
D
.
V
i
k
a
s
,
J.
D
e
s
h
mu
k
h
,
P
.
R
a
t
h
o
d
e
,
a
n
d
V
.
D
o
m
p
l
e
,
“
A
c
o
m
p
a
r
a
t
i
v
e
st
u
d
y
o
f
t
o
p
i
c
a
l
p
e
r
m
e
t
h
r
i
n
,
o
r
a
l
i
v
e
r
mec
t
i
n
a
n
d
c
o
m
b
i
n
a
t
i
o
n
o
f
p
e
r
me
t
h
r
i
n
w
i
t
h
i
v
e
r
mec
t
i
n
i
n
p
a
t
i
e
n
t
s
o
f
sc
a
b
i
e
s
,
”
I
O
S
R
J
o
u
rn
a
l
o
f
D
e
n
t
a
l
a
n
d
M
e
d
i
c
a
l
S
c
i
e
n
c
e
s
,
v
o
l
.
1
5
,
n
o
.
5
,
p
p
.
6
7
–
7
2
,
2
0
1
6
.
[
1
6
]
A
.
K
r
e
n
t
e
l
e
t
a
l
.
,
“
A
m
u
l
t
i
c
e
n
t
e
r
,
c
o
mm
u
n
i
t
y
-
b
a
s
e
d
,
m
i
x
e
d
m
e
t
h
o
d
s
a
sse
ssm
e
n
t
o
f
t
h
e
a
c
c
e
p
t
a
b
i
l
i
t
y
o
f
a
t
r
i
p
l
e
d
r
u
g
r
e
g
i
me
n
f
o
r
e
l
i
mi
n
a
t
i
o
n
o
f
l
y
mp
h
a
t
i
c
f
i
l
a
r
i
a
s
i
s,”
P
L
o
S
N
e
g
l
e
c
t
e
d
T
r
o
p
i
c
a
l
D
i
s
e
a
ses
,
v
o
l
.
1
5
,
n
o
.
3
,
2
0
2
1
,
d
o
i
:
1
0
.
1
3
7
1
/
j
o
u
r
n
a
l
.
p
n
t
d
.
0
0
0
9
0
0
2
.
[
1
7
]
J.
A
.
W
a
t
k
i
n
s,
J.
D
.
C
.
R
o
ss,
S
.
Th
a
n
d
i
,
C
.
B
r
i
t
t
a
i
n
,
J
.
K
a
i
,
a
n
d
F
.
G
r
i
f
f
i
t
h
s,
“
A
c
c
e
p
t
a
b
i
l
i
t
y
o
f
a
n
d
t
r
e
a
t
m
e
n
t
p
r
e
f
e
r
e
n
c
e
s
f
o
r
r
e
c
u
r
r
e
n
t
b
a
c
t
e
r
i
a
l
v
a
g
i
n
o
s
i
s
—
To
p
i
c
a
l
l
a
c
t
i
c
a
c
i
d
g
e
l
o
r
o
r
a
l
m
e
t
r
o
n
i
d
a
z
o
l
e
a
n
t
i
b
i
o
t
i
c
:
Q
u
a
l
i
t
a
t
i
v
e
f
i
n
d
i
n
g
s
f
r
o
m
t
h
e
V
I
TA
t
r
i
a
l
,
”
PL
o
S
O
N
E
,
v
o
l
.
1
4
,
n
o
.
1
1
,
p
.
e
0
2
2
4
9
6
4
,
N
o
v
.
2
0
1
9
,
d
o
i
:
1
0
.
1
3
7
1
/
j
o
u
r
n
a
l
.
p
o
n
e
.
0
2
2
4
9
6
4
.
[
1
8
]
M
.
S
e
k
h
o
n
,
M
.
C
a
r
t
w
r
i
g
h
t
,
a
n
d
J.
J.
F
r
a
n
c
i
s,
“
A
c
c
e
p
t
a
b
i
l
i
t
y
o
f
h
e
a
l
t
h
c
a
r
e
i
n
t
e
r
v
e
n
t
i
o
n
s:
A
n
o
v
e
r
v
i
e
w
o
f
r
e
v
i
e
w
s a
n
d
d
e
v
e
l
o
p
m
e
n
t
o
f
a
t
h
e
o
r
e
t
i
c
a
l
f
r
a
mew
o
r
k
,
”
B
MC
H
e
a
l
t
h
S
e
rv
i
c
e
s
R
e
se
a
rc
h
,
v
o
l
.
1
7
,
n
o
.
1
,
p
.
8
8
,
D
e
c
.
2
0
1
7
,
d
o
i
:
1
0
.
1
1
8
6
/
s1
2
9
1
3
-
0
1
7
-
2
0
3
1
-
8.
[
1
9
]
D
.
B
.
E
v
a
n
s,
J.
H
s
u
,
a
n
d
T.
B
o
e
r
ma
,
“
U
n
i
v
e
r
sa
l
h
e
a
l
t
h
c
o
v
e
r
a
g
e
a
n
d
u
n
i
v
e
r
s
a
l
a
c
c
e
ss,
”
B
u
l
l
e
t
i
n
o
f
t
h
e
W
o
rl
d
H
e
a
l
t
h
O
r
g
a
n
i
z
a
t
i
o
n
,
v
o
l
.
9
1
,
n
o
.
8
,
p
p
.
5
4
6
-
5
4
6
A
,
A
u
g
.
2
0
1
3
,
d
o
i
:
1
0
.
2
4
7
1
/
B
LT
.
1
3
.
1
2
5
4
5
0
.
[
2
0
]
J
.
F
.
L
e
v
e
s
q
u
e
,
M
.
F
.
H
a
r
r
i
s
,
a
n
d
G
.
R
u
s
s
e
l
l
,
“
P
a
t
i
e
n
t
-
c
e
n
t
r
e
d
a
c
c
e
s
s
t
o
h
e
a
l
t
h
c
a
r
e
:
C
o
n
c
e
p
t
u
a
l
i
s
i
n
g
a
c
c
e
s
s
a
t
t
h
e
i
n
t
e
r
f
a
c
e
o
f
h
e
a
l
t
h
s
y
s
t
e
m
s
a
n
d
p
o
p
u
l
a
t
i
o
n
s
,
”
I
n
t
e
r
n
a
t
i
o
n
a
l
J
o
u
r
n
a
l
f
o
r
E
q
u
i
t
y
i
n
H
e
a
l
t
h
,
v
o
l
.
1
2
,
n
o
.
1
,
p
.
1
8
,
2
0
1
3
,
d
o
i
:
1
0
.
1
1
8
6
/
1
4
7
5
-
9
2
7
6
-
12
-
1
8
.
[
2
1
]
V
.
B
r
a
u
n
a
n
d
V
.
C
l
a
r
k
e
,
“
T
h
e
m
a
t
i
c
A
n
a
l
y
s
i
s,”
i
n
E
n
c
y
c
l
o
p
e
d
i
a
o
f
Q
u
a
l
i
t
y
o
f
L
i
f
e
a
n
d
W
e
l
l
-
Be
i
n
g
Re
s
e
a
rc
h
,
C
h
a
m:
S
p
r
i
n
g
e
r
I
n
t
e
r
n
a
t
i
o
n
a
l
P
u
b
l
i
s
h
i
n
g
,
2
0
2
2
,
p
p
.
1
–
7
.
d
o
i
:
1
0
.
1
0
0
7
/
9
7
8
-
3
-
3
1
9
-
6
9
9
0
9
-
7
_
3
4
7
0
-
2.
[
2
2
]
S
.
K
.
A
h
m
e
d
,
“
T
h
e
p
i
l
l
a
r
s
o
f
t
r
u
s
t
w
o
r
t
h
i
n
e
ss
i
n
q
u
a
l
i
t
a
t
i
v
e
r
e
s
e
a
r
c
h
,
”
J
o
u
rn
a
l
o
f
M
e
d
i
c
i
n
e
,
S
u
rg
e
ry,
a
n
d
Pu
b
l
i
c
H
e
a
l
t
h
,
v
o
l
.
2
,
p
.
1
0
0
0
5
1
,
A
p
r
.
2
0
2
4
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
g
l
m
e
d
i
.
2
0
2
4
.
1
0
0
0
5
1
.
[
2
3
]
F
.
a
n
d
D
.
A
.
R
e
p
u
b
l
i
c
o
f
t
h
e
P
h
i
l
i
p
p
i
n
e
s,
“
F
D
A
A
d
v
i
so
r
y
N
o
.
2
0
2
1
-
0
5
2
6
|
|
P
u
b
l
i
c
H
e
a
l
t
h
W
a
r
n
i
n
g
o
n
t
h
e
P
u
r
c
h
a
s
e
a
n
d
U
s
e
o
f
I
v
e
r
mec
t
i
n
V
e
t
e
r
i
n
a
r
y
P
r
o
d
u
c
t
s
f
o
r
C
O
V
I
D
-
19
–
F
o
o
d
a
n
d
D
r
u
g
A
d
m
i
n
i
st
r
a
t
i
o
n
,
”
F
o
o
d
a
n
d
D
r
u
g
A
d
m
i
n
i
st
r
a
t
i
o
n
P
h
i
l
i
p
p
i
n
e
s
.
A
c
c
e
ss
e
d
:
D
e
c
.
1
6
,
2
0
2
3
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s:
/
/
w
w
w
.
f
d
a
.
g
o
v
.
p
h
/
f
d
a
-
a
d
v
i
s
o
r
y
-
no
-
2
0
2
1
-
0
5
2
6
-
p
u
b
l
i
c
-
h
e
a
l
t
h
-
w
a
r
n
i
n
g
-
on
-
t
h
e
-
p
u
r
c
h
a
se
-
a
n
d
-
u
s
e
-
of
-
i
v
e
r
me
c
t
i
n
-
v
e
t
e
r
i
n
a
r
y
-
p
r
o
d
u
c
t
s
-
f
o
r
-
c
o
v
i
d
-
19/
.
[
2
4
]
P
h
i
l
i
p
p
i
n
e
D
e
r
ma
t
o
l
o
g
i
c
a
l
S
o
c
i
e
t
y
,
“
P
D
S
a
d
v
i
s
o
r
y
o
n
t
h
e
u
s
e
o
f
I
v
e
r
mec
t
i
n
f
o
r
C
O
V
I
D
-
1
9
.
”
A
c
c
e
ss
e
d
:
Ju
n
.
1
5
,
2
0
2
2
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s:
/
/
w
w
w
.
c
o
v
i
d
1
9
t
r
e
a
t
men
t
g
u
i
d
e
l
i
n
e
s.
n
i
h
.
g
o
v
/
a
n
t
i
v
i
r
a
l
-
.
[
2
5
]
C
.
A
l
v
a
r
e
z
-
M
o
r
e
n
o
e
t
a
l
.
,
“
L
o
n
g
-
t
e
r
m
c
o
n
se
q
u
e
n
c
e
s
o
f
t
h
e
mi
s
u
se
o
f
i
v
e
r
mec
t
i
n
d
a
t
a
,
”
T
h
e
L
a
n
c
e
t
I
n
f
e
c
t
i
o
u
s
D
i
sea
ses
,
v
o
l
.
2
1
,
n
o
.
1
2
,
p
p
.
1
6
2
4
–
1
6
2
6
,
D
e
c
.
2
0
2
1
,
d
o
i
:
1
0
.
1
0
1
6
/
S
1
4
7
3
-
3
0
9
9
(
2
1
)
0
0
6
3
0
-
7.
[
2
6
]
B
.
M
a
g
s
a
m
b
o
l
,
“
F
D
A
O
K
s
r
e
g
i
s
t
r
a
t
i
o
n
o
f
i
v
e
r
m
e
c
t
i
n
f
o
r
h
u
m
a
n
a
n
t
i
-
p
a
r
a
s
i
t
i
c
t
r
e
a
t
m
e
n
t
,
”
R
a
p
p
l
e
r
.
A
c
c
e
s
s
e
d
:
D
e
c
.
1
6
,
2
0
2
3
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
w
w
w
.
r
a
p
p
l
e
r
.
c
o
m
/
p
h
i
l
i
p
p
i
n
e
s
/
f
d
a
-
a
p
p
r
o
v
e
s
-
re
g
i
s
t
r
a
t
i
o
n
-
i
v
e
r
m
e
c
t
i
n
-
h
u
m
a
n
-
a
n
t
i
-
p
a
r
a
s
i
t
i
c
-
n
e
m
a
t
o
d
e
-
t
r
e
a
t
m
e
n
t
/
.
[
2
7
]
E.
S
y
a
n
d
N
.
L.
Es
p
a
l
l
a
r
d
o
,
“
U
s
i
n
g
a
c
l
i
n
i
c
a
l
p
r
a
c
t
i
c
e
g
u
i
d
e
l
i
n
e
f
o
r
m
a
k
i
n
g
c
l
i
n
i
c
a
l
d
e
c
i
s
i
o
n
s
,
”
T
h
e
Fi
l
i
p
i
n
o
Fa
m
i
l
y
Ph
y
si
c
i
a
n
,
v
o
l
.
6
0
,
n
o
.
1
,
p
p
.
3
8
–
4
5
,
2
0
2
2
.
[
2
8
]
N
.
L.
Esp
a
l
l
a
r
d
o
a
n
d
N
.
R
.
G
.
Jr
,
“
E
v
i
d
e
n
c
e
-
b
a
s
e
d
f
a
m
i
l
y
p
r
a
c
t
i
c
e
,
”
T
h
e
Fi
l
i
p
i
n
o
Fa
m
i
l
y
P
h
y
s
i
c
i
a
n
,
v
o
l
.
6
0
,
n
o
.
1
,
p
.
1
,
2
0
2
2
.
[
2
9
]
I
.
A
mg
a
r
t
h
-
D
u
f
f
e
t
a
l
.
,
“
T
a
l
k
i
n
g
s
k
i
n
:
A
t
t
i
t
u
d
e
s
a
n
d
p
r
a
c
t
i
c
e
s
a
r
o
u
n
d
sk
i
n
i
n
f
e
c
t
i
o
n
s,
t
r
e
a
t
me
n
t
o
p
t
i
o
n
s
,
a
n
d
t
h
e
i
r
c
l
i
n
i
c
a
l
man
a
g
e
me
n
t
i
n
a
r
e
m
o
t
e
r
e
g
i
o
n
i
n
W
e
st
e
r
n
A
u
st
r
a
l
i
a
,
”
R
u
r
a
l
a
n
d
Re
m
o
t
e
H
e
a
l
t
h
,
v
o
l
.
1
9
,
n
o
.
3
,
p
p
.
1
–
1
1
,
S
e
p
.
2
0
1
9
,
d
o
i
:
1
0
.
2
2
6
0
5
/
R
R
H
5
2
2
7
.
[
3
0
]
K
.
F
r
a
n
ç
a
a
n
d
S
.
L
i
t
e
w
k
a
,
“
C
o
n
t
r
o
v
e
r
s
i
e
s
i
n
o
f
f
-
l
a
b
e
l
p
r
e
s
c
r
i
p
t
i
o
n
s
i
n
d
e
r
m
a
t
o
l
o
g
y
:
t
h
e
p
e
r
s
p
e
c
t
i
v
e
o
f
t
h
e
p
a
t
i
e
n
t
,
t
h
e
p
h
y
s
i
c
i
a
n
,
a
nd
t
h
e
p
h
a
r
m
a
c
e
u
t
i
c
a
l
c
o
m
p
a
n
i
e
s
,
”
I
n
t
e
r
n
a
t
i
o
n
a
l
J
o
u
r
n
a
l
o
f
D
e
r
m
a
t
o
l
o
g
y
,
v
o
l
.
5
8
,
n
o
.
7
,
p
p
.
7
8
8
–
7
9
4
,
J
u
l
.
2
0
1
9
,
d
o
i
:
1
0
.
1
1
1
1
/
i
j
d
.
1
4
2
2
2
.
[
3
1
]
A
S
EA
N
,
“
A
S
EA
N
v
a
r
i
a
t
i
o
n
g
u
i
d
e
l
i
n
e
f
o
r
P
h
a
r
mac
e
u
t
i
c
a
l
p
r
o
d
u
c
t
s
(
R
1
)
.
”
p
p
.
1
–
4
3
,
2
0
2
1
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
w
w
w
.
f
d
a
.
g
o
v
.
p
h
/
w
p
-
c
o
n
t
e
n
t
/
u
p
l
o
a
d
s/
2
0
2
1
/
0
3
/
A
S
EA
N
-
V
a
r
i
a
t
i
o
n
-
G
u
i
d
e
l
i
n
e
-
f
o
r
-
P
h
a
r
ma
c
e
u
t
i
c
a
l
-
P
r
o
d
u
c
t
s
-
R
1
.
p
d
f
[
3
2
]
Z.
R
e
n
a
n
d
A
.
Za
j
i
c
e
k
,
“
R
e
v
i
e
w
o
f
t
h
e
b
e
s
t
p
h
a
r
mac
e
u
t
i
c
a
l
s
f
o
r
c
h
i
l
d
r
e
n
a
c
t
a
n
d
t
h
e
P
e
d
i
a
t
r
i
c
r
e
s
e
a
r
c
h
e
q
u
i
t
y
a
c
t
:
W
h
a
t
c
a
n
t
h
e
o
b
s
t
e
t
r
i
c
c
o
mm
u
n
i
t
y
l
e
a
r
n
f
r
o
m
t
h
e
P
e
d
i
a
t
r
i
c
e
x
p
e
r
i
e
n
c
e
?
,
”
S
e
m
i
n
a
rs i
n
P
e
ri
n
a
t
o
l
o
g
y
,
v
o
l
.
3
9
,
n
o
.
7
,
p
p
.
5
3
0
–
5
3
1
,
N
o
v
.
2
0
1
5
,
d
o
i
:
1
0
.
1
0
5
3
/
j
.
sem
p
e
r
i
.
2
0
1
5
.
0
8
.
0
0
6
.
[
3
3
]
T.
M
.
v
a
n
d
e
r
Z
a
n
d
e
n
e
t
a
l
.
,
“
O
f
f
-
l
a
b
e
l
,
b
u
t
o
n
-
e
v
i
d
e
n
c
e
?
A
r
e
v
i
e
w
o
f
t
h
e
l
e
v
e
l
o
f
e
v
i
d
e
n
c
e
f
o
r
p
e
d
i
a
t
r
i
c
p
h
a
r
m
a
c
o
t
h
e
r
a
p
y
,
”
C
l
i
n
i
c
a
l
Ph
a
rm
a
c
o
l
o
g
y
a
n
d
T
h
e
r
a
p
e
u
t
i
c
s
,
v
o
l
.
1
1
2
,
n
o
.
6
,
p
p
.
1
2
4
3
–
1
2
5
3
,
D
e
c
.
2
0
2
2
,
d
o
i
:
1
0
.
1
0
0
2
/
c
p
t
.
2
7
3
6
.
[
3
4
]
W
H
O
,
“
Ex
e
c
u
t
i
v
e
s
u
mm
a
r
y
:
t
h
e
se
l
e
c
t
i
o
n
a
n
d
u
se
o
f
e
sse
n
t
i
a
l
me
d
i
c
i
n
e
s
2
0
1
9
:
r
e
p
o
r
t
o
f
t
h
e
2
2
n
d
W
H
O
E
x
p
e
r
t
C
o
mm
i
t
t
e
e
o
n
t
h
e
sel
e
c
t
i
o
n
a
n
d
u
s
e
o
f
e
ss
e
n
t
i
a
l
me
d
i
c
i
n
e
s:
W
H
O
H
e
a
d
q
u
a
r
t
e
r
s,
G
e
n
e
v
a
,
1
-
5
A
p
r
i
l
2
0
1
9
,
”
W
H
O
M
e
d
i
c
i
n
e
s we
b
.
[
3
5
]
R
.
o
f
t
h
e
P
.
S
e
v
e
n
t
e
e
n
t
h
C
o
n
g
r
e
ss
,
“
A
n
a
c
t
i
n
st
i
t
u
t
i
n
g
u
n
i
v
e
r
s
a
l
h
e
a
l
t
h
c
a
r
e
f
o
r
a
l
l
F
i
l
i
p
i
n
o
s,
p
r
e
scri
b
i
n
g
r
e
f
o
r
ms
i
n
t
h
e
h
e
a
l
t
h
c
a
r
e
sy
st
e
m,
a
n
d
a
p
p
r
o
p
r
i
a
t
i
n
g
f
u
n
d
s
t
h
e
r
e
f
o
r
,
”
R
e
p
u
b
l
i
c
A
c
t
N
o
.
1
1
2
2
3
.
A
c
c
e
sse
d
:
S
e
p
.
0
7
,
2
0
2
3
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
w
w
w
.
o
f
f
i
c
i
a
l
g
a
z
e
t
t
e
.
g
o
v
.
p
h
/
d
o
w
n
l
o
a
d
s/
2
0
1
9
/
0
2
f
e
b
/
2
0
1
9
0
2
2
0
-
RA
-
1
1
2
2
3
-
R
R
D
.
p
d
f
.
[
3
6
]
M
.
A
.
S
t
r
o
m
,
G
.
C
.
M
o
h
a
n
,
a
n
d
P
.
A
.
Li
o
,
“
T
h
e
r
a
p
e
u
t
i
c
s
y
n
e
r
g
y
,
n
e
u
t
r
a
l
i
t
y
,
a
n
d
a
n
t
a
g
o
n
i
s
m:
C
o
mb
i
n
a
t
i
o
n
t
r
e
a
t
m
e
n
t
i
n
d
e
r
ma
t
o
l
o
g
y
,
”
J
o
u
r
n
a
l
o
f
D
r
u
g
s
i
n
D
e
rm
a
t
o
l
o
g
y
,
v
o
l
.
1
5
,
n
o
.
1
0
,
p
p
.
1
2
0
3
–
1
2
0
7
,
2
0
1
6
.
[
3
7
]
S
t
a
t
i
st
a
,
“
H
o
u
s
e
h
o
l
d
O
O
P
p
a
y
m
e
n
t
sh
a
r
e
t
o
c
u
r
r
e
n
t
h
e
a
l
t
h
e
x
p
e
n
d
i
t
u
r
e
P
h
i
l
i
p
p
i
n
e
s
2
0
1
4
-
2
0
2
2
,
”
S
t
a
t
i
st
a
.
A
c
c
e
ss
e
d
:
N
o
v
.
2
7
,
2
0
2
3
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
w
w
w
.
s
t
a
t
i
st
a
.
c
o
m
/
st
a
t
i
st
i
c
s
/
1
1
7
3
9
7
0
/
p
h
i
l
i
p
p
i
n
e
s
-
s
h
a
r
e
-
of
-
o
u
t
-
of
-
p
o
c
k
e
t
-
h
e
a
l
t
h
-
e
x
p
e
n
d
i
t
u
r
e
-
on
-
t
h
e
-
c
u
r
r
e
n
t
-
h
e
a
l
t
h
-
e
x
p
e
n
d
i
t
u
r
e
/
.
[
3
8
]
S
.
La
V
i
n
c
e
n
t
e
,
T
.
K
e
a
r
n
s
,
C
.
C
o
n
n
o
r
s,
S
.
C
a
mer
o
n
,
J.
C
a
r
a
p
e
t
i
s
,
a
n
d
R
.
A
n
d
r
e
w
s,
“
C
o
mm
u
n
i
t
y
ma
n
a
g
e
m
e
n
t
o
f
e
n
d
e
mi
c
s
c
a
b
i
e
s
i
n
r
e
mo
t
e
a
b
o
r
i
g
i
n
a
l
c
o
mm
u
n
i
t
i
e
s
o
f
n
o
r
t
h
e
r
n
A
u
s
t
r
a
l
i
a
:
l
o
w
t
r
e
a
t
m
e
n
t
u
p
t
a
k
e
a
n
d
h
i
g
h
o
n
g
o
i
n
g
a
c
q
u
i
s
i
t
i
o
n
.
,
”
PL
o
S
n
e
g
l
e
c
t
e
d
t
ro
p
i
c
a
l
d
i
s
e
a
ses
,
v
o
l
.
3
,
n
o
.
5
,
p
.
e
4
4
4
,
M
a
y
2
0
0
9
,
d
o
i
:
1
0
.
1
3
7
1
/
j
o
u
r
n
a
l
.
p
n
t
d
.
0
0
0
0
4
4
4
.
[
3
9
]
E.
M
i
t
c
h
e
l
l
e
t
a
l
.
,
“
C
o
mm
u
n
i
t
y
p
e
r
s
p
e
c
t
i
v
e
s
o
n
sca
b
i
e
s,
i
mp
e
t
i
g
o
a
n
d
ma
ss
d
r
u
g
a
d
m
i
n
i
st
r
a
t
i
o
n
i
n
F
i
j
i
:
A
q
u
a
l
i
t
a
t
i
v
e
s
t
u
d
y
,
”
PL
o
S
n
e
g
l
e
c
t
e
d
t
r
o
p
i
c
a
l
d
i
s
e
a
s
e
s
,
v
o
l
.
1
4
,
n
o
.
1
2
,
p
.
e
0
0
0
8
8
2
5
,
D
e
c
.
2
0
2
0
,
d
o
i
:
1
0
.
1
3
7
1
/
j
o
u
r
n
a
l
.
p
n
t
d
.
0
0
0
8
8
2
5
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
2
,
J
u
n
e
20
2
5
:
9
9
7
-
1
0
0
7
1006
B
I
O
G
RAP
H
I
E
S O
F
AUTH
O
RS
Ro
we
n
a
F.
G
e
n
u
in
o
is
a
n
a
n
a
t
o
m
ist/
d
e
rm
a
to
lo
g
ist/
c
li
n
ica
l
e
p
i
d
e
m
io
lo
g
ist
w
o
rk
i
n
g
o
n
sc
a
b
ies
a
n
d
o
t
h
e
r
sk
in
-
re
late
d
n
e
g
lec
ted
tro
p
ica
l
d
ise
a
se
s.
S
h
e
is
a
fe
ll
o
w
o
f
th
e
P
h
il
i
p
p
in
e
De
rm
a
to
lo
g
ica
l
S
o
c
iety
wh
e
re
s
h
e
h
e
a
d
e
d
t
h
e
Re
se
a
rc
h
Co
m
m
it
tee
fro
m
2
0
1
1
-
2
0
1
2
.
He
r
re
se
a
rc
h
ra
n
g
e
s
fro
m
p
re
v
a
len
c
e
su
rv
e
y
s,
sy
ste
m
a
ti
c
re
v
iew
s,
v
a
li
d
a
ti
o
n
o
f
t
o
o
ls,
e
c
o
n
o
m
ic
e
v
a
lu
a
ti
o
n
,
c
li
n
ica
l
tri
a
ls,
a
n
d
q
u
a
l
it
a
ti
v
e
stu
d
ies
in
v
a
rio
u
s
to
p
ics
su
c
h
a
s
a
c
n
e
,
a
to
p
ic
d
e
rm
a
ti
ti
s,
c
u
tan
e
o
u
s
in
fe
c
ti
o
n
s,
a
n
d
h
e
rb
a
l
m
e
d
icin
e
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
r
fg
e
n
u
in
o
@u
p
.
e
d
u
.
p
h
.
Ma
r
ia
Christin
a
Fi
lo
m
e
n
a
R.
Ba
ta
c
is
a
d
e
rm
a
to
lo
g
ist
a
n
d
m
y
c
o
lo
g
ist,
in
v
o
l
v
e
d
in
d
e
rm
a
to
lo
g
y
re
si
d
e
n
c
y
train
i
n
g
a
n
d
tea
c
h
in
g
o
f
u
n
d
e
rg
ra
d
u
a
tes
i
n
p
u
b
li
c
h
e
a
lt
h
a
n
d
m
e
d
ica
l
stu
d
e
n
ts.
S
h
e
is
a
fa
c
u
lt
y
a
n
d
h
e
a
d
o
f
t
h
e
C
o
m
m
u
n
it
y
De
rm
a
to
l
o
g
y
se
c
ti
o
n
o
f
t
h
e
Un
i
v
e
rsity
o
f
th
e
P
h
il
i
p
p
i
n
e
s
-
P
h
il
ip
p
in
e
G
e
n
e
ra
l
Ho
sp
i
tal
De
p
a
rtme
n
t
o
f
De
rm
a
to
lo
g
y
.
S
h
e
h
a
s
c
o
n
tri
b
u
ted
to
re
se
a
rc
h
o
n
sk
in
n
e
g
lec
ted
tr
o
p
ic
a
l
d
ise
a
se
s
su
c
h
a
s
sc
a
b
ies
,
y
a
ws
,
a
n
d
d
e
rm
a
to
m
y
c
o
se
s.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
m
rb
a
tac
@u
p
.
e
d
u
.
p
h
.
Ale
n
a
Ma
r
ie
B.
Ma
r
ia
n
o
is
a
r
e
sid
e
n
t
p
h
y
sic
ian
train
e
e
in
Oto
r
h
in
o
lar
y
n
g
o
l
o
g
y
a
t
th
e
Eas
t
Av
e
n
u
e
M
e
d
ica
l
Ce
n
te
r,
Qu
e
z
o
n
Cit
y
,
P
h
il
ip
p
i
n
e
s.
S
h
e
c
o
m
p
lete
d
h
e
r
p
re
m
e
d
ica
l
c
o
u
rse
B.
S
.
P
sy
c
h
o
lo
g
y
a
t
th
e
U
n
iv
e
rsit
y
o
f
th
e
P
h
il
i
p
p
i
n
e
s
-
Dili
m
a
n
a
n
d
g
ra
d
u
a
ted
fr
o
m
th
e
Co
ll
e
g
e
o
f
M
e
d
icin
e
o
f
U
n
iv
e
rsit
y
o
f
th
e
P
h
i
li
p
p
in
e
s
-
M
a
n
il
a
.
He
r
re
se
a
rc
h
in
tere
sts
fo
c
u
s
o
n
p
sy
c
h
o
lo
g
y
s
u
c
h
a
s
fa
m
il
y
re
latio
n
sh
ip
s
a
n
d
e
x
p
e
rien
c
e
s
o
f
e
ld
e
rl
y
g
a
y
m
e
n
a
n
d
ro
le
o
f
o
n
li
n
e
a
n
o
n
y
m
it
y
a
n
d
e
m
o
ti
o
n
o
n
se
lf
-
d
isc
lo
su
re
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
a
b
m
a
rian
o
@u
p
.
e
d
u
.
p
h
.
Be
len
L.
Do
fit
a
s
is
a
d
e
rm
a
to
l
o
g
ist,
wo
u
n
d
sp
e
c
ialist,
c
li
n
ica
l
e
p
id
e
m
io
l
o
g
ist
,
a
n
d
p
u
b
li
c
h
e
a
lt
h
p
h
y
sic
ian
.
S
h
e
is
a
n
As
so
c
iate
P
ro
fe
ss
o
r,
Vic
e
-
Ch
a
i
r
fo
r
Re
se
a
rc
h
,
a
n
d
S
e
c
ti
o
n
Ch
ief
o
f
S
k
in
Ne
g
lec
ted
Tro
p
ic
a
l
Dise
a
se
s
o
f
th
e
De
p
a
rtme
n
t
o
f
De
rm
a
to
lo
g
y
,
C
o
ll
e
g
e
o
f
M
e
d
icin
e
a
n
d
t
h
e
P
h
i
li
p
p
in
e
G
e
n
e
ra
l
Ho
sp
it
a
l,
Un
iv
e
rsity
o
f
th
e
P
h
il
i
p
p
i
n
e
s
M
a
n
il
a
.
S
h
e
h
a
s
se
v
e
ra
l
stu
d
ies
a
n
d
p
u
b
li
c
a
ti
o
n
s
o
n
S
k
i
n
Ne
g
lec
ted
Tr
o
p
ica
l
Dise
a
se
s
su
c
h
a
s
lep
ro
sy
,
y
a
ws
,
e
c
to
p
a
ra
sites
,
ti
n
e
a
im
b
rica
ta,
i
n
se
c
t
b
it
e
s
a
n
d
sti
n
g
s
,
h
e
rb
a
l
a
n
d
n
a
tu
ra
l
p
ro
d
u
c
ts
f
o
r
in
fe
c
ti
o
u
s
d
ise
a
se
s,
COV
ID
-
1
9
,
c
u
rre
n
t
e
v
id
e
n
c
e
o
f
g
l
u
tath
i
o
n
e
-
c
o
n
tain
i
n
g
p
ro
d
u
c
ts,
wo
u
n
d
h
e
a
li
n
g
,
p
so
rias
is,
tele
d
e
rm
a
to
lo
g
y
,
in
f
o
r
m
a
ti
c
s,
v
a
li
d
a
ti
o
n
o
f
q
u
a
li
ty
-
of
-
li
fe
to
o
ls
fo
r
sk
in
d
ise
a
se
s,
a
n
d
p
sy
c
h
o
so
c
ial
a
sp
e
c
ts
o
f
sk
in
d
is
e
a
se
s.
S
h
e
h
a
s
b
e
e
n
p
a
rt
o
f
i
n
ter
n
a
ti
o
n
a
l
a
n
d
l
o
c
a
l
tec
h
n
ica
l
wo
rk
i
n
g
g
r
o
u
p
s
fo
r
S
k
i
n
Ne
g
l
e
c
ted
Tro
p
ica
l
Dise
a
se
s.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
b
ld
o
fit
a
s@
u
p
.
e
d
u
.
p
h
.
Fra
n
c
is
R.
C
a
p
u
le
is
a
m
u
lt
i
-
a
wa
rd
e
d
p
h
a
rm
a
c
ist
-
re
se
a
rc
h
e
r.
He
is
a
d
o
c
to
ra
l
g
ra
d
u
a
te
in
c
li
n
ica
l
p
h
a
rm
a
c
y
fro
m
M
a
h
id
o
l
U
n
iv
e
rsit
y
in
T
h
a
il
a
n
d
(2
0
1
8
)
a
n
d
a
g
ra
d
u
a
te
o
f
M
S
P
h
a
rm
a
c
o
lo
g
y
(2
0
1
3
)
a
n
d
B
S
P
h
a
rm
a
c
y
(2
0
0
4
)
fr
o
m
th
e
U
n
iv
e
rsity
o
f
th
e
P
h
i
li
p
p
in
e
s
(UP)
M
a
n
il
a
.
He
is
c
u
rre
n
t
ly
a
n
As
so
c
iate
P
ro
fe
ss
o
r
a
n
d
th
e
De
a
n
a
t
t
h
e
UP
Co
l
leg
e
o
f
P
h
a
rm
a
c
y
(UPCP
).
He
is
th
e
p
ro
g
ra
m
lea
d
o
f
th
e
UPCP
Cli
n
ica
l
P
h
a
rm
a
c
y
Train
in
g
P
ro
g
ra
m
.
He
is
o
n
e
o
f
th
e
p
ro
p
o
n
e
n
ts
o
f
th
e
UPC
P
Tele
p
h
a
rm
a
c
y
S
e
rv
ice
.
He
a
lso
se
rv
e
s
a
s
a
m
e
m
b
e
r
o
f
th
e
P
h
il
i
p
p
i
n
e
F
o
o
d
a
n
d
Dr
u
g
Ad
m
in
istrati
o
n
(F
DA
)
Dru
g
A
d
v
is
o
ry
P
o
o
l
o
f
Ex
p
e
rts.
His
re
se
a
rc
h
in
tere
sts
a
re
fo
c
u
se
d
o
n
c
li
n
ica
l
p
h
a
rm
a
c
y
,
p
h
a
rm
a
c
o
g
e
n
e
ti
c
s,
p
h
a
rm
a
c
o
g
e
n
o
m
ics
,
a
n
d
p
re
c
isio
n
m
e
d
icin
e
.
H
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
frc
a
p
u
le@
u
p
.
e
d
u
.
p
h
.
Evaluation Warning : The document was created with Spire.PDF for Python.