The Philippine Online Chronicles

Tuberculosis (TB) is a contagious infectious disease that mainly affects the lungs, but can also spread to other parts of the body such as the brain, kidneys, liver and heart. The bacteria that causes tuberculosis is commonly transmitted through the air. When one with active TB sneezes or coughs, the bacteria spreads via droplets released in the air. This is one explanation why tuberculosis is common in places that are poorly ventilated, unsanitary and overcrowded.

The World Health Organization (WHO) states that more than two billion people are infected with the TB bacilli. The number of new cases has decreased on a global scale, but incidence in Southeast Asia remains stable. Of the 22 high burden countries for tuberculosis, the Philippines ranks 9^th according to the WHO’s Global TB Report in 2009. This list is topped by India, followed by China, Indonesia, Nigeria, South Africa. Also included in the list are Bangladesh, Ethiopia, Pakistan and the Democratic Republic of Congo.

In the Philippines, tuberculosis is the 6^th greatest cause of illness and death. The National TB Program (NTP) is the Philippine government’s commitment to deal with tuberculosis problems. This nationwide activity is implemented in government health centers and government hospitals. The program’s goal is to spot at least 70% of active TB cases and cure at least 85% of these cases.  Accomplishing these could result in the decline of tuberculosis cases in the country.

To further reinforce the urgency and amplify the need to reduce the incidence of tuberculosis, the Philippines observes National Tuberculosis Awareness Month. This is celebrated every August of each year.

Building awareness, pushing for detection nationwide

One of the thrusts of National TB Awareness Month is strictly implementing the DOTS program, or Directly Observed Therapy-Short Course. This program, recommended by WHO in the mid ‘90s, has progressively helped strengthen the fight against tuberculosis. Its components include:

• (a) Political commitment with increased and sustained financing,
• (b) Case detection through quality-assured bacteriology,
• (c) Standardized treatment with supervision and patient support,
• (d) Effective drug supply and management system, and
• (e) Monitoring and evaluation system and impact measurement. DOTS requires patients to take their tuberculosis medicine in the presence of a health care worker to make sure there is proper compliance with the treatment program.

This helps control the problem of patients selling their free medication to others once they began feeling better. DOTS services are free, and are available in selected government hospitals, rural and urban health units and health centers nationwide.

Regions across the country prepare their own set of activities to campaign against tuberculosis and adopt the DOTS program. The common goal is to emphasize among citizens the importance of understanding TB and getting immediate treatment once diagnosed. Massive information campaigns at the barangay level is one of the hardworking ways to get the message across to the masses. Free medical consultations, free treatments for patients diagnosed with tuberculosis, and vast information drives strengthen the program against the disease. Some city health units also bolster the program by asking for support from families who may have a tuberculosis patient at home. The patient can then avail of free treatment at the health center.

Gawad Kalinga has also participated in the fight against tuberculosis via their Gawad Kalusugan Program. Its purpose was to spread the knowledge on tuberculosis among Gawad Kalinga residents. This activity complements the National TB Program as it offers Gawad Kalinga sites as settings for information dissemination via seminars. Health volunteers in Gawad Kalinga sites have been trained to become treatment partners to ensure the proper implementation of DOH’s DOTS procedure.

When individuals incorrectly take tuberculosis medication, such as stopping medication prematurely, this can cause them to develop drug-resistant tuberculosis. In recent news, a Baguio-based pulmonologist stresses that a multi-drug-resistant tuberculosis can evolve from pulmonary tuberculosis. This MDR-TB is said to be resistant to at least two of the most powerful anti-tuberculosis medications – isoniazid (INH) and rifampicin (RMP). Treatment of MDR-TB can take approximately three times longer than ordinary TB. While curable, side effects of drugs intented to cure MDR-TB could be uncertain. The DOH and the Global Fund have funded a center for MDR-TB treatment at the Baguio General Hospital and Medical Center.

Responsibility: The patient and his support system

While many programs and activities have been established to help control and eliminate the disease, the onus of ensuring these efforts are successful lies in the hands of those who are aware of their infection. As tuberculosis is highly contagious, it is best to have a sense of urgency about it and manage the disease right away. The quicker it is controlled, the less people will be harmed by the ill effects of tuberculosis. With National Tuberculosis Awareness Month celebrated every August of each year, the fight against tuberculosis in the Philippines could slowly but surely be key to pushing for proper action among the affected.

Photos: from World Health Organization website. Some Rights Reserved