- Christine Jane M. Gonzalez
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National Lung Month: Tuberculosis as a persistent health concern in the Philippines
Despite being a preventable and curable disease, tuberculosis or TB kills an average of 70 Filipinos daily according to the Department of Health. It is considered as one of the most pressing health concerns not only in the country but globally as well.
Tuberculosis is caused by the bacterium called Mycobacterium tuberculosis and is spread when a person with active TB expels microscopic, bacteria-carrying droplets when they cough or sneeze. A person can contract the bacteria by inhaling these droplets in extended periods of time. Symptoms of the disease include: severe coughs that lasts 3 weeks or longer, chest pains, coughing up blood, unintended weight loss, fever, night sweats, loss of appetite, and fatigue.
One of the major challenges in decreasing TB burden in the country is that the disease is highly prevalent in urban poor communities with little access to health care, according to an article on TB detection and patient care in Payatas and Tondo published in the journal Public Health Action in 2017. Although local government units (LGUs) implement programs to bring TB-patient care services to those who need them, there are several factors that hinder TB presumptive patients to undergo diagnosis and seek appropriate treatment. In Payatas and Tondo, poor communication by healthcare workers as well as inconsistent follow ups contribute to late diagnosis and delayed treatment of the disease.
Moreover, there is a tendency of inaccurate diagnosis due to the symptoms being similar to those of other diseases. To address this problem, the Philippine Council for Health Research and Development under the Department of Science and Technology supports projects that provide more accurate diagnosis of the disease. One such PCHRD-funded project is the Newton Agham Tuberculosis Filipino Impact Testing (TB FIT) by the Liverpool School of Tropical Medicine (LSTM) and De La Salle Medical and Health Sciences Institute (DLSMHSI) which developed a local mathematical model to determine the cost-effectiveness of new TB diagnostics and predicted a new point-of-care. Another project is the Low-cost Point-of-care Diagnostics for Simultaneous Detection of Paragonimus westermani and Mycobacterium tuberculosis using RPA technology being developed by the University of the Philippines Manila- Institute of Molecular Biology and Biotechnology.
However, the challenges on TB management do not end with early detection. It is followed by the need to undergo consistent medication for a minimum of six months according to the Department of Health. If treatment is interrupted, there is a risk of developing drug-resistant tuberculosis which progresses faster and is harder to cure. In this regard, training healthcare workers and educating patients are key to increasing TB detection among presumptive patients, allowing them to receive appropriate treatment as early as possible.
As the National Unified Health Research Agenda (NUHRA) 2017-2022 identifies communicable diseases such as tuberculosis as one of its research priorities, the DOST-PCHRD is also funding projects that aim to strengthen TB-control efforts in communities by initiating systemic improvements. One of these is the project “Cavite for a community approach study to control and halt Drug Resistant TB (COACH-DRTC)” of the De La Salle Health Science Institute. This promotes a multi-sectoral involvement in reinforcing the TB-control programs in the province by fostering collaborations between its LGUs and health offices.
Through DOST-PCHRD, the Philippines is also involved in international initiatives on TB control and mitigation through research. The Philippines established a consortium under the Regional Prospective Observational Research for Tuberculosis (RePORT) which is a network of international consortia comprising of high TB burden areas around the world. This promotes collaboration among its members to advance tuberculosis research in their respective countries.
For more information on projects and programs for tuberculosis diagnosis and treatments supported by the DOST-PCHRD, you may browse through the PCHRD website at www.pchrd.dost.gov.ph
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753779/
https://www.who.int/philippines/news/detail/23-04-2019-doh-who-call-for-all-out-war-against-tb
https://www.rappler.com/newsbreak/iq/228777-things-to-know-tuberculosis-philippines
http://www.wpro.who.int/philippines/areas/communicable_diseases/tb/story_continuation_tb_area_page/en/
Written by Alyana Kaye Bacarra