Fewer tuberculosis cases seen in Philippines

THE Philippines shows gains in its efforts to combat tuberculosis (TB) as it now ranks ninth among 22 countries still battling the disease, an improvement from its previous ranking of seventh according to anti-TB advocates.

The country’s current ranking translates to some 250,000 Filipinos being infected with TB annually and 75 patients dying everyday from the disease.

Dr. Hesron Morfe, chairman of the 2009 World TB Day Commemoration, said the number, although it has improved compared with the previous years, is still alarming.

“In the past, two out of every three Filipinos would have TB in their lifetime but because of the campaign to fight the disease, we were able to bring it down by 40 percent,” Morfe said during the weekly Kapihan ng Bayan news forum held at Sulo Hotel in Quezon City.

Still, tuberculosis remains the 6th leading cause of mortality in the country and the government, together with the private sector, has been coming up with various programs to stop the spread of the disease in the Philippines.

Morfe urged the Philippine government to step up its information dissemination to reach more people and educate them about the disease.

The Philippines is among the top 10 countries with high TB cases, with India topping the list followed by China, Indonesia, Nigeria, Bangla­desh, Pakistan, South Africa and Ethiopia.

As health authorities observe today the celebration of the World Stop TB Day, the World Health Organization (WHO) on Monday called on member countries to strengthen their own health systems to prevent the further spread of tuberculosis, especially against the multidrug-resistant TB (MDR-TB).

“Our available tools work, but they are not enough,” said Dr Shin Young-soo, WHO regional director for the Western Pacific. “To progress, we must think bigger and look beyond [strategy] to the actual setting in which TB programs operate—national health systems.”

Today’s celebration of the World Stop TB Day is focused on the delivery of TB care through strong health systems.

Shin said that effective TB control has been hampered by weaknesses in health systems, such as chronic staff shortages, inadequate financial resources, poor laboratory capacity, low access to quality care, and flawed links between service providers in the public and private sector.

Morfe, on the other hand, warned that anyone with weak immune system could have TB, but the good news is that the disease is now curable as long as the patient would strictly follow the curing process that will eliminate the bacteria from his system.

He explained a person diagnosed with TB could show improvements within two to three weeks from the time the treatment started. However, some patients tend to stop the treatment earlier than scheduled resulting in the recurrence of the disease.

TB treatment, Morfe said, takes four to six months.

According to WHO reports, some 5,000 new TB infections occur daily in the Western Pacific Region alone, a situation made more troubling by the added threat of MDR-TB.

Dr. Pieter Van Maaren, WHO’s Western Pacific regional adviser for TB, said drug-resistant TB was more difficult to diagnose and that drugs to treat it were limited, costly and had more side-effects.

It was “a man-made problem caused by insufficient or inappropriate treatment, a result of patients stopping treatment before they are cured,” he said.

This can be seen in the Philippines and partly in China, where many TB patients resorted to “self-medication” without getting the proper medical advice, allowing the TB bacilli to survive, he added.

In contrast, the rates of drug-resistant TB in Vietnam and Cambodia were lower partly because of their good control programs and also because powerful anti-TB drugs had only been introduced in those countries in the past decade, “so the TB bacilli did not have time to develop resistance.”

Van Maaren, based at the WHO’s Western Pacific headquarters in Manila, said there were 112,000 new cases of drug-resistant TB in China alone in 2007 and figures for 2008 were likely to be similar.

He said the Philippines is the second hardest-hit country in the region, with up to 6,000 new cases of resistant TB a year.

Estimates for 2008 are not yet out but Van Maaren said the rate of new infections will “likely be in the same range” as in 2007.

Exact figures are not available, he said, saying not all of these cases are diagnosed.

Meanwhile, Shin said, “The risk of an epidemic of TB that does not respond to drugs compels countries to take action.”

WHO said that a competent and motivated workforce is fundamental to the success of TB control program. There needs to be strategies to recruit, train, retain and motivate staff, including better salaries, promotions, and other incentives.

Governments also need to ensure that TB treatment is free of charge. WHO said out-of-pocket expenses deter patients from seeking care.

Morfe said individuals suspected of being infected with TB can go to the designated health centers of the Philippine government to receive free treatment.

Tuberculosis is a contagious lung di­sease that spreads through the air, in­clud­ing through coughing and sneezing.
— Jefferson Antiporda, Reporter with Rommel C. Lontayo and AFP