World TB Day: Eradicating a vicious cycle

For one day in March every year, the whole world brings to mind a serious public concern that has plagued many countries worldwide, rich and poor alike. This is tuberculosis, more popularly known as TB, which is still one of the leading causes of sickness and death worldwide.

World Tuberculosis Day was observed last March 24.

In the Philippines, a TB control program, which had adult patients in long queues, was implemented for decades. Such a program, however, did not solve the festering TB problem because it missed the central point — childhood TB.

Why is this so? Childhood TB was not given proper attention and care because it was not immediately infectious compared to adult TB. What many people, and even doctors at that time, did not know was that untreated childhood TB is carried through adulthood, making these children active TB sufferers as adults and, in a vicious cycle, would also infect other children. Hence, in spite of long-standing adult TB control programs by the government, there is still a high incidence of TB in the country.

Today, child TB is in focus. A group of concerned healthcare providers from the government, private sector, and international support groups has recognized childhood TB as a major problem and is actively involved in eradicating this menace in the country.

A treatment protocol for childhood TB in the Philippines is underway. In fact, it is now on its fourth stage and is moving toward an ever-widening radiation effect.

It is a joint undertaking of the Philippine Ambulatory Pediatric Association (PAPA), Pediatrica Inc., POTTS Foundation, the World Health Organization (WHO), the Department of Health (DOH) and local government units.

The TB diagnosis and treatment program is primarily directed at children, to complement the current government TB program for adults.

The pilot program in Sta. Rosa, Laguna started in 2002, following the treatment guidelines set by the DOH for the Directly Observed Treatment, Short Course in Children or DOTCh. 

After two years of diligently finding and treating positive cases, the project was successfully completed last year with a 98 percent treatment success rate.

Through all the program’s experiences, it was duly noted that success is still reliant on the same five elements that spells the success of adult DOTS – sustained political commitment, access to quality-assured TB detection materials and methods, proper case management conditions, uninterrupted supply of TB drugs, and reporting and recording that will enable future assessment, learning and replication.

With the continuing support of the core group of participating sectors, the program may well be on its way to implementation nationwide. 

From the government’s end, a DOH-issued Administrative Order (No. 178) outlining the implementing guidelines for the TB control program in children has been validated by the successful implementation in Sta. Rosa, Laguna, and with all successful childhood TB programs. More training will be conducted and cascaded to other health workers nationwide.

With this program, it has been proven that treating childhood TB cases is a means to control their progression to adult TB cases.