RP opens first AsPac center on multi-drug resistant TB

MANILA, Philippines – The Philippines opened the first regional model center for the prevention and control of Multi-Drug Resistant Tuberculosis (MDR-TB) in Makati City the other day.

Dr. Pieter van Maaren, World Health Organization’s regional adviser for the Stop TB and leprosy elimination program, said the regional Model Tuberculosis Center is the second of its kind in the world. The other is the MDR-TB Center of Excellence in Riga, Latvia.

The center, funded by the US Agency for International Development’s Regional Development Mission of Asia, is located at the Tropical Disease Foundation (TDF) office in Makati City.

“In the Western Pacific region, the drug-resistant form of tuberculosis is rapidly becoming a major problem for many countries. And management of drug-resistant tuberculosis is not easy,” Maaren said in a press briefing.

“The management of drug-resistant TB also faces many problems such as side effects and long duration of treatment. The cost of the treatment may be 100 or 200 times more than the regular form of TB,” he said.

TB is an infectious disease cause by the Mycobacterium tuberculosis, which primarily affects the lungs. It is the sixth leading cause of illness and sixth leading cause of death in the Philippines.

Dr. Maria Imelda Quelapio, TDF vice president, said the center would provide high-quality technical assistance and training for health experts and national tuberculosis programs throughout the Western Pacific region.

“The model TB center will be providing technical assistance to countries in the Western Pacific region in the area of programmatic management of drug-resistant TB,” Quelapio said.

The TDF is providing training and technical assistance to healthcare workers both in the diagnosis and treatment of MRD-TB.

Maaren said the Philippines became the first project site for MRD-TB management in the world in 2000.

Maaren said the Philippines has the second most number of TB cases in the Western Pacific region, next to China. Other countries with very high cases of tuberculosis are Vietnam, Cambodia, Laos, Mongolia and Papua New Guinea.

Based on a 1997 survey, Quelapio said there are about 16,000 MDR-TB cases in the Philippines, of which 1,534 had put on treatment as of March this year with a cure rate of about 73 percent.

Out of the 1,534 MDR-TB cases under treatment, 15 belong to the pediatric care group, Quelapio said.

She said the mortality rate for untreated MDR-TB is 10 percent.

The cost of treatment amounts to P350,000, including the drugs used to counter the side effects, Quelapio said.

The treatment for ordinary TB lasts for six months, and for MDR-TB, 18 months.

Maaren said not all drug-resistant cases are detected because of the difficulties in diagnosing drug-resistant TB.

“Incomplete treatment leads to drug resistance. Mortality rate of 10 percent may sound not too high to some people but you have to realize that a drug-resistant TB patient, when not diagnosed and treated in time, (can bring) the mortality rate… to 50 percent within a period of two years,” he said.

Dr. Rosalin Vianzon, National TB Control manager of the Department of Health, said there are five specialized MDR-TB centers in Metro Manila and one in Mandaue, Cebu.

Vianzon said 98 percent of the country’s public health centers are DOTS-equipped. DOTS stands for Directly Observed Treatment, Short-course.

Aside from these, the country also has 200 DOTS-equipped centers operated by both the public and private sectors, she said.

“We are also considering going out of Metro Manila,” Vianzon said.

Vianzon said they opened a TB treatment center in Cebu City last year, and would open additional centers in the cities of Davao and Cagayan de Oro this year.

“By the end of this year we would put up core units in the Ilocos, Bicol and Southern Tagalog regions,” Vianzon said. “We aim to have core units or treatment centers in all 17 regions of the country. Hopefully we can achieve that by next year.” – With Pia Lee-Brago