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National TB Control Program The rising incidence of tuberculosis has economic repercussions not only for the patients

family but also for the country. Eighty percent of people afflicted with tuberculosis are in the most economically productive years of their lives, and the disease sends many self-sustaining families into poverty. The rise in the incidence of tuberculosis has been due to the low priority accorded to anti-tuberculosis activities by many countries. The unavailability of anti-TB drugs, insufficient laboratory networking, poor health infrastructures, including a lack of trained health personnel, have also contributed to the rise in the incidence of the diseases. According to the World Health Organization, the Philippines ranks fourth in the world for the number of cases of tuberculosis and has the highest number of cases per head in Southeast Asia. Almost two thirds of Filipinos have tuberculosis, and up to five million people are infected yearly in our country. In 1996, WHO introduced the Directly Observed Treatment Short Course (DOTS) to ensure completion of treatment. The DOTS strategy depends on five elements for its success: Microscope, Medicines, Monitoring , Directly Observed Treatment, and Political Commitment). If any of these elements are missing, our ability to consistently cure TB patients slips through our fingers. TB Network What is TB Network? 1. It is the official communication handle of the National Tuberculosis Control Program or NTP that will stand for DOHs re-energized fight against TB. 2. It is a product of DOHs collaboration with the LGUs, PhilCAT, and Philhealth. 3. It is a special group dedicated to help/ take care of TB symptomatics and TB patients. a. Initially, it comprises regular health workers in the RHUs, MHOs and PHOs. b. Eventually, it will include everyone in the community who wish to help in the administration and financing of D.O.T.S.; family and relatives of TB symptomatics / patients, church, church organizations, civic organizations, NGOs, schools, companies/corporations. 1. TB Network comes with several information materials, such as print ads, radio and TV commercials. Poster of this TB Network as endorsed by Secretary Dayrit himself and with its battle cry Kakampi Laban sa TB will also be distributed as soon as ready. 2. It is participated in by the different stakeholders like donor agencies, private sector, nongovernment organizations, academe, professional societies, pharmaceutical companies and other TB DOTS partners and individual advocates united as one for a common cause. 3. Members of TB Network have also expanded to a huge number of other government agencies as also members of the Comprehensive & Unified Policy for TB Control in the Philippines or C.U.P.

4. DOH in cooperation with all the involved agencies as members of TB Network continuously works hand-in-hand in increasing case detection and cure rates in accordance with the NTP Targets every year. 5. In the end, it can blossom into a systematic, well-oiled, nationwide movement for the eventual complete eradication and/or control of TB-spearheaded by DOH. Creative Considerations 1. Create a strong branding for NTP 2. Establish a human connection between the NTP and Target Audiences 3. Employ a unique visual device that is attractive, impactful, and memorable Be a TB Networker now ! 10 Roles of a TB-D.O.T.S. Advocate 1. Shares experiences and accomplishments in terms of cure and referral to TB Network. 2. Disseminates right information on TB through available Information, Education, and Communication (IEC) campaign materials. 3. Serves as moral support to TB patients and fellow advocates. 4. Refers individuals with cough for two weeks or more to the nearest D.O.T.S. center for proper management. 5. Conducts health education activities on how TB disease is acquired and developed. 6. Promotes D.O.T.S. services of TB Partners including private sector. 7. Advocates D.O.T.S. as the Strategy for curing TB. 8. Participates during NTP activities including National Health Events, if possible. 9. Encourages other people from different sectors to be a TB D.O.T.S. Advocate. 10. Assists the treatment partner or may serve as the treatment partner, if necessary.

TB vs. NTP-D.O.T.S What is TB? Tuberculosis is an infectious disease caused by TB bacteria (tuberculosis) that primarily affects the lungs. This condition is known as pulmonary tuberculosis (PTB). You may also have tuberculosis in the bones, meninges, joints, genito-urinary tract, liver, kidneys, intestines and heart and this is called extra-pulmonary tuberculosis. What are some of the relevant TB statistics? The Philippines is among the 22 high-burdened countries in the world according to W.H.O. TB is the 6th leading cause of illness and the 6th leading cause of deaths among the Filipinos. Most TB patients belong to the economically productive age- group (15-54 years-old) according to the 2nd National Prevalence Survey in 1997. How does one get TB? One gets infected with TB if he inhales the germs released from air droplets when a pulmonary TB patient coughs, sneezes and spits. A PTB patient whose sputum is positive for the TB germs/bacteria, if left untreated, may infect approximately 10-20 persons in two years. How is TB diagnosed? Pulmonary TB is suspected if a person has symptoms of cough for more than 2 weeks, fever, chest and back pains, poor appetite, loss of weight and hemoptysis. He should seek medical consultation and his sputum should be examined to detect the presence of TB germs/bacteria. How is TB treated? Tuberculosis is a curable disease. Patients are prescribed with appropriate regimen to render them non-infectious and cured, as early as possible. The treatment for TB is a combination of 3-4 anti-TB drugs. NEVER should we prescribe a SINGLE DRUG for TB treatment! This will worsen the patients condition. What is D.O.T.S. ? D.O.T.S. stands for Directly-Observed Treatment Short-course. It is a comprehensive strategy endorsed by the World Health Organization (WHO) and International Union Against Tuberculosis and Lung Diseases (IUATLD) to detect and cure TB patients.There are five elements of DOTS that need to be fulfilled. These are: 1. political commitment 2. quality sputum microscopy for diagnosis 3. regular supply of anti-TB drugs 4. standardized recording and reporting of TB data 5. supervised treatment by a treatment partner According to the WHO Report on the TB Epidemic, 1997: A DOTS cure TB patients and it can produce cure rates as high as 95% even in the poorest countries. >A DOTS prevent new infections among children and adults. >A DOTS can stop resistance to anti-TB drugs. >A DOTS is cost-effective.

DOTS services are available in the rural health units, city health centers and government hospitals around the country. Currently, there are also private facilities that are offering DOTS services to their clients. Is TB curable? YES! TB can be cured through D.O.T.S. What is the National TB Program of the Government? The National TB Program (NTP) is the Governments commitment to address the TB problem in the country. The NTP is being implemented nationwide in all government health centers and government hospitals. Its objectives are to detect active TB cases (at least 70%) and cure them (at least 85%). Achieving and sustaining targets will eventually result to the decline of the TB problem in the Philippines. Source: Department of Health | Republic of the Philippines

National Tuberculosis Control Program How can we avail of D.O.T.S. Services?

Tuberculosis is a disease caused by a bacterium called Mycobeacterium tuberculosis that is mainly acquired by inhalation of infectious droplets containing viable tubercle bacilli. Infectious droplets can be produced by coughing, sneezing, talking and singing. Coughing is generally considered as the most efficient way of producing infectious droplets. In 2007, there are 9.27 million incident cases of TB worldwide and Asia accounts for 55% of the cases. Through the National TB Program (NTP), the Philippines achieved the global targets of 70% case detection for new smear positive TB cases and 89% of these became successfully treated. The various initiatives undertaken by the Program, in partnership with critical stakeholders, enabled the NTP to sustain these targets. Nonetheless, emerging concerns like drug resistance and comorbidities need to be addressed to prevent rapid transmission and future generation of such threats. Coverage should also be broadened to capture the marginalized populations and the vulnerable groups namely, urban and rural poor, captive populations groups. Last 2009, the National Center for Disease Prevention and Control of the Department of Health led the process of formulating the 2010-2016 Philippine Plan of Action to Control TB (PhilPACT) that serves as the guiding direction for the attainment of the Millenium Development Goals (MDGs). Learning from the Directly-Observed Treatment Shortcourse (DOTS) strategy, the eight (8) strategies of PhilPACT are anchored on this TB control framework. Moreover, these strategies are also attuned with the Governments health reform agenda known as Kalusugang Pangkalahatan (KP) to ensure sustainability and risk protection. (inmates/prisoners), elderly and indigenous

MIND YOUR BODY By Willie T. Ong, MD (The Philippine Star) Updated April 24, 2012

Dont infect your family and friends. Follow your doctors advice and take the necessary medicines. After three weeks of taking the drugs, you are not contagious anymore to the people around you. Protect your family. Stay home during the first three weeks of treatment. Dont go to school, work or come in close contact with other people. Your saliva and phlegm can infect others. Keep your windows open. TB bacteria can spread via airconditioning in a closed room. If its not too hot, use a fan to blow the air outside. Cover your mouth with a tissue when you cough, sneeze or laugh too hard. Then throw the tissue away in a sealed container. Consider wearing a face mask during the first three weeks of treatment. This is important: Complete the six- or nine-month course of your medicines. Do not stop your medicines without your doctors permission. Doing so will cause the TB bacteria to mutate and come back in a stronger and more virulent form. Stay positive. Continue with your normal activities and hobbies and seek your familys support. The good news is that after you finish your treatment course, you will most likely be completely healed. Observe a healthy lifestyle to stay well.

Vision: TB-free Philippines Goal: To reduce by half TB prevalence and mortality compared to 1990 figures by 2015 Objectives: The NTP aims to: 1. Reduce local variations in TB control program performance 2. Scale-up and sustain coverage of DOTS implementation 3. Ensure provision of quality TB services 4. Reduce out-of-pocket expenses related to TB care

Tips for active TB patients