by ERNESTO T. SOLIDUM
The weekly Kapihan forum held at Carmen Hotel on March 22, 2014 discussed the World TB Day observance with the theme, “Stop TB, Makialam, Tama Na!” The guests are Dr. Cornelio Cuachon, Jr. Prov’l. Health Officer I; Dr. Juliet Macahilas, Pulmonary Specialist, and Dr. Makarius Dela Cruz II, Mun. Health Officer, Kalibo.
Atty. Ronquillo C. Tolentino cited overriding principle that the strength of a nation depends upon the health of the citizens. Observance of World TB day must create awareness since the disease ranks number nine as cause of morbidity in Aklan, said the former Vice Governor.
Human capital index or quality of life manifested in improved health, education, infra, welfare, and housing among others for the Philippines is rated number 153 out of 187 countries by the United Nations. Being among the bottom list makes us less liveable and should alert us to concrete action, according to Atty. Allen S. Quimpo.
Dr. Cuachon Jr. revealed that based on data of National Tuberculosis Program (NTP) there are nine million TB patients in the Philippines, three million of which do not get medical treatment. In 2002 TB ranked number VI in morbidity and mortality cases in Aklan. Today, with 20 DOTS facilities, one public hospital, two private hospitals and one clinic and collaboration of Aklan TB Council, we have succeeded on case detection rate of 90 percent and cure rate of 91 percent. Our program targets to reduce TB prevalence and death rates by 50 percent in 2015 and eliminating it by 2050.
TB DOTS facilities or Tuberculosis Directly Observed Treatment Short Course provides diagnostic services through sputum examination, treatment and counseling. Once a person is found positive of pulmonary TB, he automatically undergoes therapy. Choice center on 5 drugs which are: Isoniazid, Rifampin, Pyrazinamide, Streptomycin and Ethambutol. The first 3 drugs may be given in the same capsule to minimize the number of pills in the dosage. As of 1998, many patients were given Isoniazid and Rifampin together for 6 months with Pyrazinamide added for the first 2 months.
Chances of recovery from TB is good for most patients if the disease is diagnosed early and when treatment is undertaken for the whole 6 months period. Hospitalization is rarely necessary because many patients are no longer infectious after about two weeks of combination treatment. Follow up involves monitoring of side effects and monthly sputum tests. TB patients undergoing medication must faithfully comply with the requirements otherwise cessation or stoppage may cause relapse or development of multi-drug resistance, stressed Dr. Cuachon.
Dr. Macahilas revealed that TB occurrence is as old as mankind itself. From human remains of ancient Egypt, it has afflicted people 5,000 BC. Pulmonary TB is caused by tubercle bacilli and is spread by droplet infection. Bacterium once inhaled reaches the lungs (alveoli) and multiplies rapidly. The usual symptoms are coughing that lasts for 2 weeks, weight loss, shortness of breath and fatigue. Tubercle bacilli may migrate to other parts of the body like bones, kidneys, female reproductive organs, abdominal cavity, joints, meninges, skin, intestines and adrenal glands. A person is advised to immediately consult a doctor if he/she experiences symptoms of TB, said Dr. Macahilas.
While Kalibo is listed in the report as having the third highest case detection rate, it has embarked on a systematic campaign by organizing and training barangay health teams on TB prevention and treatment. High rate of detection can be traced to heightened awareness. The provincial capital is the center of health institutions and had achieved respectable cure rate of 84 percent, stressed Dr. Makarius Dela Cruz.
The NTP data show, there are 9 million Filipinos suffering from TB and only two thirds (2/3) get medical treatment. This is both chilling and disturbing. This means nearly 1 out of 10 pinoys is inutile, reticent to work and potential carriers of the dreaded disease.
In Aklan, the highest TB incidence in 2013 was in Malay with 179 cases, Nabas – 118 and Kalibo – 105. Both Kalibo and Malay are first class municipalities with high immigration rate.
With only 91 percent accomplishment in the cure rate of all cases detected in Aklan, it means it is not gaining enough ground towards complete eradication of the disease. The incidence of TB poverty-related and with 27 percent of Aklan’s population living below the poverty line, the problem may persist for decades unless other sectors of the economy are strengthened.
It is significant to note that the World Health Organization is in the forefront of global initiative to completely eradicate the scourge. One must consider that only the most potent drugs are used and given to patients who may not have the capacity to pay the cost, the cast in itself is the noblest form of humanitarian aid. Dispensing of these drugs must be properly done and closely followed up. However, it appears that target to halve the total incidence by 2015 cannot be reached. The obvious reason is that more cases of TB is detected every year while cure rate appears to level off. The five year trend shows cure rate of 78 percent in 2009, 77 percent in 2010, 90 percent in 2011, 91 percent in 2012 and 91 percent in 2013.
This year’s theme says it all. Optimism runs high. TB could be wiped out at the home front! /MP
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