National Tuberculosis Control Program Department of Health Philippines Dr. Vivian S. Lofranco Medical Specialist IV

TB Indicators* Philippines, 2003 No. of new cases 119,841 (149.1/100,000) No. of new smear positive 68,562 (85.3/100,000 % smear positive out of total new cases 57.21% % retreatment cases out of total new cases 2.97% % population with access to DOTS 100% DOTS cure rate 77.1%** DOTS success rate 88.1%** DOTS case detection rate 58.83% Partial data **Partial data 2002

Notification Rate ( per 100, 000) Philippines, 1992-2002 Year

Notification Rate by Region, 2003 REGION POPULATION NEW TB CASES RATE PER 100,000 CAR 1403570 1766 125.82 I 4402637 6907 156.88 II 2908032 4138 142.29 III 7996679 11391 142.44 IV 13116156 11206 85.43 V 4925342 9132 185.40 VI 6553250 11081 169.09 VII 5757032 6924 120.27 VIII 3823255 4720 123.45 IX 3020496 6304 208.70 X 2894006 5752 198.75 XI 3951438 5233 132.43 XII 3557198 5486 154.22 NCR 10744386 21281 197.13 CARAGA 2271411 5818 239.71 ARMM 3048499 3075 100.86 NATIONAL 80373387 119841 149.10

Treatment Outcomes Philippines 1998 1999 2000 2001 2002 (partial) Cured 75.9% 70.0% 73.0% 74.5% 77.4% Completed 7.3% 17.3% 15.2% 13.1% 10.7% Defaulted 7.4% 5.7% 5.9% 6.0% 5.2% Failed 2.9% 1.6% 1.2 1.3% 1.0% Died 2.6% 2.3% Trans-out 3.5% 3.0% 2.7% Non evaluated ND 25.1% 6.64% 16.8%

Mortality Data Philippines Information system: -Civil Registrar Information System* Death Certificate -Mortality Rate on TB** 38.3/100,000 (1998) 28,041 8% of the total deaths *National Statistics Office ** Philippine Health Statistics

Overall Assessment of National Information System TB is one of the notifiable diseases Existing FHSIS(Field Health Surveillance Information System) of the DOH. - consolidates, analyzes, disseminates reports nationwide TB unit, has its own recording/reporting system following the WHO/IUATLD guidelines - gather reports from the designated Regional coordinators during Biannual National Consultative Meetings, monitoring visits.

Overall Assessment of National Information System Problems identified - Limited program indicators on NTP, cure rate not included in the existing system - Delayed reporting of data( 2001 Morbidity; 1998 Mortality)* * available data

Prevalence Survey Philippines, 1981 and 1997 1981-83 1997 Sample size 23,254 ( 38 clusters) 21,960 (36 clusters) Screening procedures Chest x-ray examn Sputum microscopy, culture , tuberculin testing % of population with TB infection 54.5% 63.4% Annual risk of infection 2.5% 2.3% Prevalence of smear(+) Cases 6.6/1000 326,941 3.1/1000 221,804 Radiographic findings suggestive of TB 4.2%

Prevalence Surveys Difficulties encountered 1. Inaccessible areas, terrain, mountains 2. Threat of security, no assurance of safe accomodation Lessons learned 1. More attention need be focused not only on case finding but also on ensuring adequate treatment. 2. Enablers are given to increase coverage(e.g food 3. Regular meetings and documentation allowed timely review of data from fields.

Tuberculin Survey Indicator 1981-83 1997 Prevalence of infection in the unvaccinated pop. 54% 63.4% Annual risk of infection 2.5% 2.3% Estimated rate of smear (+) new cases from ARI 123 per 100,000 164 per 100,000 Estimated Case Detection Rate NA 65%

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