Dr. Trisha Thadhani, the medical doctor for the Doctors Without Borders Tondo tuberculosis (TB) project, assesses the health condition of a child in the Aroma neighborhood, Barangay 105, Tondo, Manila. The team conducts active case finding (ACF) activities for TB in Tondo districts I and II. 2023 © Ria Cristina Torrente
In districts 1 and 2 of Tondo, Manila, Doctors Without Borders has been running an active case-finding activity for tuberculosis since 2022, in collaboration with MHD. This Doctors Without Borders project makes TB screening accessible and available near the areas where Tondo residents live and work. Doctors Without Borders teams provide free TB screening, trace household contact cases, and refer TB-positive patients to local health centers. They also follow up with patients to ensure they adhere to the treatment regimen and break the chains of transmission.
Proper diagnosis and treatment, especially in line with updated recommendations from the World Health Organization (WHO) are key to eliminating TB, but these cannot be achieved without the sufficient and timely supply of drugs. Doctors Without Borders strongly urges all stakeholders involved in TB care in the Philippines to find durable solutions to tackle the issue of drug shortage in the country.
The shortage is not limited to drugs for the treatment of TB. There is also a delay in the provision of preventive treatment, due to a shortage of the tuberculin skin test (TST), needed to test some children prior to initiating preventative treatment, and to the lack of child-friendly fixed dose dispersible tablets (FDC)--used for preventive treatment for children who are exposed to TB patients—which is currently not available in the country.
Tondo is one of the country’s most densely populated areas, with approximately 76,000 inhabitants per square kilometer. To date, Doctors Without Borders has screened 29,291 people and diagnosed 1,280 patients with TB. These findings translate to an average positivity rate of 4.3%, which is higher than the 3% national TB positivity rate in the Philippines.
Agustina with her grandsons Clark and Ion during a medical evaluation at one of Doctors Without Borders active case finding sites for tuberculosis in Tondo, Manila. Photo credit: Ezra Acayan, 2023.
Through close collaboration with the Manila Health Department and the City of Manila’s TB Prevention and Control Office, the active case-finding project of Doctors Without Borders includes screening through x-ray, computer-aided diagnosis, medical evaluation and sputum collection. Doctors Without Borders also handles disclosure of diagnosis; initiation of treatment to regular follow-ups and home visits to ensure adherence to treatment regimen; identifying close contacts of patients and encouraging them to pursue screening; examination of children in the patient’s household to assess their eligibility for preventive treatment; and provision of drugs for the preventive treatment of children. To date, 340 children have been started on preventive treatment.
TB is one of the world’s deadliest infectious diseases, and the Philippines is one of the top ten countries in the world with the highest TB burden. Governments all over the world—including the Philippines—are strongly urged to commit efforts and resources to eliminate TB.
