TB or not TB? TB of course!

As per the community preceptors’ advice, the team had to create an additional Community Health Plan, and thus, chose to tackle Barangay Sinai’s Tuberculosis problem. The disease entity has been an ongoing problem in the Philippines, and it continues to be a burden due to its high communicability, the lack of awareness in people especially those living in urban areas. Tuberculosis is very curable and preventable, however, if the treatment being given is incomplete or is not regularly taken, it may lead to drug resistance or even death.

For this community exposure, the team visited the Regional Health Unit to gather secondary data from the Dug Susceptible TB Register from 2015 through 2017, and from the NTP Laboratory Register. The team discovered that Barangay Sinai has had eight patients diagnosed with Tuberculosis within the span of 2015-2017, all of which were pulmonary in anatomical site. As of January 2018, only one is still undergoing treatment and out of the seven other patients who had completed their treatment, only three were declared as cured (smear- or culture-negative in the last month of treatment and on at least one previous occasion in the continuation phase). Out of thae eight patients, three were retreated due to relapse, which means that they still got clinically diagnosed or bacteriologically confirmed to have TB even after being declared as cured. Two out of the eight patients also were retreated because of treatment failure. The team also probed the RHU’s access to medical resources and facilities, and it was discovered that they have no real access to the determination of drug resistance, i.e. they have not utilized access to GenXpert in Dapitan and they no access to culture centers with drug susceptibility testing and PMDT centers. With the said problems, it was determined that the issues can be attributed to poor compliance to TB management protocols (as per NTP); which might include poor compliance to medication, poor monitoring, poor follow-up after treatment, lack of knowledge and information dissemination, lack of access to TB treatment resources and facilities, and so on.  The team also conducted a survey so as to find new presumptive TB cases and referred such cases to the RHU.

For the coming ten-month exposure, Team Sinai plans (1) to increase the knowledge of the TB patients and the TB concerned health workers by conducting health teachings (house-to-house and at the RHU, respectively); (2) to strengthen the barangay’s monitoring system by appointing a new health worker to specifically monitor and educate the TB patients, (3) to improve case detection in barangay Sinai by conducting quarterly case findings in all of the puroks in barangay Sinai; and (4), to improve treatment outcomes by collaborating and improving the barangay’s access to drug susceptibility testing through GenXpert, Culture centers, and/or PMDT centers.

As community devoted medical doctors, Team Sinai aims to make the people of our barangay fully equipped and self-sufficient in combating tuberculosis as one of their most serious problems. And as Joan Halifax, compellingly once said:

“If compassion is so good for us, why don’t we train our health care providers in compassion so that they can do what they’re supposed to do, which is to transform suffering?”

– Revantad

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