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A Successful Community Based Tuberculosis Control Program in Children in the Philippines

Benjamin P. Sablan Jr., MD, MDM1, Josephine G. Aldaba, MD2, Florianne F. Valdes, MD3, Benjamir M. Cabrera, General, Pediatrician, Amelia Fernandez and Mutya San Agustin
University of the Philippines College of Medicine, Manila, Philippines
Philippine Ambulatory Pediatric Association, Incorporated, Manila, Philippines
Child Health Delivery
 
Background

The Philippines has the ninth highest tuberculosis (TB) burden worldwide, with an estimated prevalence of 280/100000 as of 2009. In 1996, the National Tuberculosis Programme (NTP) of the Department of Health (DOH) adopted the directly observed treatment short-course (DOTS) strategy for tuberculosis control among individuals older than 10 years of age. Recognizing the absence of guidelines for TB control in children <10 years of age, the DOH NTP convened a technical working group and drafted guidelines for the implementation of DOTS in children in 1999 and these were available in 2001. However, at that time, the guidelines were neither field-tested in the community nor adopted in a systematic manner. The Philippine Ambulatory Pediatric Association (PAPA) developed a framework for strengthening of DOTS in children to assist in community preparation, conduct and monitoring in communities. Since 2001, PAPA has been involved in training of local health workers on detection, treatment and monitoring of patients, screening of patients using the DOTS in children guidelines, quality assurance of tuberculin skin test and reading, manner of implementation of directly-observed treatment, and treatment completion and monitoring.
 
Objectives
 
The Philippines has the ninth highest tuberculosis (TB) burden worldwide, with an estimated prevalence of 280/100000 as of 2009. In 1996, the National Tuberculosis Programme (NTP) of the Department of Health (DOH) adopted the directly observed treatment short-course (DOTS) strategy for tuberculosis control among individuals older than 10 years of age. Recognizing the absence of guidelines for TB control in children <10 years of age, the DOH NTP convened a technical working group and drafted guidelines for the implementation of DOTS in children in 1999 and these were available in 2001. However, at that time, the guidelines were neither field-tested in the community nor adopted in a systematic manner. The Philippine Ambulatory Pediatric Association (PAPA) developed a framework for strengthening of DOTS in children to assist in community preparation, conduct and monitoring in communities. Since 2001, PAPA has been involved in training of local health workers on detection, treatment and monitoring of patients, screening of patients using the DOTS in children guidelines, quality assurance of tuberculin skin test and reading, manner of implementation of directly-observed treatment, and treatment completion and monitoring.

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