DTBE in Philippines
Capital City: Manila
Area*:300,000 sq. km. (117,187 sq. mi.)
Population (est.), 2010*: 94.01 million
Estimated TB Incidence, 2010**: 275/100,000
Estimated TB Prevalence, 2010**: 502/100,000
Adult HIV Prevalence Rate, 2009***: <0.2%
Number of people living with HIV (PLHIV), 2009***:8,700
Percent of tested TB patients who were HIV+, 2010**: 0%
**Source: WHO Global TB Control Report 2011
***Source: UNAIDS, Report on the Global AIDS Epidemic, 2010
While the Philippines has low rates of TB and HIV coinfection, it is one of the world’s 22 high-burden TB countries and the second largest contributor to non-US born TB cases in the United States. Since 1998, the Centers for Disease Control and Prevention’s Division of Tuberculosis Elimination (CDC/DTBE) has worked with U.S. Agency for International Development (USAID), World Health Organization (WHO), Tropical Disease Foundation of the Philippines, Philippine Coalition Against Tuberculosis, and National TB Program to enhance case detection and management of TB and multidrug-resistant TB (MDR TB).CDC/DTBE also provides assistance in the identification of and response to outbreaks of TB disease.
Recent Accomplishments & Ongoing Collaborations
Program Strengthening and Epidemiology
Operational Research Training: CDC/DTBE conducted a series of four operational research courses from August 2008 to August 2009. The objective of the operations research course was to build the research capacity of the TB, HIV, and malaria program managers and staff. Participants developed program focused research protocols. Nine research protocols with direct application to national public health programs in TB, HIV, and Malaria were implemented between 2009 and 2011. Completion of the analyses, integration and application of the findings into the respective programs, and dissemination of findings is ongoing.
TB Laboratory Assessment: Since 2007, CDC/DTBE has worked closely with the National Tuberculosis Research Laboratory (NTRL) and the National TB Program (NTP) to conduct TB laboratory assessments of laboratory practices, procedures and capacity.
Implementation and Impact Assessment of MGIT Liquid Culture and DST: Tropical Disease Foundation (TDF), Foundation for Innovative New Diagnostics (FIND) and CDC collaborated on a study to demonstrate the feasibility and impact of Mycobacteria Growth Indicator Tube (MGIT) liquid culture and DST in the Philippines. The project provided evidence for WHO policy change and analysis of the impact of more rapid diagnosis of MDR TB on patient-important outcomes is currently underway.
Multidrug-Resistant TB (MDR TB), TB/HIV, and Other At-Risk Populations
Preserving Effective TB Treatment Study (PETTS): In collaboration with the Ministry of Health and local partners in nine countries (including the Philippines), DTBE spearheaded the Preserving Effective TB Treatment Study (PETTS). PETTS, a large multi-year, multi-country study compared programs approved by the Green Light Committee (GLC) to programs that were not GLC approved; this was done to determine the incidence and consequences of acquired resistance to second-line drugs (SLD) among MDR TB patients. Preliminary results suggest that acquired resistance to these drugs was lower in GLC approved programs. GLC approved projects also demonstrated higher cure rates, lower mortality, and lower treatment failure rates when compared with non-GLC approved projects. PETTS has informed the new framework for WHO and international partners that support countries in achieving universal access to the diagnosis, treatment, and care of MDR TB.