CHN – M2 – DOH

DOH □ STRATEGIES, ACTIONS POINTS & TIMELINE

🍏National TB Control Program 2017-2022 PH Strategic TB Elimination Plan
○ Activate communities & Pt grps to promptly access quality TB services
□VISION 🖸 A Tuberculosis-free PHs ○Collaborate w/ other gov’t agencies to ↓reduce out-of-pocket expenses &
0 deaths, disease & suffering due to TB expand social protection programs
□MISSION ○Harmonize local & national efforts mobilize adequate &
○To ↓reduce TB burden (TB incidence & TB mortality) competent human resources
○To achieve catastrophic cost of TB-affected households ○Innovate TB information generation & utilization for decision making
○To responsively deliver TB service ○ Enforce standards on TB care and prevention and use of quality products
○Value Clients & Pts thru integrated Pt-centered TB services
□ GOALS ○Engage national, regional & local gov’t units/
Long Term Goal (2035): agencies on multi-sectoral implementation of TB elimination plan
↓Reduce TB burden by ↓d.ing TB mortality by 95% & TB incidence by 90%.
Medium Term Goals (2022):
● ↓Reduce TB burden by: STIDER = tricycle collecting the sputum specimen from the community to be
○ ↓Decreasing the # of TB deaths by 50% from 22,000 to 11,000 given to rural health medtech for geneexpert.
○ ↓D.ing TB incidence rate by 15% from 554/100,000 to 470/100,000
● Reduce catastrophic costs incurred by TB-affected households SPUTUM & GENE EXPERT = free of charge
from 35% to 0%. ATM to be given to MDR every month 500-1000 PHP for bloodchem
● At least 90% of patients are satisfied
w/ the services of the DOTS facilities. DOTS: medicine TB drug can be obtained in the health center every 2 week;
Multi-Drug Resistant “MDR” - require to get their TB drug every day.
□ OBJECTIVES
Specific objectives by 2022
1. Improve the utilization of TB care & prevention services
by Pts & communities.
2. ↓Reduce catastrophic cost of TB-affected households
accessing DOTS facilities to 0%.
3. Ensure adequate & competent human resources □GENEXPERT
for TB elimination efforts. (GENEXPERT MYCOBACTERIUM TB/ RIFAMPICIN ASSAY)
4. Improve the use of TB data for effective TB elimination efforts.
5. Enhance quality of all TB care & prevention services. GOLD standard in diagnosing TB

6. ↑ncrease to at least 90% of DOTS facilities that are providing SIMULTANEOUSLY DETECTS MYCOBACTERIUM TUBERCULOSIS &
expanded integrated Pt-centered TB care & prevention services.
RESISTANCE to RIFAMPICIN IN (≤) 2hrs.
7. Enhance the political stewardship thru HIGH-lvl political commitment
of national gov’t agencies & LGUs to implement localized TB RESULTS - AVAILABLE QUICKLY; CAN QUICKLY IDENTIFY MDR TB.
elimination plan in coordination w/ diff sectors.

□ About NTP
The National TB Control Program □ New TB Testing
- Organized in [1978] - new!test can reveal in (≤) 2hrs, w/ very H↑GH accuracy, whether some1
- Operating w/in a devolved H. C. delivery system has TB & if it’s resistant to the main drug for treating it
- 1 of the public health programs being managed & coordinated by the
Infectious Diseases for Prevention & Control Division (IDPCD) of the
Disease Prevention & Control Bureau (DPCB) of the Dept of Health (DOH).

□ NTP Mandate
1. Dvlop policies, standards & national strategic plan,
2. Manage program logistics,
3. Provide leadership &technical assistance to the ↓ower health offices/units,
4. Manage data, &
5. Conduct monitoring & evaluation.
!! Advantages:
The program's TB diagnostic &Tx protocols & strategies, • GOLD standard in diagnosisng TB
issued thru the Manual of Procedures, are in accordance w/ the policies of • can detect rifampicin resistant
(WHO) & the International Standards for TB Care (ISTC). •sputum collection- geneexpert 1 time sputum collection
•2x sputum collectin 1 hour in b/w collect (medtech) - viability / back up
 P = arthralgia d/t hyper-uricemia
Category I (aspirin or nsaid; sx persist, consider gout and request for BROADBAND
Type of Pt.→ New Pulmonary TB ULTRASOUND ATTENUATION (BUA)
Intensive Phase: 2RIPE
Maintenance Phase: 4RI
E = impairment of visual acuity & color vision d/t optic neuritis
(D/C drug)

Type of Pt.→ New Extra-Pulmonary, CNS/ Bones or Joints S = PAIN @ injection site (warm compress; rotate injection sites)
Intensive Phase: 2RIPE --- same = severe skin rash (D/C drug)
Maintenance Phase: 4RI --- same = hearing impairment, ringing of the ear & dizziness
due to 8th cranial nerve damage (D/C drug)

Category II □SINGLE DRUG FORMULATION

Type of Pt.→Pulmonary or Extra-Pulmonary; - Each drug prepared individually.
previously treated drug susceptible TB Ex. Rifampicin 450mg
→Relapse Treatment after Failure Isoniazid (INH) 100mg
→Tx After Lost to Follow-up (TALF) Pyrazinamide 500mg
→Previous Tx Outcome Unknown (PTOU) Ethambutol 400mg
→Others Streptopmycin 1gm
I. Phase: 2RIPES/ 1RIPE
M. Phase: 5RIE

□FIXED DOSE COMBINATION

- 2/ more 1ST line ANTI-TB drugs COMBINED in 1 tablet
Type of Pt.→ Extra-Pulmonary;
previously treated drug-susceptible TB – CNS/Bones or Joints Ex. MYRIN P-FORTE; QUADMAX (RIPE)
I. Phase: 2RIPES/ 1RIPE MYRIN P (RIE)
M. Phase: 9RIE
DUOMAX (RI)
ECONOKIT (RIPE)

OTHER Category
1◎Standard Regimen Drug-resistant (SRDR) □FDC: Fixed Dose Combination Tabs (2)
- FDC pills include → 2, 3 or even 4 drugs in 1 pill
Type of Pt.→ Rifampicin-resistant TB - ADVANTAGES of FDC
→ Multidrug-resistant TB ○↓Reduces the # of pills Pts. must take
M. Phase: 4RI ○↓Minimizes errors in dosing
○Simplifies distribution of pills to Pts
2◎XDR-TB Regimen ○Simplifies monitoring adherence
Type of Pt.→ Extensively drug-resistant TB
I. Phase: Individualized based on Drug Susceptibility Testing 🍏STI-HIV/ AIDS
M. Phase: result & Hx of previous Tx HIV “Human Immunodeficiency Virus”
- Virus causes Acquired Immunodeficiency Syndrome/ AIDS.
- Harms ur immune system by destroying the WBCs that fight inxn
□TB Drug side effects & management - Puts u @ risk for serious infxns & certain cancers.
R = Orange/Red colored urine (Reassure the Pt)
= Flu-like symptoms (fever, muscle pains) → anti-pyretics AIDS “Acquired Immunodeficiency Syndrome”
= thrombocytopenia, anemia, shock → discontinue drugs - the FINAL stage of infxn w/ HIV
- ✗t every1 w/ HIV develops AIDS.

RIP = gastro-intestinal intolerance
[give drugs @ bedtime; or w/ small meals]
I = burning sensation in the feet d/t peripheral neuropathy
(B6 50-100mg daily for treatment; 10 mg daily for prevention
= psychosis & convulsion (discontinue drug)
HIV most often spreads thru unprotected sex w/ an infected person.
May also spread by sharing drug needles/
Thru contact w/ the Blood of an infected person
Women can give it to their babies during pregnancy/ childbirth
1st signs of HIV infxn may be swollen glands & flu-like Sxs.
These may come & go w/in 2-4wks.
SEVERE Sxs may ✗t appear until months/ yrs later.
Blood test can tell if u have HIV infxn. gender-responsiveness, and age appropriateness, including meaningful
H. C. provider can do the test,/ u can use a home testing kit. participation of communities affected by HIV & AIDS situation;
Or to find free testing sites.
2. Ensure access to HIV & AIDS-related services by eliminating the climate
Make sure to do counseling b4 & after testing as of stigma & discrimination that surrounds the country’s HIV & AIDS situation
(+) result may result to anxiety. and the people directly & indirectly affected by it; and

✗cure, but there are many medicines that fight HIV infxn & 3. (+)ly address & seek to eradicate conditions that aggravate the spread of
lower the risk of infecting others. HIV infxn, w/c include
Ppl who get early Tx can live w/ the disease for a long time. poverty, gender inequality, marginalization & ignorance

Philippine National AIDS Council (PNAC) shall ensure the implementation of

the country’s response to the HIV and AIDS situation

□STRATEGIES, ACTION POINTS, & TIMELINE

○ Scale up Tx, care & support. for infants, children or adults living w/ HIV
A comprehensive package of prevention, Tx & care intervention should be
made available.

○Invest strategic info.

Includes: surveillance of HIV & Sexually Transmitted Infxn,
monitoring and evaluation & continuing research for vulnerabilities &
operation researches to strengthen health system.

□ ABCDE ng STI at HIV Prevention

A - AYOKO (abstinence)
B- Basta ikaw at ako lamang (be mutually faithful w/ ur partner)
C - Condoms gamitin ng tama at palagian
(consistent & correct use of condoms)
D - Dapat pang-ineksyon laging bago (dont use drugs)
E- Edukasyon at tamang kaalaman (early detection & education)

🍏COVID-19

STI-HIV/AIDS PREVENTION PROGRAM BIDA SOLUSYON

□ OBJECTIVES B- awal walang mask
↓Reduce the transmission of HIV & STI among the Most @ Risk Population I –- sanitize ang mga kamay. / Iwas hawak sa mga bagay
& General Population & mitigate its impact @ the Indiv, fam, & community lvl D – umistansya ng 1 metro
A- lamin and totoong impormasyon
□Program Activities:
W/ regard to the prevention & fight against stigma & discrimination,
the ff are the strategies & interventions: 💉DOH Guidelines in Beating Covid-19
1. Availability of free voluntary HIV Counseling & Testing Service; A. General Preventive Measures
2. 100% Condom Use Program (CUP) 1. Personal Protection and hygiene.
especially for entertainment establishments; The practice of personal cleanliness & hygiene at all times of every Individual
3. Peer education & outreach; in the community
4. Multi-sectoral coordination thru PH National AIDS Council (PNAC); is vital to containing the spread of diseases & protecting the whole
5. Empowerment of communities; community/
6. Community assemblies and for a to ↓reduce stigma; The ff practices should be observed to halt the spread of Covid 19 from
7. Augmentation of resources of social Hygiene Clinics; & infected individuals.
8. Procured male condoms distributed as education materials
during outreach.
□ Respiratory Etiquette
□ POLICIES & LAWS 1. Cough & sneeze into tissue/ into shirt sleeve if tissue is ✗t
R.A 11166 - “Philippine HIV & AIDS Policy Act” available.
1. Establish policies & programs to prevent the spread of HIV & deliver Tx, Dispose used tissue properly & disinfect hands immediately after
care, & support services to Filipinos living w/ HIV in accordance w/ evidence- a cough/ sneeze.
based strategies & approaches that uphold the principles of human rights, 2. Avoid touching the eyes, nose & mouth to help slow of the virus
 3. The use of face mask, which provides a physical barrier from the 2. If the individual resides in a subdivision or condominium, he/she must
Covid-19 viruses by blocking large-particle respiratory propelled likewise inform the Homeowners Association or Administration Office,
by coughing or sneezing, is ONLY recommended for: which in turn must notify the BHERT.
i. Person caring for the sick 3. 3. The BHERT officer shall report the event of a possible case of
ii. H.C. worker attending to Pt. COVID-19 to the Municipal Health Officer (MHO) or City Health Officer
w/ respiratory infxn/symptoms (CHO) for verification and initial investigation. The MHO/CHO shall then
iii. Person w/ respiratory infection/symptoms report to the Regional Epidemiology Surveillance Unit (RESU) using
4. People in good health do ✗T need to use face masks. the Event-Based Surveillance System (ESR) system of the
Epidemiology Bureau (EB) of DOH.

4. 4. All members of BHERT shall perform their function based on the

□Social Distancing Measures: Department of Interior and Local Government (DILG) mEmorandum
Circular No. 2020-018: Guide to action Against “Coronavirus”.
i. When possible, keep a distance of @ least 3 feet/ 1 meter away from
other Ppl to ↓reduce the possibility of person-person transmission.
This distance should be observed even to apparently healthy persons
w/o Sxs
ii. Offer telecommuting & replace in-person meetings in the workplace
with video/ telephone conferences
iii. Postpone,/ cancel mass gathering until further advise by the DOH

□ Environmental Measures:
i. Clean frequently-touched surfaces & objects, including
tables, doorknobs, toys, desks, and computer keyboards
ii. Maintaining the environment clean, especially common-use areas and
those w/ touchpoints such as
elevators, railings, staircases, light switches, and the like.
iii. Make dispensers w/ alcohol-based hand rub
available in public areas.

□ Food Safety Measures:

i. Avoid consumption of raw or undercooked animal products. Handle raw

meat, milk or animal organs with care, to avoid cross-contamination
with uncooked food, as per good food safety practices.
ii. When visiting live animal markets, wet markets/ animal product markets
1. Practice general hygiene measures, including regular hand
washing with soap and water after touching animals and animal
products
2. Avoid touching eyes, nose/ mouth w/ hands
3. Avoid contact with
(a) sick animals or spoiled animal products
(b) other animals possibly living in the market (stray cats, dogs,
rodents, bird, bats)
(c) potentially contaminated animal waste/ fluids.

iii. Do ✗t slaughter sick animals for consumption.

Bury/ destroy dead animals and avoid contact w/ their body fluids w/o
protective clothes

□Notification and Reporting of Person Exhibiting Signs & Symptoms of

Covid-19 or with Travel Hx to affected Areas or with Hx of Exposure
1. Any individual who exhibits symptoms consistent with the Covid-19 and
has history of travel to affected areas or close contact with a caregiver
of patient under investigation (PUI) for or with a confirmed case of
Covid-19 must immediately notify the Barangay Health Emergency
Response Team (BHERT)
□