CHN LAB

National Tuberculosis Control Program

VISION
A Tuberculosis-free Philippines (Zero deaths, disease, and suffering due to tuberculosis)
MISSION

To reduce TB burden (TB incidence and TB mortality)

To achieve catastrophic cost of TB-affected households
To responsively deliver TB service
GOALS
Long Term Goal (2035):
Reduce TB burden by decreasing TB mortality by 95% and TB incidence by 90%
Medium Term Goals (2022):
Reduce TB burden by:
Decreasing the number of TB deaths by 50% from 22,000 to11,000
Decreasing TB incidence rate by 15% from 554/100,000 to 470/100,000
Reduce catastrophic costs incurred by TB-affected households from 35% to 0%
At least 90% of patients are satisfied with the services of the DOST facilities.

OBJECTIVES
1. Improve the utilization of TB care and prevention services by patients and communities.
2. Reduce catastrophic sot of TB-affected households accessing DOTS facilities to 0%.
3. Ensure adequate and competent human resources for TB elimination efforts.
4. Improve the use of TB data for effective TB elimination efforts.
5. Enhance quality of all TB care and prevention services.
6. Increase to at least 90% of DOTS facilities that are providing expanded integrated patient
centered TB care and prevention services.
7. Enhance the political stewardship through high-level political commitment of national
government agencies and LGUs to implement localized TB elimination plan in coordination with
different sectors.
ABOUT NTP
The National TB Control Program, organized in 1978 and operating within a devolved
health care delivery system, is one of the public health programs being managed and coordinated
by the Infectious Diseases for Prevention and Control Division (IDPCD) of the Disease
Prevention and Control Bureau (DPCB) of the Department of Health (DOH).

NTP Mandate
(1) develop policies, standards and national strategic plan, (2) manage program logistics,
(3) provide leadership and technical assistance to the lower health officers/units, (4) manage
data, and (5) conduct monitoring and evaluation.

The program’s TB diagnostic and treatment protocols and strategies, issued through the Manual
of Procedures, are in accordance with the policies of World Health Organization (WHO) and the
International Standards for TB Care (ISTC).

Strategies, Action Points and Timeline

2017-2022 Philippine Strategic TB Elimination Plan
1. Activate communities and patient groups to promptly access quality TB services.
2. Collaborate with other government agencies to reduce out-of-pocket expenses and expand
social protection programs.
3. Harmonize local and national efforts adequate and competent human resources.
4. Innovate TB information generation and utilization for decision making.
5. Enforce standards on TB care and prevention and use of quality products.
6. Value clients and patients through integrated patient-centered TB services.
7. Engage national, regional and local government units/ agencies on multi-sectorial
implementation of TB elimination plan.

GENEXPERT
(GeneXpert Mycobacterium tuberculosis/ Rifampicin Assay)
GOLD standard in diagnosing TB
Simultaneously detects mycobacterium tuberculosis and resistance to rifampicin in less than 2
hours. Results are available quickly; can quickly identify MDR TB.

Instruct patient to cough out of abdomen. Patient will be the one to get it themselves. It is done in
health centers. Members of the community such as a Stider, will collect the sputum and will
bring it to the gene experts. 1-2 weeks malalaman.

STEPS FOR THE NEW TB TEST

1. Take sputum sample from patient. Mix with chemicals in sample sup and let sit for 15
minutes.
2. Transfer sample into a test cartridge.
3. Load cartridge into machine that amplifies and analyzes bacterial DNA.

CATEGORIES TYPE OF PATIENT INTENSIVE PHASE MAINTENANCE

PHASE

I  New Pulmonary TB  2RIPE  4RI

 New Extra-Pulmonary,
CNS/Bones or Joints  2 RIPE  4RI

II  Pulmonary or Extra-  2RIPES/  5RIE

Pulmonary; previously treated 1RIPE
drug susceptible TB
- Relapse
- Treatment after Failure
- Treatment after Lost to Follow-
up (TALF)
- Previous Treatment Outcome
Unknown (PTOU)
- Others
 Extra-Pulmonary; previously  9RIE
 2RIPES/
treated drug-susceptible TB –
1RIPE
CNS/Bones or Joints
 Standard  Rifampicin-resistant TB  4RI
Regimen Drug-  Multidrug-resistant TB
resistant (SRDR)
XDR-TB Regimen  Extensively drug-resistant TB Individualized based on Drug Susceptibility
Testing result and history of previous
treatment.

After Effect:
R - Rifampicin
= Orange/Red colored urine (Reassure the patient)
= Flu-like symptoms (fever, muscle pains) = anti-pyretics
= Thrombocytopenia, anemia, shock = discontinue the drug treatment

RIP
= gastro-intestinal intolerance (give drugs at bedtime or with small meals)

I - Isoniazid
= burning sensation in the feet d/t peripheral neuropathy (B6 50-100mg daily for treatment; 10
mg daily for prevention
= psychosis and convulsion (discontinue drug)

P – Pyrazinamide
= arthralgia d/t hyper-uricemia (aspirin or nsaid; sx persist, consider gout and request for
BROADBAND ULTRASOUND ATTENUATION (BUA)

E (Ethambutol)
= impairment of visual acuity and color vision d/t optic neuritis (discontinue drug)

S (Streptopmycin) ~ Given intramuscularly

= pain at the injection site (warm compress; rotate injection sites)
= severe skin rash (discontinue drug)
= hearing impairment, ringing of the ear, and dizziness due to 8th cranial nerve damage
(discontinue drug)
SINGLE DROP FORMULATION
- Each drug prepared individually.

Example:
Rifampicin 450mg
Isoniazid 100mg
Pyrazinamide 500mg
Ethambutol 400mg
Streptopmycin 1gm

FIXED DOSE MEDICATION

- 2 or more first line anti-tb drugs combined in one tablet.

Example:
Myrin P-forte; Quadmax (RIPE)
Myrin P (RIE)
Duomax (RI)
Econokit (RIPE)

FDC: Fixed Dose Combination Tabs (2)

= Fixed Dose Combination pills include TWO, THREE or even FOUR drugs in one pill.
= Advantages of FDCs (Reduces the number of pills patients must take, Minimizes errors in
dosing, Simplifies distribution of pills to patients, and Simplifies monitoring adherence.)