Effectiveness of

management of TB Patients
under the program of
“Tutok Gamutan” in
Catanauan,Quezon
 Tuberculosis
 remains a major public health threat throughout
the world, developing countries shouldering much
of the burden.
th
9 leading cause of death worldwide and it is
also a leading cause of death among infectious
agents, ranking above HIV/AIDS.
In
In2016 alone
2016 aloneananestimated
estimated10.4 million
10.4 people
million people
affected
affectedwith TB,TB,
with andandaround
around1,674,000
1,674,000TBTB
deaths
deathswere
wererecorded
recorded globally.
globally.
World Health Organization (WHO)
World Health Organization (WHO)
TB was the 6th leading cause of
mortality with a rate of 26.3 deaths for
every 100,000 population and accounts
for 5.1% of total deaths.
More males died compared to
females. TB is more prevalent among
males maybe because of their social
habits and greater exposures
compared to females and among the
25–55 year old age group or the
productive age group.
 In Catanauan, Quezon, 2018 data shows that out of
72,664 population 212 persons were registered in the Drug
Susceptible TB Registry.
More males were enrolled in the program compared to
female.
Despite of the active management and treatment
following the Department of Health - National Tuberculosis
Program protocols, prevalence of tuberculosis is still high
despite of the fact that 95.00 – 97.17% treatment success
rate. The 212 tuberculosis cases was only those who are
seen and examined in the Rural Health Unit, Bondoc
Peninsula District Hospital and some private Physicians, not
all presumptive cases were not diagnosed by medical
health practitioners.
 The 2010–2016 Philippine Plan of Action to
Control TB or PhilPACT
 1: Localize implementation of TB control,
 2: Monitor health system Performance,
 3: Engage both public and private health care providers,
 4: Promote and strengthen positive behavior of communities,
 5: Address MDR-TB, TB-HIV, and needs of the vulnerable
populations,
 6: Regulate and make available quality TB diagnostic tests
and drugs,
 7: Certify and accredit TB care providers and
 8: Secure adequate funding and improve allocation and
efficiency of fund utilization.
 This study is conducted to assess the TB prevalence,
treatment outcome and associated factors among TB
patients in public hospitals and community of Catanauan,
Quezon.
Specifically, it sought to answer the following questions:

 1. What factors contributed to the high prevalence of

tuberculosis in Catanauan,Quezon.
 2. Why there is an increasing prevalence of tuberculosis
in Catanauan,Quezon despite of the adoption of new
strategies/programs being implemented.
 3. Based on the results of the study, what possible
additional interventions can be implemented to reduce
the prevalence of tuberculosis in Catanauan,Quezon.
Methodology
A cohort document review was conducted to
assess the effectiveness of management of TB
patients under the “Tutok Gamutan” enrolled
from January 2018 to December 2018, at RHU
Catanauan, Quezon.

The respondents of the research were

composed of TB Patients enrolled in “Tutok
Gamutan” Program from January to
December 2018 and their respective treatment
partners (Rural Health Midwives and Barangay
Health Workers) in Catanauan, Quezon..
 The researchers used in-depth interviews for
the treatment partners (barangay health
workers, rural health midwives) and the
program coordinator because it offers the
opportunity to capture rich, descriptive data
about their experiences as treatment partners
of TB patients. Also, to determine the practices
or strategies they used to help their patients in
compliance to the standard treatment
regimen.
 TB patients were also interviewed to
determine the motivating factors that help
them finished their six months treatment.
This method normally carried out face to
face so that a rapport can be created with
the targeted population. In order to be
successful in in-depth interview the
researchers will listen rather than talk, will
set a clear line of questioning and use
body language to build rapport.
Results and Discussion
 Indicators Actual Target Accomplishment
TB Case Notified
75% 213 197 108%
Bacteriologically confirmed among
DSTB notified 62 212 29.24%
50%
Clinically diagnosed 150 212 70.76%
No. of retreatment cases tested on Gene
Expert
6 6 100%
100%
No. of Children 13 212 6.13%
15%
Treatment Success Rate
90% 206 212 97.17%
Lost To Follow Up 2 212 0.94%
Contribution from Non DOTS Providers
50% 53 212 25%
Positivity Rate 49 187 26.20%
10-20%
Relapse 10 212 4.72%
New 202 212 95.28%
Transferred –In 0 5 0
Interview questions were also asked to the
program coordinator regarding the factors
contributed to the high success rate of “Tutok
Gamutan”.
 a well oriented workers and family members of the
patients help to motivate and monitor the patients
during the whole course of the treatment.
 Home visitation of health treatment partner/s and
continuous health education of patients and family
members
 continuous meetings, assessment of knowledge of
health workers and patients about “tutok Gamutan”
and proper documentation should be used as a
strategy in order to sustain the success rate of TB DOTS in
Catanauan, Quezon.
 Summary
Case finding remains an important principle in the
overall concept of TB control. Certainly, accurately
finding possible TB cases earlier and confirming their
diagnosis would translate to better patient treatment
outcomes. However, diagnosis of TB remains
challenging in various clinical settings where prompt
decision-making is crucial for early initiation of
appropriate treatment, thus, avoiding over – or
under- diagnosis and treatment of TB among adults
and children.
 Conclusion
After conducting the study, the researchers found out
that Tutok Gamutan is an effective management in
treating tuberculosis. There is a strict compliance to
treatment regimen among patients because of the
continuous monitoring of treatment partners.
A healthcare worker should also develop a good
relationship with the patient in order to discuss issues
about the TB treatment. Based on the different field
studies, education is a significant component in
improving treatment adherence on TB.
 Recommendation
Daily regimen is recommended for the treatment of
TB particularly if Fixed-Dose Course is used.
2. Intermittent regiment /treatment less than three
times a week are not recommended because of the
greater impact on missed doses on success rate.
3. Remind patients and treatment partners of their
appointments by pre-appointment calls and text
messages.
4. Default reminder letter or home visits for those
who miss their appointments.
5. Give incentives and enablers such as
nutritious, culturally appropriate daily meals and
food packages.
6. Coordinates with DOTS centers and support
groups.
 In addition, there are factors to be addressed to
likely improve adherence to TB treatment;

1. Increase the visibility of TB Programs in the community

level, which may increase knowledge and improve
attitudes towards TB.
2. Educate patients and communities about the
disease and treatment.
3, Increase support from family, peers and social
networks.
4. Minimize costs and unpleasantness related to clinic
visits and increase flexibility and patient autonomy.
5. Address “structural” and “personal” factors, such
as cash incentives, food assistance, and travel
reimbursement initiatives.
6. Education on the side effects of medication to
reduce the risk of patients becoming non-adherent
when experiencing treatment adverse reaction.