Diagnosis and Management of Tuberculosis by Private Practitioners in Manila, Philippines

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Introduction

Tuberculosis (TB) was declared a global emergency in 1993 by the World Health Organization, and is continuously being monitored by health care professionals around the globe. Living in the Philippines, which currently ranks 9th among 22 high burden countries, and 3rd in the Western Pacific region, it is imperative that we nurses are equipped with the proper knowledge regarding the treatment and management of this communicable disease.

Summary

The study undertaken focused on the practices of private doctors with regard to the diagnosis and management of tuberculosis in the Philippines. It determined the usual diagnostic tests and treatments given to patients who sought consult at private institutions in Malabon.

Results reveal that almost all respondents (93%) relied on clinical presentation and result of a chest X-ray to decide whether or not to start anti-TB treatments. Only 6 respondents (13%) asked for a routine sputum examination, while 19 respondents (42%) would only ask for a sputum examination in certain cases. The remaining 7 respondents (16%) rely on the signs and symptoms and on the question of whether the patient had been exposed to someone with open TB.

Most respondents thought chest X-ray was a tool with high specificity, with 39 respondents believing that discrepancies in X-ray interpretations only happened in 1 to 5% of cases. Chest X-ray also showed to be the most popular monitoring test for TB with 80% of the respondents, while the remaining 20% preferred sputum exam as their follow-up diagnostics. All respondents, however, agreed that the sputum exam is important.

In treating TB, it has been observed that over-dosage was common, except for rifampicin. As for re-treatment regimens, none of the respondents followed the prescribed regimen by the World Health Organization. 27 (60%) respondents would prescribe the same treatment, 15 (33%) would give a weaker treatment, and only 1 respondent would give a stronger...
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