New TB Treatment Guidelines Benefit Filipino Children: Four-Month Fast Track to Recovery

Children suffering from tuberculosis (TB) in the Philippines can now receive faster treatment, with a new guideline adopted by the Department of Health (DOH) that cuts the treatment period to four months. This guideline, based on the recommendations of the World Health Organization (WHO), marks a significant step forward in the fight against TB, a disease that remains a major public health issue globally.

The Department of Health recently held a comprehensive two-day workshop in Tondo specifically aimed at educating nurses from 15 health centers. Key topics covered included chest X-ray interpretation, screening methods, and diagnostic procedures for TB in children. Additionally, nurses received training on disease severity classification and treatment protocols.

Philippines Leads in Implementing WHO Recommendations

The Philippines stands out as one of the few countries to have started rolling out the new WHO recommendations within its national guidelines. According to Médecins Sans Frontières (MSF), the adoption of these guidelines can transform the way TB is managed in a country with the fourth highest burden of the disease worldwide.

Since 2022, MSF has operated a tuberculosis project in Tondo’s Districts 1 and 2. Their focus has been on screening and treatment, collaborating closely with local health centers. Once TB-positive individuals are identified, their household contacts, especially children, are also screened for potential infections.

Four-Month Treatment Regimen: A Leap Forward

The new guidelines propose a four-month treatment regimen, 2HRZE/2HR, specifically for pediatric patients aged between three months and 16 years who have non-severe drug-susceptible tuberculosis. The regimen consists of four antituberculosis drugs administered for two months, followed by two months of maintenance using just two drugs.

According to MSF, this shorter course of treatment represents a substantial improvement on previous protocols. Dr. Richard Castro, representing the Manila Health Department, emphasized the benefits of the new regimen:

“Once people identified with TB are linked to care in the health center, the household contacts — including children — are investigated for TB. Children are also identified by health centers when they present with symptoms of TB,”

“Less time for the duration of treatment means lesser logistics and commodity consumption, lesser disease burden for the family, and faster recovery from illness, especially in a challenged area like Tondo,” he said.

Doctors Without Borders Tactic Project: Enhancing TB Care

The four-month treatment regimen is part of the Doctors Without Borders Tactic project, an initiative focused on simplifying diagnosis and treatment while integrating the latest WHO recommendations into real-world settings.

Epicentre, the medical research and epidemiology satellite of Médecins Sans Frontières, along with the Municipal Health Department (MHD), is conducting a study in partnership with the Institute of Child Health and Human Development (ICHHD) at the University of the Philippines – National Institutes of Health (UP-NIH). The objective is to document the rollout’s feasibility and accessibility, assess any barriers, and propose solutions.

Importance of Community Acceptance

Dr. Castro stressed that understanding and addressing the community’s perception of this treatment change is crucial to ensuring accessibility and uptake. He stated, “Beyond providing the treatment itself, it’s also important to understand how the community accepts and supports this change. By working together and paying attention to how the community responds, we can make sure this treatment reaches every child and adolescent who needs it.”

Furthermore, the project aims to better care for children affected by tuberculosis worldwide by simplifying diagnosis, integrating WHO recommendations, and ensuring accessible care, particularly in areas with a significant burden of undiagnosed TB.

Epidemiologist Valentino Carnimeo from Epicentre echoed these sentiments: “The Tactic project plays a critical role in improving TB care for children, by simplifying diagnosis and treatment while integrating WHO’s latest recommendations into real-world settings. This applies both in Doctors Without Borders projects and other settings, particularly those without a TB focus.”

As of January, the project had screened 38,465 people and diagnosed 1,826 TB patients.

Conclusion: A Hopeful Turn in TB Treatment

The adoption of the four-month TB treatment regimen represents a significant milestone in the fight against this global health issue, particularly in densely populated urban areas like Tondo. By implementing WHO guidelines and fostering community collaboration, the Philippines is taking concrete steps towards improving health outcomes for its most vulnerable citizens.

Health professionals and communities alike stand to benefit from the streamlined treatment process, promising a brighter future for children affected by tuberculosis.

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