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Cracking the Tough Bug

By: Ivan Olegario, MD, MDevComCracking the Tough Bug

Tuberculosis (TB), a communicable disease, remains a perennial issue that our country could not eradicate. Every year, around 13,000 Filipinos still die of the disease, and about 72,000 Filipinos are diagnosed with TB. If we look at these numbers alone, it seems like all hope is lost.

However, this is not the case. This highly-infectious disease has always been among the biggest priorities of the World Health Organization (WHO), and there are TB programs that have already made great strides in helping thousands of patients to get cured.  In fact, 84% of all Filipinos treated for TB are fully recovered despite the fact that treatment requires at least 6 months of taking medications. This has been accomplished through the cooperation between the WHO, the Department of Health (DOH), private health professionals, and the patients along with their families. Indeed, a clear indication that contrary to some people’s belief, TB is a curable disease that need not be deadly if treated early and completely.

What is TB?

TB is an infection caused by the bacteria, Mycobacterium tuberculosis. This is a tough bug to crack — it grows slowly but is not killed by typical antibiotics. It is usually introduced into the lungs through droplets floating in the air from a person with TB (when they cough, for example). Once it attacks the lungs, the bacteria slowly multiplies until it destroys lung tissues. This process can take months to years. During this time, the TB patient can spread the bacteria to other people. Early TB detection and treatment is therefore important because not only will it prevent the destruction of lung tissue, but also prevent others from being infected.

Could I have TB?

Eight out of 10 Filipinos have latent TB —TB that is not actively dividing and causing disease. This latent TB can become active anytime, for example, when a person’s immunity goes down.  This means you should go to the doctor or to the local health center if you exhibit any of the following symptoms:

  • Cough for 2 weeks
  • Fever for two weeks
  • Chest pains
  • Weakness
  • Weight loss
  • Night sweats
  • Coughing out blood

You will be asked to undergo a number of tests, the most important being the sputum exam. This test requires you to submit a sample of your sputum to the laboratory. There, they will examine the sputum for the presence of TB bacteria.

The battle begins—and continues

Should your results indicate that you do have TB, don’t fret because it is a curable disease. However, you need to be patient —TB treatment takes at least 6 months of daily pill-taking. Here’s the good news, though: within 2 weeks of taking your medicines, you are no longer infectious to other people, including those you live with.

During this time, you will also start to feel better. Your cough and fever will go away, you will start to gain weight, and you will have more energy. However, this does not mean you can stop taking your medicines. The bacteria are not completely eradicated from your body.

What will happen if you stop before your doctor declares you completely cured? The bacteria can become resistant to the medications. This means that the TB can come back — and this time, your previous medications will no longer work. This could also mean that if other people catch your bug, their disease will also be resistant to medication. You could be spreading drug-resistant TB to the whole community!

What it takes to win

Right now, the DOH, together with the WHO and many private hospitals and clinics, have an extensive network in place — positioned at the thousands of health centers in the country — that offers diagnosis and treatment for TB. But why have we not yet won the war against TB? This boils down to two things: (1) people with TB are unaware of their disease, thus the failure to get diagnosed; and (2) people with TB and taking TB medications stop prematurely, leading to drug-resistant TB.

For the first point, a major reason hindering people from getting tested for TB is the fear and embarrassment of getting a TB diagnosis. While these concerns are understandable, the fear and embarrassment need to be overcome by the knowledge that TB can be cured with treatment. The fear of suffering from untreated TB should outweigh the fear of getting a diagnosis. In addition, embarrassment can be overcome by the knowledge that this disease could infect anybody. 

One way to diffuse all the tension surrounding TB is to view your health care providers as your partner, or even a friend, especially if you decide to have yourself treated at the community health center. I worked for one such health center in the past, and it is a joy to see patients come back regularly for their medications. We know them by name, and they know us by ours. Together, we are fighting the war against TB — and we are winning.

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