Download Lofranco, VS, Gonong, JR, Raymond, LO, Rubio, JA, “Leassons

Lofranco, VS, Gonong, JR, Raymond, LO, Rubio, JA, “Leassons learnt:
implementing Pilot DOTS-Plus in tertiary government hospital in Metro Manila,
Philippines,” The International Journal of Tuberculosis and Lung Disease, Vol. 11,
Number 11, Nov. 2007, Supplement 1. S264.
The Lung Center of the Philippines (LCP) is a tertiary government hospital of the
Department of Health. It is located in highly urbanized city in Metro Manila with a
population of 2.7 million. In 2005, the hospital DOTS clinic of the LCP became the first
government facility that started to diagnose and treat 52 multi-drug resistant TB
(MDRTB) under the approved GLC proposal of the Makati Medical Center DOTS Plus
pilot project. A tripartite agreement was signed between the Department of Health,
Tropical Disease Foundation and the Lung Center of the Philippines signifying
commitment and function. Hospital Circular Order was issued directing all physicians
and visiting consultants to refer all MDRTB suspects to DOTS clinic, to access quality
diagnosis and treatment if found drug resistant. Additional resources to procure second
line drugs and construction of low cost building was provided by the management to
treat and shelter patients coming from far flung areas outside Metro Manila. Capacity
development through immersion of selected LCP staff from the DOTS clinic and
laboratory was provided by the TDF staff. On-going patients have the initiative to
organize as empowered support group to counsel other patients with adverse effects of
the drugs as well as to act as treatment partner for patients compliance. Towards the end
of 2006, total of 128 MDRTB have been enrolled of which 27 were cured; 4 defaulted, 12
died, 81 ongoing treatment, 4 trans-out to other treatment centers. The preliminary results
have shown promising outcomes in the implementation of Programmatic Multi-Drug
resistant TB Management (PMTM) in the government facility. It is our observation that
limited resources in high TB burden country is not a barrier in TB control. Foremost,
strong leadership and commitment, and engaging continuous partnership are important
factors in the expansion of PMTM management in other parts of the country.