Surveillance for tuberculosis in a rural community in The Philippines

Abstract

Setting: Estimates of the tuberculosis (TB) burden in the Philippines are largely dependent on prevalence surveys.

Objective: To conduct a prospective community-based survey to generate epidemiological data on TB among patients seeking care in public health centres in a rural municipality in the Philippines.

Design: Prospective surveillance and follow-up of presumptive TB cases from May 2013 to July 2015.

Results: Of 1622 participants with presumptive TB, 468 (28.8%) (95%CI 26.6-31.1) were diagnosed with TB. The annual TB case notification rate in San Juan was 212 (95%CI 184-242) per 100 000 population. There were nine TB-attributable deaths during the study period. Only 8.8% (95%CI 6.2-11.32) of the cases were children aged <15 years; 274 (58.5%) cases were bacteriologically confirmed. Of 210 isolates tested for antimicrobial resistance, 49 (23.3%, 95%CI 17.58-29.02) were resistant. Resistance to isoniazid (INH) was common (n = 33, 15.7%); multidrug-resistant TB was 1.9%.

Conclusion: TB remains an important health problem in the Philippines. We identified low case detection of TB in children and high INH resistance rates in this rural community.