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Cycle 5 (2015 Deadline)

Using contact tracing to assess barriers to diagnosis and treatment and develop an educational campaign surrounding childhood tuberculosis in Northern Philippines

PI: Flordeliza Bassiag, Isabela State University
U.S. Partner: Tania Thomas, University of Virginia
Project Dates: December 2016 - May 2020

Project Overview:

The Northern Philippines is not exempt from the burden of childhood tuberculosis (TB), given its geographical locations with mountains and urbanizing valleys in all three regions of Ilocos, Cagayan Valley, and the Cordilleras, encompassing ten provinces and seven cities. The project will use contact tracing among adults with smear-positive TB in order to assess the disease prevalence and incidence among children in the Northern Philippines, and it will identify a spectrum of barriers to the diagnosis and treatment of childhood TB. Household contact investigations will be conducted among smear-positive index patients on TB treatment through DOTS/health facilities (public or private) within the three regions to screen for and obtain accurate baseline statistics of childhood TB and latent TB infection among children under 15. Cross-sectional surveys, key informant interviews, and focus group discussions will be employed among families and healthcare workers to identify barriers to the diagnosis and treatment of childhood TB. Results of the survey will be used to inform an educational campaign that builds upon the strategies of the Department of Health of the Philippines for improving lung health in children affected by tuberculosis.

The project aims to increase pediatric TB case detection from 1.2% to 15%, the global average detection rate for high TB-burden countries. Identification of barriers affecting treatment will inform methods to improve successful implementation of national childhood TB guidelines in the Philippines. The community-based education campaign will serve as an important advocacy tool for the lung health of children and will help decrease the stigma associated with TB. The global community is working towards the goal of “Zero TB deaths among children.” Completion of the project aims will provide critical evidence about the burden of TB-exposed and diseased children in rural Northern Philippines. Contact investigations will build research capacity among individuals and at the programmatic and institutional levels. It will also foster local capacity building at the grassroots level by promoting educational campaigns. Active case finding will generate accurate baseline statistics on TB-exposed children from an understudied region, which can aid in resource allocation and benchmark creation for future programs.

Summary of Recent Activities

As of March 2020, results of the study were presented and pitched during the 1st Luzonwide Research Forum organized by the Cagayan Valley Health Research and Development Consortium in January 22-24, 2020. Briefings about the research project results in the catchment provinces covered were undertaken with the two Regional Directors. There were three local policies developed for the tuberculosis control program. The PI has suggested enhancements to the policies to ensure that vulnerable persons, including children, are captured in TB contact tracing. Two manuscripts are being prepared for submission to scientific journals. Education materials were drafted but validating the materials in selected catchment sites has been postponed until after the COVID-19 lockdown ends.

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