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Free Content Bacillary disease and health seeking behavior among Filipinos with symptoms of tuberculosis: implications for control

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SETTING: Urban and rural communities and urban poor settlements in the Philippines.

OBJECTIVE: To determine bacillary disease and action taking among individuals with symptoms of tuberculosis (TB), and to analyze their implications for TB control.

STUDY DESIGN AND METHOD: Subjects aged 20 years and older were interviewed in the 1997 nationwide stratified multi-cluster survey. Sputum acid-fast smears and cultures were done in subjects with abnormal screening chest radiographs.

RESULTS: Individuals with TB symptoms comprised 18.1% of the population studied. The prevalence of bacillary disease was 39/1000 in symptomatic subjects compared to 13/1000 in asymptomatic subjects. Symptom screening had a 14.3% positive predictive value and a 91.4% negative predictive value for bacillary disease. Significantly more symptomatic than asymptomatic subjects attended chest radiographic screening during the survey. However, in response to their symptoms, the majority (43.0%) took no action or self medicated (31.6%), while 11.8% consulted a private practitioner, 7.5% a public health center, 4.4% a hospital, and 1.7% a traditional healer.

CONCLUSION: Sputum smear examination after symptom screening was acceptable for case finding. The health seeking behavior of subjects with TB symptoms was inappropriate. A health education program and public-private collaboration in directly observed therapy, short course (DOTS) are essential for TB control in the Philippines.
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Keywords: Philippines; health seeking behavior; symptom screening; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Tropical Disease Foundation, Makati Medical Center, Philippines 2: World Health Organization, Philippines 3: Department of Biostatistics and Epidemiology, University of the Philippines, Philippines 4: Tuberculosis Control Service, Department of Health, Philippines 5: Nutrition Center of the Philippines, Philippines 6: Research Institute for Mindanao Culture, Xavier University, Philippines

Publication date: 2000-12-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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