Bacillary disease and health seeking behavior among Filipinos with symptoms of tuberculosis: implications for control
Abstract: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.
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: December 1, 2000
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