by sunny l. natividad donnabel l. tubera md mph dih marina bay sands september 17, 2014 web-based...
TRANSCRIPT
By
Sunny L. Natividad
Donnabel L. Tubera MD MPH DIH
Marina Bay Sands
September 17, 2014
Web-based
Tuberculosis
Register for the
City of Baguio
The world is moving so fast these days that the man who says it can’t be done is generally interrupted by someone doing it- Elbert Hubbard
“Baguio is home of diverse and dynamic cultures, center for education, trade and tourism in harmony with nature managed by God-loving steadfast leaders in partnership with responsible and peace-loving citizenry.”
BAGUIO CITY
•Located 5,000 feet ASL
•Summer Capital of the Philippines;
•Mean Temperature of 18°C
BAGUIO, 1910
BAGUIO, 2010
180,111
252,386
280,786
312,314
81,673
22,745
115,841
5.05
3.94
4.394.1
2.31
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
60-70 70-80 80-90 89-95 95-2000 2005 2010
Year
Po
pu
lati
on
0
1
2
3
4
5
6
Gro
wth
Rat
e
Challenges of Urban Health
TB Management Framework
TB
Political commitment
Quality assured microscopy
Supervised treatment
PMDT
Sustained Political commitment
Rational case finding: accurate & timely diagnosis through
quality assured culture and DST
Appropriate treatment strategies that utilize 1st and 2nd line drugs
under proper management conditions
P
TB Management Framework
Regular availability of 1st
line drugs
Standardized records & reports
Uninterrupted supply of quality assured 1st and
2nd line drugs Standardized recording and
reporting system designed for DR-TB
program
TB Register
TB MDR-TB
MDG: To reduce prevalence and
mortality by half by the year
2015National TB Control
ProgramCase detection
rate: > 90%Success rate: >
90%TB in Adult
TB in Children
PMDT TB/HIV
ACSM
PPMD
TB in Workplac
eTB in PrisonPMDT
History of previous treatmen
t?
No or UPS*
Decision of MD or TBDC?
For ages <15 y/o, decide based on the following diagnostic criteria (3/5):• Clinical signs and symptoms (3/6) -
– Coughing/wheezing of > 2 weeks, esp. if unexplained
– Unexplained fever of > 2 weeks after common causes such as malaria or pneumonia have been excluded
– Loss of weight/failure to gain weight/weight faltering/loss of appetite
– Failure to respond to 2 weeks of appropriate antibiotic therapy for LRTI
– Failure to regain previous state of health 2 weeks after a viral infection or exanthema (e.g., measles)
– Fatigue, reduced playfulness, or lethargy (child has lost his/her normal energy)
• Exposure to an active TB case (adult/adolescent)
• Positive Tuberculin Skin Test• Chest X-ray suggestive of TB• Other laboratory findings
Xpert MTB/Ri
f result?
Yes
Yes
MTB positive, Rif-sensitive
Bacteriologically-confirmed PTB
Yes
Bacteriologically confirmed PTB,
New
No
Clinically diagnosed TB, New
(PTB if CXR+ or with cough)No
DSSM positiv
e?
Age <15 y/o?
No or not done
MTB negative
Not TB or investigate further/refer to specialist
Chest x-ray
findings suggestive of TB?
No
No
With access to
Xpert MTB/Rif?
Yes
Category I Treatment
Clinically diagnosed TB, Retreatment
(PTB if CXR+ or with cough)Yes
MTB positive, Rif-resistant
Refer to PMDT services for evaluation
Bacteriologically confirmed PTB, Retreatment
Yes
Category II Treatment (for Rif-sensitive)
Classification
Disposition
TreatmentDiagnosis
Xpert ResultQuestion
Diagnostic Test
COLOR LEGENDNotes: *Unable to produce sputum
PRESUMPTIVE TB:• Cough of at least 2 weeks in an adult (age >15 y/o) • A child (<15 y/o) w/ any 3 out of 6 criteria for TB Signs/Symptoms• Chest X-ray suggestive of tuberculosis• Cough of any duration in a high risk individual or a close contact of
an active TB case (adult/adolescent)
Not TB or investigate
further/refer to specialist
Clinically diagnosed TB
(PTB if CXR+ or with cough)
History of previous treatmen
t?
You just have to take the pills and that’s it?
L. Raymond, 2010
L. Raymond, 2010
• Default tracing
• Health education and counseling
• Provision of enablers
• Social support network
Abstract
The integration of Geographic Information Science
(GISc) in Health & Medicine is an innovative way for
analysis of the spread of communicable diseases.
The spatial representation helps strengthen the
construction, access, incorporation and the
publication of large volumes of geographically
related data & facts.
Objectives
• To determine the problems encountered in the
current TB Register;
• To develop the features needed in analyzing and
recording patient’s information; and
• To support the judgments of the health officials
on where to focus in preventing the spread of TB.
System Features
Users can add and modify patient and
treatment information to the system as well
as schedule an appointment for treatment
Calendar view of Scheduler
System Features
The system is also capable of generating
notifications through SMSs and pop-ups in its
interface.
System Features
Use of Geographic Information Science
(GISc) to spatially represent the spread of the
disease in the City of Baguio.
Sample Map of TB Cases in Baguio City
System Features
In addition, graphs are also added to
summarize the tabular form within the
system.
Sample Graphs
