by Evangeline T. Capuno
Mila, a 35-year-old Filipino high school teacher, is finally back where she belongs. She’s teaching again and very happy to see her students. “I was told that if I completed my treatment under supervision, I would be able to return to my work. I did as I was told, and here I am,” she says. Almost a year ago, Mila was stricken with tuberculosis (TB) and never thought she would survive. At first, she developed a nagging cough, and self-medicated with antibiotics. “The antibiotics were very expensive, but after taking them for a few weeks, I felt no better.”
The persistent cough became more severe, and Mila would go into coughing spasms, particularly at night. After one such bout, her sister Joan noticed specks of blood in her phlegm. The following morning, Joan insisted on taking her to the hospital. She relented, and had her sputum collected for examination. The nurse told them to return a week later for the report.
When Mila returned, the doctor broke the news that she had TB. “I was totally shattered,” she recalls. “How can that be? How did I get the disease? What will my co-teachers think? Will I be shunned by them?”
Mila is very lucky; she’s still alive and cured!
About one million Filipinos have active TB disease, the World Health Organization (WHO) reports. This is the third highest prevalence rate in the world – after South Africa and Lesotho.
“Every day, more than 70 Filipinos lose their lives to TB,” the WHO points out. “Many of these patients develop drug resistant tuberculosis, which are more expensive and difficult to treat.”
In Davao Region, a total of 10,363 TB cases were recorded from January to June this year. Most of the cases (4,315) were from Davao City. Davao del Norte (2,209 cases) closely trailed, followed by Davao de Oro (1,359), Davao del Sur (1,274), Davao Oriental (889), and Davao Occidental (344).
“In the past, we have had lower TB cases recorded,” said Dr. Annabelle Yumang, director of the regional office of the Department of Health. The recent rising of cases was attributed to the department’s case findings through mobile chest x-rays in urban and rural areas in the region.
“We need to end TB from this planet by 2030,” urged the United Nations health agency. “Yet, the Philippines is among the few countries where the number of people with TB continues to increase every year.”
TB is an infectious disease that is spread via an airborne route, usually through cough and sputum.
“Infection is associated with the level of exposure to infectious particles,” explains Dr. Sandy Althomsons, technical officer of Stop TB and Leprosy Elimination of the World Health Organization (WHO) in the region. “A person may not necessarily develop the disease once becoming infected with TB,” she added. “After months or even years, the body’s defenses may weaken, at which point the disease can develop and spread in the lungs (most common), or other infected areas.”
Upon inhalation of infected droplets, if these bacilli reach the small air sacs of the lung, infection can occur. “Generally, the immune system can destroy or inhibit the tubercle bacilli from attacking the lungs,” says Dr. Althomsons.
Under weakened conditions, the bacilli can multiply and cause a lesion in the lung tissue, primarily in the upper area. Further spread of the bacilli can then occur through the bloodstream, infecting other organs, as well as other parts of the lung. Even after treatment and cure, past lesions can leave scars in the lung tissue, often misleading X-ray diagnosis for past disease rather than current condition.
The most familiar signs of TB are the following: chronic cough, mild fever especially in the afternoons to evenings, sweating at night, chest and back pain, and progressive weight loss. In more serious or advanced cases, the symptoms include spitting out of blood, pale and waxy skin, and a hoarse voice.
Fighting TB requires the private and public sectors to work together. “About 150,000 people with TB seek care in the private sector every year although most of them are poor,” the WHO said. “They may do that because of time, distance, and confidentiality issues in public health facilities.
“They have the right to choose their providers,” the WHO added. “But unless we support those patients, too, we can never achieve the national targets to end TB. Besides, these patients are more likely to suffer from catastrophic costs due to TB care than those who seek care in the public sector.” Ending TB requires concerted action by all sectors and all care providers. “Everyone has a role to play in ending TB – individuals, communities, businesses, governments, societies,” the WHO reiterated. “Everyone must join the race to end TB by 2030.”
In his memoirs, Alexandre Dumas observed wryly that “it was all the fashion to suffer from chest complaints; everybody was consumptive, poets especially.”
Although TB is mainly a disease of the poor, history shows that TB knows no financial, cultural or international boundaries. Through centuries, many well-known people died from the disease.
In Asia, among those who succumbed include Philippine president Manuel L. Quezon, Filipino nationalist Marcelo H. del Pilar, legendary Japanese samurai Okita Soji, Japanese haiku poet Masaoka Shiki, Japanese writer Miyazwa Kenji, modern Chinese writer Lu Xun, and Korean poet Yi Sang. – ###
