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Tuberculosis and its co-morbidities: Clients' knowledge and health seeking behavior.


Jeffrey  F. Membreve,
Tyrone Hora

Related Institution

College of Health Sciences - Holy Name University

Publication Information

Publication Type
Thesis Degree
Publication Date
March 2016



Tuberculosis, or TB, is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease. In healthy people, infection with Mycobacterium tuberculosis often causes no symptoms, since the person's immune system acts to "wall off" the bacteria. The symptoms of active TB of the lung are coughing, sometimes with sputum or blood, chest pains, weakness, weight loss, fever and night sweats. Tuberculosis is treatable with a six-month course of antibiotics (World Health Organization Report, 2014).

TB is a major public health problem that threatens people worldwide. Today, it continues to be a big health issue in our society which alarms us to take it seriously since this will lead to drug resistance cases. As evidenced by the current statistics from the World Health Organization, as marked increase of TB cases were on the rise worldwide. Certain actions were planned and implemented to address TB that provide solution and possibly eradicate this problem in the society. A lot of interventions were created and also strategies just to answer and solve this problem because if this will be taken  fro granted, a devastating effect is expected on the part of the people and in the community in general.

TB is one of the world's deadliest diseases. One third of the world's population are infected with TB. In 2013, 9 million people worldwide became sick with TB disease, most of whom (80%) live in one of the 22 high burden countries for TB. TB is a leading killer of people living with HIV (PLHIV). TB in the Unived States reflects the global reality. TB is one of the most common infectious diseases worldwide. While significant progress has been made toward the elimination of TB in the United States, this disease remains an urgent public health problem in many other parts of the world. In 2013, 65% of all TB cases and 90% of multidrug-resistant TB cases in the United States occurred among people born in other countries. Nearly 50% of these individuals were born in just five countries. (Division of Tuberculosis Elimination Report, 2014).

The large global burden of TB and the fact that this have likely existed for years in most countries including the Philippines highlight serious limitations on the national TB control programs and follow-up efforts to ensure cure. This limitation may have arisen since therapy for TB is already available for decades. Because of the establishment of global TB control program, Tuberculosis is considered to be manageable. Because of the provision of drugs throughout the country, TB is now treatable and can be managed in the Rural Health Units n different localities.

With the implementation of different programs concerning TB, most of our people in the community evein in far-flung areas were reached and taught on the basic information and concepts about TB. This rapid education to all, many were being educated and already aware of its disease mechanism. Though TB patient have knowledge on the disease, the commitment on their part towards treatment also has a big impact especially to patients diagnose with TB. Since, drugs are accessible and for free through DOTS program, their behavior towards this is really important to attain the goal.

The Philippines has achieved improvements in case detection and exceeded the target for treatment success despite numerous challenges, particularly in making services accessible in difficult geographic and socioeconomic settings. The country aims to further improve access to diagnostic and treatment services, especially for highly vulnerable groups, while sustaining high cure and treatment success rates particularly among smear-positive PTB cases. Efforts will be directed at improving diagnostic capabilities in DOTS facilities and hospitals, addressing barriers to follow-up examinations for patients under treatment as well as the factors that promote treatment default and improving the referral system to reduce transfer-outs. Factors that contribute to TB mortality such as diagnostic and treatment delay and co-morbidities need to be addressed as well. Finally, the TB information system will be strengthened to improve its usefulness for surveillance, planning and decision-making. With the current trend of NTP performance, it is predicted  that the country will achieve Millennium Development Goals and Stop TB partnership targets before 2015 (Philippines in figures. National Statistics Office Report, 2012).

A large number of TB cases was detected in the province of Bohol this year 2015 which made this condition one among the ten leading causes of death. "Constituting the Provincial Council agaisnt Tuberculosis (PROCAT)- Bohol" is geared towards improving TB case finding and case holding in the province of Bohol. The creation of PROCAT-Bohol is also in line with the program of the Department of Health, the National Tuberculosis Control Program (NTP) and as outlined in the 2010-2016 Philippine Plan of Action to control Tuberculosis. Bohol is included on the provinces of having high number of TB cases. PROCAT Bohol reports that in 2010 there has been a significant decrease of low performing RHUs where 4 percent or 3 out of 50 RHUs registered low performance compared from previous years where more than 10 RHUs showed poor performance  (www.doh.gov.ph). Through the creation of DOTS facilities in each of the municipalities in Bohol, a greater chance is expected in increasing the case detection rate and cure rate. And on the other hand, a decrease in positive TB cases will be reported specifically in drug resistance patients. 

According to the latest data from the Municipal Health Office (MHO), Buenavista has 46 TB cases from a cumulative data from 2015 to present. These patients were enrolled in the TB-DOTS facility where they get their anti-TB drugs supply. They are constantly monitored by the treatment partners together with the RHU personnel for their monthly check-up with the physician and sputum examination follow-ups.

The focus of the researcher is Pulmonary Tuberculosis that has been a health problem affecting all places in the country specifically in the municipality of Buenavista. The researcher aims to determine Tuberculosis and its morbidities, patient's knowledge about the disease and their individual health seeking behavior towards treatment. This study would benefit all people in the community with or without TB in order to live a healthy life and help create a TB free society.


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