Web-based
Tuberculosis
Register for the
City of Baguio
By
Sunny L. Natividad
Donnabel L. Tubera MD MPH DIH
Marina Bay Sands
September 17, 2014
The world is moving so fast these
days that the man who says it
can’t be done is generally
interrupted by someone doing itElbert 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
•Summer Capital of the Philippines;
•Mean Temperature of 18°C
•Located 5,000 feet
ASL
BAGUIO, 1910
BAGUIO, 2010
350,000
6
312,314
280,786
5.05
4.1
3.94
Population
252,386
4.39
250,000
5
200,000
4
180,111
3
150,000
2.31
115,841
2
100,000
50,000
81,673
1
22,745
0
0
60-70
70-80
80-90
89-95
Year
95-2000
2005
2010
Growth Rate
300,000
Challenges of Urban Health
TB Management Framework
TB
Political commitment
Quality assured
microscopy
Supervised treatment
PMDT
P
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
TB Management Framework
TB
MDR-TB
Regular availability
of 1st line drugs
Uninterrupted supply of
quality assured 1st and 2nd
line drugs
Standardized
records & reports
Standardized recording and
reporting system designed
for DR-TB program
National TB
Control
Program
TB in Adult
Case detection rate: >
90%
Success rate: > 90%
ACSM
PPMD
TB in
Children
PMDT
PMDT
MDG: To reduce
prevalence and
mortality by half by
the year 2015
TB/HIV
TB in
Prison
TB in
Workplace
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)
DSSM
positive
?
Chest xray
findings
suggestiv
e of TB?
Yes
No
Bacteriologically
confirmed PTB,
New
History of
previous
treatment?
Bacteriologicallyconfirmed PTB
No
Yes
Bacteriologically
confirmed PTB,
Retreatment
Refer to PMDT
services for
evaluation
Category II Treatment
(for Rif-sensitive)
Category I Treatment
Notes:
*Unable to produce sputum
MTB positive,
Rif-sensitive
MTB negative
No
Yes
Yes
With
access to
Xpert
MTB/Rif?
Not TB or
investigate
further/refer to
specialist
Xpert
MTB/Rif
result?
Clinically diagnosed TB,
Retreatment
(PTB if CXR+ or with cough)
Yes
Clinically diagnosed TB,
New
(PTB if CXR+ or with cough)
No
History of
previous
treatment?
For ages <15 y/o, decide based on the
following diagnostic criteria (3/5):
• Clinical signs and symptoms (3/6) -
Age
<15 y/o?
Yes
Not TB or investigate
further/refer to specialist
MTB positive,
Rif-resistant
Decision of MD or TBDC?
No or not
done
Clinically
diagnosed TB
(PTB if CXR+ or
with cough)
COLOR LEGEND
Question
Xpert Result
Disposition
Diagnostic Test
Classification
Diagnosis
Treatment
No or
UPS*
– 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
You just have to take the
pills and that’s it?
L. Raymond, 2010
• Default tracing
• Health education
and counseling
• Provision of
enablers
• Social support
network
L. Raymond, 2010
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
Thank you!
donnabel_md@yahoo.com
sunnynatividad@gmail.com
gplus.to/sunnynatividad