Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines.
Division of Infectious Diseases, Department of Medicine, College of Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines.
PLoS One. 2021 Jun 4;16(6):e0252240. doi: 10.1371/journal.pone.0252240. eCollection 2021.
The 3rd national tuberculosis (TB) survey in the Philippines in 2007 reported a significant decline in the prevalence of TB. Since then, more significant investments for TB control have been made, yet TB burden estimates from routine surveillance data remain relatively stable.
To estimate the prevalence of bacteriologically confirmed pulmonary TB in the Philippines amongst individuals aged ≥15 years in 2016.
In March-December 2016, we conducted a population-based survey with stratified, multi-stage cluster sampling of residents in 106 clusters aged ≥15 years. Survey participants were screened for TB by symptom-based interview and digital chest X-ray. Those with cough ≥2 weeks and/or haemoptysis and/or chest X-ray suggestive of TB were requested to submit 2 sputum specimens for Xpert MTB/RIF, direct sputum smear microscopy using LED fluorescent microscopy, and mycobacterial solid culture (Ogawa method). Bacteriologically confirmed pulmonary TB was defined as MTB culture positive and/or Xpert positive.
There were 46,689 individuals interviewed, and 41,444 (88.8%) consented to a chest X-ray. There were 18,597 (39.8%) eligible for sputum examination and 16,242 (87.3%) submitted at least one specimen. Out of 16,058 sputum-eligible participants, 183 (1.1%) were smear-positive. There were 466 bacteriologically confirmed TB cases: 238 (51.1%) Xpert positive, 69 (14.8%) culture positive, and 159 (34.1%) positive by both Xpert and culture. The estimated TB prevalence per 100,000 population aged ≥15 years was 434 (95% CI: 350-518) for smear-positive TB, and 1,159 (95% CI: 1,016-1,301) for bacteriologically confirmed TB.
This nationally representative survey found that the TB burden in the Philippines in 2016 was higher than estimated from routine TB surveillance data. There was no evidence of a decline in smear and culture positive TB from the 2007 survey despite significant investments in TB control. New strategies for case-finding and patient-centered care must be intensified and expanded.
2007 年菲律宾进行的第三次全国结核病（TB）调查报告称，结核病的患病率显著下降。此后，用于结核病控制的投资显著增加，但常规监测数据的结核病负担估计仍然相对稳定。
估计 2016 年菲律宾≥15 岁人群中经细菌学证实的肺结核患病率。
2016 年 3 月至 12 月，我们对 106 个≥15 岁居民的分层多阶段聚类进行了一项基于人群的调查。调查参与者通过基于症状的访谈和数字胸部 X 射线筛查结核病。对咳嗽≥2 周和/或咯血和/或胸部 X 射线提示结核病的人要求提交 2 份痰标本进行 Xpert MTB/RIF、使用 LED 荧光显微镜的直接痰涂片显微镜检查和分枝杆菌固体培养（大村法）。经细菌学证实的肺结核定义为 MTB 培养阳性和/或 Xpert 阳性。
共有 46689 人接受了访谈，41444 人（88.8%）同意进行胸部 X 射线检查。有 18597 人（39.8%）符合痰检条件，16242 人（87.3%）至少提交了一份标本。在 16058 名有痰标本的参与者中，有 183 人（1.1%）痰涂片阳性。共发现 466 例经细菌学证实的结核病病例：238 例（51.1%）Xpert 阳性，69 例（14.8%）培养阳性，159 例（34.1%）Xpert 和培养均阳性。≥15 岁人群每 100000 人结核病患病率估计值为 434（95%CI：350-518），为涂片阳性结核病；1159（95%CI：1016-1301）为细菌学证实的结核病。
这项具有全国代表性的调查发现，2016 年菲律宾的结核病负担高于常规结核病监测数据估计。尽管在结核病控制方面投入了大量资金，但与 2007 年调查相比，涂片和培养阳性结核病并没有减少的迹象。必须加强和扩大新的病例发现和以患者为中心的护理策略。
