Manila and non-Manila residents scheduled for free RT-PCR may now also avail of the free chest X-ray being offered by the City of Manila as it starts implementing the country’s first-ever bidirectional screening and testing for COVID-19 and Tuberculosis (TB) through the swabbing and isolation facilities in Sta. Ana Hospital and Delpan Evacuation Center Quarantine/Isolation Facility, an initiative that started on August 25, 2021 and September 02, 2021 respectively. Meanwhile, Manila COVID-19 Field Hospital (MCFH) has started sputum collection for rapid TB diagnostic testing among admitted individuals since the first week of September.

The initiative is anchored on promoting lung health for residents of Manila and nearby cities. Employing the brand “Kumusta Baga?” (“How are your lungs?”) under the #TBFreePH campaign, individuals who are scheduled for RT-PCR test and do not show any respiratory symptoms such as cough, fever, or shortness of breath can also avail of the free chest X-ray service in the said facilities to determine whether they have possible TB by chest X-ray in just 5 to 10 minutes only using mobile X-ray equipped with computer-aided detection or artificial intelligence (AI).

Meanwhile, individuals who are presumptive TB based on chest X-ray results or those who are showing respiratory symptoms regardless of duration are recommended to submit their sputum samples for TB confirmatory test. If tested positive, results will be sent to the partner health facilities and individuals will be informed for treatment initiation in their respective local government units.

“We want Manila to win the battle against COVID, but we don’t want to compromise our fight against other diseases such as TB. We need to address both if we really want our residents to feel safe and healthy,” Dr. Maria Julieta Recidoro, Officer in Charge at Manila Health Department’s division of TB prevention and control, said.

The COVID-19 pandemic continues to be a threat in TB-elimination programs of the Department of Health (DOH) since last year. According to the National Tuberculosis Control Program Report of 2021 of the DOH, only 256,848 new and relapse TB cases were detected in the country in 2020. This is 37.7% lower compared to 409,167 TB cases reported in 2019.

In the same document, the City of Manila was also reported to notify only 4,205 new and relapse TB cases in 2020 versus 9,857 TB cases  in 2019, a 57.7% decline in new and relapses notification.

“COVID sets back the progress of TB by a decade, and we don’t want all of our efforts to go to waste. This pilot bidirectional screening and testing in Manila will help us find individuals who have COVID and TB — an essential integration as we continue to provide TB services amidst this health crisis,” Dr. Anna Marie Celina Garfin, Medical Specialist IV of the Disease Prevention and Control Bureau (DPCB), Infectious Disease Division of the DOH.

The NTP Adaptive Plan (NAP) of the National Tuberculosis Control Program of the DOH was published in the last quarter of 2020 to ensure continued TB services in terms of prevention, screening, diagnosis, and treatment. This will also serve as a guide among health facilities and service providers in delivering TB services in the context of the “new normal” as the Philippines aims to find and treat 2.5 million TB cases by 2022, a target that was pledged by the country during the 2018 UN High Level General Assembly in New York City.

Since the COVID-19 pandemic began, most individuals avoid going to the health facilities to immediately seek care and treatment due fear of getting infected or labeled as COVID positive. Now with mobile chest X-ray van set-up at Delpan Evacuation Center Quarantine Facility and Sta. Ana Hospital, patients can now maximize their visit in swabbing facilities to get both RT-PCR and chest X-ray at the same time. Meanwhile, admitted patients in Manila Covid-19 Field Hospital and in the isolation facility of Sta. Ana Hospital will not just be treated for COVID but will also be tested for tuberculosis.

“Individuals will no longer have to go back and forth in the health facility. With this bidirectional screening, they can have their RT-PCR and chest X-ray done at the same time. We want to ensure that TB services are within their reach despite the restrictions brought by Covid-19,” Dr. Mary Rosary Santiago, DR-TB Technical Advisor from TB Innovations and Health Systems Strengthening Project.

Funded by the United States Agency for International Development (USAID) under the TB Innovations and Health Systems Strengthening (TBIHSS) Project managed by FHI 360 and with field support from Innovations for Community Health (ICH), the bi-directional testing has already screened 1,204 individuals for chest X-ray in Sta. Ana Hospital and Delpan Quarantine/Isolation Facility while 401 individuals submitted their sputum sample for TB testing in Manila COVID-19 Field Hospital and Sta. Ana Hospital as of September 30 according to Lovely Enriquez and April Joy Cagas, field implementation officers of TBIHSS.