Family and Community Medicine 3/ III-B, Group 3

Rama, Ramabel Rayos, Ma. Reina Gladys Reyes, Roman Aldo Sayo, Analiza
Ranon, Donie Andrew Razon, June Michael Reymatias, Jerome Seno, Christel Marie
Rasing, Paul Mark Relos, Donna Marie Rosanes, Glenice Simbulan, Risaline
Raymundo, Josephine Novio, Dutch Carmela Guanlao, Meynard
Romuar, Jeziel

PROJECT PROPOSAL

I. Title
“KTB: Kaalaman Kontra TB”

II. Rationale for the Project

The project entitled “Kaalaman kontra TB” is a three week project of the third year medical students to
increase the awareness of Barangay 658, Intramuros, Manila residents about the symptoms, prevention,
treatment and other important facts about pulmonary tuberculosis. In this way, an increase in the
knowledge on signs, symptoms and programs concerning Pulmonary Tuberculosis (PTB) is expected, if the
project is successfully done. Pre-test will be given to get the baseline data regarding the awareness of the
people about pulmonary tuberculosis. Then, house-to-house lectures to teach the people regarding facts
about pulmonary tuberculosis will be conducted and lastly, post-test will be given to evaluate the
effectiveness of the project.

III. General Objective

To increase the awareness of the Barangay 658, Intramuros, Manila residents about pulmonary
tuberculosis

IV.
Specific Objective Strategy Content Resources Evaluation
Indicators
To increase 1. Conduct pre-test to asses Pulmonary Man power Compare pre-tests
familiarity baseline awareness Tuberculosis Pencils and post tests
regarding regarding pulmonary Common Pad paper results to evaluate
pulmonary
tuberculosis symptoms Symptoms (The Incentives the effectiveness of
tuberculosis
symptoms 2. Lecture on the symptoms ‘B-symptoms’) (snacks,etc.) the project
of pulmonary tuberculosis
using picture booklet Materials to be
(house to house) used: Picture
3. Conduct tests to assess booklet and
the level of awareness questionnaire for
regarding pulmonary pre and post
tuberculosis symptoms assessment tests
after the lecture
To increase the 1.Conduct pre-test to asses Basic Facts About Man power Compare pre-tests
knowledge of the baseline awareness Tuberculosis; Pencils and post tests
people regarding regarding pulmonary Mode of Pad paper results to evaluate
pulmonary
tuberculosis prevention Transmission; Incentives the effectiveness of
tuberculosis
2.House-to-house lecture What Makes A (snacks,etc.) the project
prevention
about prevention of Person Vulnerable
pulmonary tuberculosis to TB?; Prevention
using picture booklet of TB
(house to house)
3.Conduct a post-test to Materials to be
assess the level of used: Picture
awareness regarding booklet and
pulmonary tuberculosis questionnaire for
prevention after the pre and post
 lecture assessment tests
To educate the 1.Conduct pre-test to asses Is TB Curable?; Man power Compare pre-tests
people about the baseline awareness of the How is TB Materials and post tests
available DOH people about different treated?; What is from the DOH results to evaluate
programs for the the effectiveness of
DOH programs for DOTS?; How can Pencils
treatment and the project
control of Tuberculosis treatment we avail of DOTS Pad paper
pulmonary and control Services? Incentive
tuberculosis 2.Conduct a house to house (snacks,etc.)
lecture to introduce Materials to be
different DOH programs used: Different
regarding control and materials from
treatment of tuberculosis. the Department of
3.Conduct a post-test to Health used in the
assess if the people fully promotion of their
understand the lecture projects regarding
given. pulmonary
tuberculosis
treatment and
control program
(example:
posters, leaflets,
etc.)

Questionnaires
for the pre and
post assessment
tests
To increase the knowledge of the people regarding pulmonary tuberculosis prevention, the
following information will be utilized: (Source: National objectives for Health 2005-2010 and notes from
Dr. Moderes’ lecture on PTB)

Objectives

1. To know how the disease is transmitted

2. To know when the one is susceptible to the disease

3. To know preventive measures on acquiring the disease

Introduction: Basic facts about tuberculosis

  It is caused by Mycobacterium tuberculosis and is one of the top causes of morbidity and mortality in
the country.

 Most TB patients belong to the economically productive age-group (15-54 years old) according to the
2nd National Prevalence Survey in 1997.
 It is transmitted via the airborne route mostly from infected persons when coughing.

 The primary lesion in the lung and lymph nodes often heal spontaneously leaving a focus of dormant
bacilli that can be reactivated at any moment in an individual’s lifetime.

 An infected person has a 5-10% chance of developing full blown TB in his/her lifetime.

 A sputum (+) person infects 10-15 other persons annually.

 A 50% chance of becoming infected from TB patient if time spent around him/her amounts to at least 8
hours a day for 6 months.

Mode of Transmission

Cough, sneeze, spit  M.tuberculosis expelled into the air  Droplets inhaled by another person Tubercle
bacilli lodge in the alveoli Macrophages in the alveoli engulfs the TB bacteria Bacteria are transmitted to
the lymphatic system and bloodstream and spread to other organ The bacteria further multiply in organs
that have high oxygen pressures, such as the upper lobes of the lungs, the kidneys, bone marrow, and
meninges

What makes a Person Vulnerable to TB?

 Lack of adequate food and nutrition, leading to significantly compromised body resistance.

 Overcrowded living conditions and dilapidated housing structures, creating ideal conditions for easy
transmission of the disease.

 Undesirable health behaviors, especially smoking and drinking.

 Limited access to health facilities due to financial constraints and lack of social security

 Lack of awareness of available public sector services or other resources.

 Lack of knowledge about TB symptoms and inability to identify signs of the disease.

 The tendency for heads of households (often working in the informal sector or self employed at small
entrepreneurial activities) to de-emphasize their own personal health in deference to the immediate
basic needs of their families.

 Lowered resistance associated with lack of sleep and anxiety about the household economic situation.

 The inability to purchase TB medicines, leading to lack of compliance with treatment regimens.

Prevention of TB

1. Role of vaccination in preventing TB infection.

 Bacille bilie de Calmette-Guerin (BCG) immunization – 0.05ml ID at birth. BCG vaccine given
immediately upon birth provides the greatest possible protection from tuberculosis.

 The risk of developing the disease is highest in children under three y/o, but the true scope of the
disease among children is unknown. An infected child has a 10 percent chance of developing the
 disease in later childhood or in adulthood. Most child deaths result from a severe form of the disease
known as TB meningitis.

 BCG vaccination is not recommended for adults because it does not confer protection

2. General recommendations to reduce the risk of spread of TB infection.

 Prompt treatment is extremely important in controlling the spread of tuberculosis for those who have
already progressed to active TB disease.
 If a TB patient requires hospitalization, it is best if the patient can be admitted to designated isolation
rooms with negative pressure systems or at least a single private room.

 Isolation of suspected or confirmed TB for at least one week preferably 2 weeks.

 All patients suspected or confirmed to have active TB should be asked to wear a surgical mask if their
pulmonary status can tolerate.
 Those who have symptoms of TB should go to the nearest health center to be evaluated for TB.
Physicians should assure that patients take their medications regularly and completely.
 All patients should be advised on proper cough etiquette:

o Cover nose nose/mouthe with a handkerchief/tissue when you cough or sneeze,

o Dispose used tissues containing respiratory secretions in the nearest waste receptacles,

o Wash your hands with soap and water or an alcohol-based handrub after coughing or sneezing,
and

o Avoid spitting.

 If one is near a person known to have active TB, one should cover his/her nose and avoid handling
items previously touched by the patient, including eating utensils. Washing hands following an
unavoidable contact is a good practice.

To educate the people about the available DOH programs for the treatment and control of
pulmonary tuberculosis, the following information will be utilized:

Is TB curable?

YES! TB can be cured through DOTS.

How is TB treated?

Tuberculosis is a curable disease. Patients are prescribed with appropriate regimen to render them non-
infectious and cured, as early as possible. The treatment for TB is a combination of 3-4 anti-TB drugs. NEVER
should we prescribe a SINGLE DRUG for TB treatment. This will worsen the patient's condition.

What is DOTS?

D.O.T.S stands for Directly-Observed Treatment Short course. It is a comprehensive strategy endorsed by the
World Health Organization (WHO) and International Union Against Tuberculosis and Lung Diseases (IUATLD) to
detect and cure TB patients.

Basic principles of treatment:

• DOTS cure TB patients and it can produce cure rates as high as 95% even in the poorest countries.
• DOTS prevent new infections among children and adults
 • DOTS can stop resistance to anti-TB drugs. Irregular drug intake impedes cure and results in chronic
cases.
• DOTS is cost-effective.
• DOTS for all patients. All treatment regimens should be administered under directly observed therapy
for total duration of the treatment. Family/treatment partner support is important.
• After 2-3 weeks of correct treatment, patient no longer highly contagious

How can we avail of DOTS Services?

DOTS services are available in the rural health units, city health units, city health centers and government
hospitals around the country. Currently, there are also private facilities that are offering DOTS services to
their clients.

In the meantime, what should patients and physicians do for the prevention and control of TB?

Those who have symptoms of TB should go to the nearest health center to be evaluated for TB. Physicians
should assure that patients take their medications regularly and completely.