IMPROVED detection of tuberculosis (TB) among detainees and inmates in Philippine jails and other detention facilities is a critical priority, particularly in view of the sharp increase in the inmate population due to President Rodrigo Duterte’s anti-drug campaign, health representatives from key government agencies learned in a three-day workshop organized by the International Committee of the Red Cross (ICRC) last week.
More than 60 senior TB coordinators and managers from the Bureau of Jail Management and Penology (BJMP), the Bureau of Corrections (BuCor), and the Department of Health (DOH) joined the workshop on “TB case-finding mechanisms in the penitentiary system” to see how best practices—such as entry screening, cough surveillance, and mass screening—could be systematically replicated across the country and eventually reduce number of people affected by the contagious disease.
“Based on three years of TB control programs in our pilot sites—the New Bilibid Prison (NBP) and Quezon City Jail—intensified TB detection methods such as mass screenings helped capture the cases that had been missed. We hope the workshop will help consolidate the approach on improving TB case detection in detention places,” said Beatriz Karottki, health coordinator of the ICRC.
The Philippines is one of the top 30 high-burden countries in the world plagued with TB. In 2015, it was estimated that every hour, about 30 Filipinos are identified with active TB. Each day, 63 Filipinos die from this preventable and curable disease.
In detention facilities, based on 2015 worldwide estimates by the World Health Organization, four or five inmates for every 100 will fall ill with TB. Overcrowding in jails and prisons contributes to the rapid spread of the disease among detainees.
The Quezon City Jail was recently the subject of an Agence France-Presse (AFP) report highlighting the overcrowding problem in Philippine jails and prisons. According to the report, the facility was originally built to house 800 inmates, but not contains more than 4,000.
In 2015, the NBP and Quezon City Jail reported 540 and 285 TB cases, respectively—incidence rates 8 to 13 times higher compared with TB incidence outside detention places. The high numbers of TB cases in both sites were captured largely through mass screening activities.
“The number of jail health personnel may be limited, but with sufficient and correct information from this workshop on how to properly conduct TB case-finding in jails, our health staff will be more competent and confident to identify and manage TB cases in jail facilities effectively,” said J/Sr. Insp. John Paul Borlongan MD, BJMP’s national TB coordinator.
Since 2007, the ICRC has been working closely with Philippine authorities to address the causes and consequences of extreme overcrowding in jails, focusing particularly on TB, living conditions, and delays in the judicial system. The ICRC also works with the authorities to strengthen the overall health system in detention facilities.
“With the support of partners and stakeholders, in particular the ICRC, the NBP TB Treatment Unit staff will continue to exhaust all efforts to diagnose and treat all TB cases to the point of cure. We ultimately hope to put an end to this menace,” said Dr. Cecilia Villanueva, BuCor TB medical coordinator.