PBSP Helps Curb TB Through the STRiders Strategy

One of the challenges in reducing Tuberculosis in the Philippines is the low notification and low utilization of the GeneXpert machine, a confirmatory diagnostic tool for TB that is recommended by the World Health Organization.

In 2017, notification of Drug-Resistant TB (DRTB) cases was only at 84 percent despite the availability of 335 GeneXpert machines. Through the GeneXpert, an efficient rapid molecular diagnostic tool, cases can be identified in a short period of time, enabling for immediate treatment of sputum-positive TB patients.

One of the factors causing these challenges is the lack of a reliable transport mechanism for Rural Health Units (RHUs) to refer eligible cases for GeneXpert testing.

STRiders Strategy

To address this gap, the PBSP, through its Advancing Client-Centered Care and Expanding Sustainable Services (ACCESS TB) Project introduced the Specimen Transport Riders (STRiders) strategy in July 2018 which contributes significantly to the number of TB cases being identified and treated today.

A total of 133,176 presumptive people with TB were tested in Regions 3, 4A, other parts of Luzon, Visayas, and Mindanao from July to December 2018 with the help of the STRiders strategy. Out of these, a total of 22,716 turned out to be TB cases and 1,542 cases were discovered to be resistant to Rifampicin.

The STRiders are motorcycle riders hired and trained by PBSP on proper handling and transport of sputum samples from RHUs/DOTS facilities and other treatment centers to Rapid Transport TB Diagnostic Laboratories (RTDLs) in the fastest possible time. It also aims to ensure that 100 percent of expert eligible cases are tested and test results are released timely.

About 138 motorcycle riders were directly contracted by PBSP to serve 1,048 RHUs and 127 GeneXpert Sites in seven regions.

From Patient to STRIder

Jinan Janaide, a former inmate and TB patient-turned-advocate from Zamboanga City, is one of the 138 STRiders hired by PBSP.

A small entrepreneur who used to sell ukay-ukay (used clothes) in the city, Janaide had to work double time when he learned that his wife was carrying their second child. When he stumbled upon the opportunity to earn PhP5,000 to PhP10,000 a day as a pedicab driver, he immediately grabbed it, even if it involved doing something illegal. The job was not just to transport passengers but also to be a courier for a drug business.

Soon enough, Janaide was caught in a drug raid and was sent to the San Ramon Prison and Penal Farm. Realizing that he could no longer support his family, he asked his wife to sell their ukay ukay business and to look for another man who can provide for their children’s needs.

Janaide slowly accepted his fate even after learning that his wife abandoned their children. Determined to reform and support his kids, he took odd jobs while in prison. He sold cigarettes, offered laundry and massage services and even took care of his sick inmates.

After nine years, Janaide was finally freed from prison, but he later found out that he had not really gotten his freedom back. He had contracted tuberculosis (TB). After completing six months of treatment, he was devastated to learn that he did not get well. In fact, he had a different strain, which is the Multi Drug-Resistant TB (MDRTB).

Janaide became one of the first patients in the country to undergo the shorter TB treatment regimen of nine months from the previous 18 to 24 months. He underwent his treatment at the Programmatic Drug-resistant TB (PMDT) Satellite Treatment Center in the Mindanao Central Sanitarium General Hospital which offered free medicines. PMDT is a component under the ACCESS TB Project managed by PBSP that caters to drug-resistant patients like him.

While on treatment, Janaide was encouraged to join the Samahang Lusog Baga, Inc., a support group composed of current and cured TB patients.

Later, he was hired by PBSP to work as a STRider which enabled Janaide to bring his advocacy of helping TB patients to the next level.

“What I love about my job now is that I am able to help poor patients. I do not only transport sputum. I also bring some patients to the treatment centers for free. This job given by PBSP is a big help to my kids. PBSP really helps us and it’s just up to us patients if we want to be helped or not,” he said.

PBSP, through the ACCESS TB Project, will continue the implementation of the STRiders Strategy until 2019 and is planning to expand the program to other regions facing the same challenges.

PBSP in TB Control

For the past 18 years, PBSP has served as one of the key players in TB control management in the Philippines, having cemented its solid experience and expertise in managing projects as subcontractor and later as principal recipient through funding from major donors like the United States Agency for International Development, United Way Worldwide and The Global Fund.

Under PBSP’s portfolio, more than 37,000 multidrug-resistant patients underwent treatment, more than 43,000 healthcare providers were trained, hundreds of treatment centers across the country were built, over 200 companies established Workplace TB policies and programs, and thousands of patients were cured. These numbers increase each year as PBSP continues to partner with the Department of Health National TB Control Program in its goal to end TB in the country.