The 0.3% active annual TB incidence is not unreported active TB prevalence, which is
at least double of that and much more likely given how filipino culture favors suffering and not going to hospitals (more so than northern peoples such as those in Laos) that I suspect prevalence much higher probably > 1% a year.
So that means in any given year, the risk of TB infection is
greater than 1.2% and relatively speaking it looks like it must be about 3 - 5% on average. Given I have been in the Philippines culmulatively for ~26 years, so my risk of TB infection is virtually the same as the general population thus 70 - 80% incidence of TB infection (not necessary active disease, just infection). And given I did not shield myself from the ~100% endemic TB infection incidence squalor population, my risk of TB infection is about 100% (and I do have TB).
So I hope you see how the 0.3% active annual TB incidence figure from the WHO is so misleading.
In other words in the Philippines, from the pool of an estimated 70 - 80% who are TB positive, roughly 3 - 5% become active and contagious with each year.Risk of infection from living with a TB patient is
greater than 38%. Contact with
people from increased poverty increases risk of infection.
The incidence of MDR (multi-drug resistant) TB is very high in the Philippines. This is nasty shit:
MDR-TB IN THE PHILIPPINES: ONE WOMAN’S FIGHT
Mildred Fernando was diagnosed with tuberculosis in her native Philippines nearly 12 years ago, at age 19. We caught up with Mildred after she spoke at a RESULTS event for World TB Day 2013, eager to hear more about her experience with a multidrug-resistant strain of the disease, the help she received from the Global Fund and her courageous, decade-long fight back to health.
Friends: So why don’t we start with a little bit of the history behind your experience with multidrug-resistant tuberculosis (MDR-TB).
Mildred: I was diagnosed to have TB in the year 2001; I was at my last semester in college during that time. I got it from my father. I went to a private doctor for treatment and diagnosis was through x-rays only. So the doctor gave me first line drugs, and then I took them every day. After six months, I wasn’t cured. And then another cycle took place with the same doctor, still using x-rays. My father already had resistance to drugs, but I don’t know why the doctor didn’t intend for me to undergo certain tests.
After five years, the last doctor said that she didn’t have any drugs that she could give to me. So she referred me to the Global Fund-financed Tropical Disease Foundation (TDF). I went there, they had me screened, and then I underwent sputum collection. I finished my treatment after 18 months. During that period I suffered from electrolyte imbalance and drug-induced hepatitis. I had profound hearing loss, especially in my right ear.
In August 2008, I was declared cured. After six months, I went back to TDF for my first post-treatment check-up. And I found out that I relapsed.
Friends: [Oh my God.]
Yeah, it was actually a decade of TB. So I relapsed, and I had to undergo another treatment for 24 months, which was covered by a clinical trial. I was confined in the hospital for six months. I lived in the hospital for six months. I underwent an operation and they put a catheter in my right arm, where one of the injectable drugs is administered twice a day for six months. After six months, I had lung surgery. So part of my right lung was cut out, and after my surgery I continued to do my treatment until I finished my 24 months of treatment.
Click here for a world map of MDR-TB incidence amongst previously treated patients.
Apparently I was mistaken, and
the 14% is for MDR in previously treated patients. For new patients, it is 2 - 4%. Apparently no worse than the USA:
http://openres.ersjournals.com/content/1/1/00010-2015
