Prolonged lockdowns and disruptions to TB services during the COVID-19 pandemic in the Philippines meant people living in overcrowded areas also faced a higher risk of contracting TB. In collaboration with the Manila Department of Health, our teams launched an active case-finding project in 2021 to detect TB with an x-ray truck in the district of Tondo, one of the capital’s most impoverished areas. The aim is to screen people, trace contact cases and refer TB-positive patients to local health centres.

The TB screening capacity of our multidisciplinary medical team was strengthened with an innovative software programme using artificial intelligence, called computer-aided detection (CAD4TB). CAD4TB is capable of rapidly recognising TB on chest x-rays. According to a study conducted by MSF this year on the implementation of the software in the project, this tool significantly sped up the screening process, enabling us to screen more Tondo residents in 2023.

At the same time, our health promotion teams toured the community to encourage people to undergo chest x-ray screening. Our medical team also followed up with patients to ensure they adhered to their treatment regimen, thereby breaking the chains of transmission. Early diagnosis and treatment are some of the most effective ways to prevent the spread of TB.

We conducted home visits immediately after a positive diagnosis to screen households’ close contacts, administer TB skin tests and offer TB preventive treatment, especially to children. Infants and young children are particularly prone to severe forms of the disease, and in Tondo, their vulnerability is exacerbated by nutrition deficiencies. However, diagnosing TB in children is more complex than in adults, as it is difficult for them to produce the sputum needed for laboratory analysis. Protecting children through preventive measures and timely treatment of adults is a key priority for our teams.