TB patients save money if labs also test for other diseases – expert

BANGKOK, Thailand — Filipino tuberculosis (TB) specialist Rugaiya Calapis once asked her patient, a 32-year-old man using the alias “Juan,” to undergo a sputum test after he complained of coughing and losing weight for two weeks.

The following week, Calapis found that her patient—who had taken an unpaid day off for his check-up—was positive for tuberculosis. This prompted a second round of testing for the human immunodeficiency virus (HIV), which is closely linked to TB.

However, according to Calapis, Juan never returned to the doctor’s office.

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“That means his TB is not treated, the train of transmission continues, and the system’s whole reply is that this is the procedure. But is it? This procedure has a name. It is called inequity. It is inefficiency,” she said.

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“This is the reason why this can be fatal for Juan. This is the daily reality in every high-burden country, especially with tuberculosis,” she added.

READ: PH has third highest burden of TB worldwide

How can the public health system streamline the testing patients need?

In her presentation at the Asia-Pacific International Roche Infectious Disease Symposium (APAC-IRIDS) in Bangkok, Thailand on Wednesday, Calapis proposed an “integrated, multi-disease testing” framework.

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Under this framework, according to Calapis, a patient would provide a specimen that is transported to a central laboratory.

The lab would then test the specimen for as many types of diseases as possible and send the results back to the doctor to determine the treatment steps.

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“Instead of establishing separate laboratory systems for TB, HIV, HPV (human papillomavirus), and other diseases, we create a common molecular platform capable of supporting multiple diagnostic programs,” Calapis said.

“Instead of navigating labyrinthine, fragmented services, they experience a more coordinated pathway that reduces waste, minimizes lost wages, and increases the likelihood of linkage to treatment,” she stressed.

A more specific testing gap

Citing the World Health Organization’s Global TB Report in 2025, Calapis said that for every 100,000 Filipinos, at least 625 were infected with tuberculosis.

This is significantly higher than the global average of 131 per 100,000 population, making the Philippines the third-most heavily burdened country for tuberculosis cases, following India and Indonesia.

Calapis, who chairs the Department of Health-National Capital Region South TB Medical Advisory Council, further flagged a specific diagnostic gap: isoniazid resistance.

READ: DOH seeks TB program funds as PH in top 3 infections worldwide

Isoniazid is an antibiotic commonly used in first-line drugs to treat tuberculosis. However, Calapis noted that Philippine health laboratories more frequently test for resistance to rifampicin, another first-line antibiotic.

“This diagnostic blind spot contributes to treatment failure, ongoing transmission, and the development of further resistance,” she said.

“Closing just this isoniazid resistance testing gap changes the entire trajectory of care. It means the right treatment, right away, instead of months of ineffective first-line treatment,” she maintained.

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“This stops the spread of drug-resistant strains within the community, lowering mortality and transmission. This is not just an incremental improvement; it’s a fundamental correction in our clinical course,” she added. /mcm