Shorter TB Treatment for Children Rolled Out in Tondo

Doctors Without Borders, the Manila Health Department (MHD), and the University of the Philippines Manila (UP Manila) have begun implementing a shorter, four-month treatment regimen for children with non-severe tuberculosis (TB). The initiative follows the Department of Health’s (DOH) adoption of updated national guidelines based on World Health Organization (WHO) recommendations.

The new treatment regimen aims to cure children within four months, compared to the previous six-month regimen, while maintaining the same level of effectiveness.

In Tondo, Manila, Doctors Without Borders and MHD trained physicians and TB nurses from 15 health centers in Districts 1 and 2 during a two-day workshop. The training covered chest X-ray interpretation, TB screening and diagnosis, disease severity classification, and treatment.

A Major Step Forward for TB Care

The Philippines is among the few countries to adopt the shorter treatment regimen and begin its rollout. The initiative is critical in a nation with the fourth-highest TB burden worldwide.

Since 2022, Doctors Without Borders and MHD have collaborated on a TB project in Tondo. As of January 2025, the project has screened 38,465 individuals and diagnosed 1,826 TB patients. Children exposed to TB are identified through household investigations or when they present symptoms at health centers.

The updated guidelines recommend the four-month regimen (2HRZE/2HR) for children aged 3 months to 16 years with non-severe, drug-susceptible TB. The treatment involves a two-month intensive phase with four drugs, followed by a two-month maintenance phase with two drugs.

Dr. Richard H. Castro, head of MHD’s TB Prevention and Control Section, highlighted the benefits of the shorter regimen. “A shorter treatment duration reduces logistics, commodities consumption, and disease burden for families. It also allows faster recovery, especially in low-income areas like Tondo,” he said.

For families, the shorter regimen means fewer health visits, less exposure to medication, and potentially lower out-of-pocket costs. “This is an important step in making treatment easier and faster for our patients in the City of Manila,” Castro added.

Collaboration and Research

The implementation of the new treatment is part of Doctors Without Borders’ TACTiC (Test, Avoid, Cure TB in Children) project. The project includes a study conducted by Epicentre, the organization’s medical research branch, in collaboration with MHD and the Institute of Child Health and Human Development (ICHHD) at UP Manila.

The study aims to assess the feasibility and accessibility of the shorter treatment regimen in the Philippines and Uganda. It will identify barriers to implementation and propose solutions to encourage global adoption of the regimen for children with non-severe TB.

Valentina Carnimeo, an epidemiologist at Epicentre, emphasized the importance of integrating WHO recommendations into real-world settings. “TACTiC simplifies diagnosis and treatment, ensuring more children recover with better, more accessible care,” she said.

Dr. Josephine G. Aldaba, a research assistant professor at UP-NIH, added, “This study is crucial in understanding the acceptability of the regimen among parents, healthcare workers, and the community. It can improve adherence to TB treatment.”

Dr. Castro underscored the importance of community engagement. “By understanding how the community accepts this change, we can ensure the treatment reaches every child and adolescent who needs it,” he said.

For more information on Doctors Without Borders, visit doctorswithoutborders-apac.org. For interview requests, contact Regina Layug Rosero at regina.layug.rosero@apac.msf.org.