An assessment of globally-accepted standards and benchmarks for tuberculosis surveillance — Philippines, 2023 (Preprint)

<sec> <title>BACKGROUND</title> The Philippines accounts for 7% of the global tuberculosis (TB) burden. In 2022, an estimated 741,000 Filipinos developed TB and 40,000 died as a result. Approximately 350,000 new TB diagnoses remain unreported annually. </sec> <sec> <title>OBJECTIVE</title> In October 2023, we undertook an assessment of the accuracy, completeness and timeliness of the national TB surveillance system using globally-accepted TB surveillance standards and benchmarks assessment tool. </sec> <sec> <title>METHODS</title> A team of Filipino and international evaluators conducted field visits to nine purposively selected health facilities across four regions. Health records were reviewed and key informants were interviewed to assess essential activities and best practices. </sec> <sec> <title>RESULTS</title> Among 16 applicable performance standards, four were fully met, nine were partially met, and three were not met. This was an improvement from a similar assessment conducted in 2019. Although electronic case-based recording and reporting had expanded greatly since 2019, large local variations in the adoption of quality assurance practices were evident. Over 60% of reported persons with TB had no bacteriological confirmation, despite a functional national laboratory network. Under-reporting due to underdiagnosis was also noted. Delayed reporting was common, especially in locations with limited internet connectivity or access to antituberculosis medications. </sec> <sec> <title>CONCLUSIONS</title> Issues related to data quality assurance, gaps in case verification and timeliness emerged as potential threats to data integrity and surveillance fidelity. Enhanced monitoring and evaluation and tailored studies, such as a national TB inventory study, could assist in quantifying potential under-reporting and clinical overdiagnosis, guiding future funding, and assessing progress toward elimination targets. </sec> <sec> <title>CLINICALTRIAL</title> N/A </sec>