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30 September 2011

Of Positive PPD Skin Test Results and Nine Months Therapy

According to the World Health Organization's Global Tuberculosis Report in 2009, the Philippines ranks ninth on the list of 22 high-burden tuberculosis countries in the world. On the other hand, in the United States, the annual incidence is approximately four per 100,000 population. See the huge difference there?


Anyhow, approximately two years ago, I had a positive skin test result for TB. (To read more about the TB skin test, click here.)


Please do not get freaked out just yet.


A positive skin test for TB does not mean that I have TB. What I mean is, I have been exposed to the bacteria and now they are "sleeping" inside my body. Therefore, the TB bacteria is not active. I do not have the symptoms for tuberculosis which includes persistent cough, fever, night sweats, weight loss, lack of appetite, and extreme fatigue. (To read more about tuberculosis, click here.)


Anyway, the test for TB does not end with having a positive skin test. After your doctor or nurse determines that you have a positive skin test, you would have to go to a clinic or radiology center to obtain a chest x-ray. Thank goodness, my chest x-ray was clear. This means... I. Am. Not. Contagious.


Please keep in mind that I had my positive skin test result and my clear chest x-ray TWO YEARS AGO.


Last Wednesday, I went to the Public Health Center to get my free checkup, blood test and medication. The very nice doctor reviewed my records and it turned out that she was doubtful about the result I had two years ago. I had exactly 10 millimeters of induration back then. And according to the doctor, that is a borderline result because a positive skin test is 10 mm or larger. And I had exactly 10 mm of induration. Nice. Bottom line is the doctor gave me a free TB skin test and told me to come back after two days.


So today, which is Friday and two days after the doctor gave me the skin test, I came back to Public Health. Guess what. I had a 10 mm red induration on my left forearm where she injected the medicine intradermally. At that moment, I just thought, "Borderline... Again!"




I was sitting in her office and for a moment, she debated whether it was a negative or a positive result. In the end, she said that it was a positive result and that she would prescribe me a medication. Here is a picture of what she prescribed me with:




This is my free 300 mg isoniazid (INH) that I would have to take for nine months. This meant nine months of abstaining from alcohol. Not that I have a problem with that anyway.


After getting my free blood work and my free one month supply of prophylactic medication for TB, I realized that I am very blessed to be able to have these privileges. In Philippines, I believe part of the reason several people die from TB is because the government could not provide their citizens with free checkup or free medications. If only Philippines could have the same system US has, then maybe, just maybe, not many people would die from tuberculosis.

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