S E T T I N G :Both depression and tuberculosis (TB) are global public health problems that have a substantial impact on human health. However, depressive state among TB patients has not been well investigated in the Philippines. O B J E C T I V E : To assess depressive state among pulmonary tuberculosis (PTB) patients and to identify factors associated with depressive state in Manila, the Philippines. D E S I G N : A cross-sectional survey of PTB patients was conducted at 10 public health centres and two nongovernment organisation clinics providing DOTS in District I, Tondo, Manila. Face-to-face interviews with 561 PTB patients using a structured questionnaire were conducted. R E S U LT S : Depressive state was observed in 16.8% of the participants. Logistic regression analysis indicated that body mass index < 18.5 kg/m 2 , marital status of cohabitation compared with married, four or more symptoms, four or more adverse drug reactions, grade 3 or higher on the Medical Research Council dyspnoea scale and low perceived confidant social support were significantly associated with depressive state.

Socioeconomic status including SHS exposure and low perceived social support, in addition to clinical factors, may be associated with poor HRQOL. Further study would be needed to assess our findings.

Socio-economically underprivileged areas in the Philippines. To review the implementation of tuberculosis (TB) contact investigations in the urban poor areas of Manila and Quezon City. A descriptive cross-sectional study based on a review of data from household contact registries in local government unit (LGU) and non-government organisation (NGO) facilities during January-December 2012 in Manila and Quezon City. Free discussion sessions were also conducted among health-care workers. Of 6161 children and adult household contacts listed in the LGUs and 1893 in the NGOs, 17% ( = 1086) in the LGUs and 95% ( = 1800) in the NGOs were evaluated. The yield of clinically diagnosed TB among children aged <15 years was 10.2% (127/1245) in the LGUs and 8.4% (63/752) in the NGOs. The yield of isoniazid preventive therapy (IPT) for those aged <5 years was 23.1% (124/537) in the LGUs and 28.0% (78/279) in the NGOs. The NGOs produced a high yield of IPT due to a better logistical system that ensured the availability of supplies and systematic home visits. Screening of household contacts in poor urban areas appears to be effective; it increased the number of children aged<15 years eligible for IPT and should be expanded as an intervention strategy for TB control in the Philippines.

To quantitatively and qualitatively describe some of the challenges faced by the Philippines' health insurance programme, PhilHealth, in the era of Universal Health Coverage. Methods: A descriptive study using a mixture of quantitative and qualitative methods. Quantitative data were collected from various sources and semi-structured interviews were conducted among staff of relevant organisations. We focused particularly on the enrolment process among eligible individuals and the system of reimbursement in five local government units (LGUs). Results: The proportion of individuals enrolled as 'poor' exceeded the number officially assessed as being poor by 1-11 times in almost all of the LGUs evaluated. Interviews revealed 'politically indigent' individuals, i.e., the enrolment of non-poor individuals as poor. Several health centres were not receiving reimbursements from PhilHealth, likely due to structural and political deficiencies in the process of claiming and receiving reimbursements. Conclusion:The composition of the sponsored and indigent membership groups requires closer examination to determine whether people who are truly marginalised are left without health coverage. PhilHealth also needs to improve its reaccreditation and reimbursement systems and processes so that health centres can appreciate the benefits of becoming PhilHealth-accredited service providers. * Data source: Personal communication with LGU representatives during the interview.† Health centres that complied with and passed the specific standards set by the DOH and PhilHealth for the delivery of quality primary care services.

The significant improvement in the total score of assessment factors strongly suggests a positive impact of the training course on improving the quality of CXRs.