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Republic of the Philippines


Valenzuela City Tuberculosis Prevention & Control Program
Legislative Building, Valenzuela City Hall, McArthur Highway,
Karuhatan, Valenzuela City
352-1000 loc. 1107

Policy on Referral System between Health Facilities under the City

Government of Valenzuela & Valenzuela City Medical Center (VMC) on the
Access of Xpert MTB/RIF Services

In line with the current efforts to scale-up Xpert MTB/RIF implementation

nationwide and as indicated in the revised NTP Manual of Procedures (MOP), 5th
edition, the Valenzuela City Tuberculosis Prevention & Control Program shall be
implementing the full utilization of Xpert MTB/RIF (GX) to the following
1. Presumptive Drug-resistant TB (DR-TB)
A. All types of Retreatment cases
a) Pulmonary or extra-pulmonary
b) Adult or children
c) Relapse, Treatment After Failure, Treatment After Lost to
Follow-up, Previous Treatment Outcome Unknown, Other
B. New cases who are contacts of confirmed DR-TB
C. New cases who are non-converter of Category 1
D. New cases who are PLHIV with at least one sign/symptom of TB
2. Presumptive Drug-susceptible TB (DS-TB) satisfying at least one of the
A. New cases who are DSSM negative but with chest X-ray findings
suggestive of TB
B. New cases who are Children with presumptive TB
C. New cases who are Presumptive extra-pulmonary TB
In view thereof, all DOTS and PMDT Health Facilities under the City
Government of Valenzuela can now refer ALL presumptive DS-TB and DR-TB
following above indications to Valenzuela City Medical Center (VMC) to avail
Xpert MTB/RIF services.
Further to above, the following facilities shall perform the following:
1. For DOTS, iDOTS facilities and Satellite/Treatment Centers under the City
Government of Valenzuela:
A. For Karuhatan Health Station operating as Satellite Treatment
Center, utilize ITIS in creation of LRF.
B. Indicate in the revised Form 2a. NTP Laboratory Request Form (LRF)
whether referred patient is Presumptive DS-TB or Presumptive DR-

TB. In case the new form is not yet available, add reason for Xpert
testing, as highlighted and instructed in said attachment.
C. Ensure complete patient information in the LRF prior to submission
to Xpert site. Incomplete forms can cause delay in processing.
D. Refer Presumptive DS-TB/DR-TB directly to VMC Xpert site. However,
presumptive DRTB are still encouraged to be screened by DOTS
facility and PMDT facilities (ie. iDOTS & Satellite Treatment Center)
prior to Xpert testing.
E. Repeat collection will only be done to those with initial Xpert results
are either
a) MTB Detected-Indeterminate results or
b) Invalid/Error results and
2. Valenzuela City Health Office:
A. Specify zoning arrangements within Valenzuela City and
disseminate accordingly to all stakeholders, at all levels, including
NTRL, IDPCD-NTP and other partners.
B. Advise all stakeholders, at all levels, including NTRL, IDPCD-NTP and
other partners should routing of specimen workload be necessary,
as in the case of limited absorptive capacity of the Xpert site.
3. Agreement with VMC as Xpert site:
A. Xpert MTB/RIF operates on schedule mandated by the hospital
provided that they will accept and properly store sputum for testing
sent by health facilities of City Government of Valenzuela.
B. It is likewise agreed that they will not reject specimens unless it
would compromise the quality of results and/or machine function.

Prepared by:

Arnel C. Gutierrez, M.D.

Tiongco, M.D.
City NTP Medical Coordinator

John Philip D.
City NTP Medical

Noted by:

Jaime M. Exconde Jr., M.D. MSM, FPSMS

OIC City Health Office