Tuberculosis, Diabetes, and Health Screening in Palau

Author: Emily Spangler
Major: Biology, Public Health Studies
Approved: Spring 2018
Status: Completed

Tuberculosis is a dangerous disease that is endemic to the Western Pacific Region and to the Republic of Palau. Regular screening is one of the most efficient methods of identifying tuberculosis at an early stage and increasing the likelihood of timely treatment. Reducing the time between the onset of TB and the delivery of treatment is critical in improving patient outcomes. This summer, I will work with the Palauan Ministry of Health, specifically their communicable disease branch, to analyze screening data and identify barriers to screening and treatment. As multidrug resistant tuberculosis becomes increasingly prevalent, early detection and prevention is increasingly necessary to save the lives of persons impacted by this disease.

Through personal experience and data analysis, I will develop an understanding of the ways in which Palau manages and controls tuberculosis and design and publish an intervention that will make suggestions to reduce inefficiencies within the current system. My primary goal is to be of greatest assistance to those in Palau I am fortunate enough to work with. When I return from Palau, I will extend my research to author a paper that will likely answer one of the following: 1) What are the barriers to TB screening in Palau and what changes could be made to diminish the effects of these barriers? 2) How effective are screening and case management in reducing the prevalence and incidence of TB and in what ways could these processes become more efficient? 3) How has TB screening and prevalence changed over time as type 2 diabetes mellitus becomes increasingly common? What are the implications of these trends and how might TB be prevented in this changing environment? 4) How has the rising prevalence of multi-drug resistant tuberculosis impacted Palau and what can be done to reduce drug resistance?