SLEC New Fees and TB Test Procedure
About SLEC New Fees and TB Test Procedure
This post is specifically about SLEC new fees and TB test procedure.
St. Luke’s Medical Center Extension Clinic, also known as SLEC , is specifically the Philippine U.S. Embassy’s accredited panel physician. In other words, SLEC is the only medical facility for a U.S. Visa medical examination.
Effective October 1, 2017, began charging new medical examination fees:
9,583.00 PHP for children ages 14 and below.
As a result, Interferon Gamma Release Assay (IGRA) is now the TB test procedure at SLEC for those ages 2 -14 years old.
Consequently, SLEC does not use the Tuberculin Skin Tests (TST) anymore. This is because of the fact that IGRA is a more reliable type of blood exam method to detect tuberculosis infection (TB).
For more information, visit the SLEC website.
Hotels Near St. Luke Extension Clinic
By the way, remember to visit our previous blog post on, “Hotels Near St. Luke Medical Center Extension Clinic (SLEC), Ermita, Philippines“.
Also, remember, that for SLEC and other places you need a hotel, that we are now a Travelbook.ph official blogger.
Travelbook.ph is a great site for both Filipinos and foreigners to use because of:
- Pay at hotel feature. Thus, no requirement for credit card.
- Best price guarantee. Therefore, they always have the lowest price in the Philippines.
- Pay over the counter at a bank or mall. In fact, this is a big feature in the Philippines.
Who Gets IGRA TB Test at SLEC
The new IGRA TB test is done at SLEC specifically for applicants 2 – 14 years of age. On the other hand, a chest x-ray is still for applicants 15 years of age and above. In addition, a chest x-ray is for children that have had exposure to or had TB. Thus, there is no change of procedure for those 15 years of age or above and children that have had exposure to TB.
Advantages of IGRA TB Test
According to the CDC the following are the advantages of the new IGRA TB test:
- Requires a single patient visit to conduct the test.
- Results are available within 24 hours.
- Does not boost responses for subsequent tests.
- Prior BCG (bacille Calmette-Guérin) vaccination does not cause a false-positive IGRA test result.
In fact, the single patient visit is a great improvement. Thus, there is no requirement to return to SLEC in order to read the results as was the case with the TST skin test.
Also, the IGRA does not affect subsequent TB testing like the sputum test.
Above all, there is no false positive for any one with a BCG vaccination. This is a very big deal in the Philippines as most peope have the BCG vaccination. As a result, this should significantly decrease the number of false positives.
What Has Not Changed in SLEC TB Testing
As we state above, there is no change of the x-ray procedure for those 15 years of age or above. Similarly, the same is true of x-rays for children that have had exposure to TB.
There is no change for the follow-up sputum testing if the IGRA or chest x-ray result indicates M. tuberculosis infection.
Also, there is no change to the 6 months of DOT (directly observed therapy) treatment if the sputum test is positive.
See the updated work flow charts from SLEC.
What if My Fiance or Spouse is TB Positive
In fact, it is very hard and deflating news to accept at the beginning.
However, it is not the end of the word.
This is due to the fact that subsequent sputum testing may rule out TB.
Those testing positing with the new IGRA test receive a chest x-ray. If there is a normal finding, then they are clear of further testing. If there is an abnormal finding, then they go onto sputum testing.
Also, if the sputum test confirms TB, you can still get your embassy interview after 6 months of TB treatment.
SLEC does not cancel an interview appointment, but they are supposed to notify the USEM that your case will be delayed pending the culture/passing the medical exam. Hence, make sure you cancel your interview appointment if you are undergoing sputum testing.
Initially, SLEC collects 3 sputum test samples over 3 days. This occurs sometime around a week or so after the a positive IGRA blood test or initial x-ray showing signs of past or present TB.
SLEC evaluates these cultures over an 8 week (2 month) period.
Those samples are used to determine if the suspect case is in fact TB. It only takes one of those samples to go positive for the case to be classified as TB positive.
SLEC may contact you earlier than 8 weeks. However, this usually means that there is a TB positive result. It sucks, but it is also a good thing as TB kills. Moreover, it now can be cured and still attend your interview appointment after treatment.
If the sputum culture is negative, then the person doesn’t need to be treated. However, if its positive, then that’s when the 6 month DOT treatment comes in.
If you had to complete the sputum culture test, keep close track of the your visa validity date. This is because of the fact that it is tied to the initial medical date. Hence, you will be short of the 6 months to enter the U.S. As a result of this, you may only have 90 to 120 days before the visa expires.
6 Months DOT Treatment for TB
After positive determination, SLEC requires the person to receive medication daily (5 days per week) at their facility for 6 months.
If your spouse, fiance or child is from outside the Manila area they will require suitable accommodations in Manila. A bed-spacer close to SLEC costs approximately 5,000 php a month. An apartment is about 15,000 php plus utilities. Most chose the apartment route and budget about 30,000 php a month for everything.
See our Travelbook.ph site and search for vacation rentals in Manila.
Also, see our previous blog post on, “Asian Vacation Home Rental- Using HomeAway Asia or airbnb” for a home rental. Also, search local classified for apartment or bed spacer availability.
After the start of treatment, SLEC does a series of 3 sputum tests during the 6 month DOT process. Each test is 2 samples. SLEC collects the final 2 sputum samples at the end of the 5th month of DOT. They take these over 2 days, 24 hours apart. That culture will marinade for 2 months. The DOT is weekdays at SLEC and they’re not open on weekends and holidays. There’s a return trip required at the end of the 7th month to get the final sputum results, redo medical and to get the treatment paperwork.
Therefore, it’s a 9 month process from the point of X-ray or blood detection if the sputum is positive. That’s if all goes well.
If you have to complete the 6 months of DOT treatment, you pay for a second medical fee upon completion. However, this allows you a fresh 90 days to enter the USA.
After you are officially clear of TB, then make your embassy interview appointment.