Everyone can help control TB in Singapore

19 Mar 2010

World TB Day

1. 24 March is World Tuberculosis (TB) Day. The World Health Organisation’s theme for this year is “On the move against tuberculosis: Innovate to accelerate action”. On this day, we will join hands with all other countries to raise public awareness in the global fight against TB.

Update on the Tuberculosis Situation in Singapore

2. MOH was notified of 1,442 new cases among Singapore residents in 2009. This was slightly lower than the 1,451 cases notified in 2008. Older age groups and males continue to make up a significant proportion of the new cases. Of the 1,442 new cases notified, 837 (58%) were 50 years and older, and 1040 (72%) were males.

3. The emergence of multi-drug-resistant TB (MDR-TB) is a serious health issue for many countries. Fortunately MDR-TB comprised less than 0.5% of all TB cases and between 0-3% of relapsed cases in Singapore during the period 2005 to 2009. Three new cases of MDR-TB had been reported among Singapore residents in 2009. The low incidence of MDR-TB could be attributed to our strong emphasis on treatment compliance under the national TB control programme.  Please refer to Annex for the detailed statistics.

Importance of Early Diagnosis and Complete Treatment of TB Cases

4. To successfully control TB and curb community transmission, it is important to ensure that all cases with TB are diagnosed early and undergo complete treatment (6 to 9 months) until fully cured. Those who fail to adhere to treatment may continue to be infectious or may suffer a relapse some time later as all the TB bacteria may not have been killed. Worse still, the tuberculosis bacteria may mutate to a drug-resistant form which will be more difficult to treat. Treatment will then have to be for at least 18 months, instead of 6 months.

5. Directly Observed Treatment (DOT) is the international standard of care for TB treatment. Under DOT, a trained healthcare professional supervises the patient taking each dose of anti-TB medication and ensures patient’s compliance with treatment. At the same time, it enables the healthcare professional to monitor the patient for any side-effects of treatment. DOT is therefore the ideal mode of treatment for patients with TB and is available in all polyclinics in Singapore.

6. Persons with symptoms suggestive of TB (such as prolonged cough, fever, night sweats, unexplained loss of weight and appetite, tiredness) should seek medical attention as soon as possible. Family members should also bring their loved ones to the doctor if they notice these symptoms.

Controlling TB is Everyone’s Responsibility

7. Everyone plays an important role in controlling TB in Singapore and keeping our community safe and free of TB.

8. At the individual level, we can all do our part by ensuring early diagnosis and compliance with full treatment should we suffer from TB. As TB is a respiratory illness, patients should also observe proper cough etiquette (e.g. coughing into tissue) to prevent transmission.

9. The stigma attached to TB patients and prolonged treatment required of TB patients may be barriers to people coming forward for diagnosis and treatment. At the community level, family, friends and employers of TB patients can play a critical role by giving them support and encouragement.

10. For example, family members should encourage and remind patients to adhere strictly to treatment. Employers should be supportive by allowing their workers to take some time off to go to the polyclinic for DOT. Employers should uphold workers who take every dose of medicine faithfully and complete their treatment, as responsible colleagues who are considerate to their fellow workers. Generally, a person becomes non-infectious after just 2 weeks of treatment. This period of treatment is covered by medical leave. There is thus no risk of transmission at the workplace when the TB patient returns to work.

11. For those who persistently default treatment and thus pose a public health risk to the community, MOH will take enforcement action by requiring them to comply with treatment under the Infectious Diseases Act. Persons who continue to default their treatment may also be detained at the Communicable Diseases Centre at Tan Tock Seng Hospital for treatment until they are cured.

12. TB is curable and the spread of TB is preventable. With everyone playing his part, we can reduce the community transmission of TB in Singapore. More information on TB is available at the MOH FAQs at http://www.pqms.moh.gov.sg/apps/fcd_faqmain.aspx

MINISTRY OF HEALTH

19 March 2009

Annex (0.55 MB)