Tuberculosis

Name and Constituency of Member of Parliament
Mr Melvin Yong Yik Chye
MP for Tanjong Pagar GRC

Question No. 2807
To ask the Minister for Health in view of the continued increase in the number of active tuberculosis (TB) cases from 2017 to 2018 (a) what measures are in place for early TB detection; and (b) whether the current measures to contain local TB cases are effective. 

Name and Constituency of Member of Parliament
Ms Joan Pereira, 
MP for Tanjong Pagar GRC

Question No. 2772
To ask the Minister for Health regarding the increasing number of active tuberculosis cases (a) what is being done to address the issue of the elderly increasingly making up a significant proportion of new active tuberculosis cases; and (b) what is being done to combat the multi-drug resistant tuberculosis which is emerging. 

Answer

Active TB incidence rates in Singapore 

1    The incidence rates of active tuberculosis (TB) cases in 2017 and 2018 were similar, at 39 cases per 100,000 resident population. In fact, the rate had remained within a stable range of about 37 to 41 cases per 100,000 over the last 5 years. 

2    In 2018, almost half of new active TB cases were aged 60 years old and older, although their incident rates had also remained stable. Many older Singaporeans were exposed to TB when they were younger, when incidence rates in Singapore were much higher. As such, up to 30% have latent TB.  Latent TB patients do not exhibit symptoms and are not infectious, but 1 in 10 may progress to active TB during their lifetime. 

3    The World Health Organization (WHO) and local experts do not recommend population-level preventive medication to treat latent TB. Those with active TB and recent latent TB infection will be treated with medication. The treatment approach for older Singaporeans is the same as for the general population. 
 
Measures to contain TB transmission 

4    To contain TB transmission, the Tuberculosis Control Unit (TBCU) conducts contact investigations to identify persons who have had close and prolonged contact with infectious TB cases. Contacts are tested for TB for early detection and treatment of the disease to prevent its spread. 

5    MOH launched the TB Clinical Practice Guidelines in 2016 to strengthen TB management. 

Multi-Drug Resistant TB

6     For Multi-Drug Resistant TB (MDR-TB), patients are isolated for treatment until they become non-infectious, which takes about 2 months, and they will undergo directly observed therapy (DOT) for about 2 years. We have also adopted new technologies such as rapid DNA tests for drug resistance, reducing time taken for identification of MDR-TB from two months to a few hours to facilitate early intervention.