UPDATE ON TUBERCULOSIS SITUATION IN SINGAPORE

               On World Tuberculosis (TB) Day on 24 March, Singapore joins the global community in reiterating our commitment to continue the fight against TB. The World Health Organization’s (WHO) theme for 2022’s World TB Day is “Invest to End TB. Save Lives”, which conveys the pressing need to commit resources to accelerate the fight against TB.

2.             TB remains a global public health threat. In 2020, there were an estimated 9.9 million cases of active TB globally, with 1.5 million deaths. In addition, there were almost half a million cases of multi-drug resistant TB (MDRTB). MDRTB is more difficult to treat and has lower cure rates, with death rates as high as 30 to 40 percent.

3.             TB is endemic in Singapore and latent TB infection is not uncommon in our population, with rates of up to 30 per cent in the older age groups. Singapore’s TB testing capacity remained stable during the COVID-19 pandemic and there was no decrease in access to testing. In 2021, there were 1,306 new cases of active TB among Singapore residents. This is lower than the 1,360 cases in 2020. The incidence rate was 32.8 cases per 100,000 population in 2021, compared to 33.6 cases per 100,000 in 2020. Older age groups and males continue to make up a significant proportion of the new active TB disease cases. Please refer to the Annex for details.

TB Screening and Treatment in Singapore

4.             TB is an air-borne disease and is transmitted through close and prolonged exposure to an infectious individual with untreated, active pulmonary (lung) TB disease. Not all individuals who are exposed to an infectious individual will get TB.

5.             TB is curable and the spread of TB is preventable. To ensure early detection and treatment, and to curtail the spread of TB, the National TB Programme (STEP) carries out contact tracing and screening of close contacts to ensure that those at risk of infection are tested and receive appropriate treatment.

6.             Persons diagnosed with active TB disease will be started on treatment immediately and placed on medical leave. Once treatment starts, the person will rapidly become non-infectious and no longer pose as a source for infection. There is no further risk of exposure in the workplace or school, and there is therefore no need for workplaces or places where a recently diagnosed active TB case disease has visited to be closed. Close contacts found to have latent TB infection are not infectious and can continue their activities as usual.

7.              While there are national control measures in place to reduce the risk of TB transmission in Singapore, everyone plays an important role in preventing the spread of TB. Individuals who are unwell and display symptoms, such as prolonged cough, should seek medical attention early to ensure prompt diagnosis and treatment.

Importance of Treatment Adherence

8.             The full course of active TB disease treatment takes six to nine months (up to 24 months for drug-resistant TB). If patients do not adhere strictly to the treatment programme (e.g. taking their medication on time and completing the full course of medication), there is a higher chance of disease relapse and developing MDRTB.

9.             Directly Observed Treatment (DOT) is a widely used strategy to ensure treatment adherence globally, and it remains a pillar of TB control in Singapore. It comprises the administration of TB medicines by a trained healthcare worker to the patient.

10.          Support and encouragement from patients’ family members, friends and co-workers are vital in ensuring that TB patients successfully complete their treatment. Employers can also play their part, by granting their employees flexibility during the day to access DOT. Treatment adherence and completion will not only benefit the patient, but also protect patients’ family, workplace and community from infection.

11.          With everyone playing their part, we can ensure that TB patients are treated effectively and reduce community transmission of TB in Singapore. More information on TB is available at the MOH website or the HealthHub website.

MINISTRY OF HEALTH

24 MARCH 2022