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 World TB Day 2025 is “Yes! We Can End TB: Commit, Invest, Deliver”. 

2.             TB remains a global public health threat. In 2023, there were more than 10.8 million cases of active TB globally, with 1.25 million deaths[1]. In addition, there were an estimated 400,000 cases of multi-drug resistant or rifampicin-resistant TB (MDR/RR-TB)[1]. MDR/RR-TB is more difficult to treat and has lower cure rates, with a treatment success rate of 68% compared to almost 90% for drug-sensitive TB[1]. 

Update on Local TB Situation 

3.             In 2024, there were 1,156 new cases of active TB disease among Singapore residents. This is lower than the 1,201 cases in 2023. The incidence rate was 27.6 cases per 100,000 residents in 2024, compared to 28.9 cases per 100,000 in 2023. Older age groups and males continue to make up a significant proportion of the new active TB cases. Of the 1,156 new cases notified in 2024, 901 (77.9%) were 50 years old and above, and 780 (67.5%) were males. In 2024, Singapore had three new cases of MDRTB among its residents. Please refer to the Annex for details. 

4.             TB is endemic in Singapore, and latent TB infection is not uncommon in our population, with rates of up to 30% in the older age groups. Persons with latent TB infection carry the TB bacteria in their bodies, but they are not infectious as the bacteria are not active. 

TB Screening and Treatment in Singapore 

5.       TB is curable and the spread of TB is preventable. To ensure early detection and treatment, and to curtail the spread of TB, under the National TB Programme, contact tracing and screening of contacts are carried out to ensure that those at risk of infection are tested and receive appropriate treatment. As of July 2024, the screening of TB has been made mandatory for contacts. This is to enable earlier diagnosis of TB cases and timely treatment of latent TB infection, thereby reducing the spread of active TB. 

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 will no longer spread the bacteria. There is no further risk of exposure in the workplace or school, and there is therefore no need to close workplaces or places visited by a recently diagnosed TB disease case. Contacts found to have latent TB infection are not infectious and can continue their activities as usual. 

Supporting People with TB 

7.       The full course of active TB treatment takes six to nine months, and possibly longer for drug-resistant TB. If persons diagnosed with TB do not adhere strictly to the treatment programme (e.g. taking their medication on time), there is a higher chance of disease relapse and development of MDRTB. 

8.       Directly Observed Treatment (DOT) remains a pillar of the National TB Programme. It comprises the administration of TB medicines by a trained healthcare worker to persons diagnosed with TB and is available at all the polyclinics. The National Tuberculosis Care Centre also manages an outreach DOT programme for persons who are unable to commute to clinics for their medications due to age or infirmity. Under outreach DOT, trained healthcare workers administer TB medication at the patients’ home. To increase the accessibility of TB treatment, video-observed therapy is also available for selected patients, who must have demonstrated good adherence to their treatment. 

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

10.      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. Those identified as contacts should go for screening, so that they can be offered preventive treatment if tested positive for latent TB infection. 

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

[1] Source: WHO Global Tuberculosis Report 2024 (https://www.who.int/publications/i/item/9789240101531)

Annex