Update on the Tuberculosis (TB) Situation in Singapore
- MOH was notified of 1533 new cases of TB among Singapore residents in 2011, which is slightly higher than the 1,478 cases in 2010. Correspondingly, the incidence rate was 40.5 cases per 100,000 population in 2011, compared to 39.2 cases per 100,000 in 2010. The number of non-residents2 notified with TB was 593 in 2011 compared to 550 in 2010.
- Most of the cases (84.0%) among Singapore residents were Singapore-born. Older age groups and males continue to make up a significant proportion of the new cases. Of the 1533 new cases notified, 892 (58.2%) were 50 years old and above, and 1067 (69.6%) were males.
- There were 158 relapsed cases among Singapore residents of which 132 (83.5%) were Singapore-born.
- The emergence of multi-drug-resistant TB (MDR-TB) remains a serious public health challenge. In 2011, Singapore had 6 new cases of MDR-TB, comprising three Singapore-born and three foreign-born residents. The numbers of such cases must be kept low despite a higher regional prevalence of MDR-TB, through strong emphasis on treatment compliance under the national TB control programme. Please refer to Annex for the detailed statistics.
Control of TB in Singapore
- Early diagnosis and complete treatment till cure is the key to successful control of TB in Singapore. Patients with symptoms suggestive of TB should consult a doctor promptly and complete the full course of treatment (6 – 9 months).
- Non-adherence to treatment may result in a relapse of TB with resistant strains i.e. MDR TB and XDR TB, which are more difficult and expensive to treat. Directly Observed Therapy (DOT) is the international standard of care for TB treatment, where a trained healthcare professional observes the patient taking his medication and checks whether the patient has any side-effects from taking the TB medication.
- MOH will take public health enforcement action against those who persistently default treatment as they pose a public health risk to the community. Such persons will be required under the Infectious Diseases Act (IDA) to comply with treatment by DOT until completion. Persons who continue to default their treatment may be also be detained at the Communicable Disease Centre at Tan Tock Seng Hospital till they are cured.
How individuals and the community can help control TB
- People with TB can be treated and cured earlier if they seek medical help promptly and adhere to their treatment. This can safeguard the patients’ health as well as the people around them. There is still stigma attached to TB patients and this acts as a hurdle for people coming forward for diagnosis and treatment. The community can hence also play its part by providing support and encouragement to TB patients. For instance, families of patients should encourage patients to adhere to treatment and employers should be understanding and allow their workers to take time off to go to the polyclinic for DOT.
- More information on TB is available at the MOH FAQs at http://www.pqms.moh.gov.sg/apps/fcd_faqmain.aspx
MINISTRY OF HEALTH
11 November 2012