Greater community effort needed to “Stop TB in My Lifetime”

1      March 24 marks World Tuberculosis (TB) Day where the international community, led by the World Health Organisation, pledges to “Stop TB in My Lifetime”. Though Singapore has one of the lowest incidence rates of TB in Asia – despite our proximity and open borders with high TB burden countries – the disease continues to pose a public health problem here. Some factors that have caused our TB incidence rates to rise in recent years include the increased reactivation of TB in our older population who were exposed to TB in the 1950s and 1960s, the continued community transmission and global travel and movement.

Update on the TB Situation in Singapore

2      Our TB situation continues to show an upward trend which has been observed since 2006 (when the number of notified TB cases was 1256 and incidence rate was 35 per 100,000 population). In 2012, MOH was notified of 1,560 new cases of TB among Singapore residents¹, which is slightly higher than the 1,533 cases in 2011. Correspondingly, the incidence rate was 40.9 cases per 100,000 population in 2012, compared to 40.5 cases per 100,000 in 2011. The number of non-residents² notified with TB was 643 in 2012 compared to 593 in 2011.

3      Most of the cases (85.7%) among Singapore residents were Singapore-born. Older age groups and males continue to make up a significant proportion of the new cases. Of the 1,560 new cases notified, 941 (60.3%) were 50 years old and above, and 1,103 (70.7%) were males.

4      There were 136 relapsed cases among Singapore residents.

5      The emergence of multi-drug-resistant TB (MDR-TB) remains a serious public health challenge. In 2012, Singapore had eight new cases of MDR-TB, comprising six Singapore-born and two 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.

Greater community effort needed to reduce TB

6      TB is curable and the spread of TB is preventable. While national control measures are in place to reduce the risk of ongoing transmission, each of us play an important role in keeping our community safe and free of TB. Individuals who display TB symptoms should seek medical attention early to ensure early diagnosis. TB patients should adhere to the full treatment to avoid development of drug resistance. As part of social responsibility, proper cough etiquette (e.g. coughing into tissue) should be observed to prevent transmission.

7      As TB treatment takes six to nine months to complete, strong support from family members, friends and the community is essential to encourage patients to finish their treatment regimen. Employers should be supportive of TB treatment for their workers, by granting them the flexibility to go to polyclinics for Directly Observed Treatment (DOT) when necessary. Generally, a TB patient becomes non-infectious after just two weeks of treatment, this period being covered by medical leave. There is thus no increased risk of infection in the workplace when the TB patient returns to work. Treatment compliance and completion will benefit the patient, his family, his workplace and the community.

8      The Health Promotion Board (HPB) continues to actively engage the community and workplaces to promote an understanding of how to prevent infectious diseases, including TB. As part of its outreach efforts to schools, the HPB has produced information booklets for parents and teachers to equip them with relevant knowledge on TB. These booklets were distributed to 170 secondary schools in 2012 and from April 2013 these resources will be dispersed to 179 primary schools. Partnerships such as that with the Singapore National Employers' Federation and the Tsao Foundation further extends public TB education to the general population as well as targeted groups who are at risk. In addition, public education efforts focusing on older adults will emphasise early detection of TB through recognition of symptoms, and the treatability of the disease.

9      With everyone playing their part, we can reduce the community transmission of TB in Singapore. More information on TB is available at MOH’s website at http://www.pqms.moh.gov.sg/apps/fcd_faqmain.aspx or HPB website at http://www.hpb.gov.sg/diseases/article.aspx?id=586.

MINISTRY OF HEALTH
25 March 2013

¹ Residents refer to Singaporeans and Permanent Residents
² Non-residents refer to foreigners on long term stay here for work, study or visit