Plans to fight against multi-drug resistant tuberculosis

Name and Constituency of Member of Parliament

Mr Melvin Yong Yik Chye

MP for Tanjong Pagar GRC

Question No. 1940

To ask the Minister for Health (a) what are the primary sources of infection for tuberculosis in Singapore; (b) what more can the Ministry do to reduce active and latent tuberculosis cases; and (c) what plans does the Ministry have to fight against multi-drug resistant tuberculosis.

Oral Reply

1        Tuberculosis (TB) is an air-borne infectious disease. One can be infected with TB through close and prolonged exposure to a person with active TB, such as household members, co-workers and classmates.  When infected, most will develop latent TB.  Persons with latent TB do not have symptoms and are not infectious.  The elderly, and persons who have weakened immune systems such as those with severe medical conditions, are more likely to develop active TB.  About 1 in 10 healthy persons with latent TB will progress to active TB at some point during their lifetime.

2        To control the spread of TB, the Tuberculosis Control Unit (TBCU), adopts four strategies to detect, treat, and prevent transmission that is in-line with the World Health Organization’s recommendations.  These are:

                   i.         Early detection and prompt treatment;

                   ii.         Ensuring compliance to treatment through Directly Observed Treatment;

                   iii.         Close monitoring of treatment progress; and

                   iv.         Tracing and screening of close contacts of infectious cases to identify infected contacts early and offer those with latent TB preventive treatment.

In addition, to prevent the importation of TB into Singapore, foreigners applying for work-permit in Singapore are screened for active TB.

3        To further strengthen TB management among the medical community, MOH launched the TB clinical practice guidelines in 2016.  These equip the medical community with better knowledge on TB diagnostic tools, treatment regimens and public health measures for TB control.  To deepen our understanding of TB transmission and develop better control strategies, TBCU is progressively implementing whole genome sequencing for TB cases.  This helps to identify related TB clusters more precisely and improve our ability to prevent TB transmission.

4        Specifically on multi-drug resistant TB (or MDR-TB), the TBCU will be implementing rapid DNA tests for drug resistance testing of all TB cases, reducing the testing duration from 8 weeks to just a few hours.  By ensuring that TB patients adhere to treatment through Directly Observed Therapy, it has been shown to reduce treatment failures and development of drug-resistant TB.