Together we can stop TB in Singapore

23 Mar 2011

24 March is World Tuberculosis (TB) Day. The World Health Organisation’s theme for this year is a continuation of a two-year campaign on the slogan, “On the move against tuberculosis: Innovate to accelerate action”. On this day, we join the global community to raise public awareness in the effort to stop TB.

Update on the Tuberculosis Situation in Singapore

2 MOH was notified of 1,478 new cases of TB among Singapore residents¹ in 2010, which is slightly higher than the 1,442 cases notified in 2009. The number of non-residents² notified with TB was 550 in 2010 compared to 524 in 2009.

3 Most of the cases (82.4%) among Singapore residents were Singapore-born. Older age groups and males continue to make up a significant proportion of the new cases. Of the 1,478 new cases notified, 882 (59.7%) were 50 years old and above, and 996 (67.4%) were males.

4 There were 126 relapsed cases among Singapore residents of which 104 (82.5%) were Singapore-born.

5 While the emergence of multi-drug-resistant TB (MDR-TB) remains a serious health issue for many countries, Singapore was fortunate that it only reported 3 such cases among Singapore residents last year. Of these, two were new cases consisting of a Singapore-born and a foreign-born resident while another was a relapse case from a Singapore-born resident. The low incidence of MDR-TB could be attributed to our strong emphasis on treatment compliance under the national TB control programme.  Please refer to Annex for the detailed statistics.

Early Diagnosis and Complete Treatment of TB Cases is key to the control of TB 

6 To successfully control TB, it is important to ensure that all cases with TB are diagnosed early and undergo complete treatment (6 to 9 months) until fully cured so as to curb community transmission at the earliest opportunity. Those who fail to adhere to treatment may continue to be infectious and may suffer a relapse of TB some time later as not all the TB bacteria had been killed. Worse still, the TB can come back as a drug-resistant form. This will make it more difficult to treat. Treatment will then have to be for at least 18 months, instead of 6.

7 Directly Observed Treatment (DOT) is the international standard of care for TB treatment. Under DOT, a trained healthcare professional supervises the patient taking each dose of anti-TB medication and ensures patient’s compliance with treatment. At the same time, it enables the healthcare professional to monitor the patient for any side-effects of treatment. DOT is therefore the ideal mode of treatment for patients with TB and is available in all polyclinics in Singapore.

8 Persons with symptoms suggestive of TB (such as prolonged cough, fever, night sweats, unexplained loss of weight and appetite, tiredness) should seek medical attention as soon as possible. Family members should also bring their loved ones to the doctor if they notice these symptoms.

Everyone can play a part in reducing the transmission of TB in the community

9 All of us can do our part in controlling TB in Singapore and keeping our community safe and free of TB.

10 At the individual level, we can all do our part by ensuring early diagnosis and adherence to the full treatment should we suffer from TB. Adherence to treatment is important to ensure that they do not develop drug-resistant strain of TB. As TB is a respiratory illness, patients should also observe proper cough etiquette (e.g. coughing into tissue) to prevent transmission.

11 The stigma attached to TB patients and prolonged treatment required of TB patients may be barriers to people coming forward for diagnosis and treatment. At the community level, family, friends and employers of TB patients can play a critical role by giving them support and encouragement to complete their treatment.

12 For example, family members should encourage and remind patients to adhere strictly to treatment. Employers should be supportive by allowing their workers to take some time off to go to the polyclinic for DOT. Employers should uphold workers who take every dose of medicine faithfully and complete their treatment under DOT, as model workers who are responsible to their fellow workers. Generally, a person becomes non-infectious after just 2 weeks of treatment, which is covered by medical leave. There is thus no risk to the workplace when the TB patient returns to work and is treated under DOT. Treatment completion will benefit the patient, his family, workplace and the community.

13 The Health Promotion Board (HPB) has partnered the Singapore National Employers Federation to reach out to workplaces to encourage support for TB treatment. HPB has produced a TB booklet to equip HR professionals with knowledge on TB and DOT. To date, a total of 260 workplaces have shared these booklets with their employees. The booklets will also be distributed to 80 trade union member organisations. In addition to workplaces, HPB also works with community partners such as the Singapore Anti Tuberculosis Association and the Tsao Foundation to educate and foster the message that early detection and complete treatment of TB is key in our fight against the disease.

14 For those who persistently default treatment and thus pose a public health risk to the community, MOH will take enforcement action by requiring them to comply with treatment by DOT under the Infectious Diseases Act. Persons who continue to default their treatment may also be detained at the Communicable Diseases Centre at Tan Tock Seng Hospital for treatment until they are cured.

15 TB is curable and the spread of TB is preventable. With everyone playing a part, we can reduce the community transmission of TB in Singapore. More information on TB is available at the MOH FAQs at

http://www.pqms.moh.gov.s/apps/fcd_faqmain.aspx or HPB website at http://www.hpb.gov.sg

1 Residents refer to Singaporeans and Permanent Residents

2 Non-residents refer to foreigners on long term stay here for work, study or visit

MINISTRY OF HEALTH

23 March 2010

Annex (349 KB)