UPDATE ON TUBERCULOSIS SITUATION IN SINGAPORE

On World Tuberculosis (TB) Day on 24 March, Singapore joins the global community in reiterating its commitment to continue the fight against TB. The World Health Organization’s (WHO) theme for 2023’s World TB Day is “Yes! We Can End TB!”.

2.       TB remains a global public health threat. In 2021, there were more than 10.6 million cases of active TB globally, with 1.6 million deaths¹. In addition, there were almost half a million cases of multi-drug resistant TB (MDRTB). MDRTB is more difficult to treat and has lower cure rates, with death rates as high as 40 to 58 percent².

3.       TB is endemic in Singapore and latent TB infection is not uncommon in our population, with rates of up to 30 per cent in the older age groups. In 2022, there were 1,251 new cases of active TB among Singapore residents. This is lower than the 1,300 cases in 2021. The incidence rate was 30.7 cases per 100,000 population in 2022, compared to 32.6 cases per 100,000 in 2021. Older age groups and males continue to make up a significant proportion of the new active TB cases. Please refer to the Annex for details.

TB Screening and Treatment in Singapore

4.       TB is an air-borne disease and is transmitted through close and prolonged exposure to an infectious individual with untreated, active pulmonary (lung) TB. Not all individuals who are exposed to an infectious individual will get TB.

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 close contacts are carried out to ensure that those at risk of infection are tested and receive appropriate treatment.

6.       Persons diagnosed with active TB will be started on treatment immediately and placed on medical leave. Once treatment starts, the person will rapidly become non-infectious and no longer pose as a source for infection. There is no further risk of exposure in the workplace or school, and there is therefore no need for workplaces or places where a recently diagnosed active TB case has visited to be closed. Close contacts found to have latent TB infection are not infectious and can continue their activities as usual.

7.       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 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.

Supporting people with TB

8.       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 developing MDRTB.

9.       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 TB Programme 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 in the patient’s home. Video-observed therapy is also available for suitable patients to increase the accessibility of TB treatment.

10.      Support and encouragement from the 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 access DOT. Treatment adherence and completion will not only benefit persons diagnosed with TB, but also protect his family, workplace, and community from 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 the HealthHub website.

MINISTRY OF HEALTH

24 MARCH 2023

[1] Source: World Health Organization (27 October 2022). https://www.who.int/news-room/fact-sheets/detail/tuberculosis

[2] Source: WHO Global Tuberculosis Report 2022 (accessed on 7 February 2023). https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022