Improper treatment means TB will remain major killer<\/p>\n
Fitri Wulandari, The Jakarta Post, Jakarta<\/p>\n
Tuberculosis (TB) will likely continue to linger as a major
\nhealth problem in Indonesia, as eliminating the disease is being
\nhindered by a lack of information and improper treatment,
\naccording to two lung specialists.<\/p>\n
Despite the government's efforts to combat the disease, TB
\nremains a major killer in Indonesia because the public is not
\nwell-informed about the disease and its treatment, the two lung
\nspecialists said over the weekend.<\/p>\n
An integrated anti-TB program called the Direct Observation
\nTreatment Short Course (DOTS), adopted by the government in 1999
\nto reduce the prevalence of the disease, has not yet been
\nimplemented effectively, they said.<\/p>\n
DOTS, which has been recommended by the World Health
\nOrganization (WHO), consists of five components -- political
\ncommitment of the government, diagnosis by smear microscopy,
\nwell-organized distribution of TB drugs, directly observed
\ntreatment and good reporting and recording systems.<\/p>\n
"Many people do not know much about TB due to the limited
\navailability of publications on what the disease is, how to treat
\nit, why it is important to follow strict treatment, why it is
\ncontagious, etc," Pradjna Paramita, a lung specialist of the
\nJakarta-based Gatot Subroto Army Hospital, said.<\/p>\n
TB treatment conducted by doctors frequently resulted in the
\ndeath of patients, Pradjna said, adding that such incidents would
\nnot necessarily occur if the patients had adequate knowledge on
\nthe disease and the importance of strictly abiding by doctors'
\norders.<\/p>\n
TB, an infectious disease attacking the lungs, has been known
\nfor 600 years. It made a comeback in the 1990s, forcing the WHO
\nto declare TB a global epidemic in 1993.<\/p>\n
WHO estimates that 2 million people worldwide die of TB every
\nyear. The spread of the human immunodeficiency virus (HIV), the
\nemergence of a new strain of TB, and global population movements,
\nincluding refugees, have helped propel the disease's global
\nepidemic.<\/p>\n
In Indonesia, TB infection has been worsened by a prolonged
\neconomic crisis, which started hitting the country in 1997.
\nEthnic conflicts that create millions of internally displaced
\npersons raise the number of low-income bracket people who are
\nmost vulnerable to the epidemic.<\/p>\n
WHO ranks Indonesia third on the list of countries suffering
\nfrom a high incidence of TB, after India and China, with 140,000
\ndeaths annually and 500,000 new cases found every year.<\/p>\n
TB, which spreads through the air, does not only exist in
\ndensely populated and poorly sanitised slum areas but also in
\nhigh rise luxury buildings that have bad air circulation.<\/p>\n
To be cured of TB, a patient has to undergo a strict treatment
\nof at least six months by taking a full course of correct dosage
\nanti-TB medication.<\/p>\n
Information about TB and its effective treatment should not be
\njust for the layman but also doctors and paramedics, Pradjna
\nsaid.<\/p>\n
"There are many doctors, especially those in remote areas, who
\ndo not fully understand DOTS or know how to treat TB patients
\neffectively," Pradjna said.<\/p>\n
Rita Rogayah, another lung specialist, echoed Pradjna's
\nremarks, saying the effective implementation of DOTS, supported
\nby a good education campaign on TB among the public and health
\nofficials, are the keys to combating TB successfully.<\/p>\n
Rita said the public health centers (Puskesmas), the
\nspearheads of the public health service, could not run DOTS
\neffectively because of a lack of human resources.<\/p>\n
"We don't know when Indonesia will be free from TB but if we
\ncan implement DOTS effectively, we might have hope," Rita said.<\/p>",
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