Jakarta high-risk zone for TB disease

Sari P. Setiogi, The Jakarta Post, Jakarta

Biyan (not his real name) is a keyboardist with a famous music band in Jakarta, who earns a good income, lives in a luxurious house in a prestigious neighborhood in Jakarta, and whose father is an internist. It never occurred to him that he might be infected with TB.

The 23-year-old was therefore very much surprised when his doctor told him two years ago that he had tuberculosis, better known as TB.

"My doctor said I might have gotten infected with TB because of the nocturnal lifestyle I lead. I am an active smoker and so are others in my environment. As part of a band playing in several clubs, it is hard for me to get home before 4 a.m. I only have a few hours to sleep," said Biyan.

Dr. Wia Melia of the Organization for Eradication of Tuberculosis (PPTI) lung clinic in Tanah Tinggi, Central Jakarta, told The Jakarta Post that smoking and a nocturnal lifestyle were potential causes of TB.

"Some of my patients here are women working in nightclubs, pubs or billiard arcades in Mangga Dua and Mangga Besar. They inhale secondhand smoke from cigarettes almost 24 hours a day, and it is weakening their lungs," she said. "A person's working environment and house are important factors," she added.

"The current tough economic situation also puts people in a stressful condition. It also becomes difficult for people to maintain their health in an excellent condition," said Wia.

She also said that the city's pollution levels were rising and were thus reducing the people's access to clean and healthy air. "Eating habits are also important. Most people these days have bad diets and less time to exercise," she said.

The chances of infection by the mycobacterium tubercolosis bacteria that causes TB would increase if a person's physical condition is weak, or if one is suffering from malnutrition, she said.

Tuberculosis patients who were treated at the PPTI clinic, said Wia, were increasing by about 10 percent per annum.

By the end of 2002, there were 1,457 patients treated by the clinic. About 30 percent were declared healthy after medication, while 31 patients later died. In 2001, there were 1,280 patients, of whom 1,162 were cured and 53 died.

In the meantime, Dr. Tjandra Yoga Aditama, a lung specialist at Persahabatan Hospital in East Jakarta, told the Post that during peak days he would sometimes treat about 100 TB patients.

"About 30 of them would be first-time patients," he said. However, he could not give the precise number of TB sufferers in the city.

According to Tjandra, who is the former chairman of the Indonesian Pulmonologist Association (PDPI), most of his patients came from the middle and middle-lower economic background. "But there are also entrepreneurs and flight attendants among them," he said.

A TB sufferer should be under constant medication for between six and nine months, and should take about four different types of medication during that period.

"The medicines taste terrible and most patients usually stop taking their drugs the moment they feel better. But such behavior is not recommended, because it will leave stronger and more resistant bacteria in the body," said Wia.

"If such bacteria should infect someone else, the next sufferer might risk an attack by incurable TB for the rest of their lives," she said.

According to Tjandra, three among every 1,000 people on average in Indonesia are infected with TB. "The government can only reach about 20 percent of TB sufferers in this country, but about 85 percent of them are cured," he said.

Minister of Health Achmad Suyudi told the Post earlier that the government was targeting to reach 50 percent of TB sufferers by 2005.

Symptoms of TB infection: (1) Chronic cough for over three weeks, (2) Nighttime fever and cold sweat, (3) Constant malaise, (4) Loss of appetite, (5) Reduced body weight, (6) Chest pains, (7) Coughing up blood.