RI rank third in TB stakes
Leony Aurora , The Jakarta Post, Jakarta
The rate of tuberculosis (TB) has declined steadily in the past few years but the country remains among those with the highest number of TB patients, says the World Health Organization (WHO).
According to WHO, the rate dropped from an estimated 130 per 100,000 people in 1999 to 122 in 2001, and further down to 115 in 2002.
It also said that Indonesia, the world's fourth largest country with over 215 million people, was third after China and India in terms of the number of patients.
Meanwhile, a report by University of Indonesia (UI) researchers, concluded that the disease costs the country some Rp 8.3 trillion (US$963 million) annually.
"About 75 percent of TB patients are in their productive age -- between 15 and 49 years," said researcher Prastuti Chusnun of UI's Health Economy Research Center.
TB infects about 583,000 people and kills 140,000 every year, making it the second leading cause of death after cardiovascular diseases.
The government, according to Minister for Health Achmad Sujudi, has provided free drugs for TB patients.
He, however, called on regencies and municipalities to allocate funds for free sputum examinations in public health centers and other necessities.
"The challenges now lie on how to inform the poor about the free drugs available for them and on the commitment of local administrations," the minister stated during a journalist's forum on Tuesday.
The ministry's Director of Communicable Diseases Umar Fahmi Achmadi said the government was focused mostly on improving infrastructure and human resource capacity to manage TB.
"Ninety-nine percent of public health centers have adopted DOTS. Lung clinics have also joined in," he said, adding that now the ministry was ready to launch a campaign to inform the public about TB.
DOTS is the acronym for Direct Observed Treatment, Short- course, an internationally recommended strategy for controlling TB, which was introduced in Indonesia in 1995.
The program's success lies with the health workers, trained volunteers and family members, who observe and record patients taking their daily medicine over the full course of anti-TB treatment, which lasts between six and eight months.
Patients have to complete the course, as otherwise the TB will not be completely eradicated and will reemerge.
With DOTS, Indonesia's TB treatment success rate -- the number of patients recovering fully from TB -- has reached 86.3 percent.
Case detection rate (CDR) is also increasing. In 1997, Indonesia's CDR stood at mere 7.5 percent of all assumed cases and rose to 20 percent in 2000 and 41.3 percent in 2003.
"We hope to reach 60 percent by the end of this year," said Umar.
WHO has set international targets of 70 percent for CDR and 85 percent for success rate by 2005.