TB remains killing disease in Indonesia; ranked number three
JAKARTA (JP): Do not assume you are free from infection with tuberculosis (TB), even though the disease is commonly found among refugees in emergency centers during a crisis.
TB remains a major killer in Indonesia; it has ranked third in recent years on mortality lists, following cardiovascular and respiratory diseases, and before infections/parasites and diarrhea.
The World Health Organization (WHO) reported that some 50 percent of total refugees in the world were possibly suffering from TB. Each year, more than 17,000 refugees suffer from the disease; the problem is compounded because a lot of the refugees do not settle at one emergency site.
WHO also reported that 1 percent of the total population in the world has contracted TB and that the tourist and travel industry, including immigration affairs, is also vulnerable to TB.
Pneumophthisiologist Muherman Harun said the mode of TB transmission was the same all over the world.
"TB is an airborne-infectious disease spread by patients producing small sputum particles containing tubercle bacilli," he said.
Quoting data from the Ministry of Health, Harun said there were 175,000 fatalities from TB each year, translating into almost 500 TB deaths daily.
"However, there is still uncertainty about these figures according to the Director General on Communicable Diseases Control," he added.
He said TB mainly affected people from the lower socioeconomic levels, and those of productive age (15 years to 60 years).
He cited a report in the Journal of the Medical Association last year, saying that with a population of 204,323,000 in 1997, Indonesia was estimated to have a prevalence of positive sputum cases of up to 715,000, and about 262,000 new TB cases per year. It is estimated the prevalence of all TB cases were 1,606,000 and 583,000 new cases, while the estimation of the TB death rate was 140,000.
Data from the Indonesian Stop TB Initiative (Gerdunas TB) said Indonesia registered the third greatest number of TB cases in the world after India and China.
According to the World Health Organization (WHO), there are up to three million deaths from TB each year in the world. There is one TB death each second and one person infected with TB every four seconds somewhere in the world.
Last year, the government pledged to reduce the prevalence of tuberculosis by 50 percent in the next five years with an integrated anti-TB program.
It adopted a plan called the Direct Observed Treatment Short Course (DOTS), comprising five elements: political commitment, diagnosis by smear microscopy, well-organized distribution of TB drugs, directly observed treatment and good reporting and recording systems.
Harun said Indonesia would be freed from the scourge of TB within the next 20 years, but there were some constraints to TB control.
WHO admitted there was reluctance from some governments to provide free medical treatment to TB patients. Moreover, potentially fatal diseases are often not considered a priority when most of those affected are poor.
There is also the prevalent misconception that TB occurs as a common consequence of poverty.
"In Indonesia, there's lack of commitment at all levels," Harun said. "There are too many TB programs, in which all of them are without proper implementation. I think there's also been inadequate assessment of TB programs and unreliable or no reporting system." (icn)