TB remains killing disease in Indonesia; ranked number three
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)