TB strategy to be implemented
Leony Aurora, The Jakarta Post, Jakarta
Special training will be provided for general practitioners and nurses in hospitals on Direct Observed Treatment, Short course (DOTS), a strategy used internationally to battle tuberculosis (TB).
The Ministry of Health's Director of Transmitted Diseases Control Haikin Rachmat said on international TB Day on Wednesday that the target was to get 30 percent of the existing 1,100 hospitals to implement DOTS this year.
Currently, only 10 percent of public and private hospitals implement this method, he added.
"Without their involvement, it will be difficult to increase the case detection rate (CDR)," said Rachmat.
Indonesia saw a sharp increase of CDR -- the number of TB patients detected vis a vis the assumed number of cases -- from 21 percent in 2001 to 29 percent in 2002 and 41.3 percent last year. Nevertheless, the CDR is far below the international target of 70 percent, set to be reached by 2005.
"Our priority will be hospitals in regencies where public health centers are already implementing DOTS well," said Rachmat.
In DOTS, TB patients are required to take drugs every day for six months. Health workers, trained volunteers and family members supervise the patient during this time, as unfinished an course of medication leads to immunity to the Mycobacterium tuberculosis and TB will recur.
World Health Organization Medical Officer for Tuberculosis in Indonesia Firdosi Mehta said that hospitals were good in diagnosing and detecting cases but weak in making sure that patients completed their treatment.
"The challenge is in linking hospitals with public health centers close to where the patient lives," Mehta told The Jakarta Post.
A model was tried out in Yogyakarta, where after diagnosis, patients were handed over to the centers for medication supervision, he said. Over three years, the number of cases detected in the province increased 500 percent.
Every year, TB infects approximately 583,000 people afresh, which adds to the existing 981,000 patients. Some 140,000 patients die from this disease annually.