TB strategy to be implemented

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.