Tuberculosis third deadliest disease in Indonesia
Evi Mariani, The Jakarta Post, Jakarta
Mycobacterium tuberculosis was identified 121 years ago on March 24. However, despite its long run, tuberculosis (TB) is still going strong as the third deadliest disease in Indonesia, after cardiovascular diseases and respiratory syndromes, such as asthma and pneumonia.
The government observed TB day during a ceremony attended by, among others, Minister of Health Achmad Suyudi, Coordinating Minister for Peoples' Welfare Jusuf Kalla and Minister of Social Affairs Bachtiar Chamsyah.
On the occasion, Global Fund, an affiliate of the United Nations, signed an agreement with the government to give US$21.6 million in grants to eradicate TB, as well as malaria and HIV/AIDS.
A World Health Organization (WHO) report estimates that every year there are about 583,000 new TB cases in Indonesia, of which 262,000 are communicable. The figures have made Indonesia the country with the third largest number of TB cases, after India and China.
However, from WHO's estimation, only 20 percent to 22 percent of those cases can be detected.
As Indonesia's population is the fourth largest in the world, overcrowding is inevitable, and these overcrowded places are comfortable homes for spreading TB bacilli that attack mostly lungs and spread through the air.
Therefore, TB is mostly found in slum areas that are usually overcrowded and where most residents suffer from malnutrition.
In 2000, 83,410 TB cases were detected, of which 52,476 were communicable. In 2001, there were 97,124 detected cases, of which 56,705 were communicable. During the first three quarters of 2002, there were 107,234 cases that were detected, of which 61,498 were communicable.
In 1994, when WHO declared a "global emergency" status for TB, it introduced a Directly Observed Treatment Short Course (DOTS) to help eradicate the deadly disease.
DOTS offers a curative strategy under which TB patients who are taking medicine are observed closely by local health officials or their relatives to make sure they take their pills every day.
Previously, most TB patients quit taking their pills after about two months from their prescribed six-to-eight-month course of treatment because they said they felt well, whereas the bacilli were still active inside their bodies.
As a consequence, the bacilli had an opportunity to develop a resistance against the pills and when TB struck again, the second attack would be more difficult to treat.
Indonesia has had the DOTS strategy in place since 1995 and has so far developed TB clinics in 6,830 out of its total 7,240 community health centers.
This year's TB day has been given the theme "People with TB" with the slogan: "DOTS cured me -- it can cure you, too."