Tuberculosis third deadliest disease in Indonesia

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."