UGM Expert Highlights High Tuberculosis Figures
Data from the Indonesian Ministry of Health indicates that tuberculosis (TB) cases are estimated to reach 1,060,000 per year. With the increasing prevalence of cases, Indonesia ranks second in the world for the highest number of TB cases after India.
Despite various efforts, the TB case figures are still estimated to be high and not fully detected, indicating that this condition requires handling not only through medical interventions but also broader social, educational, and structural approaches.
A lecturer from the Faculty of Medicine, Public Health, and Nursing at Universitas Gadjah Mada (FK-KMK UGM), Dr Rina Triasih, M.Med(Paed), Ph.D., Sp.A(K), highlights the wide gap between the estimated number of TB cases and those successfully identified in Indonesia. This situation serves as a primary indicator that case detection efforts are not yet optimal, leaving many patients outside the healthcare system and potentially continuing to transmit the disease in their surroundings.
According to her, the estimated TB cases in Indonesia reach around one million, but to date, only several hundred thousand cases have been identified and medically recorded.
She asserts that this discrepancy is not merely a data issue but reflects real obstacles in the field, such as low public awareness to seek check-ups from the onset of initial symptoms, limited access to health facilities, and insufficient public literacy in recognising TB signs.
“The prediction reaches 1 million, but only several hundred thousand have been confirmed by doctors, yet there are still many TB patients out there who have not been found or treated by medical professionals,” she explained on Monday (6/4).
Rina explains that undiagnosed patients pose a significant potential as new sources of transmission. This causes the number of cases to continue rising, especially after the COVID-19 pandemic.
This increase, according to her, could be due to two factors: an actual rise in cases or improved government effectiveness in uncovering hidden cases. “During COVID, the number of detected TB cases was low, but post-COVID, it has actually increased,” she added.
As part of the UGM Centre for Tropical Medicine, Rina is involved in developing Active Case Finding (ACF) strategies, a method for actively discovering cases in the community. This programme, initiated by Zero TB Yogyakarta since 2020 under UGM’s auspices, involves directly approaching communities using mobile X-ray facilities to detect TB in both symptomatic and asymptomatic individuals.
“We go to the patients rather than waiting for them to come to hospitals or community health centres,” Rina clarified.
She added that this method has proven effective in finding previously undetected cases. Over time, the programme has also begun receiving government support through better provision of equipment and facilities.
On the other hand, a major challenge arises from drug-resistant TB cases. Rina explains that this occurs due to incomplete treatment, causing the bacteria to mutate. Consequently, this type of TB requires more complex treatment, with longer durations and more medications.
“Usually, after two months, improvement is visible and patients feel better. So, feeling healthy, they do not continue treatment, which poses a risk of developing drug-resistant TB,” she elaborated.
She emphasises that combating TB cannot focus solely on medical aspects. Social factors such as stigma, education levels, economic conditions, and living environments play a significant role in disease spread.
“For instance, if a TB patient returns home to cramped and squalid housing, others in the household will automatically be affected, and the TB cases will not resolve,” she explained.
To that end, Rina stresses the importance of innovative education that directly engages communities. She suggests that education should not only use conventional media like posters or flyers but also more interactive approaches, such as featuring TB survivors in talk shows or memorable repeated campaigns.
Indonesia’s geographical factors pose a challenge by causing disparities in healthcare access, particularly outside Java Island. This becomes an obstacle to equitable detection and treatment of TB across all regions.
As a strategic step, Rina recommends a comprehensive approach through three main pillars: Search, Treat, and Prevent. “Search involves finding and quickly detecting patients. Treat provides adequate treatment until complete recovery. Prevent implements preventive measures and education,” she concluded.