Lower cure rate of TB at private hospitals

NST: KUALA LUMPUR: How are private hospitals coping with the rise in cases of tuberculosis?
Director-General of Health Tan Sri Dr Ismail Merican is concerned that lack of standardisation of diagnosis and treatment may lead to poor management of the disease.
He said the cure rate of TB at private hospitals was lower than at government hospitals.
"The quality of diagnosis and treatment, in general, is not the same and this is of concern to us," he said at the opening of the International Union against Tuberculosis and Lung Disease Asia Pacific Region — 1st Asia Pacific Region Conference 2007 at Shangri-la Hotel yesterday.
He warned that poor management of TB, including diagnostic delays, would contribute towards the spread of the disease, higher cost of treatment and the risk of multi-drug resistant tuberculosis (MDR).
The emergence of an increasing number of MDR patients is also worrying authorities.
Resistance occurs when patients stop taking medication after a month or two, thinking that they have been cured.
Dr Ismail said it was important that a TB patient strictly followed the medication regime prescribed by his doctor as it would be hard to recover if medication was stopped midway.
He encouraged private hospitals, which handled 5.5 per cent of TB cases, to adopt the Directly Observed Treatment-Short Course (Dots) strategy to stop the spread of the disease.
The World Health Organisation introduced the strategy to emphasise importance of supervision of patients throughout treatment.
Dots has had almost 100 per cent success in some countries.
The supervision can be done by a family member, a member of the community, or a trained medical staff.
Their duty would be to check if patients have taken their medicine, ticking it off on a checklist.
The battle with TB has raged for more than 60 years, when the illness killed many in the 1940s.
In Malaysia, according to Health Ministry statistics, TB infects 45 people daily, killing four over time.
This is despite the aggressive National TB control programme implemented in the early 1960s that has managed to keep the disease from spreading aggressively.
Last year, 16,665 new infections were registered, with 1,500 deaths.
Within the Asia-Pacific region, 100 people are infected with TB every hour with 35 people dying in that space of time.
The rate of infection has risen so much in recent years that a 2007 WHO report listed Malaysia at the "intermediate" prevalence level for TB, from the previously "low-medium prevalence" ranking last year.
The incident rate has fallen from more than 80 per 100,000 population 25 years ago to 62.5 per 100,000 population last year.
Dr Ismail said the ministry was working towards reducing by half the number of cases and deaths by 2010.
Meanwhile, Malaysian Association for the Prevention of Tuberculosis president Datuk Seri Yeop Jr Yeop Adlan said among infectious diseases, TB was the nation’s top killer.
He said this was largely due to migration of Indonesians, Myanmars and Filipinos.
He cited Johor, Selangor, Kuala Lumpur, Sabah and Sarawak as examples of states with more TB cases due to the influx of foreigners.