TB remains problem in Indonesia

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Headline News
March 14, 2007

The Jakarta Post, Jakarta

While Indonesia has reached the 2005 global cure rate target for tuberculosis, it still remains the most deadly communicable disease in the country, particularly in eastern regions.

A proactive approach is necessary in dealing with tuberculosis in eastern parts of Indonesia due to the often difficult geographical terrain and the lack of skilled human resources, Carmelia Basri, an official at Health Ministry responsible for tuberculosis, said Tuesday.

"We need to take an active approach for detection in this region, where the prevalence of TB is among the highest in the country. We can't just wait for patients to come to community health centers," she said on the sidelines of a symposium on tuberculosis hosted by the Coalition for a Healthy Indonesia.

Indonesia has reached the global cure target of 85 percent for TB, but a national survey found that eastern Indonesia had the highest prevalence of the disease with 210 cases for every 100,000 people, far higher than the national rate of 125. The lowest rate was recorded in Yogyakarta and Bali, with 64 cases per 100,000 people, while Java had 107 cases and Sumatra 160 for every 100,000 people.

"This year, we started a mobile health service program to detect TB cases and give proper treatment for patients. Under this program, the mobile health units will regularly visit kampongs once every three months," Carmelia said.

She said that due to a lack of financial and human resources, the program could only be implemented in turns in many regencies and municipalities in the eastern part of the country, with Papua the first target for the program.

In Papua, where the HIV infection rate is among the highest in the country, the number of co-infected people is 320 per 100,000, according to Carmelia.

Co-infection with HIV is extremely dangerous because TB is one of the leading factors in the deaths of people living with HIV. On the other hand, HIV is also the biggest risk in stimulating latent TB to become active.

The Coalition for a Healthy Indonesia said the government's efforts to combat TB, which focus on supplying free medicine, diagnostic equipment and laboratories, as well as providing training for medical personnel, allowed the country to reach the 2005 global cure rate target for the disease.

However, the detection rate only reached 68 percent, lower than the 2005 global target of 70 percent. The country recorded more than 210,000 new cases in 2004 and has estimated there will be 250,000 new cases and 300 deaths from tuberculosis annually.

Indonesia is still third in the world in terms of the TB mortality rate, after China and India.

People's lack of information about TB, its dangers and the free treatment available contributes to the high mortality rate, which is also due to the lack of political and financial support from local administrations, the coalition said.

However, the coalition, which has introduced TB communication and mobilization programs since 2005, says public understanding of the disease has improved and significantly more people are going to community health centers to be tested.