Tuberculosis still a threat in Sabah – doctor

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KOTA KINABALU: About 40 per cent of 10,000 people screened last year showed no symptoms of Tuberculosis (TB) in the state, said Sabah State Health Department (TB/Leprosy) principal assistant director Dr Richard Avoi.

Dr Richard said the key strategy to TB control is to ensure the general public are aware of the deadly disease and know that the TB situation in Sabah is still not under control.

He added that compared to other infectious diseases, the airborne TB is actually the main disease to tackle.

“One of the main activities to control this disease is to diagnose it as early as possible. Those with the disease must take the medication and get cured from the disease. Now the challenge is to diagnose the disease as early as possible. That is where the awareness comes in,” said Dr Richard, who is also Sabah Anti-Tuberculosis Association (SABATA) medical advisor.

“One of the activities done is mobile TB screening through our mobile bus X-ray. We have screened more than 10,000 last year and we picked up a number of TB cases through these activities by doing X-ray among the high risk group population.

“What I found from our data so far, of the number of TB cases detected through these activities, about 40% do not have the symptoms but they have TB. That is why it is important that, even though you do not have symptoms, you must come forward for TB screening, especially if you have history of exposure to TB,” he stressed.

Dr Richard disclosed that a total of 4,953 newly diagnosed TB cases were detected in Sabah last year, which is 19 per cent of the national 25,739 figure.

From January to May 2017 there were 1,875 newly diagnosed cases, only 109 short of the 1,984 within the same period last year.

“It is almost the same. That means if the trend continues, at the end of the year, we will hit almost 5,000 cases of newly diagnosed TB cases (in Sabah),” he said.

“You see the burden of TB cases in Sabah is still high. Therefore a lot of activities must be carried out to control TB in the state.

“If people don’t come forward to check, the detection will be late. People must come forward as soon as possible if they experience chronic and prolonged cough for more than two weeks, that is the standard.

“Once diagnosed, they must take medication for at least six months without interruption as failure to do so would not cure them from the disease and they will continue to be the source of infection for other people,” he explained.

Dr Richard said 1,264 foreigners and 3,689 Malaysians were diagnosed with TB last year, and 255 foreigners and 732 Malaysians were found TB positive between January to March 20 this year.

He noted both foreigners and Malaysians alike have resisted coming forward to get tested for TB in the past.

“We have experienced a contact of a TB patient who did not want to come forward for check-up. We have to beg and tell them to come but yet they refused.

“The more activities we do to find TB cases, the more cases we pick up. It just means there are still a lot of TB cases out there that had not been detected, so the detection activities must go on.

“From our experience, to control TB among immigrant population is very challenging. I think most people know they are not coming forward and majority of them, once they are diagnosed, are not able to complete the six-month treatment because either they are sent back home or they just disappear and you cannot trace them, especially those with the status of illegal immigrants. These are the group of people who will not come forward until the disease become very severe and they have no choice but to come to us for check-up. We have seen a lot of situations where the patient ends up dying because of the late detection,” he disclosed.

Dr Richard highlighted that late detection equals to TB patients spreading the disease to many people.

“We want the detection to be done as early as possible before many people are exposed to them. So that is one of the challenges,” he reiterated.

“A lot of people say TB is no longer a disease, thinking it has already been eradicated many years ago. That is wrong and people shouldn’t talk like that.

“TB has never been eradicated in Sabah. It is only your awareness that is not so good. Therefore you think, you perceive that TB is no longer a problem. TB is becoming a major infectious disease not just in Sabah but the whole of Malaysia,” he added.

Dr Richard also stressed that everyone will be offered free medication irrespective of their nationality and status in the name of TB eradication in Sabah.

Sabata also offers between RM350 to RM400 for eligible TB patients whilst undergoing treatment under its Tuberculosis Allowance Scheme.