Dismissing staff with TB worsens stigma of disease

Children who attended a Bukit Batok pre-school are being screened for tuberculosis (TB) after a teacher at Little Greenhouse was diagnosed with the disease.
Children who attended a Bukit Batok pre-school are being screened for tuberculosis (TB) after a teacher at Little Greenhouse was diagnosed with the disease.ST PHOTO: TIFFANY GOH FOR THE STRAITS TIMES

We are concerned to learn from the report last Thursday ("Pre-schoolers screened for TB at Bt Batok centre") that the pre-school concerned had planned to prematurely terminate the teacher's contract because of tuberculosis ("Firing staff with TB sends wrong message" by Mr Tai Yu Hsiang; last Friday).

It is most unfortunate that the pre-school children and staff have to undergo contact tracing, which is distressing. However, dismissing the teacher - or any employee in general - solely because of TB would send the wrong message to society, exacerbate the current stigma already associated with the disease, and perpetuate marginalisation of the sick.

Tuberculosis is an airborne infectious disease that is curable. Once appropriate treatment is initiated, the risk of infecting others declines rapidly in the first two weeks. Once certified fit, these employees can return to their original place of work while continuing their treatment.

Although standard treatment takes six to nine months, cure rates exceed 95 per cent, especially if patients are adherent to their TB medicine by directly observed therapy (DOT).

The chance of TB recurring after completion of therapy is exceedingly low.

DOT is part of the National TB Programme implemented by the Ministry of Health, coordinated by the Tuberculosis Control Unit. It is implemented at all polyclinics, and most patients attend DOT to ensure good adherence and a high chance of cure.

Patients who work may need to take a short time off to visit the polyclinics in order to take their medications under DOT.

We hope employers will support their affected employees as they undergo DOT for the entire treatment period. This not only benefits the health of the worker, but also provides reassurance to the employer that the affected worker will not be at risk of spreading TB at his or her workplace.

For people who are exposed to TB, contact tracing is done. Contacts who have been found to have latent TB, the dormant non-infectious form of the disease, can be treated to prevent progression to active TB.

We urge all employers to support their employees in times of illness, and strive to create a workplace of equal opportunities.

Catherine Ong (Dr)
Associate Consultant
Division of Infectious Diseases
National University Hospital

Hsu Li Yang (Associate Professor)
Saw Swee Hock School of Public Health
National University of Singapore

Cynthia Chee (Dr)
Senior Consultant
Tuberculosis Control Unit
Tan Tock Seng Hospital

A version of this article appeared in the print edition of The Straits Times on August 29, 2016, with the headline 'Dismissing staff with TB worsens stigma of disease'. Print Edition | Subscribe