We thank Dr Catherine Ong, Associate Professor David Lye and Associate Professor Brenda Ang for their suggestions on how tuberculosis (TB) controls can be further strengthened in Singapore (The battle against TB is not over; March 24).
TB is a global public health threat and is endemic in Singapore.
The incidence of TB in Singapore has declined substantially over the past decades, and incidence rates are similar for Singapore residents and long-staying foreigners.
To reduce the risk of imported active TB, the Ministry of Health (MOH) requires foreigners entering Singapore for long-term employment and residence, and those renewing their long-term entry passes, to be screened.
Those with findings suggestive of active TB are referred to the TB Control Unit (TBCU) for further assessment and treatment.
Low-incidence countries such as the US and Australia screen immigrant children for latent TB to prevent local TB rates from increasing.
Singapore does not routinely screen all incoming foreigners for latent TB as the disease is common here, with latent TB rates as high as 30 per cent.
We perform active TB detection and contact tracing to control the spread locally.
This is in line with the World Health Organisation's position, and adapted to our context.
Persons with latent TB do not exhibit symptoms and do not spread TB to others.
In most healthy persons with latent TB infection, the TB bacteria remain inactive in their body throughout their lives.
MOH pays close attention to the screening and treatment of individuals who have close contact with young children or seniors with compromised immunity.
To remove any cost barriers to treatment, subsidies are currently available for TB testing and treatment under the National TB Control programme.
MOH is also exploring ways to make it less inconvenient for active TB patients on Directly Observed Therapy (DOT).
MOH will continue to review our policies to strengthen the effectiveness of TB control, and take into consideration new developments.
We need everyone to play a part too, by seeking medical attention if they have symptoms of TB and adhering to treatment.
Lim Bee Khim (Ms)
Ministry of Health