Make latent TB treatment part of prevention

The desire to reduce Singapore's tuberculosis (TB) rates to below 20 cases per 100,000 people as mentioned by Senior Parliamentary Secretary for Health Amrin Amin is commendable (Number of older folk with latent TB makes it hard to set control targets, May 8).

While it is good to benchmark ourselves against high-income countries on TB rates, we should also relook our current TB management strategies and see how we can lower our current rates, which have been hovering around 37 to 41 cases per 100,000 people in the past five years.

Latent TB is reported to infect an estimated 2 per cent to 29 per cent of Singaporeans.

In comparison, the World Health Organisation (WHO) has reported that about one-quarter of the world's population has latent TB.

These are people who have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease.

This is significant as about a tenth of the people with latent TB contract active TB later in life.

Therefore, by identifying at-risk groups and screening and treating them, we can lower the TB rates.

This is an effective way of scaling up our preventive tuberculosis treatment programme.

Either a tuberculin skin test or interferon gamma release assays can be used to screen for latent TB infection.

A new TB vaccine is now undergoing clinical trials, and this will help lower TB rates worldwide when available for use.

K. Thomas Abraham (Dr)

A version of this article appeared in the print edition of The Straits Times on May 13, 2019, with the headline 'Make latent TB treatment part of prevention'. Subscribe