TB patients okay with time spent on treatment, but say it has affected their mental well-being

A SingHealth Polyclinics (SHP) nurse, in the midst of directly observed therapy (DOT) with a tuberculosis patient. PHOTO: SINGHEALTH POLYCLINICS

SINGAPORE - Most tuberculosis (TB) patients - about seven in 10 - do not mind going for directly observed therapy (DOT) daily, which involves taking medication for the illness in front of a nurse.

However, nearly one in two said the therapy has caused them them to take part in fewer social activities, while close to three in four said they experienced negative feelings such as depression during the treatment.

This was revealed in a survey conducted by SingHealth Polyclinics (SHP) from May 2013 to April 2014, involving 356 multi-ethnic Asian patients, from its nine polyclinics islandwide.

DOT, which began in Singapore in 1997, ensures patients' compliance to TB treatment by making them head to polyclinics daily or thrice a week to take their medication under the supervision of nurses.

Last year, more than 1,400 people were diagnosed with TB, a bacterial infection which attacks the lungs.

Last month, residents of a housing block in Ang Mo Kio were screened for TB after six earlier cases were found in the block.

For the survey, participants, who had an average age of 43, filled out a questionnaire on TB treatment and its social and economic impact.

The survey found that slightly over a fifth of participants felt that their employers were disgruntled because their work schedules were affected as participants had to go for therapy regularly. A small number quit their jobs.

Almost three-quarters reported increased travelling time and treatment costs, with average expenditure ranging from $260 to $389 for six to nine months of treatment. These costs do not include the medication, which is free.

About the same number of participants had negative feelings such as despair, anxiety or depression, during the course of DOT.

A third said they were afraid to let others, such as their friends, know they were undergoing TB treatment.

The negative impact of DOT could cause some patients to not follow through with the treatment, said SHP.

Dr Tan Ngiap Chuan, director of research at SHP, said it is crucial for patients to continue and complete the course of their medication.

"If you do not complete the antibiotic treatment, the germs can become resistant to the antibiotic," he said, "This will lead to longer TB treatments and more medications."

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