Parliament: Setting TB control targets is difficult because many older people have latent TB

TB rates in Singapore have ranged between 37 and 41 cases per 100,000 people in the past five years.
TB rates in Singapore have ranged between 37 and 41 cases per 100,000 people in the past five years. PHOTO: LIANHE ZAOBAO

SINGAPORE - It is difficult to set tuberculosis control targets in Singapore, as a significant number of older people have latent TB infections, said Senior Parliamentary Secretary for Health Amrin Amin on Tuesday (May 7).

But he added that in the long term, Singapore's goal is to benchmark itself against high-income countries with TB rates of less than 20 cases per 100,000 people.

"Due to previous exposure, where TB rates were quite high in the 1950s and 1960s, there is now a fairly significant number of older Singaporeans with latent TB infections," Mr Amrin said.

"Waning immunity in older adults also contributes to reactivation of this latent TB later on in life, hence it is quite hard to set a firm target to achieve TB control."

TB rates in Singapore have ranged between 37 and 41 cases per 100,000 people in the past five years. Last year, nearly half of those who developed active TB were aged 60 and older.

Latent TB is not uncommon, and is estimated to affect between 2 per cent and 29 per cent of Singaporeans. Someone with a latent infection does not have symptoms or feel sick, and cannot spread TB to others. But one in 10 will eventually develop an active form of the disease.

Responding to a question on multi-drug resistant TB (MDR-TB), Mr Amrin said patients with this form of the disease are isolated for treatment until they become non-infectious, which takes about two months. They have to undergo directly observed treatment, which involves taking medication for the illness in front of a nurse, for two years.

 

"We have also adopted new technologies such as rapid DNA tests for drug resistance, reducing time taken for identification of MDR-TB from two months to a few hours to facilitate early intervention," he said.