TUBERCULOSIS (TB) remains a public health priority for Brunei Darussalam with about 200 new cases occurring every year, the Minister of Health Dato Paduka Dr Awang Haji Zulkarnain bin Haji Hanafi said.
An ageing population, increase in number of people with chronic diseases (particularly diabetes mellitus) and smoking contribute to the ongoing TB incidence in Brunei, the minister said in a message in conjunction with the World TB Day 2016 which carries the theme ‘Unite to End TB’.
Persistent cough, fatigue, fever, night sweats, and weight loss are common signs and symptoms of TB and persons experiencing these symptoms should consult their doctor, he said.
“In Brunei Darussalam, progress towards TB control has been remarkable. As a country, we have achieved the United Nations Millennium Development Goal (MDG) 2015 target to reduce the burden of TB by 50 per cent. The incidence rate (new cases) has decreased from 91.9 per 100,000 population in the year 2000 to 48.7 per 100,000 population in 2014. Despite this improvement however, the rate of decline has become stagnant in recent years.
“This year’s theme ‘Unite to End TB’ is particularly pertinent for us in Brunei Darussalam and is especially well-aligned with the Ministry of Health’s strategic priorities for the next five years; to make health everyone’s business, to enhance quality of service delivery, and to prevent and control non-communicable diseases.
“In the coming year, in addition to continuing to provide high quality care to those diagnosed with TB, the Ministry of Health will focus on ensuring the case detection and diagnosis of those individuals still not reached, along with additional efforts to find and treat latent TB infection which holds the key to stopping the cycle of TB transmission.
File photo shows Dato Paduka Dr Awang Haji Zulkarnain bin Haji Hanafi, Minister of Health, speaking during the recent Legislative Council Meeting. – DEAN KASSIM
“To this end, the Ministry of Health has adopted the recommendations of the World Health Organization (WHO) post-2015 global TB strategy – the End TB Strategy. The overall goal of the strategy is to end the global TB epidemic, with corresponding 2035 targets of a 95 per cent reduction in TB deaths and a 90 per cent reduction in TB incidence (both compared with 2015), and 2050 target of TB elimination as a public health problem.
“To achieve this in Brunei Darussalam, the Ministry of Health Plan of Action for the Control of TB focuses on increasing the awareness of all, including health professionals and the public regarding tuberculosis; enhancing the TB screening programme; and continue to ensure appropriate treatment and monitoring of TB patients, including preventing the emergence of drug-resistant TB.
“Disease surveillance in the country indicates that certain high-risk groups are vulnerable to TB. These include those individuals in prison and detention centres, and also individuals with diabetes due to their lowered immune response. Consequently, the prevention and control of non-communicable diseases, especially diabetes, are of particular importance in the fight against TB in Brunei Darussalam.
“A successful TB elimination strategy cannot solely be based on treating the acute infection but it must be an integrated approach that takes into account both environmental determinants as well as other chronic diseases that increase the risk of acquiring TB.
“To further strengthen the effectiveness of our TB prevention and control measures, it is vital for the Ministry of Health to reach out and work together alongside our clients – the local community. Dialogue and partnership engagement with relevant stakeholders underpin our approach to tackling the burden of TB in Brunei.
“We all have a role to play in our families and our communities to identify those individuals at risk of infection, ensure that they seek medical attention, and assist them in complying with medical care,” the minister said.
“World TB Day provides the opportunity to raise awareness about TB-related problems and solutions and to support our national TB-control efforts. While great strides have been made to control TB in Brunei Darussalam, people still get sick and die from this disease. As a society, we can do more to eliminate this disease and prevent future deaths. TB is preventable and working together in partnership we will achieve our vision of a healthy nation.
“Despite being both preventable and curable, the disease remains a major global health problem, responsible for illness among nine million new cases each year, and deaths of 1.5 million individuals. Worldwide, TB ranks as the second leading cause of death from an infectious disease, after the human immunodeficiency virus (HIV). Of the nine million people newly diagnosed with TB each year, a third of them are ‘missed’ by the health systems. Many of these three million people are among marginalised populations such as migrant workers, prisoners and drug users.
“World TB Day is one of eight official global public health campaigns marked by the WHO and is commemorated each year on 24th March. It recalls the discovery of the TB bacillus thus allowing for its prevention, diagnosis and treatment. It is a day to build public awareness about the global epidemic of tuberculosis and our efforts to eliminate the disease.
“Significant advancements have been made in TB care including BCG vaccination. However, even today, after the development of advanced screening, diagnostic and treatment methods for the disease, a third of the world’s population has been exposed and is currently infected with TB.”
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