Malaysia aims to be TB-free by 2035
The main goal of the National Strategic Plan (NSP) for TB Control (2016 to 2020) is to reduce tuberculosis (TB) burden by ensuring universal access to timely and quality diagnosis and treatment of all types of TB, and preventing the development of drug resistant TB, says an expert.
The WHO’s End TB Strategy outlined three high-level indicators for the elimination of TB by 2035: TB deaths, TB incidence rate and the percentage of TB patients and their households that experience catastrophic cost as a result of the disease. Targets are set for years 2030 and 2035 with accompanying milestones at years 2020 and 2025. In line with the international strategy, the NSP’s vision is to eliminate TB from Malaysia by year 2035, said Dr. Mohamed Naim Abdul Kadir, of the Disease Control Division, MOH Malaysia.
To achieve those goals, the NSP specified three targets for TB control by year 2020. The first target is to reduce TB mortality by 25 percent. In 2016, the WHO estimated global TB mortality rate at 7.9 per 100,000 population. According to MOH statistics, locally, the TB mortality rate was 6.3 per 100,000 population, he said.
The second target is to increase TB notification rate to 100 per 100,000 population. Last year, the notification rate for all types of TB was 84 per 100,000 population, said Mohamed Naim.
The third target is to ensure universal access to diagnosis and treatment of all types of TB, including multiple drug-resistant-TB and extensively drug-resistant-TB. This target also includes the successful treatment of at least 90 percent of MDR-TB cases, he added.
Multiple efforts are needed to achieve the NSP targets. Existing control and prevention activities need to be strengthened, he said. For instance, early case detection and notification, contacts screening, infection control and systematic screening of high risk groups require improvements. According to 2016 MOH statistics, the average contact screening at 1st visit was 73.4 percent for the whole nation. However, the average contact screening at 4th visit dropped to 9.4 percent. The states with the lowest 4th visit contact screening were Kuala Lumpur and Labuan (0 percent), Kedah (0.5 percent) and Penang (1.4 percent).
Among the other efforts needed are the expansion of laboratory networks and facilities, introduction of new healthcare policies that are people-centred and provides universal health coverage, and enhancement of TB research, he continued.
In 2012, the number of reported TB cases in Malaysia was 22,710 and in 2016, the number rose to 25,739, said Mohamed Naim. The state with the highest number of TB cases is Sabah, followed by Selangor and then Sarawak. Sabah was also the state with the highest TB mortality rate.
Mohamed Naim was speaking at the Malaysian Thoracic Society Annual Congress 2017 held recently in Kuala Lumpur.