13 July 2016, The Straits Times

By: Fabian Koh

While most tuberculosis (TB) patients do not mind going for directly observed therapy (DOT) daily, nearly three in four said they experienced negative feelings such as depression during the treatment.


This emerged from a survey of 356 multi-ethnic Asian patients from nine polyclinics under SingHealth Polyclinics. The findings were released yesterday.


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


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


The poll – from 2013 to 2014 – found slightly more than a fifth of respondents felt their employers were unhappy that work schedules were affected because the participants had to go for therapy regularly.


A small number quit their jobs. Almost three-quarters reported increased travelling time and costs, with average travel 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, while almost half of the participants said they reduced their social activities.


A TB patient, who declined to give her name, was one of those who did not tell her friends about her condition. "If they know I have TB, they would run away from me!" said the patient, who has been undergoing DOT for four months.


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


Residents of a housing block in Ang Mo Kio were screened for TB last month, after six earlier cases were

traced to residents there.


Dr Tan Ngiap Chuan, director of research at SingHealth Polyclinics, said steps are in place to make DOT sessions more convenient. Waiting times have been cut by abolishing front-end registration, and patients

can select their polyclinic of choice.


"Things can change, perhaps the way you administer the DOT. I hope people will take on new technology to come up with newer ways to treat people with TB," said Dr Tan.


He also noted that nurses play a major role in helping the patients, as they interact with them on a daily basis.


"They can probe a bit deeper and see if the patient is experiencing any psycho-social issues, especially

in the early phase," he said.


"Sometimes they just need someone to voice their frustration to, and they feel a bit better. A simple thing like that can really help them complete their treatment."


Dr Tanalso said it is crucial for patients to continue and complete the course of their medication. "If they do not complete the antibiotic treatment, the germs can become resistant to the antibiotic.


This will lead to longer TB treatments and more medication." He added: "If they complete the treatment, the chance of recovery is high."