TB is endemic in Singapore and latent TB infection is not uncommon in our population, with rates of up to 30 per cent in the older age groups. In 2020, there were 1,370 new cases of active TB among Singapore residents. This is lower than the 1,398 cases in 2019.24 Mar 2021
The Straits Times
Science Talk: Is tuberculosis still a problem in Singapore?
Ahead of World Tuberculosis Day on March 24, NCID associate consultant Tay Jun Yang answers some common questions about the disease.
21 Mar 2022, 5:00 am SGT
Over the past 16 years, the TB incidence rate in Singapore has remained between 30 and 40 per 100,000 people.
Given that TB was prevalent in Singapore before the 1960s – an immunisation programme for newborn babies was started in the mid-1950s – there is still a sizeable number of older people in Singapore with latent TB infection.
This means that while the bacterium is present in their bodies, they do not show any symptoms and are not infectious as the bacterium is suppressed by the immune system.
These patients can potentially develop active TB disease – when symptoms start to show and the patient becomes infectious – when their immunity wanes, posing a risk of transmission in the community.
Update On Tuberculosis Situation In Singapore
On World Tuberculosis (TB) Day on 24 March, Singapore joins the global community in reiterating our commitment to continue the fight against TB. The World Health Organization’s (WHO) theme for 2022’s World TB Day is “Invest to End TB. Save Lives”, which conveys the pressing need to commit resources to accelerate the fight against TB.
2. TB remains a global public health threat. In 2020, there were an estimated 9.9 million cases of active TB globally, with 1.5 million deaths. In addition, there were almost half a million cases of multi-drug resistant TB (MDRTB). MDRTB is more difficult to treat and has lower cure rates, with death rates as high as 30 to 40 percent.
3. TB is endemic in Singapore and latent TB infection is not uncommon in our population, with rates of up to 30 per cent in the older age groups. Singapore’s TB testing capacity remained stable during the COVID-19 pandemic and there was no decrease in access to testing. In 2021, there were 1,306 new cases of active TB among Singapore residents. This is lower than the 1,360 cases in 2020. The incidence rate was 32.8 cases per 100,000 population in 2021, compared to 33.6 cases per 100,000 in 2020. Older age groups and males continue to make up a significant proportion of the new active TB disease cases. Please refer to the Annex for details.
TB Screening and Treatment in Singapore
4. TB is an air-borne disease and is transmitted through close and prolonged exposure to an infectious individual with untreated, active pulmonary (lung) TB disease. Not all individuals who are exposed to an infectious individual will get TB.
- The TB incidence in the local Singapore population (i.e. citizens and permanent residents) rose for the first time in ten years to 40 per 100,000 in 2008 and 39 per 100,000 in 2009. Prior to this, the TB rate of the local population had declined steadily from 57 per 100,000 in 1998 to 35 per 100,000 in 2007. TB continued to be a disease of older males. The TB incidence rate among Malays remained the highest among the three main ethnic groups.
- The majority (83.6%) had pulmonary TB. The two commonest extrapulmonary sites were the pleura and the lymphatic system.
- The number of TB cases among foreigners in Singapore has increased since 2005. In 2009, long-term immigration pass holders comprised 20.8% and short- term pass holders 21.9% of all notified TB cases in the country.
- In 2009, the proportion of primary drug resistance among new pulmonary TB cases in Singapore residents examined was 6.6%. Streptomycin resistance was the most commonly encountered. The proportion of multi-drug resistant (MDR) tuberculosis among new pulmonary TB cases in Singapore residents examined has remained very low, at 0.3%. The MDRTB rate is, however, 10 or more times higher among foreigners reported with TB in Singapore, i.e. 3% among Indonesians and those from the People’s Republic of China, 4% among Vietnamese and 6% among Burmese.