Multiple drug resistance — and a huge increase in HIV/AIDS cases — has led to the re-emergence of tuberculosis as a major health threat in Indonesia, according to health experts.
Sangkot Marzuki of the Eijkman Institute for Molecular Biology told The Jakarta Post that tuberculosis was becoming difficult to cure because it rapidly adapted to host defenses and antibiotics.
“Mycobacteria have rapidly adapted, negatively affecting the treatment, diagnosis, and therapy for diseases,” he said on the sidelines of a three-day symposium om genetics and disease management organized by the Eijkman Institute and the NITD-Eijkman Institute-Hasanuddin University Clinical Research Initiative (NEHCRI).
He said various strains of the tuberculosis bacillus had become more resistant to antibiotics.
According to the World Health Organization (WHO) annual report for 1995, there were nine million tuberculosis cases and three million tuberculosis deaths globally in 1995.
An estimated 95 percent of tuberculosis cases and 98 percent of tuberculosis deaths occurred in developing countries such as Indonesia, with 75 percent of global tuberculosis cases afflicting the productive age bracket.
According to the Health Ministry, there were more than 520,000 cases of tuberculosis a year in Indonesia, resulting in more than 90,000 deaths. About 75 percent of the cases afflicted people between the ages of 15 and 49.
Indonesia now ranks among the countries in the world with the highest number of tuberculosis cases, following India, China, South Africa and Nigeria.
The Health Ministry’s national tuberculosis program director Dyah E. Mustikawati said that Indonesia should keep an eye on its number of tuberculosis cases due to the rapidly growing number of HIV/AIDS cases in the nation.
According to the national prevalence survey for 2006-2008, from 2 percent to 15 percent of all Indonesian tuberculosis patients also had HIV.
HIV prevalence in tuberculosis cases globally reached 3 percent as recorded by the WHO Global Report 2009.
“There is currently a tuberculosis epidemic that has been triggered by the ongoing HIV epidemic,” she said.
Eijkman Winkler Center for Microbiology scientist Jan Verhoef said multiple drug resistance for some diseases, especially tuberculosis, had emerged as a result of the “indiscriminate” use of antibiotics.
“We depend too much on antibiotics and vaccines,” he told the Post.
The indiscriminate use of antibiotics, he said, had led to the emergence of resistance and the spread of resistant microorganisms.
“Many people consume antibiotics when they feel sick. They don’t hesitate to use them without prescriptions..in situations in which there is no reason to use antibiotics at all,” he told the Post. (ebf)
