Country Progress Report

MALAYSIA

Country Progress Report

MALAYSIA

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The ninth Technical Advisory Group and National TB Programme Managers meeting for TB control in the Western Pacific Region

Manila, Philippines9 -12 December 2014

SURVEILLANCE

National TB Strategy/PoliciesNational TB Strategy/Policies National Strategic Plan for

Tuberculosis Control, 2011-2015 was launched in 2011

It is in line with the 6 Strategies of TBC by WHO / Stop TB Org.

Fund is allocated as proposed by National TB Coordinator under CDC, calculated on basis of planning as well as outcome of previous year

Fund is solely by Ministry of Health, under jurisdiction of Finance Ministry

INCIDENCE (NOTIFICATION) RATE OF TB (per 100,000) MALAYSIA, (1990-2013) INCIDENCE (NOTIFICATION) RATE OF TB (per 100,000) MALAYSIA, (1990-2013)

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Treatment Outcome of New Smear Positive Cases (Cohort 2006 -2013)

Treatment Outcome of New Smear Positive Cases (Cohort 2006 -2013)

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TB MORTALITY RATE, MALAYSIA (1990-2013)TB MORTALITY RATE, MALAYSIA (1990-2013)

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Year Notified TB Cases (All Forms)

Isolates tested for DST

MDRCases

% MDR (By number of culture positive tested for DST)

2004 15429 5083 13 0.32005 15875 6309 17 0.32006 16665 6386 42 0.72007 16918 6687 41 0.62008 17506 6264 56 0.92009 18102 7137 55 0.82010 19337 6963 51 0.72011 20666 10477 141 1.32012 22710 9722 74 0.82013 24071 13777 124 0.9

Okt, 2014 17496 14607 78 0.5

MDR-TB MALAYSIA, (2004-2013)

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Treatment outcome of MDRTB cases Malaysia (2007-2011)

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Note: Treatment outcome for MDRTB cases are using previous 2 years cohort analysis

TUBERCULOSIS IN FOREIGNERSTUBERCULOSIS IN FOREIGNERSIn 2000, 10% of notified TB cases were in foreigners with In 2000, 10% of notified TB cases were in foreigners with majority (90%) from Indonesia and Philippines. (Iyawoo majority (90%) from Indonesia and Philippines. (Iyawoo K, 2004)K, 2004)

In 2003, a rate of 30% of foreign cases was reported In 2003, a rate of 30% of foreign cases was reported among 425 patients at the national referral centre. Rates among 425 patients at the national referral centre. Rates were higher in men compared to women. (Nissapatorn et were higher in men compared to women. (Nissapatorn et al, 2007)al, 2007)

Locals were older than foreigners (44 vs 30 years).Locals were older than foreigners (44 vs 30 years).

Lost to follow-up and transfer out was greater in Lost to follow-up and transfer out was greater in foreigners compared to locals. No difference in risk foreigners compared to locals. No difference in risk factors, new cases, smear negative cases.factors, new cases, smear negative cases.

CONCLUSIONCONCLUSION

There was significantly more cases of tuberculosis in There was significantly more cases of tuberculosis in foreigners than expected and this increase is foreigners than expected and this increase is disproportionately greater in women than men. disproportionately greater in women than men.

Foreign cases were significantly younger and less educated.Foreign cases were significantly younger and less educated.

There were more sputum negative cases and There were more sputum negative cases and relapsing/recurrent TB in locals. More foreigners moved relapsing/recurrent TB in locals. More foreigners moved away or were lost to treatment.away or were lost to treatment.

Local cases were more likely to have risk factors such as Local cases were more likely to have risk factors such as diabetes, smoking, and HIV infection.diabetes, smoking, and HIV infection.

Major Challenges Major Challenges Sustainability of the TB programme beyond 2015. An estimated (20-30)% of notified TB cases are not

MTB confirmed and takes 3 weeks to 3 months for confirmed results.

Ensuring the availability of quality assured TB drugs.Ensuring quality screening and clinical management

of pulmonary TB, extra pulmonary TB and TB in children including contact investigation.

Ensuring adequate infection control measures to limit infection transmission in health care facilities.

Way ForwardWay Forward1. Research on TB will be prioritized as policy research.

2. Public Private Partnership Project and Implementation

3. Safety assessment of targeted Public Health Facilities

4. Enhance use of Fluorescent Microscope in exchange to conventional microscope at clinic level.

5. Revive mass screening for TB targeted groups using mobile x-ray.

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