Indonesia has implemented Directly Observed Treatment Shortcourse (DOTS) as a tuberculosis (TB) treatment strategy. This strategy was recommended by the World Health Organization (WHO) and adopted in the National TB Program in various countries. In 2009, TBâ€™s case detection rate coverage reached 71% and treatment success rate reached 90%. TB mortality rate in 2008 dropped significantly to 38 per 100,000 population compared to the year 1990, which was 92 per 100,000 population. That happened because the implementation of the DOTS strategy in Indonesia has been carried out extensively. Nevertheless, the challenges of TB problem ahead are still huge, especially with the new challenge in form of the development of TB-HIV dual epidemic and outbreak cases of drug resistance of anti tuberculosis (Multi-Drugs Resistant MDR-TB). Therefore, the information from TB patients about whether they ever received previous TB treatment is necessary. "This was left unnoticed and is often overlooked by the hospital, whether patients had received previous TB treatment? It seems trivial, but indeed critical," said Public Health Sciences researcher of Faculty of Medicine, UGM, Adi Utarini M.Sc., MPH, Ph.D. during the Scientific Discussion of Innovation Acceleration in TB management in the province of Yogyakarta Special Region, Thursday (1/4), at the Hall of Provincial Health Office.
She said that the role of community health centers, Hospitals, and Lung Disease Clinic is still very important in TB management programs and already achieved some progress. One of the innovations already made in the province is to strengthen the internal network at the hospital, especially inpatient services with other units. Head of Health Problems Prevention and Treatment, Yogyakarta Provincial Health Office, drg. Daryanto, B.Sc., M. Kes., explain that Yogyakarta Provincial Health Officeâ€™s strategy in the treatment of TB patients is Directly Observed Treatment Shortcourse (DOTS) program. The program is conducted by strengthening infield network cooperating with various parties, such as the Indonesia Tuberculosis Eradication Association, FamilyÂ Welfare Training Units, and Non-Governmental Organizations. "The effort to strengthen the network is intended to detect the TB patients effectively so we can expect an increase in the target discovery of TB new cases," he said. In addition, efforts have been made through the DOTS program that must be implemented in all community health centers, including 29 hospitals and 120 community health centers in the province.
Chairman of the Division II, Indonesia Public Health specialist Association (IAKMI) of Yogyakarta, dr. Yodi Mahendradhata, M.Sc., Ph.D., said actually the province has developed a range of innovative TB control, such as the involvement of private hospitals and practitioners in DOTS strategy, integrated control of TB-HIV, and field testing of new diagnostic technology for TB. Faculty of Medicine UGM has also been working closely with health agencies and foreign donors since 2007 and also developed Asia TB training center. "Thereâ€™s a lot of hope that further innovations for TB control here will emerge and from that we can learn to control TB in other provinces in Indonesia and other countries," he said.