KUCHING: Insufficient funding for facilities and lack of amenities for public medical care centres are partly to blame for the rise of tuberculosis (TB) cases in Sarawak and can very well be the same all over the country.
An investigative report on the outbreak of the disease made available to theantdaily showed that a healthcare worker in a rural Sarawak district was diagnosed with the affliction in September 2012 after having the symptoms for one month.
The 34-page report, quoted on condition of anonymity of the authors, recorded the various steps taken to investigate the outbreak originating at a public medical facility, in which five healthcare workers and 22 patients were examined for signs of TB.
The results of the investigation indicated that TB was detected in two of the patients at the facility. In addition, records showed that another healthcare worker employed there was diagnosed with TB in 2009 but had succumbed to the disease the same year.
Among the issues uncovered in the investigation are no natural aeration in the facility (as all windows were closed), no blower installed, no high-efficiency particulate air (HEPA) filter or ultraviolet germicidal irradiation (UVGI).
The stagnant air and the absence of all these items were pivotal in the transmission of TB, which is in essence an airborne disease and has mutated to other strains, as previously reported by theantdaily.
The conclusive remarks made in the report made recommendations of protocols for a more stringent surveillance system and early routine screening for TB among both staff and patients at the facility.
A healthcare professional told theantdaily that the nature of the investigation was not surprising as there were rampant cases of inadequate facilities, improper handling and non-adherence to standard operating procedures by healthcare staff.
The professional, with 30 years of industry experience, added that the lack of equipment and proper protocol was merely the tip of the iceberg, resulting in the standard of healthcare and coverage across Sarawak deteriorating, as seen in the rising number of TB cases of late.
On funding for the public healthcare system in Sarawak, he noted that the lack of approved and actually disbursed funding from the federal government was further exacerbated by improper allocation within Sarawak by the state authorities as well.
According to state health director Datuk Dr Zulkifli Jantan, there were 2,000 TB cases reported in 2010 and 2,055 in 2011. Last year, there was an increase of about 400 cases to 2,430, giving an average increase of 0.8 per cent of TB cases every year.
Overall, Malaysia has seen a marked increase in TB cases, with Health Minister Datuk Seri Dr S Subramaniam pointing at overcrowding of foreign workers as being one of the causes.
~ The Ant Daily