Did you know, Indonesia is ranked 3rd with the most TB cases in the world. Reports from the Global TB Report 2021, the estimated TB cases in Indonesia are 824,000 with 13,110 deaths and only 47% of cases are reported. From this data, what do you think? Wow, if we look again, it turns out that we may actually have been exposed to TB bacteria, namelyMycobacterium tuberculosis.And it could be that our bodies have actually been infected with TB bacteria and even the immune system is not strong enough to completely eliminate TB bacteria in the body, but because our bodies are able to control the spread of TB bacteria, ultimately no TB symptoms appear. So, this is called Latent Tuberculosis Infection or ILTB or in shortinfected with TB but have no symptoms and have not developed active TB.
People with ILTB usually occur in people who have household contact with active TB patients. For example, if a father is infected with active TB, it could be that his wife and children have ILTB, which means they have been infected but have not developed active TB. However, several study results show that around 5-10% of people with ILTB will develop active TB, usually within 5 years of first being infected. People with ILTB can also develop active TB if they have a weak immune system.
How do we know if we have ILTB?For people with ILTB, if a Tuberculin Skin Test (TST) or Interferon Gamma-Release Assay (IGRA) is performed, the results will be positive, but the results of the thorax x-ray examination are normal and the results of the sputum examination and Xpert MTB/Rif® are negative. However, when a patient who has just been diagnosed with TB is positive, household contacts, especially children, are considered as one of the beneficiaries of TB services.Household contacts need to be given Tuberculosis Prevention Therapy or TPT.
TPT is one step to prevent ILTB people who are at risk of developing positive TB disease. The aim of administering TPT is to prevent TB disease so that it can reduce the burden of TB. Specifically, let's seeWho can be given TPT?
People with HIV/AIDS (PLWHA)
Household contact with a patient with bacteriologically confirmed pulmonary TB
Children under 5 years old
Children aged 5-14 years
Teenagers and adults (over 15 years old)
Another risk group is HIV negative
Other immunocompromised patients (Patients undergoing cancer treatment, patients receiving dialysis treatment, patients receiving long-term corticosteroids, patients preparing for organ transplantation, etc.).
Correctional Inmates (WBP), health workers, boarding schools, military barracks, injecting drug users.
TPT is given in the form of medication. The TPT alloy itself is divided into 3, namely 3HP, 3HR and 6H which can be adjusted based on recommendations from doctors or local health workers.
Source: Technical Instructions for Handling ILTB 2020
6H Alloy:
This combination is given in the form of the drug Isoniazid (INH). Given once a day, preferably at the same time (morning, afternoon, evening or night) on an empty stomach (1 hour before eating or 2 hours after eating) for 6 months.
3HP Alloy:
Given in the form of the drugs Isoniazid (INH) and Rifapentine. The medicine is consumed once a week for 3 months. The medicine should be consumed at the same time (morning, afternoon, evening or night) on an empty stomach (1 hour before eating or 2 hours after eating).
3HR Alloy:
The drugs that will be given are Isoniazid (INH) and Rifamycin (R). The drug is consumed once a day and the duration of administration is 3 months (1 month = 28 days of treatment). The medicine should be consumed at the same time (morning, afternoon, evening or night) on an empty stomach (1 hour before eating or 2 hours after eating).
This TPT drug must be consumed completely by people with ILTB. Administration of TPT medication to both adults and children is said to be complete if they complete at least 80% of the preventive treatment series according to the duration of the selected TPT combination. For complete TPT alloys, seehereyes
