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Tuberculosis (TB) is a major infectious disease problem in the world, especially

developing countries, such as Indonesia. Despite the availability of free drugs for TB patients
and other Indonesian governments investments to combat TB, the number of TB cases are
still high, with an estimated 9.6 million people are infected and 1.2 million died due to TB
infection in 2014. This death rank fifth from all death cause Indonesia in the same year.
Under-detection and high drop-out of TB are important contributors to this problem.
Under-detection of TB can be improved by actively screen the household contacts or
other close contacts of the TB patients, people living with HIV, and current and former worker
with silica exposure. This can be communicated with the insurance company for the
screening cost.
Dropout rate were reported as much as 47.9% among total treated cases. The cause
of drop out is influenced by various factors, including low education levels, lower
socioeconomic, and even the number of TB drug stocks are limited, especially in remote
areas.
As a doctor in the near future, we will put our best efforts to decrease the dropout rate by
implementing several strategies. Firstly, we want to increase the knowledge of patients and
their closest people about the disease. It is important that the patients acknowledge that TB
is an infectious disease that can be cured, as long the patient comply to take a cocktail of
medication daily or regularly for a minimum period of 6 months, which can be longer
depends on the patients condition. When it is not possible to assign a formal supervisor to
ensure the daily consumption of drugs, the role of patients family to be the supervisor is
important to remind and encourage patients while taking the drugs. It is also important to
inform the patient about the disadvantage of stopping drug consumption before the complete
course, i.e. the occurrence of MDR-TB which need even much more complex, lengthy, and
expensive therapy.
The side effects of TB therapy are not uncommon. This has to be communicated well to the
patients and the family so that they will not stop taking drugs because they experience side
effect(s).
Using the information technology, we wish to develop a smartphone app which will function
to remind patient in taking their drugs, as a help tool for patient who seek for information
regarding TB and its drugs We want to build a well-organized, computerized registry of TB
patients which can be use nationally to monitor which patient missed the regular visit for
check-up or drug order, which patient has a treatment failure, monitor the spread of MDR
TB, etc. It will act as a alarm or reminder for us to take immediate actions before things gone
worse.
Besides the assurance of patients drug compliance, it is necessary for us to ensure
the availability of TB drugs at least in our own facilities, so that a case in which patients do
not take medication due to unavailability of the drugs will not occur. We have to collaborate
with various stakeholders at the national and regional level to ensure the availability of these
drugs.
We believe that by improving the detection of active TB cases and patients
compliance will decrease TB transmission and eventually decrease TB case numbers.

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