TB is still the biggest infection problem in the world and in Indonesia until now. Treatment of TB in Indonesia still experiences many obstacles due to the stigma experienced by patients suffering from TB. They are often ostracized, not invited to socialize, not accepted for work, or expelled from work. Fear of this stigma also hinders their diagnosis and treatment process, and can even cause mental problems such as depression.
Based on data from the Ministry of Health of the Republic of Indonesia (Kemenkes RI) which was disseminated in March 2023, it was said that the Ministry of Health had succeeded in detecting more than 700 thousand cases of TB in Indonesia. This figure is the highest figure since TBC became a National Priority program. This situation prompted the Ministry of Health to create a new protocol, collaborating with various professional associations and organizations.
As one of the universities that has the best Faculty of Medicine (FK) in Indonesia, FK Universitas Indonesia (UI) through the Primary Health Care Research and Innovation Center Cluster IMERI FKUI is carrying out an innovative collaboration with the Liverpool School of Tropical Medicine, UK. The two of them held a webinar with the theme “TB-CAPS: Together Reducing Tuberculosis Stigma” which was held online and attended by 161 participants from various educational institutions, health workers and others. This event was also the kick-off of collaborative research entitled “TB Caps is a mixed methods study to implement a peer-led, community-based psychosocial support intervention for Indonesians affected by tuberculosis stigma”.
Director of Prevention and Control of Infectious Diseases, Indonesian Ministry of Health, Dr. Imran Pambudi, MPHM., as one of the speakers in this webinar, said that Indonesia is the second country with the highest death rate due to TB in the world. The main intervention in controlling tuberculosis consists of 4 activities, namely preventive activities, detection or surveillance activities, treatment activities, and health promotion.
He further said that there were six activities carried out as a strategy to control TB in Indonesia in 2020-2024. The first is to support the national TB program’s efforts to identify and overcome service quality challenges, by providing community-based feedback on the quality of TB services in health facilities. Second, provide data on barriers to accessing TB services that will be used by stakeholders at the national, provincial and district/city levels as evidence to identify alternative solutions.
Third, strengthen the response to health and community services to eliminate stigma and discrimination at all levels. Fourth, create a friendly environment for patients to achieve successful treatment. Fifth, campaigns or education for the public to increase knowledge about TB, especially in schools and workplaces to eliminate stereotypes. Finally, the sixth activity is strengthening communities and society to create an environment without stigma and discrimination for TB patients and their families.
Meanwhile, FKUI-RSCM Psychiatry Department Staff Dr. Feranindhya Agiananda, Sp.KJ(K) said that disease-related stigma is a negative view of a person or group of people who share certain characteristics and certain diseases. “The existence of stigma also has an effect on individuals delaying seeking medical assistance or actually stopping treatment, which result in the form of resistance to treatment and even worsening medical conditions where the quality of life decreases,” said Dr. Feranindhya.
In handling this matter, he said that various parties needed to play a role. This includes the role of health workers in providing education to the community on an ongoing basis. Apart from that, providing support to individuals, as well as collaboration with social institutions or communities, and the role of the family in providing support to individuals in the form of practical medical emotions and creating a positive environment.
Another speaker who also provided education at the webinar which was held on August 24th 2023, was the Indonesian Tuberculosis Research Network, Dr. Dr. I Wayan Gede Artawan Eka Putra, M. Epid. This event was also attended by Principal Investigator Liverpool School of Tropical Medicine Tom Wingfield, MD, PhD. This webinar ended with the TB-CAPS Kick-Off event hosted by one of the researchers from FKUI, Dr. Ahmad Fuady, M.Sc, Ph.D. He said that the TB-CAPS study will be carried out from September 2023 to December 2024. TB-CAPS is a follow-up study to the previous study, namely CAPITA, which has adapted and validated the Van Rie TB stigma scale in seven provinces in Indonesia, which will then be used in the TB-CAPS Study.
Director of IMERI FKUI Prof. Dr. Badriul Hegar, Sp.A(K), Ph.D., said, “BoD (Board of Directors) IMERI FKUI, really appreciates friends from the Primary Health Care Research and Innovation Center IMERI FKUI, who have explored a collaboration with Liverpool School of Tropical Medicine. This collaborative effort is an innovative strategy whose results we hope will provide a new breakthrough for more comprehensive TB management. Hopefully, what we have done and will do can provide benefits for the development of science and improvement of health services for the Indonesian people,” said Prof. Hegar.