Country Progress Report
MALAYSIA
The ninth Technical Advisory Group and National TB Programme Managers meeting for TB
control in the Western Pacific Region
Manila, Philippines
9 -12 December 2014
1
SURVEILLANCE
National TB Strategy/Policies
 National Strategic Plan for
Tuberculosis Control, 20112015 was launched in 2011
 It is in line with the 6
Strategies of TBC by WHO /
Stop TB Org.
 Fund is allocated as
proposed by National TB
Coordinator under CDC,
calculated on basis of
planning as well as outcome
of previous year
 Fund is solely by Ministry of
Health, under jurisdiction of
Finance Ministry
TARGET
1 To Reduce 50% Inc. Rate by
the year 2015 Relative to
1990 Level
2 To Increase 95% Case
Detection Rate by year 2015
3 To Achieve Beyond 85%
Cure Rate
by year 2015
4 To Achieve Beyond 85%
Treatment Success Rate by
year 2015
5 To Reduce 50% TB Death
Rate By the year 2015
Relative to 1990 Level
INCIDENCE (NOTIFICATION) RATE OF TB
(per 100,000) MALAYSIA, (1990-2013)
30000
90
77
72
25000
81
80
68
70
Number of case
20000
60
50
15000
40
10000
30
20
5000
10
0
0
Year
Total Case
Notification Rate/100,000
13
Treatment Outcome of New Smear Positive Cases (Cohort 2006
-2013)
100
90
80
70
60
46
67
69
78
78
79
78
77
%
50
40
30
20
10
0
2006
69
2007
46
2008
67
2009
78
2010
78
2011
79
2012
78
2013
77
Complete
1
3
5
1
1
1
1
2
Died
8
6
8
8
9
9
9
9
Defaulter
10
3
5
4
4
4
4
4
Failed
0
0
0
0
0
0
0
0
Not Evaluated
12
42
15
9
8
7
8
8
Cure
15
TB MORTALITY RATE, MALAYSIA (1990-2013)
16
MDR-TB MALAYSIA, (2004-2013)
Year
Notified TB Cases Isolates tested for
(All Forms)
DST
MDR
Cases
% MDR
(By number of
culture positive
tested for DST)
2004
2005
2006
15429
15875
16665
5083
6309
6386
13
17
42
0.3
0.3
0.7
2007
2008
2009
2010
2011
16918
17506
18102
19337
20666
6687
6264
7137
6963
10477
41
56
55
51
141
0.6
0.9
0.8
0.7
1.3
2012
22710
9722
74
0.8
2013
Okt, 2014
24071
17496
13777
14607
124
78
0.9
0.5
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Treatment outcome of MDRTB cases
Malaysia (2007-2011)
Treatment success rate (%)
100
80
60
59
47
40
36
25
28
2010
2011
20
0
2007
2008
2009
Treatment success rate
Target
Note: Treatment outcome for MDRTB cases are using previous 2 years cohort
analysis
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TUBERCULOSIS IN FOREIGNERS
In 2000, 10% of notified TB cases were in foreigners with majority
(90%) from Indonesia and Philippines. (Iyawoo K, 2004)
In 2003, a rate of 30% of foreign cases was reported among 425
patients at the national referral centre. Rates were higher in men
compared to women. (Nissapatorn et al, 2007)
Locals were older than foreigners (44 vs 30 years).
Lost to follow-up and transfer out was greater in foreigners
compared to locals. No difference in risk factors, new cases, smear
negative cases.
CONCLUSION
There was significantly more cases of tuberculosis in
foreigners than expected and this increase is
disproportionately greater in women than men.
Foreign cases were significantly younger and less educated.
There were more sputum negative cases and
relapsing/recurrent TB in locals. More foreigners moved
away or were lost to treatment.
Local cases were more likely to have risk factors such as
diabetes, smoking, and HIV infection.
Major Challenges
 Sustainability of the TB programme beyond 2015.
 An estimated (20-30)% of notified TB cases are not
MTB confirmed and takes 3 weeks to 3 months for
confirmed results.
 Ensuring the availability of quality assured TB drugs.
 Ensuring quality screening and clinical management
of pulmonary TB, extra pulmonary TB and TB in
children including contact investigation.
 Ensuring adequate infection control measures to
limit infection transmission in health care facilities
.
Way Forward
1. Research on TB will be prioritized as policy research.
2. Public Private Partnership Project and Implementation
3. Safety assessment of targeted Public Health Facilities
4. Enhance use of Fluorescent Microscope in exchange to
conventional microscope at clinic level.
5. Revive mass screening for TB targeted groups using
mobile x-ray.
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