Why TB Patients Must Have Drug Control Supervisors (PMO)

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Tuberculosis (TB) is one of the infectious diseases caused by germs named Mycobacterium tuberculosis. These germs can attack all parts of the body, although it is more often found to attack the human respiratory tract, especially the lungs. This disease is one of the highest causes of death in infection in the world, in addition to malaria. In the 2013 WHO report, it was estimated that there were 8.6 million TB cases in which 1.1 million people (13%) were HIV-positive TB. Transmission through the air causes this disease to be more prevalent in dense settlements where the distance between a close house and less sunlight goes into the house.

Moist conditions like in Indonesia, increase the resistance of germs to multiply faster. Indonesia is the country with the 4th largest TB patients in the world after India, China and South Africa. It is estimated that the number of TB patients in Indonesia is around 5.7% of the total number of TB patients in the world, with each year there are 450,000 new cases and 65,000 deaths.

When someone is diagnosed with tuberculosis infection, it takes a long time to destroy this germ from inside the body. Someone with pulmonary TB infection requires a minimum of 6 months of treatment, in which the first 2 months aim to kill TB germs, and 4 months afterwards to control the seeds of the germs that hide so they are not active. Not to mention, if the TB germs have spread to other organs, the treatment time can be longer which is 9-12 months.

Long periods of time and many types of drugs make many TB patients not adhere to treatment. As a result, germs become immune and treatment must be repeated. Therefore, the Ministry of Health of the Republic of Indonesia made a special mentoring program, namely the Drug Control Supervisor (PMO).

What is the Supervisor for taking medicine?

TB treatment will cure most patients without triggering the emergence of drug resistant (immune) germs. To achieve this, it is very important to ensure that the patient swallows all drugs given as recommended by direct supervision by a PMO (Supervisor for Drugs, or often also called the Superintendent of Swallowing Drugs) to prevent drug resistance The choice of place of treatment should be agreed upon with the patient in order to provide comfort. Patients can choose to come to health facilities (puskesmas, hospitals, private hospitals) closest to the residence of the patient or PMO to come to the patient's home. If there are no complications, treatment can be given on an outpatient basis.

What are the requirements to become a PMO?

A PMO must be someone who is known, trusted and approved, both by health workers and patients,
PMO must be respected and respected by patients, so that patients can obediently carry out the instructions given.
Someone who lives close to the patient.
Willing to help patients voluntarily.
Willing to be trained and / or received counseling together with patients

Who can become a PMO?

PMOs should be health workers, for example village midwives, nurses, workers, sanitarians, immunization interpreters, and others. If there are no possible health workers, PMOs can come from health cadres, teachers, PPTI members, PKK, or other community leaders or family members. A study shows that PMO from family members increases patient compliance with taking medication. However, family members must first be educated by health workers regarding the ins and outs of TB disease.

What are the tasks of a PMO?

The task of a PMO is not to replace patients taking medicine from the place of treatment. The task of the PMO is very important to improve the patient's recovery rate, including:

Supervise TB patients to take medication regularly until they finish treatment. Without PMO, patients are vulnerable drop out, so the germs are already immune to the drug and the treatment time can be repeated and longer.
Give encouragement to patients to get regular treatment.
Remind the patient to check phlegm at the specified time.
Providing counseling to family members of TB patients who have suspicious symptoms of TB to immediately go to the Health Services Unit.

In carrying out their duties, a PMO must also actively provide important information that TB patients and other family members need to understand. These things include:

That TB is caused by germs, not hereditary diseases or curses.
How do you transmit TB, suspicious symptoms and how to prevent it.
That TB can be cured by regular treatment, if it is not compliant the treatment becomes longer because germs are already more wild and immune to the drug.
How to administer patient treatment (intensive and advanced stages).
What is the importance of monitoring so that patients are treated regularly.
Possible side effects of the drug and the need to immediately request help to the nearest health facility.

Given its large role, it is very important for a TB patient to have a supervisor to take medication. With the collaboration of solid PMO-patients, the rate of disability and death from TB can be reduced.

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