Why is a Tuberculosis Checkup Part of the 6ME? A Case Study of Tuberculosis in Singapore

medical specialist discussing x-ray results

Medically Reviewed by Dr Jackie Lam, M.B.B.S (Singapore)

In the realm of healthcare, the 6 monthly medical examination (6ME) holds a significant place, ensuring the health and well-being of individuals. Tuberculosis (TB), a contagious bacterial infection, is a notable inclusion in the 6ME whereby a chest X-ray is done once at the 2 year mark of a foreign worker’s tenure. 

This article looks into the reasons behind TB being a crucial component of the domestic worker examination, using a case study of tuberculosis in Singapore to shed light on the importance of regular screenings and preventive measures.

Tuberculosis in Singapore: A Case Study

The tuberculosis (TB) outbreak in Jalan Bukit Merah last May 2022, as reported by The Straits Times, serves as a significant case study in public health management. With around 170 individuals testing positive for TB, the Ministry of Health (MOH) has responded swiftly by extending screening efforts to contain the spread of the infectious disease.

The Ministry of Health also stated that further tests are needed to determine if those who tested positive have active TB disease or TB infection. Those with latent TB infections were given appointments at the TB control unit and were offered treatment when required. Those with active TB disease were also provided treatment.

Health Authorities’ Response

The situation highlighted the proactive response of health authorities in Singapore. As we have seen from COVID-19, being complacent or slow to action can lead to a rampant spread of a disease which can then lead to an epidemic, or worse, a pandemic. Therefore,  swift and decisive measures to identify and manage the confirmed cases are necessary to prevent such a situation. 

Extending screening initiatives is presented as a strategic move to reach a broader population and identify individuals who may be carriers of the TB bacteria, even if they remain asymptomatic. 

Community Involvement

The event also underscores the importance of community involvement in managing outbreaks. It explores how health authorities are encouraging residents in the affected area and neighbouring communities to actively participate in the screening efforts. The involvement of the community is presented as a critical factor in controlling the spread of TB and preventing further cases.

Collaborative Efforts

The case also emphasises the collaborative efforts between healthcare professionals, local authorities, and the community to tackle the situation effectively. It sheds light on the coordination between different stakeholders, showcasing how a unified approach is essential in managing and mitigating the impact of infectious diseases within a community.

Preventive Measures

The situation clearly demonstrates the preventive measures being implemented, urging residents to prioritise their health and participate in screening programs. It serves as a reminder that early detection and intervention are crucial in preventing the further transmission of infectious diseases.

The TB outbreak in Jalan Bukit Merah provides valuable insights into the challenges and strategies involved in managing infectious diseases within a community. The swift and collaborative response of health authorities, coupled with community involvement and preventive measures, serves as a model for addressing and containing outbreaks effectively. 

It also underscores the importance of proactive public health measures and highlights the need for ongoing vigilance in managing and preventing the spread of infectious diseases.

Understanding Tuberculosis and its Global Impact

Tuberculosis, caused by the bacterium Mycobacterium tuberculosis, primarily affects the lungs but can involve other organs as well. With nearly 10 million new cases reported globally each year, TB remains a major public health concern. The bacterium spreads through the air when an infected person coughs or sneezes, making it highly contagious.

The Significance of Chest X-ray as part of domestic worker screening.

The 6ME is a health screening designed to monitor and detect various health conditions regularly. In Singapore, it is a mandatory requirement for certain groups to undergo a 6ME, including foreign workers. This periodic health check aims to identify and address potential health issues promptly, preventing the spread of communicable diseases within the community. The following states the requirements for the various types of examinations that a foreign worker has to undergo: 

  • Pregnancy and Syphilis – every 6 months
  • HIV- every 2 years
  • TB – Once, upon 2 years of stay in Singapore
  • Checks on Body Mass Index (BMI) and visible signs of abuse – every 6 months 

Prevalence and Incidence in Singapore

Singapore has made significant progress in controlling TB, with a steady decline in incidence rates over the years. This is why a TB screening is only part of the 6ME at significant milestones. However, due to its status as a global city with a high influx of residents and travelers, there remains a need for continuous monitoring and preventive measures.

Challenges in Detection and Control

Despite the advanced healthcare infrastructure in Singapore, detecting TB poses challenges. The asymptomatic nature of latent TB, where individuals carry the bacteria but do not exhibit symptoms, complicates early identification. Regular screenings through programs like the 6ME become pivotal in identifying latent TB cases and preventing the progression to active disease.

Treatment and Management Strategies

For individuals identified with latent TB during the medical examination, appropriate treatment and management strategies are initiated promptly. This preventive approach involves the use of antibiotics to eliminate the bacteria before it becomes active. Timely intervention not only protects the individual’s health but also contributes to the overall public health goals of TB control in Singapore.

The Importance of Compliance and Follow-Up

In the case of identified TB cases or latent TB, compliance with prescribed treatments and follow-up screenings are paramount. This minimises the risk of TB transmission and fosters a healthier population.

Prioritise Your Health with Keystone Clinic & Surgery

As we navigate the challenges posed by infectious diseases like tuberculosis, it’s crucial to prioritise regular health screenings. For a comprehensive and reliable 6ME in Singapore, Keystone Medical offers top-notch services tailored to meet your health needs. 

Visit Keystone Clinic & Surgery to schedule your 6 Monthly Medical Examination and take proactive steps towards safeguarding your well-being. Your health is an investment, and Keystone Clinic & Surgery is here to guide you on your journey to a healthier and safer future.


World Health Organization. (2021). Tuberculosis. https://www.who.int/news-room/fact-sheets/detail/tuberculosis

Ministry of Health Singapore. 2021. Update on Tuberculosis Situation in Singapore. https://www.moh.gov.sg/news-highlights/details/update-on-tuberculosis-situation-in-singapore-2023#:~:text=TB%20is%20endemic%20in%20Singapore,the%201%2C300%20cases%20in%202021.

World Health Organization. 2020. Latent tuberculosis infection: Updated and consolidated guidelines for programmatic management. https://www.who.int/publications-detail-redirect/9789241550239

Ministry of Manpower Singapore. 2022. Medical Examination for Migrant Workers. https://www.mom.gov.sg/passes-and-permits/work-permit-for-foreign-worker/sector-specific-rules/medical-examination

HealthHub Singapore. 2023. Tuberculosis. https://www.healthhub.sg/a-z/diseases-and-conditions/tuberculosis

StraitsTimes.com. 2022. About 170 People Test Positive for TB in Jalan Bukit Merah; MOH Extends Screening. https://www.straitstimes.com/singapore/health/more-than-150-tested-positive-for-tb-in-jalan-bukit-merah-moh-extends-screening

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