PhD student leading tuberculosis prevention in Indonesia
Dr Trisasi Lestari is passionate about tuberculosis prevention, and it’s not surprising given the impact her PhD is already having on the health of children in Papua, Indonesia.
Indonesia has a high burden of TB, and before her study began, the focus was very much on treatment rather than prevention. Sasi’s HOT NORTH project is the opposite. It gives the TB prevention drug Isoniazid to children under five in Papua, who live in the same house as a TB patient.
“We cannot eliminate TB unless we do more radical intervention.” She says. “We can’t wait until sick people come and ask for treatment, we have to go to the field and look for already infected people. If you are exposed to a TB patient, there is a chance you will get the infection but there is a delay between getting the infection and catching the disease. So, it’s like a time bomb. But we can kill the bacteria before they are active.”
Sasi started her research in September 2017 and already, dozens of children have received the drug. Her success has had a ripple effect. Her study was in conjunction with five health facilities, but others heard about it and started implementing the same prevention – so now, even more children are being protected.
“Children usually have a lower immunity system than adults.” She explains. “If they get the disease, they usually get a more severe type of TB so it’s very bad for their future.”
The World Health Organization already recommends prevention, and it’s in the Indonesian health guidelines, but so far it hasn’t been well implemented in Papua province. Sasi hopes it will soon become routine practice there and then the whole country. She’s immensely proud of what has been achieved by her team.
“Papua is considered a very rural area and people tend to underestimate Papuan people. The fact that we can start it and run it well, shows the resourcing and capability is there in a resource limited setting.”
Sasi trained as a physician in Indonesia but always loved doing research and says her clinical work helps her understand it better. She completed her Master of Public Health in Sweden after her medical training, and then became a research fellow for tropical research at Gadjah Mada University. She thinks her future is in research more than clinical work and she has huge ambitions.
“I love the dynamism of research,” she says. “I want to finish my PhD as soon as possible and do more research with Menzies. I also want to improve research capacity in Papua; and with support of Menzies, it’s not impossible to build a good research centre there.”
She’s very humble about the success of her PhD programme.
“It’s what you’re supposed to do; it’s not about me, it’s the people in the clinic that do all the work. I’m very proud that the people in the clinic are doing what people in the big cities aren’t managing to do.”
Sasi says she won’t be in Papua forever, so it’s important to improve capacity and capability while she can.
She’s had a lot of support from Menzies and has regularly travelled to Darwin for meetings and courses. She was also an integral part of AAI Tuberculosis (the Australia Awards in Indonesia Short Term Award: Tuberculosis: Prevention and Eradication).
“The courses are very useful and interesting. I’ve also had other great opportunities, like networking with brilliant TB researchers in Australia. It’s also so friendly here.”
Back in Papua, the trickiest obstacle she faces is bureaucracy, but the National TB Program is watching her study and have even asked for the protocol, so the future is looking promising.
“Let’s see what happens”, Sasi says, hopefully.