Malaysia Faces Rising Tuberculosis Rates: A Looming Public Health Challenge
Kuala Lumpur – A seemingly innocuous cough can sometimes be the first sign of a serious health crisis. This was the reality for Hisyam Mohamad, a 42-year-old oil palm smallholder from Pahang, whose cough in 2023 escalated to coughing up blood-streaked phlegm. His experience is becoming increasingly common as Malaysia grapples with a resurgence of tuberculosis (TB), a disease many believed to be largely under control.
The Numbers Tell a Concerning Story
In 2023, Malaysia recorded 26,781 tuberculosis cases, a 5.5 percent increase from the previous year. This upward trend has continued into 2026, with 3,161 cases reported nationwide in the first six weeks – a 10 percent jump year-over-year. Currently, Sabah leads with the highest number of cases (755), followed by Selangor (596) and Sarawak (332). Johor recorded 280 cases, while Kuala Lumpur and Putrajaya together reported 244, according to the Malaysian Health Ministry as of February 25.
Latent TB: The “Sleeping” Threat
Hisyam’s case highlights the insidious nature of latent TB infection, often referred to as “sleeping TB.” This occurs when the bacteria is present in the body but remains dormant. However, declining immunity, exposure to other diseases, and treatments affecting the immune system can reactivate the bacteria, leading to active TB. Even prior exposure, like Hisyam’s contact with a father-in-law who contracted TB in 2017, doesn’t guarantee immunity.
A Contrast with Singapore
While Malaysia is experiencing a rise in TB cases, neighboring Singapore is seeing a different trend. In 2024, Singapore reported 1,156 fresh cases of active TB, continuing a six-year decline from a high of 1,306 cases in 2021.
How TB Spreads and Why Now?
Unlike rapidly spreading illnesses like COVID-19, TB transmission requires prolonged, close contact with an infected individual, typically in poorly ventilated indoor spaces. Experts suggest several factors are contributing to the resurgence in Malaysia, including declining immunity, delayed detection, and poor compliance with treatment regimens, leading to drug resistance. Crowded gatherings, such as those expected during Ramadan bazaars, pose a particular risk.
The Challenges of Treatment
TB treatment is a long and strict process, requiring patients to adhere to a regimented medication plan for at least six months, taking multiple pills daily at fixed times. Interruption of treatment can undo progress and even necessitate restarting the entire course. Malaysia’s treatment interruption rate of around 24 percent and a treatment success rate of 81.5 percent fall short of the World Health Organization’s 95 percent target, contributing to the emergence of drug-resistant strains.
What Can Be Done?
Early detection is critical. Experts recommend seeking medical attention for a persistent cough lasting more than three weeks, especially if accompanied by phlegm (yellow or green), difficulty breathing, fever, chills, or unexplained weight loss. Public health officials emphasize the importance of proper cough and sneeze etiquette, good ventilation in enclosed spaces, and wearing masks when symptomatic or in crowded settings.
Addressing the Stigma
There remains a stigma surrounding TB, with some mistakenly believing it only affects certain populations. Experts stress that TB is curable with early diagnosis and consistent treatment, regardless of socioeconomic status.
Frequently Asked Questions
- What are the symptoms of TB? A persistent cough (lasting more than three weeks), coughing up blood-streaked phlegm, fever, chills, unexplained weight loss, and difficulty breathing.
- Is TB contagious? Yes, but it requires prolonged, close contact with an infected person.
- How long does TB treatment take? At least six months, with strict adherence to a medication regimen.
- Can TB be cured? Yes, with early diagnosis and consistent treatment.
“The TB endgame is a long-term project with no quick fixes,” stated a public health physician.
Pro Tip: If you experience a persistent cough, don’t dismiss it. Seek medical attention promptly to rule out TB and other potential health issues.
Have you or someone you understand been affected by the rise in TB cases? Share your thoughts and experiences in the comments below.
