Tuberculosis (TB) has recently returned to the spotlight following a rise in reported cases.
The resurgence of the infectious disease has raised fresh concerns among the public, especially as some people assume the disease had long disappeared.
The renewed attention surrounding TB has prompted questions about whether the disease still poses a threat, even though treatment and control measures to curb it have long been available.
As of Feb 21, statistics from the Ministry of Health recorded 596 new TB cases detected nationwide up to Epidemiological Week Six this year (EW6/2026), bringing the total number of cases so far to 3,161.
TB STILL PERSISTS
Commenting on the disease, Consultant Physician and Respiratory Specialist at Hospital Tawakkal, Dr Tengku Saifudin Tengku Ismail, said that although treatment and TB control systems have long existed in Malaysia, several factors have contributed to the recent increase in cases.
He explained that TB still exists within the community and has never completely disappeared because it is an infectious disease that can remain dormant in a person’s body for years without symptoms (latent TB) and only becomes active when the immune system weakens.
Malaysia, he said, is still categorised as a country with a moderately high TB risk, with tens of thousands of cases reported annually.
“On average, the TB incidence rate in Malaysia is around 80 to 100 cases per 100,000 population per year. In Johor, which has a dense population and high population movement, the number of cases recorded is among the highest in the country,” he told Bernama recently.
Dr Tengku Saifudin added that many patients delayed seeking medical examination after the COVID-19 pandemic due to limited access to healthcare facilities or concerns about visiting clinics.
“When screening activities were strengthened again, more cases were detected. This made the numbers appear to increase, although some of these cases may have previously gone undetected,” he said.
FACTORS BEHIND THE RISE IN CASES
Explaining the factors contributing to the rise in TB cases, Dr Tengku Saifudin said population density in major cities plays a significant role in the spread of the disease.
TB spreads through the air when an infected person coughs or sneezes. In crowded areas such as flats, workers’ hostels or enclosed workplaces with poor ventilation, the bacteria can easily spread from one individual to another.
He added that another contributing factor is the increase in chronic diseases, particularly diabetes.
“High-risk groups such as the elderly, diabetes patients, people living with HIV and individuals with weakened immune systems are more susceptible to TB. In Malaysia, the diabetes rate is high — about one in five adults has diabetes.
“Diabetes patients are two to three times more likely to develop TB. As the number of diabetes patients increases, the risk of TB cases also rises. Factors such as population density, the increase in chronic diseases and disruptions to screening during the pandemic have had a significant impact on current figures.
“TB is not a new disease, but it becomes more prominent when risk factors within society also increase. To control the situation, we need to focus on early screening, complete treatment and better management of chronic diseases,” he said.
Dr Tengku Saifudin also warned that incomplete treatment can cause the disease to recur and make the bacteria more difficult to treat.
“The rise in TB cases does not necessarily mean the control system has failed, but it shows that TB remains a public health challenge. It requires early detection, complete treatment, control of chronic diseases such as diabetes and cooperation from the community to reduce transmission in the long term,” he said.
Explaining the definition of TB and how it differs from common lung infections, he said TB is an infectious disease caused by the bacterium Mycobacterium tuberculosis.
The disease most commonly attacks the lungs but can also affect lymph nodes, bones, the intestines, the brain and other organs.
“Unlike common lung infections such as pneumonia, which usually occur suddenly and recover quickly with standard antibiotics, TB develops slowly over weeks or months and requires specialised treatment.
“TB treatment involves four types of medication for at least two months, followed by two types of TB medication that must be taken for at least another four months. The minimum treatment period is six months,” he said.
On the link between foreign workers and the spread of TB, Dr Tengku Saifudin said foreigners account for about 15 per cent of the total TB cases in Malaysia based on data from the Ministry of Health.
“Although TB is endemic in this country, the majority of cases (85 per cent) involve Malaysian citizens, particularly those with risk factors such as diabetes. Based on the available data, blaming the entry of foreign workers as the main cause of TB spread is inaccurate.
“Health screening is conducted for foreign workers, but TB is not solely a disease of migrants,” he said.
CONTROL
Community participation plays an important role in controlling TB as the disease spreads through the air.
Dr Tengku Saifudin said the public should be aware of TB symptoms such as coughing for more than two weeks, prolonged fever, night sweats and unexplained weight loss.
“If such symptoms occur, seek medical examination at a clinic immediately and do not wait until the condition worsens. The earlier it is detected, the easier it is to treat and the lower the risk of infecting others.
“In addition, patients diagnosed with TB must take their medication consistently until the treatment is completed, even if they already feel better. Family members and friends can help by providing moral support, reminding them to take their medication and avoiding stigma or isolating the patient. TB can be cured if treated properly,” he said.
He stressed that it is crucial for patients with active TB to complete the full course of treatment as prescribed to ensure the infection does not recur and to prevent the bacteria from developing drug resistance.
He added that failure to adhere to the prescribed treatment schedule and dosage may not only cause the disease to return in a more severe form, but also increase the risk of transmission and require a longer and more complex course of treatment.
He also urged the public to practise basic preventive measures such as covering their mouths when coughing or sneezing, ensuring good ventilation at home and workplaces, and reducing overcrowding in enclosed spaces where possible. He added that wearing a mask, especially in crowded or poorly ventilated areas, can help reduce the risk of transmission.
“Avoid spreading inaccurate information or blaming any particular group. Cooperation, understanding and community support are key to breaking the chain of infection and reducing TB cases in the long term,” he said.
When asked about the level of public awareness regarding TB, Dr Tengku Saifudin said public knowledge in Malaysia has improved but remains insufficient.
He said many people are aware that TB is infectious and treatable, but not everyone understands the early symptoms or the importance of seeking prompt treatment.
“Some people consider prolonged coughing as normal and only visit a clinic when the condition becomes severe. Stigma against TB patients also still exists because the disease is often associated with poverty, poor hygiene and viewed as a ‘dangerous and shameful’ illness.
“Some people fear infection simply by being near a patient, even though patients who are already receiving treatment are usually not infectious after a certain period. This stigma can cause patients to feel ashamed to seek treatment, delay seeing a doctor and stop taking medication early because they fear being discovered by others.
“This can delay recovery and increase the risk of spreading the infection to others,” he said.
Dr Tengku Saifudin said common misconceptions about TB include the belief that it cannot be cured, that it only affects certain groups and that patients must be completely isolated for long periods.
“In reality, TB can be fully cured if medication is taken consistently until the treatment period ends. The disease can affect anyone regardless of background. With proper treatment and close monitoring, most patients can return to living normal lives.
“Therefore, health education and community support are essential to eliminate stigma and help patients obtain early and complete treatment,” he said.
LATENT TB AND ACTIVE TB
Meanwhile, Respiratory Consultant at Hospital Raja Perempuan Zainab II (HRPZ II), Datuk Dr Mat Zuki Mat Jaeb, said the public discussion on TB has resurfaced following the recent cases, highlighting the need to further strengthen awareness.
He said it is important for the public to understand latent TB and how it spreads because latent TB is a condition where the bacteria exist in the body without causing symptoms.
“In latent TB cases, infection initially occurs through the respiratory tract. An individual can be exposed when they are close to a TB patient who coughs or talks, as the bacteria spread through airborne droplets. When droplets containing the bacteria are inhaled, they enter the respiratory tract and eventually reach the lungs.
“However, the body naturally has defence mechanisms to control the infection. Some bacteria may die while others are controlled by the immune system. In this situation, the infection remains latent because the bacteria are still present but inactive,” he said during Bernama TV’s talk show Ruang Bicara: Ancaman Tibi – Jangan Ambil Mudah recently.
In contrast, active TB is characterised by symptoms such as persistent coughing, fever, loss of appetite and night sweats.
Dr Mat Zuki explained that TB bacteria can remain in the body for years and only become active when a person’s immune system weakens due to ageing or chronic diseases.
“The immune system can control TB, but in certain conditions when immunity weakens — for example among patients with diabetes, HIV, those taking steroid medication or cancer patients — the body can no longer control the bacteria hiding in the cells.
“When this happens, the bacteria begin to multiply and cause active infection. This is what causes latent TB to develop into active TB,” he said.
He also reminded patients not to stop treatment prematurely even if they feel better, as this could lead to drug-resistant TB or Multi-Drug Resistant TB (MDR-TB), which is far more difficult and time-consuming to treat.
STILL STABLES
Deputy Director-General of Health (Public Health) Dr Ismuni Bohari said the main challenge in controlling TB currently is the spread of latent TB because its symptoms are not visible.
“What we mean by latent TB is that when infection occurs, a person’s body is still strong and the individual may not even realise they are infected because there are no symptoms. The bacteria can remain in the body for months, a year, or even up to three years.
“At some point, when the immune system weakens, the individual may develop active TB. This is what concerns us the most. Every time a TB case occurs, we conduct investigations and comprehensive contact tracing to identify individuals who may have been infected so that early action can be taken,” he said in the same talk show.
Speaking about the TB situation in Malaysia, Dr Ismuni said it remains stable, with infection rates remaining between 61 and 80 cases per 100,000 population since 2015.
“For the past three years — 2023, 2024 and 2025 — the number of new cases recorded has been about 78 per 100,000 population in 2023, followed by 76 cases in 2024 and 77 cases in 2025,” he said.
Nevertheless, Dr Ismuni advised the public to remain vigilant and not become complacent.
He emphasised that TB has long existed within the community and is not a new disease like COVID-19, which emerged suddenly.
At the same time, he urged individuals showing symptoms to wear face masks or undergo screening before attending social gatherings, especially in enclosed spaces, in order to protect others with weaker immune systems.
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