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MALAYSIA is witnessing a renewed discussion around tuberculosis, a disease long thought to be a relic of the past, following an increase in reported cases since the start of 2026.
The Ministry of Health recorded 3,161 cases as of 21 February, including 596 new cases reported in the sixth epidemiological week of the year.
The resurgence has raised questions over whether tuberculosis remains a threat despite longstanding treatment and control measures in the country. Experts emphasise that the disease has never truly disappeared.
Dr Tengku Saifudin Tengku Ismail, Consultant in Respiratory Medicine at Hospital Pakar Tawakkal, explained that tuberculosis can remain dormant within the body for years without symptoms — known as latent TB — and may become active if the immune system is weakened.
“Latent TB shows no symptoms and is not infectious, but it can become active if an individual’s immunity declines. Active TB, however, can spread through the air, particularly in poorly ventilated spaces,” Bernama reported him saying.
Malaysia is classified as a medium-high risk country, with an average TB incidence of 80 to 100 cases per 100,000 population annually. Saifudin noted that the recent increase is partly due to the resumption of screening activities that had been disrupted during the COVID-19 pandemic.
“Some of the newly reported cases may have existed earlier but went undetected as individuals could not access medical screening during the pandemic,” he said, adding that high-risk groups such as the elderly, diabetes patients, and those living with HIV — all with weaker immune systems — contribute to rising numbers.
He highlighted that people with diabetes face a two- to threefold higher risk of contracting TB, and with one in five Malaysian adults living with diabetes, this is a significant factor. Contrary to public misconceptions, foreign nationals account for only 15 per cent of cases, with the majority of infections — 85 per cent — occurring among Malaysians.
“While TB is endemic, the majority of cases involve Malaysian citizens, particularly those with risk factors such as diabetes. It is inaccurate to blame foreign workers as the main source of TB spread,” Saifudin emphasised.
Tuberculosis is caused by the bacterium Mycobacterium tuberculosis, most commonly affecting the lungs but capable of infecting glands, bones, intestines, the brain, and other organs. Unlike typical respiratory infections such as pneumonia, TB develops slowly over weeks or months and requires specialised treatment.
Symptoms of active TB include coughing lasting more than two weeks, persistent fever, night sweats, and unexplained weight loss. Early detection is critical. “The sooner TB is identified, the easier it is to treat and the lower the risk of transmission,” Saifudin said.
Treatment for TB involves an initial two-month course of four drugs, followed by at least four months of two additional medications, with the minimum treatment duration spanning six months. Completion of the prescribed regimen is essential to prevent recurrence and the emergence of drug-resistant strains.
“TB is entirely curable if patients take their medication consistently. Education and community support are vital to eliminate stigma and encourage early and complete treatment,” he said.
Stigma remains a significant barrier, as TB is often associated with poverty, poor hygiene, and social shame.
This can discourage patients from seeking treatment, lead to premature cessation of medication, and ultimately increase the risk of transmission. Misconceptions that TB only affects certain groups or requires long-term isolation are also misleading and hinder effective control.
Datuk Dr Mat Zuki Mat Jaeb, Consultant in Respiratory Medicine at Hospital Raja Perempuan Zainab II, echoed the need for public awareness, noting that latent TB spreads through respiratory droplets when an infected person coughs or talks.
The immune system may suppress the bacteria for years, but when immunity is compromised — due to age, chronic illness, diabetes, HIV, steroid treatment, or cancer — latent TB can become active.
Dr Ismuni Bohari, Deputy Director-General of Health (Public Health), confirmed that TB incidence in Malaysia remains relatively stable, with rates between 61 and 80 cases per 100,000 population since 2015.
However, latent TB remains a concern due to its asymptomatic nature, and public health authorities continue rigorous contact tracing to identify potential cases promptly.
Individuals showing symptoms are advised to wear masks and undergo screening, particularly in enclosed spaces, to protect those with weaker immune systems.
Experts stress that only through early detection, consistent treatment, and public education can the spread of TB in Malaysia be effectively controlled. - March 6, 2026