Kuala Lumpur – A rise in tuberculosis cases has been reported in Malaysia, with 26,781 infections recorded in 2023, a 5.5 percent increase from the previous year. Health officials are urging vigilance, particularly during the Ramadan season, as crowded gatherings pose a transmission risk.
Rising Tuberculosis Cases in Malaysia
Hisyam Mohamad, a 42-year-old oil palm smallholder from Pekan, Pahang, initially dismissed blood-streaked phlegm as a minor ailment in 2023, opting for cough syrup and painkillers. However, his condition rapidly deteriorated, leading to a weight loss of over 30kg in less than a month, accompanied by chills, exhaustion, and shortness of breath.
Mr. Hisyam’s experience highlights a growing concern. He had only one known close contact with a TB patient – his father-in-law, who contracted the disease in 2017 and died a year later. Doctors later diagnosed him with latent TB, often referred to as “sleeping TB,” where the bacteria remained dormant in his body.
While tuberculosis has historically been viewed as a disease of the past in Malaysia, recent data indicates a resurgence. In the first six weeks of 2026, 3,161 cases were recorded nationwide, a 10 percent increase year-over-year. Sabah recorded the highest number of cases at 755, followed by Selangor (596) and Sarawak (332). Johor reported 280 cases, while Kuala Lumpur and Putrajaya together recorded 244.
In comparison, Singapore reported 1,156 new cases of active TB in 2024, continuing a downward trend from a high of 1,306 cases in 2021.
Transmission of tuberculosis typically requires prolonged, close exposure, unlike the rapid spread of COVID-19. Health consultancy Galen Centre for Health and Social Policy identified Chinese New Year gatherings as a potential risk factor due to crowded, poorly ventilated indoor settings.
Public health physician Venugopalan K. Balan explained that cases like Mr. Hisyam’s occur due to the reactivation of latent bacteria, often linked to declining immunity with age and exposure to other illnesses. He also suggested that COVID-19 could increase susceptibility to TB through residual lung injury or impaired immune response.
However, Dr. Venugopalan stressed there is no need for panic or a return to pandemic-era measures like social distancing and masking, stating they are “overkill.” He emphasized that transmission occurs through prolonged contact with an undiagnosed patient and that masking is most relevant in healthcare facilities and close-contact situations at home.
He characterized TB as a neglected disease, often delayed in detection and treatment due to poor patient compliance. The emergence of drug-resistant TB strains is also a concern, linked to Malaysia’s high treatment interruption rate (around 24 percent) and a treatment success rate of 81.5 percent, falling short of the World Health Organization’s 95 percent target.
Treatment for TB requires a strict medication regimen for at least six months, with multiple pills taken daily at fixed times. Mr. Hisyam described the treatment as “strict and unforgiving,” emphasizing the importance of adherence for complete eradication of the bacteria and preventing potential fatality.
The Malaysian Health Ministry has issued reminders to take precautions during Ramadan, particularly in crowded bazaars and gatherings, advising proper cough and sneeze etiquette, good ventilation, mask-wearing when symptomatic, and prompt medical attention for persistent coughs lasting more than two weeks.
Experts emphasize the importance of early detection. Consultant lung specialist Helmy Haja Mydin at Pantai Hospital Kuala Lumpur recommends suspecting TB with a persistent cough lasting more than three weeks, potentially accompanied by phlegm, blood, difficulty breathing, fever, chills, and unexplained weight loss. Further investigation, including chest X-rays and sputum analysis, is then warranted.
Dr. Helmy cautioned against stigmatizing those with TB, noting that it affects individuals across all socioeconomic groups, not just foreign workers or lower-income earners. He stressed that TB is curable with early diagnosis and consistent treatment.
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