Arya News - Malaysia saw a 5.5% rise to 26,781 TB cases in 2023, and a 10% increase early 2026, highlighting the disease`s resurgence.
KUALA LUMPUR – When Mr Hisyam Mohamad woke up and coughed out blood-streaked phlegm one morning in 2023, his instinct was to ignore it, instead reaching for cough syrup and painkillers. However, his condition deteriorated.
The 42-year-old oil palm smallholder from Pekan, Pahang, lost more than 30kg in less than one month. He constantly felt cold and shivered, and was exhausted and short of breath.
Mr Hisyam was among the 26,781 tuberculosis cases recorded in Malaysia in 2023 , a year that saw rates of the respiratory disease rising by 5.5 per cent from the previous year.
Relating his experience with the infectious disease to The Straits Times, he said his only close contact with a TB patient was in 2017, when his father-in-law contracted the disease and died from it a year later.
“For years, I thought I was safe,” Mr Hisyam said, recalling that doctors told him he had a latent TB infection, sometimes referred to as “sleeping TB”.
“The bacteria was already in my body, but it was dormant,” he added.
Tuberculosis has afflicted humans for thousands of years. Many Malaysians view it as a problem of the past, associated more with history books than with news headlines.
But it has come back under the spotlight in the country after the number of infected cases rose again in the first six weeks of 2026, with 3,161 cases recorded nationwide – a 10 per cent increase from the previous year.
What’s behind the TB spike in Malaysia
Sabah recorded the highest number of cases at 755, followed by Selangor (596) and Sarawak (332), according to the latest statistics from the Malaysian Health Ministry as at Feb 25.
Next was Johor (280), while the federal territories of Kuala Lumpur and Putrajaya together recorded 244 cases.
Meanwhile, the most recent data from Singapore’s Ministry of Health in March 2025 showed that there were 1,156 new cases of active TB in Singapore in 2024 , which is trending downwards from a high of 1,306 cases in 2021.
Unlike Covid-19, which can spread rapidly through brief contact between people, transmission of tuberculosis typically requires prolonged, close exposure to an infectious person, often in enclosed spaces.
In a press statement on Feb 16, health consultancy Galen Centre for Health and Social Policy flagged Chinese New Year gatherings as a risk factor, noting that any crowded, poorly ventilated indoor setting poses a risk.
Public health physician Venugopalan K. Balan said cases like Mr Hisyam’s happen because of latent bacteria being reactivated due to declining immunity that comes with ageing, as well as exposure to other diseases and treatment that affect immunity.
“Covid-19 could cause increased susceptibility to TB if it caused residual lung injury after the initial infection,” said Dr Venugopalan.
“Apart from this, impaired immune response resulting from primary Covid-19 infection could also lead to increased TB susceptibility.”
But he stressed that there is no need to panic, adding that public anxiety over infectious diseases is generally overblown. Suggestions to bring back some pandemic measures, such as social distancing and community masking, are “overkill”, he added.
“There is no need (for Covid-19 measures), as transmission occurs through prolonged contact with an undiagnosed TB patient,” said Dr Venugopalan, who was a senior epidemiologist with the Health Ministry of Malaysia for 36 years.
“Masking is more relevant for (those in) healthcare facilities and (those with) close contacts at home.”
He said TB has been a neglected disease that remained in society due to delayed detection and treatment, as well as poor treatment compliance from patients who had stopped their treatment halfway.
“The TB endgame is a long-term project with no quick fixes,” Dr Venugopalan said.
The problem is compounded by the emergence of drug-resistant TB strains – a direct consequence of Malaysia’s high treatment interruption rate of around 24 per cent, and its 81.5 per cent treatment success rate that falls below the World Health Organization’s 95 per cent target, according to the Feb 16 statement by Galen Centre.
Unlike many other diseases, treatment for TB requires patients to follow a strictly regimented medication plan for at least six months, taking multiple pills daily at fixed times without delay.
Failure to adhere to the regimen could undo progress, including having to restart the entire course for another six months.
Mr Hisyam, who underwent the treatment, described it as “strict and unforgiving”.
“The doctor said it has to be that way to make sure the bacteria is fully killed. Unlike Covid-19, it takes a year to fully recover from TB. One could die if it goes untreated,” he said.
How to detect and protect yourself from TB
The timing of the spike in infections in Malaysia has prompted warnings to curb TB transmission during the Ramadan season. As Malaysians flock to bazaars and gatherings to break fast, Malaysia’s Health Ministry has reminded the public to take precautions, especially in crowded and enclosed spaces.
“Crowded, enclosed and poorly ventilated spaces increase the risk of transmission, especially if an individual with untreated active TB is present,” it said in a statement on Feb 21.
“Ramadan itself is not a cause of TB transmission. However, higher social interaction during the month may increase exposure risks.”
It urged the public to:
Practise proper cough and sneeze etiquette.
Ensure good ventilation in enclosed spaces.
Wear a face mask when symptomatic or in crowded settings.
Seek medical attention promptly if a person has a persistent cough lasting more than two weeks or other related symptoms.
Early detection is critical, said experts.
Dr Helmy Haja Mydin, a consultant lung specialist at Pantai Hospital Kuala Lumpur, said TB should be suspected when a person has a persistent cough lasting more than three weeks.
“These are prolonged episodes of coughing, usually with phlegm – yellow or green – which, in some cases, is severe enough to cough up blood,” Dr Helmy said.
“These are sometimes associated with difficulty breathing, fever, chills and unexplained weight loss.”
These symptoms warrant further investigations such as chest X-rays and checking sputum or mucus for the presence of the TB germ.
Dr Helmy stressed that TB is not an epidemic like Covid-19 and cautioned against stigmatising those who have it.
“There is even a stigma that says only foreign workers, the B40 group, have this disease,” he said, referring to the bottom 40 per cent of income earners in Malaysia.
“It’s important to know that it’s entirely curable, provided that it’s diagnosed early and patients take the right prescription for the right duration.”
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