KUALA LUMPUR – A concerning rise in tuberculosis (TB) cases is prompting health officials in Malaysia to urge vigilance, particularly as the country prepares for the gatherings associated with the upcoming Ramadan season. While many Malaysians once viewed TB as a disease of the past, recent data indicates a resurgence, with cases increasing both nationally and in key regions.
In 2023, Malaysia recorded 26,781 TB cases, representing a 5.5 percent increase from the previous year. This upward trend has continued into 2026, with a 10 percent increase observed in the early part of the year. As of February 25, 2026, a cumulative total of 3,161 cases have been reported nationwide, according to the Malaysian Health Ministry.
Sabah currently leads the country in reported cases, with 755, followed by Selangor (596) and Sarawak (332). Johor has recorded 280 cases, while Kuala Lumpur and Putrajaya combined have 244.
The increase in cases is linked to several factors, including declining immunity, delayed detection, and poor compliance with treatment regimens, leading to drug resistance. Experts emphasize that TB spreads through prolonged, close contact, making crowded and poorly ventilated spaces – such as Ramadan bazaars – potential hotspots for transmission.
The experience of Hisyam Mohamad, a 42-year-old oil palm smallholder from Pekan, Pahang, illustrates the insidious nature of the disease. Mr. Hisyam initially dismissed blood-streaked phlegm as a minor ailment, reaching for over-the-counter remedies. However, his condition rapidly deteriorated, resulting in a 30kg weight loss, constant chills, exhaustion, and shortness of breath. He was eventually diagnosed with TB, revealing a latent infection that had been dormant for years, stemming from contact with his father-in-law in 2017.
“For years, I thought I was safe,” Mr. Hisyam recalled, remembering doctors explaining he had a “sleeping TB” infection. The bacteria had been present in his body but inactive until his immunity was compromised.
Public health officials stress that while the rise in cases is concerning, panic is unnecessary. They emphasize the importance of early detection, which hinges on recognizing persistent coughs and other related symptoms. Treatment for TB is lengthy and requires strict adherence to a medication plan, often lasting at least six months with multiple daily doses.
“The TB endgame is a long-term project with no quick fixes,” said public health physician Venugopalan K. Balan. He highlighted that Malaysia’s treatment interruption rate of around 24 percent and a treatment success rate of 81.5 percent – falling short of the World Health Organization’s 95 percent target – contribute to the problem.
The emergence of drug-resistant TB strains further complicates the situation, directly linked to inconsistent treatment adherence. Unlike many other infectious diseases, TB requires a regimented medication schedule to ensure complete eradication of the bacteria.
Mr. Hisyam described the treatment process as “strict and unforgiving,” emphasizing the importance of following the doctor’s instructions precisely. “Unlike Covid-19, it takes a year to fully recover from TB. One could die if it goes untreated,” he said.
The Health Ministry has issued guidelines to mitigate transmission risks during Ramadan, advising the public to practice proper cough and sneeze etiquette, ensure adequate ventilation in enclosed spaces, wear masks when symptomatic or in crowded settings, and seek prompt medical attention for persistent coughs lasting more than two weeks.
Consultant lung specialist Helmy Haja Mydin stressed that a persistent cough lasting over three weeks, often accompanied by phlegm – sometimes blood-streaked – difficulty breathing, fever, chills, and unexplained weight loss, should prompt immediate medical evaluation. He also cautioned against stigmatizing those with TB, emphasizing that it is a curable disease with early diagnosis and consistent treatment.
“There is even a stigma that says only foreign workers, the B40 group, have this disease,” Dr. Helmy said, referring to the bottom 40 percent 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.”
While the situation warrants attention, experts maintain that TB is not an epidemic like Covid-19 and that implementing pandemic-era measures like social distancing and widespread masking is “overkill.” Focus remains on early detection, consistent treatment, and public awareness.
