Consultant physician and respiratory specialist Dr Lo Shan Min says the disease is often misunderstood, particularly when it comes to how it spreads.
“TB is transmitted when someone with an active infection coughs, speaks or sneezes – but it usually requires prolonged exposure in indoor environments, not brief or casual contact,” he explained.
That distinction matters, especially as Malaysia continues to record new cases each week. As of Epidemiological Week 6 this year, 3,161 cases have been reported nationwide, with Sabah, Selangor and Sarawak among the most affected states.
Globally, Malaysia remains a country with a significant TB burden. The World Health Organization estimates about 122 cases per 100,000 people, with more than 26,000 infections recorded annually in recent years.
Yet, despite these numbers, early symptoms are often overlooked.
A persistent cough lasting more than two weeks is one of the earliest warning signs of active pulmonary TB. Other symptoms can include night sweats, low-grade fever, fatigue, unexplained weight loss and, in more advanced stages, coughing up blood or experiencing chest pain.
“Because the symptoms develop gradually, many people assume it’s just a lingering cold and delay seeking treatment,” Lo noted. “But early detection is crucial, both for recovery and to prevent spreading the infection to others.”
While TB is less contagious than viral respiratory illnesses, risk increases significantly with prolonged exposure in enclosed environments. Households, workplaces, dormitories and other crowded settings can all become transmission points if an infected person is present.
Notably, TB bacteria spread through airborne particles, which can linger in poorly ventilated areas, making long exposure a key factor in transmission.
Other factors, including urban crowding, high population mobility, ageing communities, and conditions such as diabetes, may also contribute to the continued presence of TB.
The good news is that the disease is highly treatable when caught early. WHO data reveals that treatment success rates for drug-susceptible TB range between 85% and 90% when patients complete the standard six-month course.
And according to Lo, improved screening and diagnostic tools are helping to detect infections earlier. Expanded contact tracing, rapid molecular testing, and wider screening efforts mean more cases are being identified that might previously have gone unnoticed.
“Better detection is a positive step: it allows us to treat patients sooner and reduce the risk of further spread,” he said.
Still, controlling the disease depends heavily on awareness and early action. Simple steps such as seeking medical advice for a persistent cough, practising proper cough etiquette, and screening close contacts can go a long way in reducing transmission.