Malaysia risks under-reporting of TB cases as ‘slow-burn epidemic’ persists



The persistent tuberculosis cases in Malaysia are indicative of an outbreak that could be under-reported for a disease that is easy to diagnose and treat, according to medical experts.

Malaysia had detected 10 active TB clusters nationwide as of February 7, with a total of 2,571 cases.

Four of these clusters – defined by health authorities as two or more epidemiologically linked cases identified within a specific setting or time frame – were found in Selangor, Malaysia’s most populous state. The other clusters were in Johor, Kedah, Kelantan, Pahang, Perlis and Sabah.

In 2025, the health ministry recorded 88 TB clusters involving 254 cases nationwide. Most of them were contained, while there were active clusters carried over to this year in Selangor, Sarawak, Kedah, Kuala Lumpur, Putrajaya, Johor, Kelantan and Terengganu.

“I would describe TB as what we call a slow-burn epidemic,” said Venu Gopalan, a Kuala Lumpur-based doctor, pointing to a steady rise in TB cases over the last decade.

The World Health Organization has warned that Malaysia’s TB cases may be under-reported. While the country has reported an incidence rate of about 70 TB infections per 100,000 people from 2023 to 2024, the UN agency has estimated that the actual number could be closer to 110 per 100,000.

It is much more difficult to do contact tracing in large institutional environments

Amar-Singh HSS, a consultant paediatrician



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