According to the World Health Organisation, Tuberculosis (TB) is an infectious disease that most often affects the lungs and is caused by a type of bacteria. It spreads through the air when infected people cough, sneeze or spit but is curable [i]. In Malaysia, it remains a significant public health challenge, with a concerning increase of 17% in TB cases in 2022 compared to 2021, and a 12% rise in TB-related deaths in 2022 compared to 2021 [ii]. Health Minister Dr Zaliha Mustafa recently echoed this during her recent speech at the UN General Assembly High-Level Meeting.
Dr Rosmadi Ismail, Consultant Interventional Pulmonologist and Internal Medicine at Sunway Medical Centre, Sunway City, shares the diagnosis methods, treatment options, preventive measures, and ongoing research efforts in Malaysia’s fight against TB.
Diagnosis Methods and Latest Advancements
Dr Rosmadi explains that Malaysia employs diverse methods to ensure the accurate and timely detection of TB. This includes the following:
- Smear microscopy, culture and sensitivity testing, as well as nucleic acid amplification tests (NAATs) to facilitate the identification of TB cases.
- Chest radiography and clinical tests like the Tuberculin Skin Test (TST), which are crucial in confirming the infections.
In recent years, there have been several innovative techniques currently undergoing clinical trial all over the world, including biosensing technologies and nano-diagnostics, promising quicker and more accurate results.
Dr Rosmadi shares, “Ongoing research focuses on innovative methods like computer-aided detection (CAD) through artificial intelligence, aerosol capture technologies, and antigen-based skin tests, all poised to revolutionise TB diagnosis, enhancing efficiency and effectiveness in the future.”
Treatment Options
Malaysia’s TB treatment follows the World Health Organization guidelines, reflecting a global standard. Dr Rosmadi states, “The standard treatment for drug-susceptible TB in Malaysia involves a combination of four drugs: ethambutol, rifampicin, isoniazid, and pyrazinamide, administered for a duration of six to eight months. A vital component of TB treatment is the Directly Observed Treatment (DOT) strategy, where patients are supervised by healthcare workers, ensuring the complete intake of medication.”
Dr Rosmadi emphasises, “While no new medications or therapies have shown superior results in TB treatment, it’s crucial to note that our treatment for drug-resistant TB involves a distinct medication regimen and extended treatment duration. This tailored approach has proven effective even in cases of drug-resistant TB, reinforcing our commitment to comprehensive patient care.”
Preventive Measures
Dr Rosmadi shares some preventive measures, which include:
- Stay Clear of Crowded Places: It’s best to avoid crowds, especially if they’re poorly ventilated. Crowded spaces make it easier for TB to spread.
- Listen to Your Body: If you’re experiencing a persistent cough, fever, or unexpected weight loss, seek medical help promptly. This will help you get better and stop the disease from spreading.
- Get Checked if You’re at Risk: If you have a weak immune system or have been around people with TB, consider getting tested. It’s a simple step that can catch the disease early if exposed.
- Complete your treatment regime and take precautionary steps: If you’re diagnosed with TB, completing your treatment is essential. Preventive measures such as wearing a mask, covering your mouth and nose when you cough or sneeze, and disposing of tissues properly can help protect yourself and those around you.
- Stay Protected at Work: If your job puts you in contact with many people, wear the proper protective gear as an added layer of safety.
- Think about Getting Vaccinated: The current TB vaccine, Bacillus Calmette Guérin (BCG), offers partial protection to infants and young children against severe forms of TB. However, it doesn’t protect adolescents and adults who are the primary carriers of TB, but it could help in the long run.
Dr Rosmadi added, “The Ministry of Health Malaysia has also published a Clinical Practice Guideline (CPG) for managing TB, which provides recommendations for diagnosing, treating, and preventing TB cases. These guidelines provide valuable information to medical personnel on all aspects of TB case management. To bolster our prevention efforts, there is also ongoing active research on new vaccines, especially for adolescents and adults.”
The fight against TB in Malaysia demands a comprehensive, multi-faceted approach. Dr. Rosmadi states, “By focusing on advanced diagnostics, adherence to treatment, and preventive measures, we can significantly curb the spread of TB. Community awareness and collaboration with international research initiatives further enhance our arsenal against this disease.”
[i] https://www.who.int/news-room/fact-sheets/detail/tuberculosis#:~:text=Overview,Tuberculosis%20is%20preventable%20and%20curable.
[ii] https://newsaf.cgtn.com/news/2023-03-25/Malaysia-sees-rise-in-TB-cases-moves-to-increase-awareness-1irBgaF0VMI/index.html
Dr Rosmadi Ismail
Consultant Interventional Pulmonologist and Internal Medicine,
Sunway Medical Centre, Sunway City
