Kuala Lumpur, 15 February 2026 — Malaysia faces an elevated risk of tuberculosis (TB) transmission during the Chinese New Year travel and visitation period and through the Ramadan–Hari Raya Aidilfitri season. This is when communities gather more frequently indoors, in crowded public spaces, and for longer periods of time. The risk of drug resistant TB is also present.

“During Chinese New Year and Ramadan, families and communities increase travel, visiting, shared meals, congregational prayers, and large indoor gatherings. These are settings potentially associated with higher TB transmission risk,” said Azrul Mohd Khalib, Chief Executive of the Galen Centre. “TB spreads through the air. Any activity where persons with active TB are talking, shouting, singing, coughing, and sneezing in crowded, indoor, and poorly ventilated settings such as homes full of visitors, packed public transport, workplaces, dormitories, and places of worship can spread it. One infectious person can unknowingly infect many others.”

“Studies in high-incidence areas indicate that over 80% of transmission can occur outside the household in places like workplaces, public transport, and social gatherings.”

“Congregational prayer sessions conducted during the Ramadan month, which include daily and Friday prayers, are augmented with tarawih prayers involving larger groups of people for longer periods each night for a month. These are particularly worrying to me. At the very least, people need to wear masks during these tarawih sessions. Those attending congregational prayer sessions at churches and temples should also do the same during this period.”

“The Ministry of Health has reported 2,571 TB cases between 1 January and 7 February, an increase of at least 200 cases compared to the same period last year. There are now more than a dozen active TB clusters across every state in the country. Over the past five years, the incidence of TB has been on a steady upward trend, with more than 26,000 cases in 2024. In that year, Malaysia reported 2,580 TB-related deaths out of 26,183 cases. However, states like Sarawak have experienced much higher fatality rates.”

“TB is endemic to Malaysia. Around 85% of all cases are Malaysians, while 15% are non-citizens,” Azrul emphasised.

“We are particularly concerned about the emergence and spread of drug-resistant TB, including multidrug-resistant TB (MDR-TB), resistant to a number of first line treatments, and extensively drug-resistant TB (XDR-TB). These are far harder to treat and associated with higher mortality.

“TB can be treated effectively with antibiotics. Standard first-line antibiotics such as rifampin, ethambutol, and isoniazid need to be taken for up to 6–9 months, and treatment is most effective when patients complete it without interruption. Treatment works, if people can complete it. Malaysia faces persistent challenges in this area, including a high treatment interruption rate (around 24%) and an 81.5% success rate for new cases, which is below WHO targets. Defaulting on treatment increases drug resistance.”

“Drug-resistant TB is the consequence of missed doses and incomplete treatment. It is more expensive to manage, more complex for services, and more dangerous for patients and communities,” Azrul added.

“We need to take the threat of TB seriously. Older adults and those with chronic illnesses are particularly vulnerable. If you are showing symptoms such as prolonged coughing, coughing up blood and significant weight loss in a short period, don’t wait it out or self-treat. Mask yourself, get medical care and avoid visiting others. Improve ventilation at venues and at home during visits. Targeted screening in high risk settings such as factories and dormitories should be considered.”.