Tuberculosis in Malaysia: Disease timeline, epidemiology, control initiatives and outlook.

IF 0.6 4区 医学 Q4 PATHOLOGY
Malaysian Journal of Pathology Pub Date : 2025-04-01
F A Fadzil, S R Ramli, H Neoh
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Abstract

In Malaysia, tuberculosis remains a public health problem despite initiatives in disease control and prevention. This review explores the timeline of pulmonary tuberculosis (PTB) in Malaysia, epidemiology, management and outlook of the disease in the country. PTB was first reported in Malaya in the early 20th century and caused high morbidity and mortality. With the establishment of the National TB Control Programme in 1961 and chest clinics in every state general hospital, mortality was successfully reduced. Nonetheless, PTB incidence rate increased steadily after 2011, and Malaysia is currently an endemic country for the disease. Diagnosis for PTB is performed according to the Ministry of Health's Clinical Practice Guidelines which include chest X-ray, sputum culture and antibiotic susceptibility testing. Patients are treated according to WHO guidelines. While the country has seen a 0.02% decrease in drug-resistant cases in recent years; two cases of extensively drug-resistant tuberculosis have been reported. All major Mycobacterium tuberculosis lineages (Indo-Oceanic; East-Asian (including Beijing), East-African-Indian and Euro-American) have been reported in the country. The Beijing family of strains were found to have a higher prevalence in Peninsular Malaysia compared with Sabah and Sarawak, suggesting divergence of pathogen evolution between the two locations. Most antibiotic-resistant strains were found to harbour mutations in rpoB, katG, embB and pncA. Increasing usage of molecular platforms and artificial intelligence in diagnostics, apps and alert systems for better surveillance, and implementation of universal coverage in terms of treatment will be important for the country to achieve a tuberculosis-free status in 2035.

马来西亚结核病:疾病时间表、流行病学、控制举措和前景。
在马来西亚,尽管采取了疾病控制和预防措施,但结核病仍然是一个公共卫生问题。这篇综述探讨了马来西亚肺结核(PTB)的发病时间、流行病学、管理和该病在该国的前景。肺结核最早于20世纪初在马来亚报告,造成高发病率和死亡率。随着1961年国家结核病控制规划的建立和每个州综合医院的胸科诊所的建立,死亡率成功地降低了。尽管如此,2011年后肺结核发病率稳步上升,马来西亚目前是该疾病的流行国家。肺结核的诊断是根据卫生部的《临床实践指南》进行的,其中包括胸部x光、痰培养和抗生素敏感性试验。根据世卫组织指南对患者进行治疗。虽然该国近年来耐药病例减少了0.02%;已报告了两例广泛耐药结核病病例。所有主要结核分枝杆菌谱系(印度-大洋;据报道,东亚(包括北京)、东非-印度人和欧美人在该国发病。北京家族菌株在马来西亚半岛的流行率高于沙巴和沙捞越,这表明两地的病原体进化存在差异。大多数耐药菌株携带rpoB、katG、embB和pncA突变。在诊断、应用程序和警报系统中增加分子平台和人工智能的使用,以更好地进行监测,并在治疗方面实现全民覆盖,对于该国在2035年实现无结核病状态至关重要。
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来源期刊
CiteScore
3.60
自引率
5.60%
发文量
34
期刊介绍: The Malaysian Journal of Pathology is the official journal of the College of Pathologists, Academy of Medicine Malaysia. The primary purpose of The Journal is to publish the results of study and research in Pathology, especially those that have particular relevance to human disease occurring in Malaysia and other countries in this region. The term PATHOLOGY will be interpreted in its broadest sense to include Chemical Pathology, Cytology, Experimental Pathology, Forensic Pathology, Haematology, Histopathology, Immunology, Medical Microbiology and Parasitology. The Journal aims to bring under one cover publications of regional interest embracing the various sub-specialities of Pathology. It is expected that the articles published would be of value not only to pathologists, but also to medical practitioners in search of a scientific basis for the problems encountered in their practice, and to those with an interest in diseases which occur in the tropics.
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