{"title":"Tuberculosis in Malaysia: Disease timeline, epidemiology, control initiatives and outlook.","authors":"F A Fadzil, S R Ramli, H Neoh","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":48723,"journal":{"name":"Malaysian Journal of Pathology","volume":"47 1","pages":"13-23"},"PeriodicalIF":0.6000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Malaysian Journal of Pathology","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PATHOLOGY","Score":null,"Total":0}
引用次数: 0
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.
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.