Sri Lanka remains a low-burden country for Tuberculosis (TB), ranking as the second lowest in the region after the Maldives. However, the fight against the disease continues.
According to the National Programme for Tuberculosis Control and Chest Diseases (NPTCCD), 9,180 new TB cases were reported in 2024. This includes 5,219 males, 3,259 females, and 228 children (aged 14 and below). The World Health Organization (WHO) estimates around 14,000 cases in Sri Lanka annually, indicating that many cases go undiagnosed. This underscores the need to strengthen Sri Lanka’s TB surveillance system.
The highest TB caseload in Sri Lanka is found in the Western Province, particularly in the Colombo district, with a concentration in the Colombo Municipal Council area. While TB cases recorded a steady decline between 2013 and 2021—dropping from 9,010 cases to 6,544 at an average rate of -4.6% per year— the cases had risen again with the emergence of Covid-19 pandemic.
TB is an infectious disease caused by bacteria that most often affects the lungs. It spreads through the air when people with TB cough, sneeze or spit. A person needs to inhale only a few germs to become infected.
Tuberculosis is preventable and curable. About a quarter of the global population is estimated to have been infected with TB bacteria. “About 5–10 percent of people infected with TB will eventually get symptoms and develop TB disease. Those who are infected but free of disease cannot transmit it. TB disease occurs when bacteria multiply in the body and affect different organs.
TB disease is usually treated with antibiotics and can be fatal without treatment. Despite being a preventable and curable disease, 1.5 million people die from TB each year – making it the world’s top infectious killer. TB is the leading cause of death of people with HIV and also a major contributor to antimicrobial resistance,” the WHO said in a web post on March 14.
Ongoing efforts
“The disease is more complicated with TB-HIV co-infection, rising non-communicable diseases, and emerging drug resistance. The emerging pandemics, environment changes, and dynamic socioeconomic state significantly influence disease behaviour and how preventive and control strategies shall behave.
Even though Sri Lanka is a low burden country with TB, it still needs to pay much attention due to its geographical location, trade, and commerce and as a popular destination for tourism,” said NPTCCD Director Dr. R. Pramitha Shanthilatha.
“The district level TB control activities are conducted through the District Chest Clinics (DCCs) covering all 26 districts in the country. Case detection through clinical assessment, screening and microbiological and radiological testing facilities are provided by every district clinic for free of charge. The Provision of anti-TB drugs to patients referred from state sector as well as private sector are provided free through the national programme,” she added.
“The NPTCCD has taken steps to improve diagnostic facilities incorporating the latest technology so that the quality of care will be improved. Ending TB is challenging but achievable goal for Sri Lanka. We appreciate the continuous commitment rendered by every stakeholder, including patients and their relatives, who came forward to comply with treatment and collaborate to reduce the stigma associated with the disease,” she said.
In Sri Lanka, the Bacillus Calmette–Guérin (BCG) vaccine is administered to all newborn babies immediately after birth, preferably within 24 hours, as part of the national immunisation program to protect against tuberculosis (TB). The vaccine prevents deaths from TB and protects children from serious forms of TB.
Vulnerable groups
Despite being prevalent in low- and middle-income countries, TB exists worldwide. WHO reports that half of all TB cases occur in eight countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, the Philippines, and South Africa.
Those at higher risk include individuals with compromised immune systems, such as people living with HIV, malnutrition, or diabetes, and tobacco users and alcoholics. In 2023, approximately 161,000 people died from HIV-associated TB globally, as per the WHO statistics. However, Sri Lanka’s TB-HIV burden remains low, with HIV prevalence at less than 1 percent among the general population.
Common symptoms of TB are prolonged cough (sometimes with blood), chest pain, weakness, fatigue, weight loss, fever and night sweats. Tuberculosis is particularly difficult to diagnose in children.
TB that doesn’t respond to standard drugs is called drug-resistant TB and requires treatment with different medicines. Drug resistance emerges when TB medicines are used inappropriately, through incorrect prescription by health care providers, poor quality drugs, or patients stopping treatment prematurely.
The WHO advises seeking medical attention if experiencing a persistent cough, fever, or unexplained weight loss. Early treatment not only improves recovery chances but also prevents further spread. People with TB are encouraged to wear masks to minimize transmission.
World TB Day
Every year, March 24 is observed as World TB Day to amplify the urgency of ending tuberculosis (TB), the world’s deadliest infectious disease. TB continues to devastate millions globally, inflicting severe health, social and economic consequences. “Worldwide, TB has probably returned to being the world’s leading cause of death from a single infectious agent, following three years in which it was replaced by Covid-19,” the WHO said.
This year’s theme is “Yes! We Can End TB: Commit, Invest, Deliver”. “It offers an opportunity to reflect on ongoing efforts and encourage stronger commitment at local, national and international levels to end TB, including by combating the growing threat of drug-resistant TB. Stronger commitment is crucial, especially as declining international funding for TB in the current geopolitical climate threatens the achievement of global targets to end TB by 2030,” the WHO said its web post.
The NPTCCD declared an awareness raising week from March 17 to 23 parallel to the World TB Day, and the national event will take place in Colombo from March 24 to 25. The WHO-recommended four-symptom screen (W4SS) for TB will be launched tomorrow (24) at the National Hospital. It identifies individuals for further investigation based on symptoms like cough, fever, night sweats, or weight loss. A walk to mark the World TB Day will be held on March 25 from the Colombo District Chest Clinic to the National Hospital, starting at 8.30am.
The NPTCCD organised awareness raising programs with TB screening at the National Hospital for Respiratory Diseases in Welisara, the Fort Railway Station, the Kolonnawa Medical Officer of Health (MoH) Office, within the Colombo Municipal Council area and the Welikada Prison from March 17-21. With collective effort and commitment, Sri Lanka aims to make TB a disease of the past. Strengthening surveillance, improving diagnostics, and ensuring access to free treatment will help the country move closer to eliminating this disease.
