TB Symptoms, Tests and Finishing Treatment

Tuberculosis, usually called TB, is caused by bacteria that most often attack the lungs. The World Health Organization reports that 10.7 million people fell ill with TB in 2024 and 1.23 million died, and that Pakistan accounts for about 6.3% of TB cases worldwide. TB is curable. What goes wrong most often is waiting too long to get tested, or stopping the medicine once you feel better.

What are the symptoms of TB?

WHO lists these common signs of TB disease:

• A cough that goes on and on, sometimes with blood
• Chest pain
• Weakness and tiredness
• Weight loss
• Fever
• Night sweats

The NHS says the key warning sign is a cough that lasts more than three weeks, often with feeling tired all the time, losing your appetite and losing weight without trying. TB does not only affect the lungs. Elsewhere in the body it can cause swollen glands, swollen joints, tummy pain, headaches or confusion.

How does TB spread?

TB travels through the air. When a person with TB in their lungs coughs, sneezes or spits, tiny droplets carrying the bacteria go into the air and other people breathe them in. WHO notes that some people with TB disease have no symptoms at all and can still pass it on. The NHS adds that catching TB usually takes repeated, close contact over time.

Some people are more likely to become ill: those with diabetes, those with HIV or another condition that weakens the immune system, those who are undernourished, and people who use tobacco or misuse alcohol.

What is the difference between TB infection and TB disease?

CDC describes two different states. With inactive TB (also called latent TB infection), the germs are in your body but you have no symptoms and you cannot pass TB to anyone. With active TB disease, you have symptoms and you can infect others. Inactive TB can turn into active disease later, which is why it is treated too.

What tests are used?

WHO says rapid tests should be used first when TB is suspected, including molecular tests that give an answer within 48 hours. To find TB infection, health services use a tuberculin skin test, a blood test called an interferon gamma release assay, or an antigen-based skin test. A positive infection test does not by itself prove active TB disease, so further checks are done first.

How is TB treated, and why must you finish?

TB is treated with a combination of antibiotics taken every day. WHO says the usual course runs for four to six months. CDC says active TB may be treated for four, six or nine months depending on the plan, and inactive TB for three to nine months.

CDC is blunt about this: take and finish all your TB medicines exactly as your health worker recommends, because it can be very dangerous to stop them or take them irregularly. This is how drug-resistant TB is created. WHO explains that when treatment is not properly completed, the bacteria can become resistant to the main TB drugs, and that resistant form is much harder to treat and can spread to others.

To help people finish, TB programmes use directly observed therapy: a health worker watches you take your medicine, in person or on a video call, every day or several times a week. CDC calls this the best way to remember to take your TB medicines. TB care belongs in the official TB programme at a government health facility, where the right medicines and this support come together.

When to see a doctor

• A cough lasting more than three weeks
• Coughing up blood, or phlegm with blood in it — get medical advice urgently
• Fever, night sweats or weight loss you cannot explain
• You live with or care for someone who has TB
• Side effects or travel are making treatment hard to continue — tell your TB team instead of stopping

Emergency signs need immediate care: a stiff neck with a severe headache, sensitivity to light, a fit, sudden confusion or a change in behaviour, or weakness on one side of the body. Call Rescue 1122 where available, or go to the nearest hospital emergency department.