A cough that will not go away is easy to ignore — blamed on the weather, on dust, on smoking. But in Pakistan, any cough lasting more than two weeks deserves a TB test. Tuberculosis is completely curable, treatment is free at government centres across the country, and the earlier it is caught, the easier the cure and the fewer people around you are exposed.
What is tuberculosis?
TB is a bacterial infection caused by Mycobacterium tuberculosis. It usually attacks the lungs (pulmonary TB) but can affect lymph nodes, bones, the abdomen, or the brain. It spreads through the air when a person with active lung TB coughs, sneezes or speaks — not through sharing food, utensils or touch.
Pakistan carries one of the heaviest TB burdens in the world — the WHO ranks us fifth globally, with over half a million new cases estimated every year, and a significant number of drug-resistant cases. Many people also carry latent TB: the bacteria sleep in the body without causing illness and without spreading to others, sometimes waking years later when immunity dips.
Symptoms of TB
- Cough lasting more than 2 weeks, sometimes with phlegm or blood
- Low-grade fever, typically in the evenings
- Night sweats that soak clothes or bedding
- Unexplained weight loss and loss of appetite
- Persistent tiredness
- Chest pain or breathlessness in later stages
TB outside the lungs can appear as a painless swelling in the neck (lymph node TB, common in Pakistan), long-standing back pain, or abdominal swelling.
Danger signs — go to hospital now
Go to an emergency department, or call Rescue 1122, if someone has:
- Coughing up fresh blood in significant amounts
- Severe breathlessness or blue lips
- High fever with confusion or a stiff neck (possible TB meningitis)
- A child with drowsiness, vomiting and fever after TB contact
- Sudden severe chest pain
How doctors test for TB
Pakistan's National TB Control Programme, aligned with WHO guidance, has made modern testing widely available:
- Sputum GeneXpert test — the WHO-recommended first test. A phlegm sample gives a result in about two hours and also detects rifampicin resistance, flagging drug-resistant TB immediately. Available free at government TB centres.
- Sputum smear microscopy — the older AFB test, still used in many facilities.
- Chest X-ray — shows lung changes suggestive of TB.
- For TB outside the lungs — needle tests of neck glands (FNAC), fluid analysis, or biopsies.
- CBC and ESR — supportive tests only; a raised ESR alone does not diagnose TB.
Treatment: six months, free, and it works
TB treatment follows the WHO-endorsed DOTS strategy and is provided completely free at government TB centres and many partner clinics across Pakistan — medicines included. Standard treatment for drug-sensitive TB is a 6-month course of a combination of antibiotics: an intensive phase of about two months on four medicines, then a continuation phase on fewer medicines. Your doctor and TB centre will supervise doses, monitor side effects and check progress with follow-up sputum tests.
Three rules make the difference between cure and disaster:
- Never stop early. Most people feel dramatically better within weeks. Stopping then allows surviving bacteria to return as drug-resistant TB (MDR-TB), which takes far longer to treat with harsher medicines.
- Never skip doses. Irregular treatment is the main cause of resistance in Pakistan.
- Report side effects instead of quitting. Yellow eyes, severe vomiting, vision changes or joint pain should be reported to the doctor promptly — regimens can be adjusted safely.
Good food is part of treatment: TB consumes the body, and a protein-rich diet — eggs, daal, meat, milk — supports recovery. Hakeem remedies and nutritional tonics may comfort, but only the full antibiotic course kills TB bacteria; using them instead of DOTS treatment costs lives.
Prevention
- Ensure newborns receive the BCG vaccine, given free at birth under Pakistan's EPI programme — it protects young children from the most severe forms of TB
- People with active lung TB should cover coughs, ventilate rooms and wear a mask for roughly the first two weeks of treatment, after which infectiousness drops sharply
- Household contacts, especially children under 5, should be screened; WHO recommends preventive therapy for eligible contacts
- Do not share unventilated closed rooms for long periods with someone with untreated TB
Age-specific notes
- Children: TB in children is often missed because they may not cough much — poor weight gain, prolonged fever and reduced playfulness after TB contact are important clues. A childhood cough with fast breathing may also be pneumonia — see our child pneumonia guide.
- Adults: smoking and uncontrolled diabetes both raise TB risk and worsen outcomes; people with diabetes should be extra alert to a persistent cough.
- Over-60s: TB in older adults can look like general weakness and weight loss without much cough. Do not dismiss it as old age.
- Pregnancy: TB can and must be treated in pregnancy — most first-line medicines are considered safe under specialist supervision, and untreated TB is far more dangerous to mother and baby than treatment.
Frequently asked questions
TB ka ilaj kitne mahine ka hota hai?
Standard TB treatment is 6 months. Drug-resistant TB takes longer — usually 9 to 24 months depending on the regimen. Completing the full course is the only way to guarantee cure and prevent resistance.
Kya TB ka ilaj Pakistan mein free hai?
Yes. Testing (including GeneXpert) and the complete course of medicines are free at government TB/DOTS centres throughout Pakistan under the National TB Control Programme.
Is TB contagious after starting treatment?
Infectiousness falls quickly once effective treatment begins — usually within about two weeks for drug-sensitive TB. Until then, masks, covered coughs and ventilated rooms protect your family.
TB aur nimonia mein kya farq hai?
Pneumonia comes on fast — high fever, cough and breathlessness over days — while TB creeps in over weeks with evening fever, night sweats and weight loss. Only tests can confirm either, so a lingering cough always deserves a check.
Kya TB dobara ho sakta hai?
Yes, relapse or re-infection is possible, especially if the first course was incomplete or immunity is low. A returning cough, fever or weight loss after past TB should be tested promptly — do not restart old medicines on your own.
A cough that has crossed two weeks deserves attention today. Start with our free symptom check to see what your symptoms could mean. This article is general health education, not a diagnosis. Always consult a doctor about your own health.