Symptoms of drug-resistant TB: Pulmonologist on why early treatment is critical

India holds the grim distinction of having the highest number of TB cases in the world, accounting for nearly 27 percent of global infections, according to the World Health Organization (Image: Canva)

Tuberculosis (TB) is a serious but preventable disease caused by bacteria that mainly affects the lungs. It spreads through the air when infected people cough or sneeze as per the World Health Organization. Every year, TB  sickens 10 million and kills 1.5 million worldwide. People with weak immune systems are most at risk, especially those with HIV, diabetes or poor nutrition.

In an age of instant diagnoses, high-speed scans, and cutting-edge treatments, it’s easy to assume diseases like tuberculosis are relics of the past. But TB, one of the world’s oldest infections, continues to claim lives across India. The reasons include: delayed diagnoses, shattered families, and stigma that silences patients.

Even today India holds the grim distinction of having the highest number of TB cases in the world, accounting for nearly 27 percent of global infections, according to the World Health Organization, says Dr Gurmeet Singh Chabbra, Director Pulmonology, Yatharth Hospital, Faridabad. “TB hides behind common symptoms — cough, mild fever, fatigue — which many dismiss. By the time it’s taken seriously, the infection may have already spread.”  he says and adds, “In crowded urban areas and under-resourced rural regions, poor ventilation, self-medication, and a lack of awareness allow TB to thrive.”

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One of the biggest shifts in recent years is the rise in drug-resistant TB. “This isn’t just a more stubborn strain — it’s a medical nightmare,” He shares that the standard treatment becomes ineffective, and patients may require 9 to 20 months of intense therapy — with stronger drugs, heavier side effects, and lower success rates. “Drug resistance often occurs because patients stop treatment midway, either due to side effects or lack of awareness,” explains Dr Chabbra. “This makes the bacteria tougher and far harder to eliminate.”

The National TB Elimination Programme (NTEP) has introduced better diagnostic tools and digital patient tracking, but treatment adherence and regular follow-ups remain key challenges. “TB still carries social shame, particularly for women, who may be rejected in marriage or lose jobs if their diagnosis becomes known. As a result, many hide their symptoms, delay treatment, or avoid clinics altogether. Patients are often more scared of what society will say than of the disease itself. That delay can be deadly.”

This stigma also means fertility issues and pregnancy complications linked to TB are rarely talked about, even though they can be severe.

If someone has a persistent cough lasting over two weeks, especially with fever, weight loss, or coughing blood, it’s time to see a doctor — preferably a pulmonologist. Diagnosis often starts with chest X-rays or sputum tests, but for complex cases, Bronchoscopy, CT scans, or even biopsies may be needed to confirm TB or rule out other lung conditions. “Getting the right diagnosis early can make all the difference,” says Dr Chabbra. “And it prevents complications, especially in drug-resistant cases.”

Also read | Reduce TB risk with these simple lifestyle changes

Tips to help prevent tuberculosis (TB):

In order to protect yourself and others from TB, keep rooms airy by opening windows.  Always cover your mouth (with a handkerchief or your elbow) when you cough or sneeze. If a cough lasts over two weeks, see a doctor. Take all your medicines as prescribed, and stay healthy with good food, rest, and regular check-ups.

FAQs on tuberculosis symptoms, treatment tips

1. What are the initial symptoms of tuberculosis?

The initial symptoms of TB include a persistent cough lasting over two weeks, mild fever, fatigue, and weight loss. Sometimes, coughing blood may occur.

2. How is tuberculosis diagnosed?

TB diagnosis often starts with chest X-rays or sputum tests. For complex cases, bronchoscopy, CT scans, or biopsies may be needed to confirm TB or rule out other lung conditions.

3. How does drug-resistant TB differ from regular TB?

Drug-resistant TB does not respond to standard treatments, requiring 9 to 20 months of intense therapy with stronger drugs and more severe side effects, resulting in lower success rates.

4. Why is tuberculosis still prevalent in some regions?

TB remains prevalent due to delayed diagnoses, poor ventilation, self-medication, lack of awareness, and the stigma that silences patients, particularly in crowded urban areas and under-resourced rural regions.

5. How can tuberculosis be prevented?

Preventing TB involves keeping rooms airy, covering your mouth when coughing or sneezing, consulting a doctor for a persistent cough, taking all prescribed medicines, and maintaining good health with nutritious food, rest, and regular check-ups.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for a specific health diagnosis.