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Ishita Roy

Is Cough Really Necessary For TB? 80% Of Patients Don't Have It, Says Study

Every year, March 24 is observed as <span>World Tuberculosis Day</span> to spread awareness about the infectious disease. In India, it remains one of the most pressing infectious diseases. Dr Arup Halder, Consultant Pomologist at CK Birla Hospitals, CMRI says that India still accounts for roughly a quarter to over a quarter of world's tuberculosis or <span>TB</span> cases. "In 2023–2024, India reported around 25–26 lakh TB patients out of an estimated 27 lakh cases, reflecting improved detection but also highlighting a persistently high burden," he points out. 

While TB incidence has fallen by about 20 per cent since 2015 and mortality has also declined to roughly 21 deaths per lakh population, it still remains well above national elimination targets for 2025. 

<h2>TB Could Happen Even Without A Persistent Cough</h2>

What makes TB so difficult to eliminate? While many associate TB with persistent coughing, studies show that 80 per cent of patients do not show the symptoms of cough that is "presumed" to be a common symptom. This is why, TB could go ignored until it is too late. 

A research led by Amsterdam UMC and the Amsterdam Institute for Global Health and Development analyzed data on more than 600,000 individuals in Africa and Asia and found that around 82.8 per cent of those with TB had no persistent cough. The study also found that 62.5 per cent had no cough at all. The findings were published in the<strong><em> Lancet Infectious Diseases</em></strong>. 

The study in fact noted that this could be the "probable reason why, despite huge efforts to diagnose and treat the disease, the tb burden across Africa and Asia is hardly declining". Frank Cobelens, Professor of Global Health at Amsterdam UMC and Senior Fellow at the AIGHD says, "A persistent cough is often the entry point for a diagnosis, but if 80 per cent of those with TB do not have one, then it means that a diagnosis will happen later, possibly after the infection has already been transmitted to many others, or not at all." 

Another 2019 study published in Elsevier notes: "Coughing does not appear to be a necessary prerequisite for TB transmission." The study further mentions, "Frequency of cough is associated with infectivity but this does not imply mechanistic causality for TB transmission."

<h2>Does It Mean Coughing Is Harmless?</h2>

The simple answer to this is: No. Coughing does not mean harmless, especially when it is a persistent one. The study only shows that TB does not always mean persistent coughing, however, if one experiences this symptom, they should always get a test done and should not ignore the symptoms. 

Researchers from The University of Texas at Dallas' Center for Advanced Pain Studies working with colleagues from UT Southwestern Medical Center note that TB coughing could cause pain. This is one of the way one can distinguish the symptoms. The findings published in journal <strong><em>Cell </em></strong>notes that before this study, "no one had even shown that TB produces an irritant that acts directly on the sensory innervation of the lungs". 

Corresponding author Dr Michael Shiloh, associate professor of internal medicine and microbiology at UT Southwestern said, "People with active tuberculosis can cough for months and spread disease even when they are receiving appropriate treatment."

Read: <a href="https://www.healthandme.com/health-news/world-tuberculosis-day-2026-theme-origin-and-significance-article-153905337" data-type="tilCustomLink">World Tuberculosis Day 2026: Theme, Origin, And Significance</a>

<h2>What Is India Doing To Control TB Cases?</h2>

On <span>World TB Day</span>, President Droupadi Murmu stressed that TB continues to pose a significant public health challenge and has affected millions of lives across the world. She urged all stakeholders to work together with collective resolve to end TB once for all. 

To act on it, Union Health Minister Jagat Prakash Nadda will launch a series of initiatives, including 'TB Mukt Bharat Abhiyaan - 100 Days Campaign', the TB Mukt Bharat App, and the TB Mukt Urban Ward Initiative. These measures are designed to strengthen the case detection, improve treatment adherence, and enhance last-mile delivery of TB services, especially in high-burden areas. The initiatives have also been aligned with the objectives of the National Tuberculosis Elimination Programme.

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Every year, March 24 is observed as World Tuberculosis Day to spread awareness about the infectious disease. In India, it remains one of the most pressing infectious diseases. Dr Arup Halder, Consultant Pomologist at CK Birla Hospitals, CMRI says that India still accounts for roughly a quarter to over a quarter of world's tuberculosis or TB cases. "In 2023–2024, India reported around 25–26 lakh TB patients out of an estimated 27 lakh cases, reflecting improved detection but also highlighting a persistently high burden," he points out. While TB incidence has fallen by about 20 per cent since 2015 and mortality has also declined to roughly 21 deaths per lakh population, it still remains well above national elimination targets for 2025. TB Could Happen Even Without A Persistent CoughWhat makes TB so difficult to eliminate? While many associate TB with persistent coughing, studies show that 80 per cent of patients do not show the symptoms of cough that is "presumed" to be a common symptom. This is why, TB could go ignored until it is too late. A research led by Amsterdam UMC and the Amsterdam Institute for Global Health and Development analyzed data on more than 600,000 individuals in Africa and Asia and found that around 82.8 per cent of those with TB had no persistent cough. The study also found that 62.5 per cent had no cough at all. The findings were published in the Lancet Infectious Diseases. The study in fact noted that this could be the "probable reason why, despite huge efforts to diagnose and treat the disease, the tb burden across Africa and Asia is hardly declining". Frank Cobelens, Professor of Global Health at Amsterdam UMC and Senior Fellow at the AIGHD says, "A persistent cough is often the entry point for a diagnosis, but if 80 per cent of those with TB do not have one, then it means that a diagnosis will happen later, possibly after the infection has already been transmitted to many others, or not at all." Another 2019 study published in Elsevier notes: "Coughing does not appear to be a necessary prerequisite for TB transmission." The study further mentions, "Frequency of cough is associated with infectivity but this does not imply mechanistic causality for TB transmission."Does It Mean Coughing Is Harmless?The simple answer to this is: No. Coughing does not mean harmless, especially when it is a persistent one. The study only shows that TB does not always mean persistent coughing, however, if one experiences this symptom, they should always get a test done and should not ignore the symptoms. Researchers from The University of Texas at Dallas' Center for Advanced Pain Studies working with colleagues from UT Southwestern Medical Center note that TB coughing could cause pain. This is one of the way one can distinguish the symptoms. The findings published in journal Cell notes that before this study, "no one had even shown that TB produces an irritant that acts directly on the sensory innervation of the lungs". Corresponding author Dr Michael Shiloh, associate professor of internal medicine and microbiology at UT Southwestern said, "People with active tuberculosis can cough for months and spread disease even when they are receiving appropriate treatment."Read: World Tuberculosis Day 2026: Theme, Origin, And SignificanceWhat Is India Doing To Control TB Cases?On World TB Day, President Droupadi Murmu stressed that TB continues to pose a significant public health challenge and has affected millions of lives across the world. She urged all stakeholders to work together with collective resolve to end TB once for all. To act on it, Union Health Minister Jagat Prakash Nadda will launch a series of initiatives, including 'TB Mukt Bharat Abhiyaan - 100 Days Campaign', the TB Mukt Bharat App, and the TB Mukt Urban Ward Initiative. These measures are designed to strengthen the case detection, improve treatment adherence, and enhance last-mile delivery of TB services, especially in high-burden areas. The initiatives have also been aligned with the objectives of the National Tuberculosis Elimination Programme.

is cough really necessary for tb? 80% of patients don't have it, says study

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