Tuberculosis (TB): symptoms, testing, and treatment

TB is a serious infection, most often of the lungs. It is caused by a bacterium and spreads through the air when someone with active TB coughs or sneezes. TB can be cured — but only if you finish the full 6-month course of tablets.

On this page

• What is TB?
• Symptoms
• When to go to a health post
• Getting tested
• Treatment
• Preventing spread to your family
• Living with TB — support and stigma

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What is TB

TB is caused by a bacterium called Mycobacterium tuberculosis. It usually attacks the lungs (pulmonary TB) but can also affect other parts of the body — lymph nodes, spine, brain (extrapulmonary TB).

TB spreads through the air. When a person with active pulmonary TB coughs, sneezes, or sings, tiny droplets carry the bacterium. People nearby can breathe it in.

You cannot catch TB from:

• Sharing a cup or plate
• Shaking hands
• Toilet seats
• Insect bites

Most people who breathe in TB bacteria never get sick — their immune system controls it. This is called latent TB. About 1 in 10 people with latent TB will develop active TB during their lifetime. That risk is much higher in people living with HIV, in young children, and in people with diabetes or poor nutrition.

Symptoms

Symptoms of pulmonary TB usually build up slowly, over weeks or months. They include:

• A cough that lasts more than 2 weeks — sometimes with blood
• Chest pain
• Fever, especially in the afternoon or evening
• Night sweats (waking up drenched)
• Losing weight without trying
• Feeling very tired
• Loss of appetite

TB in other parts of the body causes different symptoms. TB of the spine causes back pain. TB of the lymph nodes causes painless swelling in the neck.

When to go to a health post

Go to your health post if you have had a cough for more than 2 weeks, especially if you also have any of the other symptoms above.

TB testing is free at government health facilities in Ethiopia. Treatment is also free.

Go today if:

• You are coughing up blood
• You have severe chest pain
• You are having trouble breathing
• You have lost a lot of weight quickly

Getting tested

At the health post, a health worker will ask about your symptoms and how long you have had them.

The main test is a sputum test — you cough phlegm into a small container. The lab checks it for TB bacteria.

Newer tests like GeneXpert give results in about 2 hours and also check if the TB is resistant to common medicines. Not every health post has GeneXpert, but most district-level facilities do.

If sputum tests are inconclusive, the health worker may order a chest X-ray.

Everyone with an unclear or positive TB result should also be tested for HIV. TB is much more dangerous in people living with HIV, and both need to be treated together.

Treatment

TB is treated with a combination of 4 antibiotics for the first 2 months, then 2 antibiotics for the next 4 months — 6 months total.

In Ethiopia, the standard first-line combination is:

• Isoniazid (H)
• Rifampicin (R)
• Ethambutol (E)
• Pyrazinamide (Z)

Taken every day, usually as a single combined tablet.

::: doList

Do

• Take every dose, every day, at the same time
• Take tablets on an empty stomach if you can (or with light food if they upset your stomach)
• Continue for the full 6 months, even when you feel completely better after 2 or 3 weeks
• Attend every follow-up visit — the health worker will re-test your sputum at 2 months and again at 5 months
• Tell the health worker about any side effects: yellow eyes, tingling in your hands or feet, joint pain, or a rash
• Cover your mouth when coughing for the first 2-3 weeks of treatment :::

::: dontList

Don’t

• Do not skip doses. Even one missed week can let the TB come back stronger
• Do not stop early. You will feel better long before the TB is fully treated
• Do not drink alcohol during treatment — it can damage your liver alongside the medicines
• Do not share your tablets with anyone
• Do not use traditional remedies as a replacement — they do not kill TB bacteria :::

Drug-resistant TB (MDR-TB)

If TB does not respond to the standard treatment, it may be multidrug-resistant TB (MDR-TB). This is harder to treat and needs different medicines for 9 to 20 months, sometimes with injections. Treatment is still free, but you will need to go to a treatment centre.

The single biggest cause of MDR-TB is people stopping treatment early. Finishing the full course protects you AND everyone around you.

::: factBox

DOTS — Directly Observed Treatment, Short-course

At most health posts, a trained health worker or community volunteer watches you take each dose. This is called DOTS. It sounds like a lot, but it is the reason Ethiopia has one of the highest TB cure rates in Africa. Do not skip DOTS visits. :::

Preventing spread to your family

Once you start effective treatment, you become much less contagious within 2-3 weeks. But during those first weeks, and any time before treatment starts, you should:

• Sleep in a separate room if possible
• Open windows for good airflow
• Cover your mouth with a cloth or elbow when you cough or sneeze
• Wear a mask around others for the first month, especially around children and the elderly

Everyone who lives in the same house should be tested for TB and HIV, even if they feel fine. This is standard practice at Ethiopian TB clinics. Children under 5 and people with HIV in the household may be given preventive medicine even if their test is negative.

Living with TB — support and stigma

TB carries stigma in many communities, but it is a treatable disease, not a moral failing. You did not do anything wrong. You caught something you breathed in.

• Tell close family so they can be tested and support you
• Ask your health worker about food support — TB treatment works better when you eat well
• Stay in school or at work if you feel able to and are past the contagious stage (usually 2-3 weeks in)
• Look after your mental health — feeling worried or sad during treatment is normal

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Reviewed by Dr. Hanna Alemayehu, MD, MPH — Family medicine, Addis Ababa Last reviewed: 5 September 2026 · Next review due: 5 September 2028

Sources:

1. World Health Organization. Global Tuberculosis Report 2024. October 2024.
2. Federal Ministry of Health, Ethiopia. National Tuberculosis and Leprosy Control Programme guidelines. 2022.
3. World Health Organization. Consolidated guidelines on tuberculosis treatment. 2022.

Content adapted from WHO Global TB Report 2024 and Ethiopian NTLP guidelines. Reviewed for Ethiopian context by Dr. Hanna Alemayehu.

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Draft notes (delete before publish)

• Word count: ~1,020 words
• Reading level target 6-8: aims for grade 7 with everyday language
• isTimeCritical: false — TB is a “days-to-weeks” concern not “hours”; but has a “go today if…” section for red flags
• Uses doList, dontList, factBox (DOTS explanation)
• Ethiopian context: WHO-preferred first-line RHEZ regimen, DOTS at health posts, free testing/treatment, MDR-TB centre referral, HIV co-test, contact-tracing standard practice
• Explicitly addresses stigma — critical for TB adherence in Ethiopian context
• Dr. Hanna Alemayehu is placeholder — B2B-22