Hidden Threat: WHO Alarmed by 26% of Undiagnosed TB Cases

Despite global progress, the World Health Organization (WHO) warns that 26% of Tuberculosis (TB) cases remain undetected, leaving millions untreated and at risk.

This alarming gap was a key concern during the World TB Day 2025 celebration in Kayonza District, Eastern Province, on March 24. With a TB recovery rate of just 85%—lower than the national average of 90%—Kayonza was chosen as the focal point of Rwanda’s awareness efforts.

Globally, 1.5 million people are dying from TB each year, making it a leading cause of death from a single infectious agent.  Over 10.8 million people worldwide contracted TB in 2023 including 5.9 million men, 3.6 million women and 1.3 million children.

“While we celebrate the success such as diagnosing, which is about 74% of the TB cases in 2023 worldwide, we cannot ignore the reality that 26% of the cases still are undetected and the burden of mass drug resistant TB, MDR-TB, remains considerable with only 38% of MDR-TB cases being notified worldwide. So it is still a global epidemic. In Africa, TB stands as a second leading cause of death”, Dr Theopista John Kabuteni, Medical Officer, Reproductive Maternal and Neonatal Health (RMNH) and Health Systems Policy Advisor at WHO Rwanda, said.

“The key messages are three.  One is to commit as we recall that the world leaders in 2023 at the UN high level meeting pledged to accelerate the efforts to end TB. We need to invest. TB cannot be defeated without adequate financial resources and we need to deliver, meaning that we need to turn our commitments into action”, she added.

According to Rwanda Biomedical Center, Rwanda has made significant progress in the fight against tuberculosis in recent years. TB incidence decreased from 96 cases per 100,000 populations in 2000 to 55 cases per 100,000 populations in 2023 as per the Global TB Report 2024. Rwanda has the lowest TB incidence in the East African region.

In terms of TB notification during FY 2023-2024, the total number of TB cases diagnosed was 8,551 including 92 RR/MDR TB cases. TB notification improved from 91% in 2022 to 121% in FY 2023 and community health workers contributed to 31.4% of all TB patients in FY 2023-2024.

Despite the progress made in the fight against TB, more efforts are still needed in raising the public’s knowledge about TB disease.

Dr Yves Habimana Mucyo, the acting director of the National Tuberculosis Control Programme at RBC, advised early screening to help individuals identify their illness in good time. In case one is diagnosed with tuberculosis, it is crucial to adhere strictly to the prescribed medication and follow medical advice to ensure full recovery without infecting others.

Among the new approaches include the integration of technologies in healthcare facilities, and there is now a plan to extend its use to villages through community health workers. These workers will conduct screenings for various diseases, including tuberculosis.

“They will use smartphones equipped with a questionnaire to assess individuals suspected of having tuberculosis. This will enable them to provide early guidance, and health facilities will be able to track patients efficiently since the information will be instantly recorded in the system”, Dr Mucyo said.

“This approach will be highly beneficial in identifying the 26% of tuberculosis patients who remain undetected by health systems due to their inability to access healthcare facilities, a factor that has been linked to increased mortality, as highlighted by the WHO. This initiative has already entered the trial phase, as the questionnaire has been finalised, and the first group of community health workers has begun piloting its use.”

Jeanine Gahongayire from Kayonza District is one of the tuberculosis patients who initially mistook her illness for a common cough. She endured it for a long time while relying on traditional medicine, even suspecting at some point that she had been poisoned.

After three months of severe illness, she decided to seek medical attention at a health centre, where she was diagnosed with tuberculosis.

She said, “They gave me medication, I took it, and I recovered. Now, I encourage anyone experiencing tuberculosis symptoms to seek medical help immediately. If you don’t take tuberculosis medication, you can die—I was at the brink of death myself, but community health workers took care of me.”

Tuberculosis is a communicable disease that is a major cause of morbidity and death. It is one of the top 10 causes of death worldwide. Most of these deaths could be prevented with early diagnosis and appropriate treatment.

The theme, “Yes, we can end TB”, calls on all those involved in the fight against TB to unite their efforts and find adequate financial resources to end TB.