TB symptoms: signs of tuberculosis and where to get a free TB test

Tuberculosis (TB) is an infection caused by a germ that most often attacks the lungs. TB of the lungs is called pulmonary TB, or PTB at health centers. In Filipino, TB is also called tisis.

TB symptoms start slowly and can stay mild for months, so many people wait too long. Watch for:

• a cough that lasts 2 weeks or more, with or without phlegm
• phlegm with streaks of blood
• fever and heavy sweating at night
• losing weight without trying, or a poor appetite
• feeling weak or tired all the time
• chest or back pain that is not from a strained muscle
• shortness of breath

The 2-week rule. The DOH TB program tells health workers to test anyone aged 15 or older who has coughed for 2 weeks or more, even if the cough is the only symptom.

Get checked for a cough of any length that has no clear cause if you live with someone who has TB, have HIV, diabetes, kidney failure or cancer, take steroids long term, or are an older adult.

Some people with TB have no symptoms but can still spread it. The DOH also screens communities with chest X-rays to find TB early.

TB can also affect the glands, bones, spine, joints, kidneys, skin and brain. Signs include a slowly growing lump in the neck that is usually painless, back pain or a new hump in the spine, a swollen joint, or a swollen belly. A stiff neck, bad headache or confusion can mean TB has reached the brain, which is an emergency (see when to get help now).

Children often do not cough up phlegm. Health workers usually look for at least 3 of these signs:

• coughing or wheezing for 2 weeks or more
• fever for 2 weeks or more with no other clear cause
• losing weight, not gaining weight, or a poor appetite
• a chest infection that does not get better after 2 weeks of antibiotics
• not getting back to normal 2 weeks after a virus such as measles
• being tired or less playful than usual

If a child lives with someone who has TB, even one of these signs needs a health center visit. See also fever in babies and children.

TB is caused by a germ (bacteria) called Mycobacterium tuberculosis. When a person with TB of the lungs coughs, sneezes, spits or talks, the germ goes into the air and others breathe it in.

TB spreads most easily between people who share the same air for a long time, such as a family in one house or co-workers in one closed room. It does not spread by touching, kissing, or sharing food, plates, glasses or spoons.

TB infection is not the same as TB disease. About a quarter of people in the world carry the germ without being sick (latent TB). They cannot spread it. Only about 5 to 10 in every 100 of them later develop TB disease, sometimes years later.

TB disease is more likely if you:

• live with someone who has TB
• have HIV (about 12 times higher risk), diabetes, or a weak immune system
• are underweight, smoke, or drink alcohol heavily
• are a child under 5 or an older adult
• had TB before and did not finish treatment

The Philippines has one of the largest numbers of TB cases in the world, about 7 in every 100 cases worldwide in 2024. That year, about 625 in every 100,000 Filipinos got TB, and it remained one of the country's leading causes of death.

• Sputum test. You cough up phlegm (sputum) from deep in your lungs into a small cup. It is checked under a microscope or with a rapid molecular test such as Xpert (GeneXpert), which also shows if the germ resists rifampicin, a main TB medicine. Rapid tests can give a first result within 2 days.
• Chest X-ray. It can show lung changes that look like TB. The DOH now uses portable, AI-assisted X-ray machines to screen people closer to their communities. An X-ray alone does not confirm TB, so a sputum test usually follows.
• TB skin test or blood test. These show if you were ever infected, but not whether you have TB disease. They are mostly used for high-risk people, such as children living with someone who has TB.

How to give a good sputum sample:

1. Rinse your mouth with plain water, and go to an open, airy place away from others.
2. Breathe in deeply, hold it for a moment, and breathe out slowly. Do this 3 times.
3. After the third breath, cough hard to bring up phlegm from deep in your chest.
4. Spit it into the cup and close the lid tightly.

Saliva or nose mucus is not a good sample, but phlegm with streaks of blood can be tested. You may be asked for a second sample.

Start at your barangay health station, rural health unit (RHU) or city health center. Say you have had a cough for 2 weeks or more. They will test you or send you to a TB-DOTS center. Find a health center near you.

What is free. Government health facilities give sputum tests and TB medicines for free under the DOH TB program. Drug-resistant TB is also treated by the government, at special treatment centers your TB-DOTS center can refer you to.

PhilHealth TB-DOTS package. For TB that responds to the usual medicines, PhilHealth pays accredited TB-DOTS centers, public and private, for outpatient TB tests, check-ups, medicines and counseling for adults and children.

PhilHealth YAKAP. YAKAP (formerly Konsulta) covers chest X-rays among its lab tests. If you are registered with a YAKAP clinic, your YAKAP doctor can order one if you need it. As of mid-2025, a private YAKAP clinic may charge up to ₱900 a year. See our PhilHealth YAKAP guide.

New from November 1, 2026: TB medicines through GAMOT. Members and dependents with confirmed TB that responds to the usual medicines (drug-susceptible TB) can also get the main TB medicines from accredited GAMOT pharmacies on a YAKAP doctor's prescription, up to a month's supply at a time. These do not use up the ₱20,000 yearly GAMOT medicine benefit. Claim them within 2 days of the prescription date. After that you would have to pay, or ask your doctor for an updated prescription. The TB-DOTS center remains the main place for TB care.

Private doctors can refer you to a TB-DOTS center so your medicines are free. See also what PhilHealth covers, or book a call with a nurse.

TB can be cured. Treatment is antibiotics taken by mouth every day, usually for about 6 months in adults, sometimes only 4 months in children with mild TB, and longer for TB of the brain, bones or joints. Your doctor chooses the medicines.

In the first 2 months you take 4 medicines, often combined in one tablet, then fewer. Your health worker weighs you monthly and repeats sputum tests.

A treatment partner helps you finish. Under DOTS, a trained person, such as the nurse, midwife, a barangay health worker or a former TB patient, watches you take your medicine and asks how you feel. In some cases, such as for children, a trained family member can do it.

Never stop early, even when you feel better. Stopping or skipping days can bring TB back and make the germ resistant to the medicines.

Side effects: orange or red urine from rifampicin is harmless. Tell your health worker about stomach upset, itching, joint pain or burning feet, and do not stop on your own. Yellow eyes or skin, a bad rash, or blurred vision or trouble telling colors apart need a doctor the same day. Ask the doctor before you take your next dose.

Drug-resistant TB needs different medicines, now often an all-oral treatment of about 6 months instead of 2 years.

Say yes to an HIV test when it is offered. If you have both HIV and TB, PhilHealth lets you use its TB-DOTS and HIV treatment packages at the same time.

Most people with TB are treated at home. To protect yourself and your household:

• Take every dose with your treatment partner. If you miss one, tell your health worker.
• Cover your cough with a tissue or your elbow, and wear a face mask around others, especially in the first weeks.
• Spit phlegm into a tissue or covered container, not on the ground, and wash your hands with soap.
• Let fresh air in. Open windows and doors, especially in the room where you sleep, and do not sit too close to others.
• Stay home from work or school for the first few weeks, as your health worker advises, and avoid crowded places.
• Eat regular, filling meals. Your health worker weighs you each month, and gaining weight is a good sign.
• Stop smoking and avoid alcohol, which can make liver side effects more likely, and keep diabetes under control if you have it.
• Ask your family to get checked, ideally in your first week of treatment. Some, especially children under 5, may be offered medicine to prevent TB.

Family members do not need separate plates or spoons. Washing them as usual is enough.

If TB brings worry or shame, talk with your health worker or a former TB patient. Our AI symptom guide can also answer questions any time.

• "TB runs in the family" (namamana). TB is caused by a germ that spreads through the air. It often affects several people in one family because they breathe the same air at home for a long time.
• "It is just a smoker's cough." A cough of 2 weeks or more needs a TB test whether or not you smoke. Smoking raises the risk of TB.
• "TB comes from overwork, cold drinks or getting rained on." TB is caused by a germ in the air. Not eating enough can make TB disease more likely, but it is not the cause.
• "TB cannot be cured." It can, and the medicines are free at TB-DOTS centers. Without treatment, TB can be deadly.

Having TB is not a disgrace. Early testing protects your family.

• BCG vaccine for babies. BCG is one of the free baby vaccines at local health centers. It protects children from serious forms of TB, but a vaccinated person with TB symptoms still needs a test.
• TB preventive treatment. If someone at home has TB, ask about preventive medicine for your household, and finish the whole course if given.
• Open windows in homes, offices and classrooms. TB spreads most in closed, crowded spaces.
• Get a long cough checked early, eat enough, avoid smoking, and keep diabetes and HIV under control.