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High Cholesterol Linked to Tuberculosis Risk Among Indonesian Migrant Workers in Malaysia
FORMOSA NEWS — Elevated cholesterol levels may help identify Indonesian migrant workers at higher risk of tuberculosis (TB), according to a 2026 study conducted by Dr. Purnamawati Tjhin, Dr. Meiyanti, and Dr. Eveline Margo from the Faculty of Medicine at Universitas Trisakti, together with Dr. Laurensia Lim of Melati Hospital. The research, published in the International Journal of Integrative Sciences (IJIS), found that migrant workers with high total cholesterol were significantly more likely to report symptoms associated with tuberculosis than those with normal cholesterol levels.
The findings are important because tuberculosis remains one of the world's deadliest infectious diseases, while migrant workers often face barriers to healthcare access, delayed diagnosis, and higher exposure to infection. The study suggests that metabolic health indicators, particularly cholesterol levels, could strengthen early TB detection programs in vulnerable populations.
Tuberculosis Remains a Major Health Challenge
Tuberculosis continues to pose a serious public health challenge worldwide. According to the World Health Organization's Global Tuberculosis Report 2023, an estimated 10.6 million new TB cases were reported globally in 2022, with Southeast Asia accounting for nearly half of the global burden.
Malaysia, one of the primary destinations for Indonesian migrant workers, continues to face challenges in TB control, especially among migrant communities. Crowded living conditions, demanding work environments, limited healthcare access, language barriers, and concerns related to immigration status can all increase the risk of delayed diagnosis and treatment.
Researchers have increasingly focused on how metabolic conditions such as diabetes, blood glucose abnormalities, and cholesterol disorders may influence susceptibility to tuberculosis. While diabetes has long been recognized as a risk factor for TB, the role of cholesterol in TB development has received growing scientific attention in recent years.
Examining the Health of Indonesian Migrant Workers
The study was conducted in April 2026 at Sekolah Indonesia Johor Bahru (SIJB), Malaysia, in collaboration with the Consulate General of the Republic of Indonesia in Johor Bahru.
Researchers analyzed data from 58 Indonesian migrant workers aged between 21 and 65 years. Participants underwent health examinations that included fasting blood glucose testing, total cholesterol measurement, and hemoglobin assessment. They also completed structured interviews regarding symptoms commonly associated with tuberculosis.
Rather than relying solely on conventional TB screening criteria, the research team used an expanded symptom definition. Participants were classified as having presumptive TB risk if they reported at least one respiratory symptom, such as coughing or prolonged productive cough, or two systemic symptoms, including fever, night sweats, or unexplained weight loss.
This broader approach was designed to identify individuals who might otherwise be overlooked by traditional screening methods.
More Than One in Four Participants Showed TB-Related Symptoms
Among the 58 migrant workers included in the study, 16 individuals, or 27.6 percent, met the criteria for presumptive TB risk.
The most commonly reported symptoms included:
- Cough during the previous three months: 19.0%
- Night sweats: 13.8%
- Productive cough lasting more than two weeks: 5.2%
- Fever lasting more than one month: 5.2%
- Unexplained weight loss: 1.7%
The prevalence identified through the expanded screening method was substantially higher than rates typically detected using standard symptom-based TB screening criteria.
According to the researchers, this finding highlights the value of broader screening strategies for migrant populations, where symptoms may be underreported or atypical.
High Cholesterol Emerged as the Strongest Risk Indicator
The most significant finding involved total cholesterol levels.
Participants classified as having presumptive TB risk showed a median cholesterol level of 207.5 mg/dL, compared with 191.0 mg/dL among those without TB-related symptoms.
The analysis found that migrant workers with total cholesterol levels of 200 mg/dL or higher were approximately 3.67 times more likely to meet the criteria for presumptive tuberculosis than those with lower cholesterol levels.
The researchers note that this association is biologically plausible. Previous studies have shown that Mycobacterium tuberculosis, the bacterium responsible for TB, can utilize cholesterol from host cells to support its survival and replication within the body.
Recent scientific evidence has also linked abnormal lipid metabolism to inflammation and disease severity in tuberculosis patients.
Blood Glucose Showed a Weaker Relationship
The study also examined fasting blood glucose levels.
Participants with presumptive TB symptoms had slightly higher median glucose levels than those without symptoms. However, the relationship did not reach statistical significance when categorized according to diabetes risk thresholds.
Similarly, hemoglobin levels showed no significant association with presumptive TB risk.
The researchers suggest that many participants may have been in the early stages of disease development, before anemia commonly associated with active tuberculosis becomes apparent.
Implications for Public Health and Migrant Screening Programs
The findings offer practical insights for healthcare providers, policymakers, and organizations working with migrant populations.
According to the research team from Universitas Trisakti, integrating metabolic assessments into TB screening programs could improve early case detection. Cholesterol testing is relatively simple, affordable, and already widely available in routine health examinations.
The authors recommend considering lipid profiling as part of standard health screening protocols for migrant workers, especially in regions where tuberculosis remains prevalent.
The study also supports a bidirectional screening strategy. Individuals with metabolic disorders may benefit from TB screening, while people with suspected TB symptoms could simultaneously undergo metabolic health assessments.
As Dr. Purnamawati Tjhin and colleagues from Universitas Trisakti explain, the relationship between metabolic health and infectious disease appears increasingly interconnected. Their findings suggest that cholesterol abnormalities may serve as an additional warning sign that warrants closer tuberculosis evaluation among migrant workers.
Beyond screening, the researchers emphasize the importance of health education programs that help migrant communities understand how metabolic conditions and infectious diseases can influence one another.
Author Profile
Dr. Purnamawati Tjhin is a researcher and lecturer in the Department of Anatomy, Faculty of Medicine, Universitas Trisakti, Indonesia. Her research focuses on public health, infectious diseases, and metabolic risk factors.
Dr. Meiyanti is a faculty member in the Department of Pharmacology and Pharmacy, Faculty of Medicine, Universitas Trisakti. Her expertise includes pharmacology, tuberculosis research, and community health
Dr. Kurniasari is a faculty member in the Department of Pharmacology and Pharmacy, Faculty of Medicine, Universitas Trisakti. Her expertise includes pharmacology, tuberculosis research, and community health..
Dr. Eveline Margo is affiliated with the Department of Physiology, Faculty of Medicine, Universitas Trisakti, with research interests in human physiology and metabolic health.
Dr. Laurensia Lim is a healthcare practitioner at Melati Hospital whose work includes clinical care and public health initiatives.
Source
Authors: Purnamawati Tjhin, Meiyanti, Eveline Margo, and Laurensia Lim
Affiliations: Faculty of Medicine, Universitas Trisakti, Indonesia; Melati Hospital
Journal: International Journal of Integrative Sciences (IJIS)
Year of Publication: 2026
Volume and Issue: Vol. 5, No. 5
Pages: 645–656
DOI: https://doi.org/10.55927/ijis.v5i5.31
URL : https://mryformosapublisher.org/index.php/ijis/index
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