ISLAMABAD - Around 420,000 people develop active tuberculosis each year in the country with 65 percent case detection rate.
According to available data, remaining 35 percent of tuberculosis patients which is around 147,000, develop the diseases during each year but do not participate in screening programme.
It said this 35 percent patients remain undiagnosed and unmanaged in the country while tuberculosis is endemic and is one of the most common causes of morbidity and mortality.
Pakistan ranks 5th among 22 high tb burden countries in world that share 81 percent of global tb burden. The international research shows that tb patients if remain untreated and unmanaged, two thirds of them would die within two to three years of disease onset.
Similarly, such patients, who remain untreated, transfer disease to 10 individuals in a year and 15-20 years in lifetime of patient.
A public heath expert, Dr Sobia Faisal, said that delays in diagnosis of tuberculosis after the onset of related signs and symptoms and inappropriate treatment result in mortality and longtime morbidity.
She said non-participation as well as delayed participation of tb suspects in tuberculosis control programme is a daunting challenge for health authorities concerned. She added these unmanaged tb cases cause spread of disease in community and also introduce much dangerous form of disease which is drug resistance tb .
In Pakistan, National tb Control Programme is implementing WHO recommended DOTS strategy where diagnostic and treatment services including free medicines are given to all tb patients free of cost at government health facilities, she said.
She said some of the highly committed general practitioners all over country in collaboration with tb control programme are giving free medication to tb patients. She said tb is treatable disease and person would be 100 percent perfect if he or she would undertake proper medication.
She said patient must visit doctor as soon as possible having signs and symptoms including cough that will not go away like more than two weeks, feeling tired all the time, weight loss, loss of appetite, low grade fever, coughing up blood and night sweats.
She said these symptoms can also occur with other types of lung disease so it is important to see a doctor and to let the doctor determine if tb disease is present or not.
She said the patient usually is given a combination of several drugs for a specific period of time which depends on type of tb and its resistance to drugs. 
The patient will probably begin to feel better only a few weeks after starting to take the drugs. It is very important, however, that the patient continue to take the medicine correctly for the advised full length of treatment.
Medical expert Dr Wasim Khawaja from Pakistan Institute of Medical Sciences (PIMS) said if the medicine is taken incorrectly or stopped the patient may become sick again.
In such case the tb may be harder to treat because it has become drug resistant which means that the tb germs in the body are unaffected by some drugs used to treat tb , he added.
He said multi-drug resistant tb is very dangerous, so patients should be sure that they take all of medicine correctly.He said some minor side effects of treatment such as reddish color urine, nausea, abdominal pain and itching of skin are very common and should not be worrisome.
Dr Wasim said regular checkups are needed to see how treatment is progressing. He said it is important both for people undergoing preventive therapy and people being treated for tb disease to immediately let a doctor know if they begin having any unusual symptoms.
If a family have tb , other people living in the same household must have their sputum test for diagnosis of tb as it spread through respiration, coughing, sneezing etc., he added