Malaria, plague, and tuberculosis are among the most historically significant infectious diseases. While malaria is caused by the parasite Plasmodium [1], plague is caused by the bacterium Yersinia pestis, and tuberculosis is caused by the bacterium Mycobacterium tuberculosis [2]. The severity, epidemiological impact, and response to treatment of these diseases vary widely. Understanding these differences is essential for prioritizing public health interventions. According to the 2022 World Health Organization report, malaria killed more than 600,000 people that year, a death toll that has not improved significantly since 2015 [3]. In addition, drug-resistant parasites and insecticide-resistant mosquitoes are spreading throughout Africa and other regions, further complicating control efforts [4].

Tuberculosis (TB) remains a leading cause of death from infectious diseases, and is among the top 15 causes of death worldwide. According to the 2022 U.S. Centers for Disease Control and Prevention (CDC) report, an estimated 7.5 million people were diagnosed with TB that year, an increase from 2021 [5]. There were an estimated 1.3 million deaths from TB in 2022, including approximately 167,000 deaths among people living with HIV [6]. However, diagnosing TB remains a major challenge; in 2022, only 63% of people treated for TB had a microbiological test confirming the diagnosis [4].

On the other hand, the bacteria responsible for the plague, Yersinia pestis, has had a profound impact on human history. This bacteria has emerged as one of the most devastating diseases, causing numerous epidemics and millions of deaths. Plague has caused the greatest horrors around the world, especially through the three great pandemics that have struck humanity [7].

This study is based on data from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and the Global Burden of Disease (GBD) reports. The analysis includes:

Death rate per 100,000 population.

Infection and transmission rates.

Case fatality rate (CFR).

Response to treatment, as measured by drug efficacy and resistance patterns [4];[8].

Statistical tools such as Excel and SPSS were used to process the data, and graphs were created using GraphPad Prism [9]; [10].

3.1 Epidemiological ranking

Malaria has the highest incidence rate among infectious diseases, but has a relatively low mortality rate due to improved availability of treatment and prevention interventions such as insecticide-treated bed nets and antimalarial drugs [1].

On the other hand, plague is considered a rare disease in modern times due to the availability of effective antibiotics, such as streptomycin and doxycycline. However, plague has a significantly high mortality rate if not treated promptly and effectively [2].

Tuberculosis (TB) remains one of the most challenging diseases globally, with the spread of multidrug-resistant (MDR-TB) strains and latent infection affecting nearly a quarter of the world’s population. An estimated 10.6 million people fell ill with TB in 2022, with significant gaps in diagnosis and treatment [11].

3.2 Severity and pathogenesis

Plague

Prevalence and risk:

Plague is one of the most rapidly spreading infectious diseases, especially in its pneumonic form, which can be transmitted via respiratory droplets. If untreated, mortality rates are 90–100% in pneumonic plague and 30–60% in bubonic plague [7].

History: Plague has caused three major pandemics throughout history, including the Black Death in the 14th century, which killed an estimated 50 million people in Europe [6].

Treatment: Plague can be prevented and treated with antibiotics such as streptomycin and doxycycline, but treatment must begin early to avoid fatal complications [6].

Malaria

Distribution: Malaria mainly affects tropical and subtropical regions, with a high concentration in sub-Saharan Africa, where it accounts for about 95% of global cases and deaths [10].

Symptoms and complications: The Plasmodium parasite multiplies in the liver and red blood cells, leading to symptoms such as fever, anemia, and organ damage in severe cases.

Treatment and prevention: Key interventions include insecticide-treated bed nets, indoor spraying, and antimalarial drugs such as artemisinin. However, drug and insecticide resistance in mosquitoes pose increasing challenges [12].

Pulmonary tuberculosis

Prevalence: TB affects approximately 10.6 million people annually, with the highest incidence rates in Southeast Asia and Africa [4].Complications :

Tuberculosis leads to chronic complications such as lung damage, respiratory failure, and death if left untreated. Latent tuberculosis It poses a great risk, as it can become active at any time .

Complications: TB leads to chronic complications such as lung damage, respiratory failure, and death if left untreated. Latent TB also poses a significant risk, as it can become active at any time.

Challenges: Multidrug-resistant tuberculosis (MDR-TB) is one of the biggest challenges, requiring longer and more expensive treatment with lower success rates. In addition, human immunodeficiency virus (HIV) makes TB treatment even more complicated, as many patients suffer from co-infection [8].