Despite many people believing TB has been eradicated in the UK it never went away. In fact, the UK experienced a two decade long rise in cases from the mid-1980s. It is only in the last four years that the UK has begun to match the global trend for falling rates of TB, with affected individuals dropping from a peak of 8,919 cases in 2011 to around 6,000 cases annually today.
In England in 2015:
- There were 5,758 TB cases
- 39% of cases were in London
- 73% of cases were among non-UK born people
- 12% of people with TB had at least one social risk factor for TB (a history of alcohol or drug misuse, homelessness or imprisonment)
- 28% of people with pulmonary TB waited over four months from onset of symptoms to beginning treatment
Who gets TB?
In 2015, 73% of TB cases were found among people born outside the UK. Of these, 60% were among people that have been in the country for longer than six years – suggesting reactivation of latent TB
India, Pakistan and Bangladesh were the most frequent countries of birth for non-UK born cases, though rates among the Indian and Pakistani community have decreased significantly over the last three years. This decrease in rates is also true in the non-UK born population as a whole.
TB remains an illness that is associated with health inequality. People in deprived communities have rates of TB seven times higher than people in the least deprived areas. 35% of cases were found among people not in education or employment.
12% of cases had at least one social risk factor for TB, a figure that increased from 10% in 2015: 4.3% had a history of drug misuse, 3.9% alcohol misuse, 4.4% homelessness and 3.9% imprisonment. People with social risk factors for TB also make up a disproportionate amount of the total number of people with drug-resistant forms of the illness.
In 2015, the government launched the Collaborative TB Strategy for England which set out the steps required to achieving the ambition of a year-on-year
decrease in TB incidence, a reduction in health inequalities and, ultimately, the elimination of TB as a public health problem in England.