Prognosis

Although the majority of patients with a diagnosis of TB have a good outcome because effective treatments are available, without treatment the mortality rate for tuberculosis is more than 50%. (1)

The following make a worse prognosis more likely:

• TB in the elderly, infants and young children.
• people with TB who experience a delay in receiving treatment.
• if there is radiological evidence of extensive spread.
• people with severe respiratory compromise requiring mechanical ventilation.
• immunosuppression.
• multidrug resistant (MDR) tuberculosis. (1)

In addition:

• in the UK the mortality is 5%
• mortality is highest in the socially disadvantaged
• proper chemotherapy provides a cure in almost all immunocompetent patients
• relapse rate is 1-2%; the rate is highest amongst poor compliers

Notes:

In 2021, the majority of people with extensively drug-resistant TB in England were born outside the UK, predominantly coming from Nigeria, Lithuania, Pakistan, India, and Romania (2)

Multidrug-resistant TB has a poorer prognosis than fully drug-susceptible TB, and risk factors include: (3)

• Previous TB drug treatment (especially if there is a history of poor adherence or treatment failure).
• Contact with a known index case of multidrug-resistant TB.
• Country of origin with a high proportion of multidrug-resistant new TB cases.

There may be an increased risk of poorer outcomes among pregnant women and new mothers with TB (4)

Reference:

• 1. Tobin E. Tuberculosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan
• 2. UKHSA (2023) Tuberculosis in England, 2022 report (data up to end of 2021). UK Health Security Agency
• 3. NICE (2019) Tuberculosis. National Institute for Health and Care Excellence
• 4. UKHSA (2019) Pregnancy and tuberculosis (TB) Information for clinicians. UK Health Security Agency