epidemiology

Last reviewed 09/2022

Tuberculosis worldwide accounts for 1.7 billion infections, and two million deaths per year.

  • over 90% of TB cases occur in low and lower-middle income countries, but a global resurgence also affecting high income countries
  • countries of Asia such as India, China, Indonesia, Pakistan and Bangladesh have the largest number of cases. Note though that there have been striking increases in the number of cases in the former Soviet Union and in sub-Saharan Africa
  • in parallel with a global epidemic of HIV, M. tuberculosis co-infection has become more common, ranging from less than 1 per cent in the Pacific islands, as high as 11 per cent in some areas of the UK, to over 60 per cent in countries such as Zambia, Zimbabwe and South Africa
  • in the developed world, the disease is more common in some sections of society eg alcoholics, undernourished, ethnic communities, the elderly, and HIV+ve individuals. The disease is also more common in patients after gastrectomy for peptic ulcer

In England and Wales, the total number of notifications for TB gradually declined over the years from around 120 000 in 1913 to 10 000 in 1976 to a low of 5000 in 1987

  • TB notifications have however gradually increased to about 7000 in 2002
    • most cases occur in inner cities and, in 2001, London accounted for 41% of all cases reported in England, Wales and Northern Ireland
    • rates of TB were highest among Black African ethnic groups (211 per 100,000), followed by Pakistani (145 per 100,000) and Indian (104 per 100,000) ethnic groups. The rate among the white ethnic group was 4.1 per 100,000, but as this is the largest ethnic group, a third of all TB cases occurred in white people
    • among the recent notifications of TB over the last 10 years, 30 per cent of cases have been extrapulmonary

Reference:

  1. MeReC bulletin (2003); 14(3):9-12.
  2. Prescriber (2004); 15 (13):12-21.