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Thorax 2006;61:ii3-ii56
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Epidemiology of tuberculosis

S001 SUBSTANTIAL INCREASE IN TUBERCULOSIS INCIDENCE IN ENGLAND AND WALES IN 2005

M. E. Kruijshaar, I. Abubakar, J. Crofts, J. M. Watson.Respiratory Diseases Department, Centre for Infections, Health Protection Agency, London, UK

Background/Aim: The epidemiology of tuberculosis in England and Wales has changed over the last two decades with a gradual increase in overall incidence. The majority of cases are now reported in the foreign-born while cases among the UK born are more likely to be from certain risk groups. Using national surveillance data, this study examines recent trends in tuberculosis epidemiology, including clinical and demographic characteristics of cases.

Methods: The Enhanced Tuberculosis Surveillance (ETS) system collects information on tuberculosis cases, including demographic, clinical and microbiological data. Cases occurring in England and Wales have been reported to this system since 1999. Population figures used for calculating national rates were calculated using mid year estimates provided by the Office for National Statistics (ONS).

Results: Provisional ETS data show that 8136 tuberculosis cases were reported in 2005 in England and Wales, a rate of 15.3 per 100 000. This compares with 7086 cases (13.4 per 100 000) reported in 2004. The rate increased by 14%, significantly more than in previous years (4% average annual increase between 1999 and 2004). This large increase is seen in both adults and children, and in those born in the UK (6% increase between 2004 and 2005 v no increase from 1999–2004). The trend differs considerably by region and is mainly comprised of non-pulmonary cases (27% increase versus 7% for pulmonary).

Discussion: Preliminary surveillance data indicate an increase in the incidence of tuberculosis in England and Wales in 2005 that is considerably larger than in previous years. Differential reporting by clinicians is an unlikely explanation, as we found a similar increase in the number of isolates reported from mycobacterial reference laboratories. While the final corrected figure for 2005 …

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