Increase in TB cases in Wales, but longer-term trend is decreasing – new report

The number of newly diagnosed TB cases in Wales increased from 71 in 2022 to 84 in 2023, but the longer-term trend is decreasing, according to a new report being published on World TB Day, which is today, 24 March.

The report, Tuberculosis in Wales, also finds that the infection is more frequently reported in those living in more disadvantaged areas.

While the increase in 2023 is 18 per cent on the previous year, the numbers are low, and Wales remains a low incidence country for TB.

Individuals from countries with a high incidence of TB, those with social risk factors such as drug or alcohol use or homelessness, or those with health conditions like diabetes or immunosuppression, are also more at risk of infection.

Over the longer term, Wales has seen a decrease in incidence of TB since a peak of 3.7 cases per 100,000 of population in 2014.

Whilst overall Wales remains within the WHO definition of a low incidence country (less than 10 cases per 100,000 population per year) there is substantial geographic variation, with higher incidence found in Southeast Wales

Josie Smith, Senior Epidemiologist for Public Health Wales, said:

“The increase in TB cases in Wales is consistent with similar trends being seen in other parts of the UK, and what we know about the impact of the disease on more disadvantaged communities.

“While the longer-term trend in Wales is of declining rates, we must not be complacent – evidence of a slowdown in the reduction in TB rates should be a concern.

“Public Health Wales will continue working in close partnership with the Welsh Government and other partners to work towards the elimination of TB, including via the Welsh Government led TB Elimination Oversight Group.”

Ending the global TB epidemic by 2030 is among the United Nations’ Sustainable Development Goals.

TB is an infection that usually affects the lungs with symptoms including a persistent cough with mucus or blood in it, feeling tired or exhausted, a high temperature or night sweats, loss of appetite, weight loss, generally feeling unwell, among other possible symptoms.

However, rates of pulmonary TB in Wales have decreased significantly in the last five years, and a greater proportion of TB diagnoses are now due to TB in other parts of the body, with the lymph nodes, kidneys and GI tract being the most common sites of extra-pulmonary infection.

Sometimes a person can have TB in their body but experience no symptoms. This is called latent TB.

More than half of all newly diagnosed TB cases (60 per cent) in Wales in 2023 were in people born outside of the United Kingdom. It is not known what proportion of these cases are the result of reactivation of latent disease acquired prior to arrival in the UK.

In most cases TB is a treatable infection with treatment in the form of antibiotics, usually taken for a period of four to six months.