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Wales has seen a downward trend in rates of tuberculosis (TB) over the last decade

Published: 19 September 2023

Wales has seen a 36 per cent decrease in the incidence of TB over the last decade, falling from a peak of 4.6 cases per 100,000 population in 2013 to 2.8 cases per 100,000 people in 2021. There were 90 new cases diagnosed in 2021, and Wales remains well within the WHO definition of a low incidence country, which is anything less than 10 cases per 100,000 annually. The findings have been published in Public Health Wales’ Tuberculosis in Wales Annual Report which includes data to the end of 2021. 

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. Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after Covid-19 (above HIV and AIDS), according to the World Health Organisation (WHO). Ending the global TB epidemic by 2030 is among the United Nations’ Sustainable Development Goals, but incidents of TB in the UK remain very rare. 

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 (64 per cent) in Wales in 2021 were in people born overseas in countries with high rates of TB. It is not known what proportion of these cases are the result of reactivation of latent disease acquired prior to arrival in the UK. 

TB is a treatable disease in most cases. Antibiotics are taken daily for four to six months. Tuberculosis that doesn’t respond to standard drugs is called drug-resistant TB and requires more toxic treatment with different medicines. Trends in drug resistant TB in Wales remain relatively stable with those identified with “any resistance to one or more first line drugs” at 9 per cent of all cases in 2021. 

Professor Daniel Thomas, Consultant Epidemiologist at Public Health Wales, said: “While Wales remains a low prevalence country for TB, and we’ve seen a steady decline in cases over the last decade, efforts should continue to meet World Health Organisation goals to eliminate the disease as a public health threat. 

“Although TB can affect anyone, cases that are identified in Wales are often found in our most vulnerable populations, so addressing this issue presents an opportunity to reduce overall health inequalities.”