Tuberculosis in the UK 2013 report Tables and figures slide-set

1. Tuberculosis case reports, UK, 2000-2012 Tuberculosis in the UK: 2013 report

Figure 1.1: Tuberculosis case reports and rates, UK, 2000-2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 3 Tuberculosis in the UK: 2013 report

Figure 1.2: Tuberculosis case reports and rates by country, UK, 2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 4 Tuberculosis in the UK: 2013 report

Figure 1. 3. Three-year average tuberculosis case rates by local area Figure 1.3. Three-year average tuberculosis case rates by local area*, UK, 2010-2012 *England – Local authorities, Wales and Scotland – Health Boards, NI – data not available London © Crown copyright and database rights 2013 Ordnance Survey 100016969 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS) Data as at July 2013 Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 5 Tuberculosis in the UK: 2013 report

Figure 1. 4: Tuberculosis case reports and rates by region Figure 1.4: Tuberculosis case reports and rates by region*, England, 2012 * HPA region CI – 95% confidence intervals   Source: Enhanced Tuberculosis Surveillance (ETS), Office for National Statistics (ONS) Data as at July 2013 Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 6 Tuberculosis in the UK: 2013 report

Figure 1.5: Tuberculosis case reports and rates by PHE Centre, England, 2012 CI - confidence intervals   Source: Enhanced Tuberculosis Surveillance (ETS), Office for National Statistics (ONS) Data as at July 2013 Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 7 Tuberculosis in the UK: 2013 report

Figure 1.6: Tuberculosis case reports by place of birth and country, UK, 2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 8 Tuberculosis in the UK: 2013 report

Figure 1.7: Tuberculosis case reports by place of birth and PHE Centre, England, 2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 9 Tuberculosis in the UK: 2013 report

Figure 1.8: Non UK-born tuberculosis case reports by time since entry to the UK to tuberculosis diagnosis, UK, 2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 10 Tuberculosis in the UK: 2013 report

Table 1.1: Most frequent countries of birth for non UK-born tuberculosis cases, UK, 2012 * Where country of birth was known; **Years Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 11 Tuberculosis in the UK: 2013 report

Figure 1.9: Tuberculosis case reports and rates by ethnic group and place of birth, England, Wales and Northern Ireland, 2012 Source: Enhanced Tuberculosis Surveillance (ETS), Rates by place of birth calculated using Labour Force Survey population estimates. Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 12 Tuberculosis in the UK: 2013 report

Figure 1.10: Tuberculosis case reports and rates by age group and place of birth, UK, 2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 13 Tuberculosis in the UK: 2013 report

Figure 1.11: Tuberculosis case reports and rates by age group and sex, UK, 2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 14 Tuberculosis in the UK: 2013 report

Figure 1.12: Tuberculosis case reports and rates by place of birth, UK, 2000-2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 15 Tuberculosis in the UK: 2013 report

Figure 1.13: Proportion of tuberculosis case reports by site of disease (pulmonary/extra-pulmonary), UK, 2000-2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 16 Tuberculosis in the UK: 2013 report

Table 1.2: Tuberculosis case reports by site of disease, UK, 2012 *With or without disease at another site **Percentage of cases with known sites of disease (8751) ±For Scotland cases, this includes both cryptic and miliary site CNS - Central Nervous System   Total percentage exceeds 100% due to infections at more than one site Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 17 Tuberculosis in the UK: 2013 report

Figure 1.14: Child to adult ratio in notifications rate, UK, 2000-2012 The child-to-adult ratio is the ratio of the case notification rate in children under 15 years of age, to that in adults. A declining trend in the ratio suggests a decrease in ongoing transmission (European Centre for Disease Prevention and Control). Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 18 Tuberculosis in the UK: 2013 report

2. Microscopy, culture confirmation, speciation and drug susceptibility Tuberculosis in the UK: 2013 report

Figure 2.1: Proportion of cases with first line drug resistance or MDR-TB, UK, 2000-2012 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

Table 2.1: Number and proportion of tuberculosis cases with drug resistance by age group, UK, 2012 *First line drugs - isoniazid, rifampicin, ethambutol and pyrazinamide**First line drugs – isoniazid, rifampicin, ethambutol and pyrazinamide **Culture confirmed cases with drug susceptibility results for at least isoniazid and rifampicin Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

Table 2.2: Proportion of tuberculosis cases with drug resistance by previous history of tuberculosis, UK, 2012* * Cases with unknown previous history of tuberculosis are excluded ** First line drugs - isoniazid, rifampicin, ethambutol and pyrazinamide $ Culture confirmed cases with drug susceptibility results for at least isoniazid and rifampicin Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

Table 2.3: Number and proportion of tuberculosis cases with drug resistance by place of birth, UK, 2012* * Cases with unknown previous history of tuberculosis are excluded ** First line drugs - isoniazid, rifampicin, ethambutol and pyrazinamide $ Culture confirmed cases with drug susceptibility results for at least isoniazid and rifampicin Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

Figure 2.2: Proportion of tuberculosis cases isoniazid and multi-drug resistance by place of birth and previous history of tuberculosis, UK, 2012* * Cases with unknown place of birth and unknown previous history of TB are not included Culture confirmed cases with drug susceptibility results for at least isoniazid and rifampicin Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

Figure 2.3: Proportion* of multi-drug resistance cases from Eastern Europe, South Asia and Sub-Saharan Africa with additional resistance, UK, 2012 *Proportion were calculated out of those who were tested Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

3. Strain typing, 2010-2012 Tuberculosis in the UK: 2013 report

Table 3.1: Number and proportion of culture confirmed cases typed or with 23 loci typed by year and country * Culture confirmed cases with a MIRU-VNTR profile with at least 23 complete loci ** Clustered cases are clustered within geographical area $ Calculated using the n-1 method (number of cases in a cluster-number of clusters/number of cases with a strain type) ‡ The number of clusters in England, Wales and Northern Ireland is higher than the sum of all clusters in the three countries because it includes clusters that span more than one country § The number of clusters in England is higher than the sum of all PHEC clusters because it includes clusters that span more than PHEC # The number of culture confirmed cases in Northern Ireland reported here is less than the 157 culture confirmed cases known about locally Source: Enhanced Tuberculosis Surveillance (ETS) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 27 Tuberculosis in the UK: 2013 report

Table 3.2: Number of tuberculosis cases and proportion of clustering stratified by place of birth, 2010-2012 * Culture confirmed cases with a MIRU-VNTR profile with at least 23 complete loci ** Calculated using the n-1 method (number of cases in a cluster-number of clusters/number of cases with a strain type) $ The number of cases in England, Wales and Northern Ireland is higher than the sum UK-born and non UK-born as 583 cases have unknown UK-born information ‡ Number of clusters with at least one UK-born person in the cluster § Number of clusters with at least one non UK-born person in the cluster Source: Enhanced Tuberculosis Surveillance (ETS) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England 28 Tuberculosis in the UK: 2013 report

4. TB treatment outcomes, UK, 2001-2011 Tuberculosis in the UK: 2013 report

Table 4.1: Treatment outcome at 12 months for tuberculosis cases, UK, 2011* * Excludes MDR-TB and RMP-resistant TB cases. Not evaluated includes missing, unknown and transferred out Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

Figure 4.1: Trends in tuberculosis treatment outcomes at 12 months post start of treatment, UK* *Cases who developed MDR or rifampicin resistance while on treatment were not available for years prior to 2010 and will remain in the 12 month treatment outcome cohort for these years. These data were also not available for Scotland. Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

Figure 4.2: Proportion of cases completing treatment by Country and PHE Centre, UK, 2011 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013 Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

Table 4.1: Relationship between tuberculosis diagnosis and cause of death at 12 months, UK, 2011 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Tuberculosis in the UK: 2013 report

Figure 4.3: Treatment outcomes at 12 months for tuberculosis cases by place of birth, UK, 2011 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Annual report on tuberculosis surveillance in the UK 2013

Figure 4.4: Treatment outcomes at 12 months for tuberculosis cases with at least one social risk factor, UK, 2011 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Annual report on tuberculosis surveillance in the UK 2013

Figure 4.5: Treatment outcomes at 12 months for tuberculosis cases with previous history of TB, UK, 2011 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Annual report on tuberculosis surveillance in the UK 2013

Table 4.3: Treatment outcome at 24 months for MDR and rifampicin resistant tuberculosis cases, UK, 2010 Source: Enhanced Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI) Data as at July 2013   Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England Annual report on tuberculosis surveillance in the UK 2013