Transcript Slide 1

Tuberculosis in the UK
2014 report
Tables and figures slide set
Tuberculosis case reports and rates, UK, 2004-2013
10,000
15
14
9,000
13
12
11
7,000
10
6,000
9
8
5,000
7
4,000
6
5
3,000
4
2,000
3
2
1,000
1
0
0
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Year
Number of cases
Rate per 100,000
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Rate (per 100, 000)
Number of cases
8,000
Three-year average tuberculosis case rates
by local area*, UK, 2011-2013
*England – Local authorities, Wales and Scotland – Health Boards, NI – Country
level
London
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for
National Statistics (ONS)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health
England
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Tuberculosis in the UK: 2014 report
© Crown copyright and database
rights 2014 Ordnance Survey
100016969
Tuberculosis case reports and rates by country, UK, 2013
Number of Cases
7,000
Number of cases
16
Rate per 100,000
13.5
14
6,000
12
5,000
10
7.3
4,000
8
3,000
4.5
4
2,000
4
1,000
2
0
0
England
Northern Ireland
Scotland
Wales
Country
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Rate (per 100,000)
8,000
Tuberculosis case reports and rates by PHE Centre,
England, 2013
3,500
40
35.5
35
3,000
Rate per 100,000
30
2,500
25
2,000
17.3
20
15.6
1,500
14.3
15
11.2
1,000
9.1
9.5
6.1
6.2
9.2
9.2
10
5.1
500
0
4.8
3.5
5
0
PHE Centre
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Rate (per 100,000)
Number of Cases
Number of cases
Tuberculosis case reports & rates by age group & place of birth,
UK, 2013
1,200
100
1,100
90
1,000
80
70
800
700
60
600
50
500
40
400
30
300
20
200
10
100
0
0
Age group (years)
UK Born
Non-UK Born
Rate in UK Born
Rate in Non-UK Born
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI),Labour Force Survey (LFS)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Rate (per 100,000)
Number of cases
900
Tuberculosis rate in UK born children (0-14 years old),
UK, 2004-2013
4.0
3.5
Rate (per 100,000)
3.0
2.5
2.0
1.5
1.0
0.5
0.0
2004
2005
2006
2007
2008
2009
Year
2010
2011
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
2012
2013
Tuberculosis case reports & rates by place of birth, UK, 2004-2013
98
93
100
91
86
86
84
6,000
84
82
90
81
Number of cases
70
5,000
80
70
60
4,000
50
3,000
40
30
2,000
20
1,000
4
4
4
4
4
4
4
4
4
4
0
0
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Year
UK born
Non-UK born
Rate UK born
Rate Non-UK born
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Labour Force Survey (LFS)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Rate (per 100,000)
7,000
Most frequent countries of birth for non-UK born TB cases, UK, 2013
Country of birth
India
Pakistan
Somalia
Bangladesh
Nepal
Nigeria
Philippines
Zimbabwe
Sri Lanka
Kenya
Romania
Afghanistan
Poland
Eritrea
China
Others (each
<1%)
Total*
Number of cases
Percentage
of cases*
Median time since
entry to UK (IQR)**
1,615
1,103
292
248
170
164
136
105
95
84
70
67
66
62
56
29.8
20.4
5.4
4.6
3.1
3.0
2.5
1.9
1.8
1.6
1.3
1.2
1.2
1.1
1.0
5 (2 -13)
7 (2 -22)
9 (4 -13)
7 (3 -18)
3 (2 -6)
7 (3 -11)
8 (5 -12)
11 (7 -12)
7 (3 -13)
22 (8 -37)
2 (0 -4)
6 (2 -11)
5 (2 -7.5)
4 (2 -7)
7 (4 -11)
1,082
20.0
5 (1 -13)
5,415
100
7 (3 -14)
* Where country of birth was known; **Years
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Time between entry to the UK & TB diagnosis for
non-UK born TB cases by year, UK, 2013
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Office for National Statistics (ONS)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Tuberculosis case reports & rates by ethnic group & place of birth,
England, Wales and Northern Ireland, 2013
350
2,000
Number of cases
286
300
Number of cases
1,500
250
220
200
170
1,000
139
127
150
100
500
61
23
31
61
30
44
38
18
3
50
29
5
10
11
0
UK born
Non-UK born
Place of birth/Ethnic group
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Labour Force Survey (LFS)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Mixed / Other
Chinese
Bangladeshi
Pakistani
Indian
Black-Other
Black-African
Black-Caribbean
White
Mixed / Other
Chinese
Bangladeshi
Pakistani
Indian
Black-Other
Black-African
Black-Caribbean
White
0
Rate (per 100,000)
Rate (per 100,000)
Proportion of TB cases by deprivation quintile residence,
England, 2013
100
90
80
Proportion of TB cases (%)
70
60
50
2,962
40
1,871
30
20
1,006
644
10
427
0
Most deprived
2nd quintile
3rd quintile
4th quintile
Deprivation Quintiles
Least deprived
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI), Index of Multiple Deprivation (IMD 2010)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Proportion of TB case reports by site of disease, UK, 2004-2013
100
Proportion of cases (%)
90
80
70
60
50
40
30
20
10
0
2004
2005
2006
2007
2008
2009
Year
Pulmonary*
2010
2011
Extra-pulmonary only
* With or without extra-pulmonary disease
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
2012
2013
Tuberculosis case reports by site of disease, UK, 2013
Site of disease*
Pulmonary
Extra-thoracic lymph nodes
Unknown extra-pulmonary
Intra-thoracic lymph nodes
Pleural
Other extra-pulmonary
Gastrointestinal
Bone – spine
Bone – other
±
Miliary
CNS – meningitis
Genitourinary
CNS – other
Cryptic
Laryngeal
Number of cases
Percentage**
4,096
1,874
931
916
673
689
432
353
220
52.1
23.9
11.9
11.7
8.6
8.8
5.5
4.5
0.5
211
172
145
129
39
19
2.8
2.7
2.2
1.8
1.6
0.2
*With or without disease at another site
**Percentage of cases with known site 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: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Proportion of TB cases with isoniazid resistance or MDR-TB,
UK, 2004-2013
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Number & proportion of TB cases with drug resistance by age group,
UK, 2013
Age
Group
0-14
15-44
45-65
65+
Isoniazid
resistant
n
%
1
238
66
24
1.6
8.1
6.9
3.7
Multi-drug
resistant
n
%
0
61
11
2
0.0
2.1
1.1
0.3
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Total
n
62
2,931
964
649
Proportion of TB cases with drug resistance by previous history of TB,
UK, 2013
Previous history
of TB
Isoniazid resistant
Multi-drug resistant
n
%
n
%
n
Yes
22
8.8
10
4.0
250
No
293
7.1
59
1.4
4,718
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Total
Tuberculosis in the UK: 2014 report
Most frequent countries of birth of non-UK born TB cases
with drug resistance, UK, 2013
Country*
India
Pakistan
Somalia
Nigeria
Lithuania
Eritrea
Bangladesh
Philippines
Ireland
Nepal
Latvia
Sierra
Leone
Sudan
Ukraine
Total
cases**
n
Isoniazid
resistant
n
%
Multi-drug
resistant
n
%
966
631
179
97
31
39
140
87
22
111
15
76
39
21
8
8
7
12
12
6
5
4
7.9
6.2
11.7
8.2
25.8
17.9
8.6
13.8
27.3
4.5
26.7
23
5
6
2
4
3
1
1
0
1
2
2.4
0.8
3.4
2.1
12.9
7.7
0.7
1.1
0
0.9
13.3
15
3
20.0
2
13.3
28
4
3
3
10.7
75.0
2
2
7.1
50.0
Multi-drug and isoniazid resistant
Isoniazid resistant only
Multi-drug resistant only
* The table shows the top ten countries of birth for the number of isoniazid resistant cases and MDR-TB cases in 2013.
For these countries, the total number of cases and proportions with resistance are shown.
**Culture confirmed cases with DST results for at least isoniazid and rifampicin
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Proportion of culture confirmed TB cases with ≥ 23 loci
typed by country, 2010-2013
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2013 report
Number of TB clusters and proportion clustered by country,
2010-2013
Notified
cases
Culture confirmed
cases
Culture confirmed
cases with a strain
type*
Number of cases with
a unique strain
Number of cases
clustered**
Number of
clusters
n
n
%
n
%
n
%
n
%
n
33,942
20,560
61
16,602
81
7,712
47
8,890
54
1,854
31,350
18,838
60
15,375
82
7,182
47
8,193
53
1,733
Wales
561
390
70
239
61
201
84
38
16
16
Northern Ireland
287
198
69
130
66
98
75
32
25
14
1,744
1,134
65
858
76
594
69
264
31
62
UK
‡
Country
England
Scotland
* Culture confirmed cases with a MIRU-VNTR profile with at least 23 complete loci
** Clustered cases are clustered with each other within the same geographical area
‡ The number of cases clustered in the UK is lower than the sum of all clustered cases in the four countries because it includes clusters that span more than one
country. The number of clusters in the UK is higher than the sum of all clusters in the four countries because it includes clusters that span more than one country.
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Proportion of TB clusters by size, 2010-2013
50
Proportion of clustsers (%)
45
40
35
30
25
20
15
10
5
0
2 cases
3 cases
4 cases
Size of clusters
5-9 cases
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
≥10 cases
Proportion of TB cases that clustered by age and place of birth,
UK, 2010-2013
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Lineage of TB cases with MIRU-VNTR strain types, 2010-2013*
n=4,088
*as determined by MIRU-VNTR
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
n=11,909
Lineage of TB cases with MIRU-VNTR strain types*
by country of birth**, UK, 2010-2013
n=1,910
n=454
n=463
n=271
n=131
n=164
n=173
n=795
n=193
n=193
n=3,397
*as determined by MIRU-VNTR
**top 15 countries of birth by burden of TB in the UK
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
n=333
n=200
n=168
n=366
TB outcome at 12 months for drug sensitive TB cases
with expected treatment duration <12 months*, UK, 2012
Treatment outcome
n
%
Completed
Died
6,438
345
82.8
4.4
Lost to follow-up
Still on treatment
Stopped
Not evaluated**
Total
307
446
79
159
7,774
3.9
5.7
1.0
2.0
* Excludes initial and amplified to rifampicin resistant TB and MDR-TB cases and MDR-TB treated cases and those with CNS, spinal, miliary or cryptic
disseminated TB
** Not evaluated includes missing, unknown and transferred out
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Treatment completion at 12 months for drug sensitive TB cases
with expected treatment duration <12 months*, UK, 2003-2012
90
Proportion of cases (%)
80
70
60
50
40
30
20
10
0
2003
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
* Excludes initial and amplified to rifampicin resistant TB and MDR-TB cases and MDR-TB treated cases and those with CNS, spinal, miliary or cryptic disseminated
TB
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
Time between start of treatment & death for drug sensitive TB cohort*,
UK, 2003-2012
* Excludes initial and amplified to rifampicin resistant TB and MDR-TB cases and MDR-TB treated cases
Source: Enhance Tuberculosis Surveillance (ETS), Enhanced Surveillance of Mycobacterial Infections (ESMI)
Data as at: May 2014. Prepared by: TB Section, Centre for Infectious Disease Surveillance and Control, Public Health England
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Tuberculosis in the UK: 2014 report
TB outcome at 24 months for drug resistant cohort, UK, 2011*
Treatment outcome
n
%
Completed
Died
47
4
48.0
4.1
Lost to follow-up
Still on treatment
Stopped
Not evaluated**
Total
19
22
4
2
98
19.4
22.4
4.1
2.0
*Excludes initial and amplified to rifampicin resistant TB and MDR-TB cases and MDR-TB treatment cases
** Not evaluated includes missing, unknown and transferred out
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Tuberculosis in the UK: 2014 report
Treatment completion for drug resistant TB cases, UK, 2004-2011*
* Includes initial and amplified to rifampicin resistant TB and MDR-TB cases and MDR-TB treatment cases only
Data labels display the number of cases completing treatment
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Tuberculosis in the UK: 2014 report