Tuberculosis: the number of cases increasing in France in 2023

Tuberculose : le nombre de cas en hausse en France en 2023

Après les baisses successives lors des années "Covid", la tuberculose a connu un rebond en France en 2023. Si l’incidence de la maladie reste faible dans le pays, Santé publique France appelle à ne pas relâcher les efforts.

Tuberculosis increased in France in 2023, according to official data which is still provisional. These, according to the weekly bulletin from Public Health France published on March 19, report an increase in cases, with 4,728 cases declared. A rebound after three consecutive years of decline in the number of diagnosed cases.

At issue: successive confinements linked to the Covid-19 pandemic, but also, to a lesser extent, greater difficulty in accessing healthcare structures.

A rising incidence worldwide

The reversal of the trend in 2023 would be linked, according to the authors of the study, "to a catch-up in diagnosed cases" .The reception of Ukrainian refugees may also have influenced the incidence of the disease in France, while in 2021, Ukraine was the second country in Europe where the incidence of the disease tuberculosis was the highest. Active screening for tuberculosis has also been put in place in France and an increase in the number of cases of tuberculosis with multidrug-resistant bacilli was observed after the arrival of infected people from Ukraine and Georgia.

However, the upward trend is observed at the global level. "The World Health Organization (WHO) estimates that approximately 10.6 million individuals will have developed tuberculosis disease in 2022 and especially notes that the number of cases officially declared in the world in 2022 is significantly higher than those of previous years, up 16% compared to 2021 and 28% compared to 2020", specifies the study. Unheard of since the establishment of the tuberculosis surveillance system in the mid-1990s.

Children, particularly at risk

Tuberculosis is an infectious disease caused by bacteria. According to the WHO, 5 to 10% of infected people develop the disease and its symptoms, with babies and children in particular at particular risk. Only people who develop the disease are contagious. The only means of prevention is vaccination. In France, the BCG vaccine is not obligatory but remains strongly recommended in children at risk, helping to reduce serious forms of the disease.

Symptoms are respiratory, with prolonged coughing and sometimes blood and chest pain. Patients also present with intense fatigue (asthenia), weight loss, fever and night sweats. They "will have varying symptoms depending on the part of the body where TB becomes active. Although tuberculosis generally affects the lungs, it also affects the kidneys, brain, spine and skin, further specifies the WHO.

A call to continue the fight against the disease

In France, since the 1970s, the incidence rate has fallen on average by 4.7% per year. This constant decline was, however, interrupted "by limited and transient increases", linked to direct or indirect events such as the war in Ukraine and the reception of refugees.

In this context, Public Health France fears a relaxation of the efforts made for several decades in the fight against tuberculosis in the country. "Tuberculosis remains a tragically relevant disease. The pursuit of an active, dynamic anti-tuberculosis fight that can adapt to the context is therefore crucial. Reaching out to the populations most at risk because they are vulnerable is particularly essential to interrupt the chains of transmission."

In 2022, 10.6 million people will have developed tuberculosis worldwide. 1.3 million people died.