Key Points

Electronic Reporting

• In the Hauts-de-France region, online reporting of tuberculosis (via the e-DO app) remains low and below the national rate of electronic reporting.

Trends in Tuberculosis Incidence

• A significant decrease in the reporting rate (-22%) was recorded in 2021, likely largely due to the health crisis. This decrease was offset by a renewed increase in the regional rate in 2022.

• The tuberculosis case reporting rate has continued to decline overall over the past 10 years in the region as well as nationally. In 2022, the regional rate was lower than the rates recorded in the years preceding the pandemic.

• At the subregional level, the highest reporting rates are observed in the departments of Nord (5.1 cases per 105 inhabitants) and Oise (6.0 cases per 105).

• The incidence of tuberculosis is twice as high among men.

• It continues to decline after age 40, and half of the cases reported over the past five years involve young adults, with a sharp increase in the number of new cases diagnosed among young people aged 15 to 24.

• Since 2017, reported cases of active tuberculosis have primarily involved highly vulnerable individuals who have recently arrived from areas or countries with high tuberculosis endemicity.

Main clinical and epidemiological characteristics of tuberculosis

• Cases of pulmonary tuberculosis, whether isolated or associated with extrapulmonary sites, remain the vast majority (80%) and are bacilliferous—and therefore contagious (smear-positive or positive microscopic examination)—in half of all cases.

• The incidence of severe forms (meningoencephalitis or miliary tuberculosis) remains low (<5% of cases) and has been stable in recent years.

• Collective housing facilities constitute the communities at highest risk and account for the vast majority of tuberculosis and latent tuberculosis infection cases diagnosed and treated in recent years.

Multidrug Resistance

• The incidence of multidrug-resistant (MDR) tuberculosis cases resistant to the two main first-line antituberculosis drugs (isoniazid and rifampicin) remains low and stable in France and in the Hauts-de-France region.

Treatment Outcomes

• In terms of tuberculosis control performance indicators, information on treatment outcomes remains insufficient (only one in two cases reported).

• Treatment completion rates (>80% since 2018 at the regional level) are higher than in other countries in the European region (73%) and are approaching the treatment success target set by the WHO (85%).

Latent Tuberculosis Infections (LTIs)

• The number of reported LTBI cases in Hauts-de-France increased in 2022.

• The LTI cases identified and treated were primarily young people aged 15 and older who had arrived in France less than two years prior and were living in group housing facilities.