Official Statistics

National quarterly report of tuberculosis in England: quarter 2, 2025, provisional data

Updated 25 July 2025

Applies to England

Main points

In April to June (quarter 2) of 2025:

• there were 1,469 people notified with tuberculosis (TB), an increase of 2.3% compared with quarter 2 of 2024
• the 3.9% rise in notifications in the first half of 2025 (2,770 individuals) compared with the first half of 2024 (2,665 individuals) is smaller than the year-on-year increases for the first half of each year of 8.7% in 2024 and 9.7% in 2023
• notifications in the first half of 2025 rose in 5 out of 9 UK Health Security (UKHSA) regions, remained stable in 2 regions and declined in 2 regions compared with the equivalent period in 2024
• the regions with the biggest increases in notification numbers were London (85 additional notifications, 9.5% rise) and the East Midlands (58 additional notifications, 32.4% rise)
• the region with the biggest decrease in the first 2 quarters was the West Midlands (61 fewer notifications, 16.9% decrease) compared with the same period in 2024
• from quarter 2 2024 to the end of quarter 1 2025, there was a 13.4% increase in numbers of notifications with multidrug or rifampicin resistance compared with the previous 4 quarters (76 individuals compared with 67 in the preceding period)

Overall numbers and geographical distribution

The number of TB notifications per quarter for the last 3 years for England are shown in Figure 1a and the cumulative number of notifications by month from 2019, in Figure 1b. The number of notifications per quarter by UKHSA region are shown in Figures 2a and 2b. Exact numbers per quarter by UKHSA region and in total are shown in Table 1 of the supplementary dataset. Due to the seasonality of TB notifications, the most recent quarter is compared with the same quarter in the previous year rather than with the previous quarter.

In quarter 2 of 2025, 1,469 people were notified with TB in England. This is similar (2.3% increase) to quarter 2 of 2024 (1,436).

Figure 1a. Number of TB notifications in England, January to March (quarter 1) of 2022 to April to June (quarter 2) of 2025 (Table 1 of the supplementary data set)

Cumulative numbers of notifications by month are shown in Figure 1b. The pre-pandemic year of 2019 is included for reference and the COVID-19 pandemic years of 2020 and 2021 are excluded to allow comparison with the years since.

In 2025, there have been 2,770 notifications, 336 (13.8%) more than at the same time point in the pre-pandemic year of 2019. Note that the number of notifications for quarter 1 of 2025 has increased from 1,266 to 1,301 since the provisional report of quarter 1 data.

Figure 1b. Monthly cumulative number of TB notifications, England. Data from pre-pandemic year, 2019, and between January 2023 to April to June (quarter 2) of 2025 (Table 2 of the supplementary data set)

When analysed by UKHSA region, in quarters 1 and 2 of 2025 compared with quarters 1 and 2 of 2024 the number of people notified with TB:

• increased in the East Midlands (32.4% increase), North East (31.4% increase), South West (10.9% increase), London (9.5% increase) and North West (5.0% increase)
• remained similar in the East of England (4.9% decrease) and Yorkshire and the Humber (0.5% decrease)
• decreased in the South East (5.1% decrease) and West Midlands (16.9% decrease)

Figure 2a. Number of TB notifications in London, England, quarter 1 of 2022 to quarter 2 of 2025 (Table 1 of the supplementary data set)

Figure 2b. Number of TB notifications in UKHSA region, England, quarter 1 of 2022 to quarter 2 of 2025 (Table 1 of the supplementary data set)

Note 1: the axes on the London figure are different to that of the other regions due to the higher number of TB notifications in London.

Note 2: figures are ordered by decreasing total number of people with TB in April to June (quarter 2) of 2025.

Demographic and clinical characteristics

The number of TB notifications by place of birth (where known) is shown in Figure 3, sub-divided by whether the site of disease is pulmonary or non-pulmonary. Pulmonary disease is defined here as disease affecting the lungs and non-pulmonary disease notifications are those without any pulmonary involvement. Note that those with pulmonary disease may also have other sites of disease outside of the lungs.

Figure 3. Number of TB notifications by place of birth and site of disease, England, over the last 8 quarters (Table 3 of the supplementary data set)

Place of birth was not known for 9 notifications in quarter 2 of 2025 and 1 notification in quarter 2 of 2024. Missing data may reflect difficulties in obtaining data (for example, if the individual died or there were language barriers). In quarter 2 of 2025, people born outside of the UK accounted for 81.9% of notifications (1,196 out of 1,460), similar to quarter 2 of 2024 (81.0% (1,163 out of 1,435)). Note that the numbers do not correspond to the total number of notifications due to missing data.

There was no missing data for pulmonary versus non-pulmonary disease. In quarter 2 of 2025, people with pulmonary TB accounted for 48.7% (715 of 1,469) of all people with TB, slightly lower than quarter 2 of 2024 (53.9%, 774 of 1,436). For those born outside the UK, pulmonary disease accounted for 45.2% (540 of 1,196) of all notifications in quarter 2 of 2025 compared with 64.8% (171 of 264) for those born in the UK. This pattern of pulmonary disease being more common in UK-born people is seen in all quarters.

Culture confirmation

The TB action plan 2021 to 2026 Priority 3 workplan (Action 3.3) aims to increase culture confirmation rates by 5% per year with a specific target within the workplan (3.3.2a) to reach the European standard of 80% culture confirmation for pulmonary disease. In quarter 2 (April to June) 2025, the number of notifications with culture confirmation will increase as laboratory results become available. Thus, further comparisons are made between quarter 1 2025 and quarter 1 2024.

Figure 4 shows the proportion of culture confirmed notifications by disease site (pulmonary or non-pulmonary) by quarter.

In quarter 1 of 2025, 60.6% (789 of 1,301) of notifications were culture confirmed. This increased to 73.3% (500 of 682), in those with pulmonary disease. The proportion of individuals with positive cultures in quarter 1 2025 was similar to quarter 1 of 2024. The 80% target of culture confirmation for pulmonary TB disease was reached in none of the last 8 quarters.

Figure 4. Proportion of culture confirmation among TB notifications by site of disease, England, over the 2 years (last 8 quarters) (Table 4 of the supplementary data set)

Figures 5a and 5b show the proportions of culture confirmation for pulmonary and non-pulmonary TB disease notifications by UKHSA regions. No UKHSA regions consistently achieved the 80% target for culture confirmation for pulmonary disease notifications. The highest proportions of culture confirmation for both pulmonary and non-pulmonary disease notifications were in the North East.

Figure 5a. Proportion of culture confirmation among TB notifications in London by site of disease, over the 2 years (last 8 quarters) (Table 5 of the supplementary data set)

Figure 5b. Proportion of culture confirmation among TB notifications by site of disease and UKHSA region, over the last 8 quarters (Table 5 of the supplementary data set)

Multi-drug resistant or rifampicin-resistant TB

Resistance to antimicrobial therapy is a major concern for treatment of TB, historically requiring extended therapy of between 12 to 24 months. New, 6-month regimens have now been recommended by the World Health Organization (WHO) and commissioned by NHS England. All notifications with a positive culture are tested for antimicrobial susceptibility using whole genome sequencing. If a notification does not have a positive culture, no susceptibility results are available.

This report uses the WHO classification of multidrug resistance (MDR) or rifampicin resistance (RR). Multidrug resistance is classified as resistance to at least isoniazid and rifampicin. Figure 6 shows the number of culture- confirmed notifications that are MDR or RR by quarter.

Figure 6. Number of culture confirmed TB notifications with MDR or RR TB at diagnosis, England, over the last 8 quarters (Table 6 of the supplementary data set)

Note: this figure displays numbers rather than proportions due to low numbers of MDR or RR TB notifications.

Numbers of TB notifications with culture confirmed MDR or RR in quarter 2 2025 were lower than the same quarter in 2024 but are likely to increase as laboratory results are finalized. For example, there were 13 MDR or RR notifications in quarter 1 2025, 2 more than previously reported for this quarter. For the 4 quarters to the end of quarter 1 2025, 76 people were reported with MDR or RR TB; this is 13.4% higher than the preceding 4 quarters (67 individuals).

Treatment delays

Treatment delay is the time between the reported symptom onset date and treatment start date. It reflects either delays in individuals seeking or accessing healthcare or delays in diagnosis after presentation, or both. Treatment delays are reported only for pulmonary TB (Figure 7) due to the risk that extended treatment delays may increase transmission within communities. Analysis excludes notifications with a diagnosis made after death (post-mortem).

The joint UKHSA-NHS England 2021 to 2026 TB Action Plan has a target of a 5% reduction per year in the proportion of people with a treatment delay of 4 months or more compared with that in 2021 and 2022 (Action plan 3.1 and 3.2).

Data was missing for a considerable proportion of people due to missing date of onset of symptoms or treatment start date. In quarter 2 of 2025 data was missing for 201 people (28.4%) compared with 156 (20.5%) for quarter 2 of 2024.

In quarter 2 2025, 72.2% of people with pulmonary TB started treatment within 4 months of symptom onset, similar to the 73.3% in quarter 2 2024. This proportion may change due to incomplete data in the latest quarter. Thus, further comparisons are made for the previous quarter compared with the same quarter in the previous year.

Figure 7. Proportion of pulmonary TB notifications starting treatment within 4 months (symptom onset to treatment start), England, over the last 8 quarters (Table 7 of the supplementary data set)

Figures 8a and 8b show the proportion of people starting treatment within 4 months by UKHSA region and quarter. In quarter 1 of 2025 compared with quarter 1 of 2024, the proportion of people with TB who started treatment within 4 months of symptom onset was:

• higher for the East of England, London, North East and Yorkshire and the Humber
• lower for the East Midlands, North West and South West
• similar for the South East and West Midlands

Figure 8a. Proportion of pulmonary TB notifications in London starting treatment within 4 months (symptom onset to treatment start), over the last 8 quarters (Table 8 of the supplementary data set)

Figure 8b. Proportion of pulmonary TB notifications starting treatment within 4 months (symptom onset to treatment start) by UKHSA region, quarter 3 2023 to quarter 2 of 2025 (Table 8 of the supplementary data set)

Treatment outcomes

Treatment outcomes at or before 12 months from start of treatment are reported for people notified up to quarter 2 of 2024 with known or assumed drug-sensitive TB, the majority of whom should have completed treatment within 12 months of treatment start. Data is not presented for those notified after quarter 2 of 2024 as many are not expected to have completed treatment. The data excludes people in the drug-resistant cohort and those with central nervous system (CNS), spinal, miliary or cryptic disseminated TB as treatment time for these groups usually exceeds 12 months.

The joint UKHSA-NHS England 2021 to 2026 TB Action Plan has a target of 90% treatment completion at 12 months by 2026 (Action plan 4.1) in those treated for drug-sensitive TB and expected to complete within 12 months.

Where treatment outcome is reported as not known or transferred to a different country, data is included in the ‘not evaluated’ group. Figure 9a shows outcomes for notifications where treatment is complete, not evaluated or other. The category ‘other’ comprises those who died, were lost to follow-up, are still on treatment (treatment period may be extended beyond 12 months in some cases) or where the treatment was stopped. The proportion of each of these is shown in Figure 9b.

The proportion of people with drug-sensitive TB (with an expected treatment duration of less than 12 months) who completed treatment at 12 months was 74.7% for people notified in quarter 2 2024 compared with 79.6% in quarter 2 2023.

Note that the latest 4 quarters evaluated tend to show a high proportion of people with treatment outcomes recorded as ‘not evaluated’ despite having started at least 12 months previously. This reflects a delay in reporting the final outcome. The proportion not evaluated is expected to decrease with time. For those notified between quarter 3 2022 and quarter 2 2024 the highest proportion of treatment completion was observed in quarter 3 2023 at 80.8%.

Figures 9a and 9b. Outcomes at 12 months for people treated for drug-sensitive TB with expected treatment duration under 12 months, England, quarter 1 (January to March) 2022 to April to June quarter 2 (April to June) 2024 (Table 9 of the supplementary data set)

Figure 9a

Figure 9b

Note 1: excludes people in the drug-resistant cohort and those with CNS, spinal, miliary or cryptic disseminated TB. People included here as drug-sensitive TB notifications include those with known drug sensitivities and those with no information on drug sensitivity or not known to be high-risk for MDR or RR TB and who were therefore not treated as MDR or RR notifications.

Note 2: not evaluated includes unknown and transferred out.

Social risk factors

Social risk factors (SRFs) are reported as categorical yes or no variables with current or past history recorded as yes. Information on these social risk factors is collected through the routine surveillance system via interviews by the clinical team. Social risk factors that are recorded include current or history of prison, drug and alcohol misuse, homelessness, mental health needs and asylum seeker status. Data reported is only for people aged over 15 years due to low numbers in young children.

Figure 10a. Proportion of TB notifications (15 years or older) with at least one social risk factor (SRF), England, over the last 8 quarters (Table 11 of the supplementary data set)

Note: the axes on the figure for people with at least one SRF (Figure 10a) are different to that for individual SRFs (Figure 10b) due to the higher proportion of people with at least one SRF.

In quarter 2 2025, 14.5% of people with TB aged 15 years and older had at least one SRF reported. This is similar to quarter 2 2024 (16.5%).

For single risk factors, shown in Figure 10b, the proportion of people with TB in April to June (quarter 2) of 2025 with:

• alcohol misuse was lower than quarter 2 2024
• asylum seeker status was slightly higher than quarter 2 2024
• current or a history of drug misuse was lower than quarter 2 2024
• current or a history of homelessness was slightly lower than quarter 2 2024
• mental health needs was lower than quarter 2 2024
• current or history of imprisonment was higher than quarter 2 2024

Figure 10b. Proportion of TB notifications (15 years or older) by social risk factor, England, over the 2 years (last 8 quarters) (Table 11 of the supplementary data set)

Data sources and methodology

Data sources and comprehensive methodological information can be found in the Quality and Methodology Information (QMI) report

Background information

This report aims to provide timely and up-to-date figures of important epidemiological indicators to inform ongoing TB control efforts in England.

Note that data for 2024 and 2025 is provisional and subject to validation and should be interpreted with caution. The data used for this report was extracted on 7 July 2025.

This report presents quarterly data on people with tuberculosis (TB) disease notified to the National TB surveillance system (NTBS) in England. Notifications include patients with culture confirmed TB or if a patient has started treatment for TB based on their clinical presentation. It is mandatory to notify cases of TB in the UK within 3 working days of making or suspecting a diagnosis of TB. Find out more about the notification of TB). Most health protection functions are devolved to the other UK nations’ public health teams in the UK, so this report only covers TB notifications and data from England.

Detailed results for data up to the end of 2023 are published in the annual report.

This report aims to provide timely and up-to-date figures of important epidemiological indicators to inform ongoing TB control efforts in England.

TB notifications

People who are diagnosed with TB in England, Wales and Northern Ireland must be notified through the NTBS. This report only includes data for individuals with TB who are resident in England or are treated in England (including individuals who are homeless or visiting from abroad). Individuals with TB are reported by area of residence and by calendar year quarter of notification. UKHSA region was derived from UKHSA region of residence based on individual’s residential postcode. If missing, UKHSA region in which treatment occurred was used, for example if a person had no fixed abode. Data from April to June (quarter 2) of 2025 onwards is provisional and are provisional for treatment outcomes for those notified from April to June (quarter 2) of 2024 onward. Verification and data cleaning and recoding, as conducted for the annual TB report dataset is not yet complete for provisional data.

Culture confirmation

Microbiological culture from biological specimens from persons with suspected disease confirms diagnosis and provides valuable information on antimicrobial susceptibility of TB and possible transmission events between persons notified with TB. It is noted that suitable specimens from children and from non-pulmonary sites are harder to obtain and culture from lower numbers of viable bacteria.

Site of disease

Site of disease is classified as pulmonary and therefore potentially infectious through airborne transmission if disease was recorded in the lungs, larynx or was recorded as miliary (that is, disseminated TB). If none of these sites were recorded, disease is classified as non-pulmonary disease. People can have multiple sites of disease and have pulmonary and non-pulmonary disease sites.

Social risk factors including prison and asylum status

People with TB are reported as having at least one social risk factor (SRF) (‘yes’) if any of the 6 SRFs has ‘yes’ recorded. As a result, the denominator is all notifications. This assumes that people for whom no data was recorded for individual SRFs were a ‘no’ and may result in under-estimation. The 6 SRFs are:

• current alcohol misuse
• current or a history of homelessness
• current or a history of imprisonment
• current drug misuse
• asylum seeker status
• mental health needs

Data for individual social risk factors reported is limited to those with recorded data, for example a ‘yes’ or a ‘no’. As a result, the denominators for these are smaller than all notifications due to missing data. If there is significant under-reporting of SRFs in those with missing data, this should result in a better estimate of the true proportion of the people with each SRF. However, if data is more likely to be recorded if the response is a ‘yes’ this could result in an over-estimates. This may be the case for the asylum seeker SRF.

Mental health needs are recorded by TB case managers and is based on their judgement if mental health concerns are likely to affect the person’s ability to complete treatment.

Alcohol misuse is as recorded by case managers and is based on their judgement if current alcohol misuse is likely to affect treatment.

History of drug misuse, homelessness and prison are self-reported by individuals and are first asked as a ‘yes’ or ‘no’ response, and then asked for additional information on the duration. This is then recorded as either current, within the last 5 years, or more than 5 years ago. Unless indicated otherwise, analyses here present these SRFs as ‘yes’ if a history was recorded, including any duration value (current, within the last 5 years, or more than 5 years ago).

Data for SRFS are reported only for people aged over 15 years due to low numbers in young children.

Treatment delay

Treatment delay is calculated as the days difference between self-reported date of symptom onset and the date treatment started. People with either a missing symptom onset date or treatment start date have no value calculated for treatment delay and are not included in the denominator for the proportion of people with treatment delay.

Treatment outcome

For people expected to complete treatment in 12 months, if no treatment outcome at 12 months was recorded this was recoded as ‘not evaluated’. Hence, the denominator for the proportion of people completing treatment in 12 months includes all people in this group.

Further information and contact details

Feedback and contact information

To provide feedback and for all queries relating to this document, please contact tbunit@ukhsa.gov.uk

Official statistics

Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to. You are welcome to contact us directly by emailing tbunit@ukhsa.gov.uk with any comments about how we meet these standards. Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or via the OSR website.

UKHSA is committed to ensuring that these statistics comply with the Code of Practice for Statistics. This means users can have confidence in the people who produce UKHSA statistics because our statistics are robust, reliable and accurate. Our statistics are regularly reviewed to ensure they support the needs of society for information. They were last formally reviewed internally in spring 2023. Actions following this review have continued to improve the trustworthiness, quality and value of the statistics, including:

• the automation of data processing to improve the accuracy of the statistics
• improved transparency of assessment of data, methods and quality assurance via publication of the accompanying quality and methodology information report
• simplified commentary to better enable users to understand the key messages
• clearer advice on appropriate use of the statistics, including consideration of seasonal trends in the data