Tuberculosis is a disease caused by a bacillus (mycobacteria of the complex tuberculosis) which most often affects the lungs but can also sometimes affect other organs. It is a disease transmissible by air, by dispersion of droplets of bronchial secretions, from a contagious patient, particularly when he coughs. Public Health France monitors tuberculosis in France thanks to the cases notified by the compulsory declaration (via e-do tuberculosis) and publishes the annual data from this monitoring every year. The opportunity to recall that the BCG vaccination of children most at risk of tuberculosis is useful to protect once morest the most serious forms of the disease.
Tuberculosis in France: epidemiological data 2021
On a national level
- 4,306 cases declared, i.e. a declaration rate of 6.4/100,000, compared to 4,606 cases and 6.8 cases/100,000 in 2020, respectively. This incidence has decreased significantly over the past two years, in connection with the Covid-19 pandemic, while it has been falling steadily but weakly for decades, on average -1.7%/year over the past 30 last years.
- Three categories of the population identified as the most affected by the disease and for which control and prevention efforts must focus:
- homeless people (68 cases per 100,000 inhabitants);
- prisoners (44 cases per 100,000 inhabitants).
- people born outside France (32 cases per 100,000 inhabitants);
- Decrease in the number of cases of multidrug-resistant tuberculosis (MDR): 43 cases in 2021 compared to 67 in 2020.
- The modification of the BCG vaccination policy in 2007 and the vaccine shortage of the last six years have not impacted the epidemiology of childhood tuberculosis. Tuberculosis reporting rates in this population group remain very low. The severe forms of children (meningeal or miliary) are stable (11 cases in 2021 once morest 9 in 2020) and in line with the predictions made when the BCG vaccination obligation was suspended.
At regional level
- Territorial and population disparities are comparable to those observed in previous years. There is a heterogeneous distribution of tuberculosis according to regions and populations.
- The highest incidences remain in the same three regions:
- Mayotte (12.0 cases per 100,000 inhabitants);
- Ile-de-France (13.2 cases per 100,000 inhabitants);
- Guyana (25.5 cases per 100,000 inhabitants);
- Ile-de-France accounts for 38% of cases. Seine-Saint Denis is the French department most affected by tuberculosis (24.3 cases per 100,000 inhabitants).
Number of reported cases and reporting rate between 2000 and 2021
Source: OD Tuberculosis; population data: ELP, Insee
Tuberculosis control and prevention
Today in France, the rapid identification of cases of tuberculosis (use of the healthcare system, targeted screening) as well as the treatment of identified latent tuberculosis infections remain the main elements of the fight once morest tuberculosis, supplemented by BCG vaccination (Bacillus of Calmette and Guérin) which protects especially once morest severe forms in children. Vaccination once morest tuberculosis is recommended from the age of 1 month, ideally during the 2nd month, and until the age of 15 years in any child at high risk of tuberculosis. The Centers for the Fight once morest Tuberculosis (CLAT) have an essential role in control and prevention activities, in particular by ensuring the detection of tuberculosis and latent infection among the groups at risk, by conducting contact surveys around cases of tuberculosis, and by contributing to the follow-up and care of patients undergoing anti-tuberculosis treatment.
The missions of Public Health France in the surveillance and fight once morest tuberculosis
- Monitoring the epidemiological evolution of tuberculosis
- To assess the impact of the suspension of mandatory BCG vaccination on the incidence of tuberculosis
- Inform health professionals and the general public regarding BCG vaccination
- Monitor the evolution of vaccination coverage
