On the occasion of World Day against Tuberculosis, Public Health France (SPF) published its surveillance data on this disease, which reveals a slight resurgence in 2023, but without impact on serious forms.
This increase compared to 2022 is a first from the Pandemic of Covid-19, assures SPF. This increase is around 16.7 % or a total of 4,866 cases declared.
The previous three years, the impact of tuberculosis was down: -10.4 % in 2020, -7 % in 2021, -2.6 % in 2022.
“The trend in 2023 probably reflects, after a regular drop for three years, a return to a pre-Pandemic situation,” notes SPF. However, adds Public Public Health France, there was no significant increase, in 2023, of serious forms (meningers and military): 5.7 % in 2023, against 5.4 % in 2022. Also, adds SPF, fifteen years after the suspension of the BCG vaccination obligation, the number of serious forms in children has not increased: 13 cases in 2023 in children under 15.
“This number remains stable around 10 cases per year for five years and corresponds to the forecasts issued during the suspension of the BCG vaccination obligation”, analyzes SPF. But the number of deaths due to tuberculosis increased, from 22 in 2022, to 30 in 2023, or 0.6 % of cases.
Most affected regions and populations
The most affected regions are “Guyana (24.0/100,000), Île-de-France (14.2/100,000) and Mayotte (12.8/100,000), with declaration rates much higher than the national average”.
The most affected people are homeless, prisoners “as well as people born out of France, especially those from sub-Saharan Africa and those who have arrived in France for less than two years”.
Public Health France also recalls that tuberculosis, but also latent tuberculous infections (ITL) in those under 18, as well as the “exits of treatment of patients with disease tuberculosis” (IDT) are compulsory (DO). “Since 2022, these declarations (TM, ITL and IDT) have been made via the E-DO application. This device simplifies the declaration process and contributes to improving the completeness and quality of the data in relation to declarations in paper form, ”informs Public Health France.
Early screening strategies
For its part, the High Authority for Health (HAS) has recently issued new screening and tuberculosis detection strategies in populations at risk (prisoners, migrants, homeless, drug users, etc.).
“Today in France, we observe the coexistence, on the one hand, of an opportunistic screening, carried out during a medical consultation in the hospital, in the city, in a penitentiary center or proposed to asylum seekers by the French Office of Immigration and Integration (OFII) and, on the other hand, a systematic screening for two types of populations (the detainees entering the regular center and the regular migrants Framework for the OFI -compulsory prevention medical examination) or during a survey around a case, ”notes the HAS. Which also notes a heterogeneity of practices according to departments, structures and target populations. Also, the High Authority for Health offers, to remedy two types of early screening programs.
| Systematic screening |
Opportunistic screening (when using care) |
| Adult or adolescent migrants : entered France for 2 years or less and from a country with an impact ≥ 100/100,000: Adults and adolescents who have made a stay abroad:
Detainees :
Children (2-11 years) and infants (<2 years):
|
Adults or adolescents : or or et |
The HAS recommends raising awareness among health professionals about these two types of early screening.
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