Tuberculosis Annual Report for Scotland
2023

About this release​​​​​

This release by Public Health Scotland (PHS) presents national surveillance of tuberculosis and provides information on the numbers, distribution, and characteristics of cases, drug resistance patterns, and treatment outcomes. Please note that data in this report are provisional and may be subject to change as data continues to be received.

Main points

• A total of 283 cases of tuberculosis were reported to the Enhanced Surveillance of Mycobacterial Infections system in 2023, equating to an annual incidence of 5.2 cases per 100,000 population. This is a 40.8% increase when compared with the annual incidence in 2022, 3.7 cases per 100,000 population (201 cases). It is the highest incidence reported in Scotland since 2017.
• Tuberculosis incidence was highest among males in the age groups 25 to 34 years and 35 to 44 years (13.5 and 8.1 cases per 100,000 population, respectively).
• Rates of tuberculosis among children under five years of age increased from 0.2 cases per 100,000 population in 2022 to 2.4 cases per 100,000 population in 2023, as did the ratio of children (under 15 years) to adult incidence (from 0.05 to 0.26). Both measures are accepted indicators of increased tuberculosis transmission.
• In 2023, where place of birth was known, 67.5% of tuberculosis cases in Scotland were born outside of the UK. Tuberculosis incidence in individuals born outside of the UK was 19.2 times higher than in individuals born in the UK. The most reported risk factor for tuberculosis was being a refugee or asylum seeker.
• In non-UK born tuberculosis cases, 71.0% were diagnosed two or more years after arriving in the UK. While this pattern is not fully understood, it could be related to either reactivation of latent infection following entry to the UK, infection within the UK, or frequent travel to countries with a high incidence of tuberculosis.
• The association between tuberculosis and deprivation remains strong with 30.8% of cases reported in 2023 residing in the most deprived Scottish Index of Multiple Deprivation (SIMD) quintile compared with 10.4% of cases in the least deprived quintile.
• An increase in the proportion of cases that present with pulmonary disease is observed; 58.0% in 2023 compared to 49.8% in 2022. Pulmonary disease poses a greater risk of transmission to others.
• To achieve optimal detection of infectious cases and assist the detection of drug resistance, a high proportion of cases should be microbiologically confirmed. In 2023, 82.9% of pulmonary tuberculosis cases were confirmed by culture, a small decrease from 86.0% in 2022, but remaining above the ECDC target of 80%.
• Of the tuberculosis cases reported in 2022*, 82.6% successfully completed treatment by 12 months. ECDC recommend that 85% of cases complete treatment within 12 months. Further work to understand the barriers to treatment completion in Scotland is required.
• In 2022*, 4.0% of cases (8) were reported to have died before completion of treatment compared; down from 6.2% in 2021. This compares to 3.8% in England and 8.2% in the European Union and European Economic Area countries (treatment outcomes reported in 2022 for 2021 cases). This represents the lowest case fatality ratio (CFR) since surveillance began in 2000.
• The proportion of isolates resistant to one drug decreased to 7.2% in 2023 from 10.6% in 2022. Two multi-drug (MDR-TB) resistant isolates were detected in 2023; the same number as 2022.

*Outcomes are reported for cases first notified in 2022, at 12 months.

Further information

The next release of this publication will be October 2025.