Tuberculosis annual report for Scotland
2024

About this release​​​​​

This annual release by Public Health Scotland (PHS) presents statistics generated from the national surveillance of tuberculosis, providing information on the numbers, distribution, and characteristics of cases, drug resistance patterns, and treatment outcomes. Following the adoption of a new UK wide real-time electronic surveillance system for tuberculosis, this year's report combines data extracted from both former and current systems resulting in minor changes in historical data. These changes do not affect the overall interpretation or conclusions to be drawn from previously published data. Further adaptations may be made to future reports, and we continue to engage with our stakeholders on their production.

Main points

• In 2024, 266 cases of tuberculosis were reported in Scotland, equating to an annual incidence of 4.8 cases per 100,000 population. Whilst this is a 6.0% decrease in case numbers compared to 2023 (283 cases, 5.1 cases per 100,000 population), it is a 33.7% increase since 2022, (199 cases, 3.7 cases per 100,000 population) and a return to levels last observed in Scotland in 2018.
• To meet the WHO ‘End TB’ goal of a 90% reduction in tuberculosis incidence by 2035 in comparison to 2015, an annual average decline of 17.3% is required in Scotland for the next 11 years.

a bar chart showing number of tuberculosis cases reported in Scotland in the Y-axis, from from 2000-2024 in the X-axis. Each bar represents the number of cases for that year. The chart shows that tuberculosis cases have steadily decreased every year since 2010 except for 2021 when the number of cases increased slightly. Meanwhile, in 2023 and 2024 the number of cases increased in comparison to 2022.

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Number of tuberculosis cases in Scotland, 2000 to 2024

• The association between tuberculosis and deprivation remains strong with 37.6% of cases reported in 2024 residing in the most deprived quintile compared with 11.8% of cases in the least deprived quintile The Scottish Index of Multiple Deprivation (SIMD) assists in identifying areas with relatively high levels of deprivation, cases categorised into SIMD quintile according to postcode with SIMD1 being the most deprived and SIMD5 being the least deprived.
• From 2009 to 2024, tuberculosis incidence rate was consistently higher in those resident in SIMD 1 and SIMD 2 in comparison to SIMD 4 and 5. From 2009 to 2022 the SIMD inequalities gap was decreasing. This trend has since reversed, with an increasing gap in 2023 and 2024.
• NHS Greater Glasgow and Clyde continues to account for the majority of notifications (38.7% and an incidence of 8.5 cases per 100,000 population), followed by NHS Lothian (18.8% and an incidence of 5.4 cases per 100,000 population).
• When compared with 2023, increased tuberculosis notifications were observed in NHS Tayside (72.7% increase), NHS Lanarkshire (30.4% increase), NHS Ayrshire and Arran (16.7% increase) and NHS Lothian (13.6% increase).
• Amongst males, the age specific incidence was highest in those aged 25 to 34 years (14.4 cases per 100,000 population) and amongst females it was highest in those aged 35-44 years (7.3 cases per 100,000 population).
• The incidence in those under five years of age was 1.6 cases per 100,000 population which is lower than reported in 2023 (2.4 cases per 100,000 population) but remains higher than 2019 to 2022 (range 0 to 0.8 cases per 100,000 population).
• In 2024, 75.2% of tuberculosis cases in Scotland were born outside of the UK, the highest proportion recorded since surveillance began. Of these, 88.6% were born in countries currently classified as high tuberculosis incidence (>150 cases per 100,000 population) countries. Scotland and the UK has a diverse population with strong connections to several of these high tuberculosis incidence countries, which underscores the importance of effective preventative strategies such as new entrant LTBI testing and treatment.
• Tuberculosis incidence in individuals born outside of the UK was 28.2 times higher than in individuals born in the UK. This is the largest recorded difference, which has widened since 2020 when the incidence in non-UK born individuals was 14.9 times higher.
• In non-UK born tuberculosis cases, 47% were diagnosed within two years of entry into the UK, and 64.9% were diagnosed within 5 years.
• A decrease in the proportion of pulmonary disease cases, which have the highest risk of infecting others, was observed (48.5% in 2024 compared to 58.3% in 2023) which is the is the lowest percentage observed since 2000.
• In 2024, the mean and median time from symptom onset to tuberculosis diagnosis was 157.2 and 91 days, respectively.
• In 2024, 19.9% of cases had a social risk factor or comorbidity recorded. The risk factor most frequently reported was being a refugee or asylum seeker (13.2%), and the most common comorbidity was immunosuppression (6.4%).
• From close contacts of tuberculosis cases assessed, 80 contacts (20.3%) were identified as having latent tuberculosis infection (LTBI) and ten (2.5%) were diagnosed with active tuberculosis.
• In 2024, 72.2% of tuberculosis cases were microbiologically confirmed by culture by the Scottish Mycobacterial Reference Laboratory (SMRL), including 81.4% of pulmonary cases and 63.5% of extra-pulmonary cases. Detection by culture helps confirm infectious cases, assist detection of drug resistance and typing for genetic cluster detection.
• In 2024, resistance to at least one first-line drug at the start of treatment was reported in 6.8% of culture confirmed cases, 84.6% of whom were born outside the UK. One multi-drug (MDR-TB) resistant case was detected and no extensively drug resistant (XDR-TB) cases were reported.
• Of the tuberculosis cases reported in 2023, 84.1% successfully completed treatment by 12 months, a reduction from 86.7% reported in 2022.
• Of the tuberculosis cases reported in 2022, 88.9% successfully completed treatment at 24 months, an improvement from 69.7% reported in 2018.
• Of the tuberculosis cases reported in 2023, 19 (6.7%) were reported to have died. Tuberculosis was recorded as the cause of death or contributing to death in 84.2% of these deaths. The highest proportion of deaths was reported in 2020 (27/219; 12.3%) and has since fluctuated.

Further information

The next release of this publication will be October 2026.