Tuberculosis: An Overview of the Disease

Tuberculosis is a disease caused by a bacillus (mycobacterium of the tuberculosis complex) that most commonly affects the lungs but can sometimes affect other organs as well. It is an airborne disease transmitted through the dispersion of droplets of bronchial secretions from an infectious patient, particularly when they cough. Tuberculosis has been a reportable disease since 1964.

Today in France, the rapid identification of tuberculosis cases (investigation, targeted screening) as well as the treatment of identified latent tuberculosis infections remain the main components of the fight against tuberculosis, supplemented by BCG (Bacille Calmette-Guérin) vaccination, which primarily protects against severe forms of the disease in children.

Tuberculosis in France: Key Figures and Results for 2020

Nationally

• In 2020, 4,606 cases of tuberculosis were reported, representing a case rate of 6.8 per 100,000, compared to 5,116 cases and 7.6 cases per 100,000 in 2019. This incidence has been steadily declining for decades, but the annual decline is small, averaging -1.7% per year over the past 30 years.

• Three population groups have been identified as the most affected by the disease and on which control and prevention efforts should focus:

  • homeless people (170 cases per 100,000 inhabitants);

  • people born outside France (34 cases per 100,000 inhabitants);

  • prisoners (64 cases per 100,000 inhabitants).

• Decrease in the number of multidrug-resistant tuberculosis cases: 67 cases in 2020 compared to 75 in 2019.

• The change in BCG vaccination policy in 2007 and the vaccine shortage over the past six years have not impacted the epidemiology of childhood tuberculosis. Tuberculosis reporting rates in this population group remain very low. Severe forms of the disease in children (meningeal or miliary) are stable (9 cases in 2020 compared to 10 in 2019) and consistent with predictions made when the mandatory BCG vaccination was suspended.

At the regional level

• Geographical and population-based disparities are comparable to those observed in previous years. There is a heterogeneous distribution of tuberculosis across regions and populations.

• The highest incidence rates remain in three regions:

  • French Guiana (22.5 cases per 100,000 inhabitants)

  • Mayotte (15.1 cases per 100,000 inhabitants)

  • Île-de-France (14.3 cases per 100,000 inhabitants)

The Ile-de-France region accounts for 38% of cases. Seine-Saint-Denis is the French department most affected by tuberculosis (23.8 cases per 100,000 inhabitants).