THE INCREASE IN TUBERCULOSIS NOTIFICATIONS IN ENGLAND AND WALES SINCE1987

Setting: A retrospective study of tuberculosis notifications in Englan d and Wales published by the Office of Population Censuses and Surveys . Objective: To analyse the rise in tuberculosis notifications in Engl and and Wales by different sub groups over the time period 1982-91. De sign: The average annual percentage change in tuberculosis notificatio n rates (per 100 000) for the groups were analysed by age, sex, standa rd region and disease site. Results: The average annual increase in tu berculosis notifications from 1987-91 in females was +2.55 (95% confid ence interval [CI] 0.5-4.7); males showed no significant change (-0.6% , 95% CI: -2.9 to +2.7). The increase was greater in younger subjects: 3.2% in females aged 25-44 (95% CI 0.9-5.5) and 4.3% in males aged 15 -24 (95% CI 1.7-6.9). Only three standard regions showed an increase: the South East, the West Midlands, Yorkshire and Humberside. This incr ease was significant only in females from the South East, and was pred ominantly in non-respiratory tuberculosis. Conclusion: The rise in tub erculosis notification rates from 1987-91 has been predominantly in fe males, in those under 65, has occurred in 3 regions, and predominantly in non-respiratory tuberculosis. The analysis highlights some of the inadequacies of the present notification system for tuberculosis.