Key Points

• In Hauts-de-France, the reported incidence of active tuberculosis has remained stable in recent years, with an incidence of 4.8 cases per 100,000 inhabitants in 2020, which remains below the national average (excluding Île-de-France) and that of many other regions in metropolitan France.

• Disparities in incidence persist at the subregional level, with reported rates in 2020 remaining higher than the regional average in the Nord department (5.6 cases per 100,000 inhabitants) and the Oise department (7.6 cases per 100,000).

• The incidence of the disease is two to three times higher among men aged 15 to 75.

• Over the past 15 years, the incidence of tuberculosis has been steadily declining among those over 40, and nearly half of the cases (46%) reported in the last five years involve people aged 15–39, with a sharp increase in the number of new cases diagnosed among young people aged 15 to 24.

• Over the past ten years, the incidence of tuberculosis among people born abroad has been steadily increasing, and since 2017, the majority of diagnosed cases have been among people born abroad, particularly those from sub-Saharan African countries.

• Among cases born abroad, the proportion of those diagnosed within two years of arriving in France remains the majority.

• Among other at-risk groups—the homeless (6%), those living in group housing (20%), and those working in health and social care professions (8%)—the proportion of cases has remained stable over the past five years.

• Isolated pulmonary forms or those associated with extrapulmonary sites remain the vast majority (73%). Half of pulmonary tuberculosis cases are bacilliferous (smear-positive or positive microscopic examination) at the time of diagnosis. This proportion was slightly higher in 2020 (55%) compared to the 2015–2019 period (49%).

• Severe forms (meningeal or miliary) remain rare (5.7% over the 2015–2020 period), particularly among those under 15 years of age, with 1 to 2 cases diagnosed each year since 2015.

• Over the 2014–2018 period, the treatment outcome was known in fewer than half of cases (48%), and treatment completion rates (77% at the regional level) remain below the WHO target (90%).