An alarming new study has highlighted the hidden tragedy of undiagnosed tuberculosis (TB) in England. Shockingly, it's estimated that one person every week dies with untreated TB, often without their loved ones even suspecting they had the disease.
Researchers from Liverpool University Hospitals NHS Foundation Trust and the Liverpool School of Tropical Medicine conducted a study published in Thorax, revealing a stark contrast between those diagnosed postmortem and the general TB patient population. While most cases in England are diagnosed in individuals born outside the UK, averaging 36 years old, those found to have TB after death tended to be older British-born men. This suggests that healthcare professionals might be overlooking the possibility of TB in patients who don't fit typical risk profiles.
The study also identified other high-risk groups for postmortem diagnosis, including children under four and individuals living outside London with a history of substance misuse. Young children's vulnerability may stem from underdeveloped immune systems, non-specific symptoms that mimic common childhood illnesses, and difficulties in obtaining suitable samples for testing. For older British-born men, the lack of suspicion for TB could lead to crucial delays in diagnosis and treatment.
Tuberculosis rates in England have reached a 10-year high, with 9.4 cases per 100,000 people in 2024 – just below the World Health Organisation's 'low incidence country' threshold of 10 cases per 100,000. Globally, TB remains the leading infectious disease killer, resulting in 1.23 million deaths and an estimated 10.7 million new infections in 2024. Despite its severity, TB is both preventable and treatable with specific antibiotics, and recent medical advancements have significantly shortened treatment durations.
Lead researcher Dr Tom Wingfield advocates for treating postmortem TB diagnoses as a 'never event', prompting investigations similar to those triggered by superbug-related deaths. This could help identify missed opportunities and prevent future avoidable deaths. Co-author Dr Paul Cleary, consultant epidemiologist at the UK Health Security Agency, notes that while data can't determine if TB was the direct cause of death, any postmortem diagnosis represents a missed chance for early identification, treatment, and prevention of transmission.
The study's findings are peer-reviewed and underscore the need for enhanced awareness among healthcare professionals to identify potential cases of undiagnosed TB.