The Health Protection Agency has published its annual report on tuberculosis surveillance in the UK for 2009. Key findings include the following:

• In 2008 in the UK, 8,655 cases of tuberculosis were reported (14.1 per 100,000 population), an increase of 2.2% in the rate of disease compared with 2007.

• The main burden of disease was concentrated in major urban areas; 39% of cases were reported from London, a rate of 44.3 cases per 100,000.

• The majority of cases continue to occur in the non-UK-born (72%) and those aged 15-44 years (61%).

• The rate among the non-UK-born population has declined to 86 per 100,000; most were diagnosed two or more years after entry into the UK (77%). Rates in the UK-born population, at around 4 per 100,000, are not declining.

• The rate in children under five years of age remained stable, at around 5 per 100,000, suggesting recent transmission is occurring in the UK.

• Just over half of all cases were culture-confirmed (56%). Sputum-smear test results were only reported for two-thirds of pulmonary cases, 56% of which were sputum-smear positive. Cases presenting exclusively with extra-pulmonary disease accounted for 45% of all cases.

• The proportion of cases resistant to isoniazid decreased to 6%, while resistance to rifampicin and multi-drug resistance was stable at 1.5% and 1.1%, respectively, all within the recommended levels.

• For the first time, the proportion of patients completing treatment increased (81%) but remained below recommended levels.