Épidémiologie de la tuberculose en France

Tuberculosis remains one of the leading cause of death from infectious disease in the world. Tuberculosis control is one of the Word Health Organisation priority. One third of the population was estimated to be bacillus tuberculosis carrier responsible for 8 million of new tuberculosis cases occuring each year and nearly 2 million deaths. In Europe near 400 000 cases have been declared in 2001 with a west-east gradient in the incidence rate: 11 cases for 100 000 in west european countries, 41 per 100 000 in central european countries and 92 per 100 000 in east european countries. The number of tuberculosis cases decreased in France with an average annual decline of 7.5% between 1972 and 1988. This trend discontinued in 1989. Between 1991 and 1993 the number of reported tuberculosis increased. This excess of cases is attributable partly to HIV infection, but also to worsening in socio-economic conditions. From 1993 to 1997 the number of cases decreases again and the incidence rate is about 11 p. 100 000 and remains stable. In 2002, 6322 cases have been declared in France. There are important geographic differences. The Ile de France region has the highest incidence rate: 27.1 per 100 000. The rates of the other regions are much lower. The infection risk is different according to age, sex and nationality. People over 75 are one of the most affected age group. Children under 15 years of age represent 4.3% of cases with half of these cases before 5 years of age. As in adult, incidence rate of tuberculosis is 11 fold higher in migrants children than in french children. Less than 10 cases of tuberculous meningitis are reported annually under 15 years of age. Since 2003, mandatory notification includes tuberculous infection for children under 15 years of age. Data recorded in mandatory notification might be useful to improve tuberculosis control in France.