The challenge of estimating tuberculosis mortality accurately in England and Wales

Maeve Lalor*, T. Mohiyuddin, T. Uddin, Helen Thomas, M. Lipman, C. N.J. Campbell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


B A C K G R O U N D: Accurate estimates of tuberculosis (TB) mortality are required to monitor progress towards the World Health Organization End TB goal of reducing TB deaths by 95% by 2035. We compared TB death data for England and Wales from the national surveillance system (Enhanced Tuberculosis Surveillance System [ETS]) and the vital registration system from the Office for National Statistics (ONS). M E T H O D S: TB cases notified in ETS were matched to deaths in ONS (dONS) with International Classification of Diseases, Tenth Revision (ICD-10) codes indicating that TB caused/contributed to the death (A15-A19). Deaths captured in one but not both systems were assessed to identify if ONS captured all TB deaths and if there was under-notification of TB in ETS. We stratified deaths into active TB, TB sequelae, incidental deaths and not TB. R E S U L T S: Between 2005 and 2015, there were fewer deaths in ETS (dETS) than dONS with ICD-10 codes A15-A19 (n ¼ 4207 vs. n ¼ 6560); 57% of dETS were recorded as dONS and 53% of dONS were notified to ETS. A total of 9289 deaths were identified from dETS and dONS: 64% were due to active TB, 23% were TB sequelae, 6% were incidental and 7% were not TB. C O N C L U S I O N S: TB deaths in ETS and ONS differ substantially. Almost one third of TB deaths recorded by ONS are not due to active TB; this can be amended through coding changes.

Original languageEnglish
Pages (from-to)572-578
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number5
Publication statusPublished - 1 May 2018

Bibliographical note

Funding Information:
This study was supported by Public Health England, London, UK; no external funding was received. Conflicts of interest: none declared.

Publisher Copyright:
© 2018 The Union.


  • Death
  • Outcome
  • TB surveillance
  • Vital registration


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