Why Are We Failing to Rapidly Diagnose TB in the UK?

30 August 2025

In the last 2 years rates of TB in the UK have increased dramatically, including in traditionally low-incidence regions. The overall TB notification rate for England rose from 8·5 notifications to 9·5 notifications per 100 000 people between 2023 and 2024 (ie, England only just remains below the threshold of 10 notifications per 100 000 people for WHO low-incidence country status).

The current global TB diagnostics standard is to apply molecular diagnostics, typically PCR-derived methods, routinely to sputum and similar pulmonary samples. The National Institute for Health and Care Excellence (NICE) TB guidelines from 2016–2017 recommended rapid diagnostic testing.

A correspondence, published in The Lancet, comments on the failure to apply rapid molecular diagnostic tools to patient specimens routinely in the UK, and emphasizes the urgency for NICE to reinforce this crucial global TB diagnostic message.