2.1 Case notifications

Tuberculosis (TB) case notifications refer to people diagnosed with TB disease and officially reported as a case to national authorities. Case notification data have been systematically collected at national level and then reported to WHO on an annual basis since the mid-1990s, based on standard case definitions and associated guidance on the recording and reporting of data provided by WHO. The most recent WHO guidance was published in 2024 (1).

Globally in 2025, 8.4 million people were diagnosed with a new episode of TB (also referred to as new and recurrent cases) and notified (Table 2.1.1). Of these, 83% had pulmonary TB and 17% had extrapulmonary TB. Three WHO regions accounted for 87% of total notifications: the African Region (24%), South-East Asia Region (38%) and Western Pacific Region (26%). In 113 countries that accounted for 85% of global notifications, 23% of people newly diagnosed with TB were reported to have been detected through screening (for further details, see Section 3).

Table 2.1.1 Case notifications of people diagnosed with TB and RR-TB, globally and for WHO regions, 2025

The annual numbers of people newly diagnosed with TB have plateaued since 2023. The 8.4 million people newly diagnosed with TB and notified as a TB case in 2025 was a small increase from 8.3 million in 2024 and 8.2 million in 2023, following the large increases that occurred between 2021 and 2023 as countries recovered from major COVID-related disruptions to TB diagnosis and treatment in 2020 (Fig. 2.1.1).

Fig. 2.1.1 Global trend in case notifications of people newly diagnosed with TB, 2010–2025

Trends in case notifications vary among the six WHO regions (Fig. 2.1.2). Patterns in the Region of the Americas and the Eastern Mediterranean, South-East Asia and Western Pacific regions were similar, with a marked drop in 2020 followed by a post-COVID recovery up to 2023 and then either a flat or declining trend; the South-East Asia Region was the strongest influence on the global trend. In the African Region, notifications fell only slightly in 2020 and subsequently increased year on year; in 2025, the reported number of people newly diagnosed with TB in the African Region was 43% above the level of 2019. In the European Region, notifications fell more sharply than the historic trend in 2020, increased in 2021 and 2022 and then resumed a decline consistent with the pre-COVID trend.

Fig. 2.1.2 Regional trends in case notifications of people newly diagnosed with TB, 2010–2025

In most of the 30 high TB burden countries and 2 global TB watchlist countries, case notifications fell in 2020 and have subsequently recovered to the pre-COVID level or beyond (Fig. 2.1.3). In some of these countries, notifications fell between 2024 and 2025: the most pronounced declines were in Cambodia, Kenya, Myanmar, the Philippines and Uganda.

Exceptions to this general pattern include:

• the Central African Republic, the Democratic Republic of the Congo, Nigeria and the United Republic of Tanzania, where notifications increased throughout the period 2019–2025;
• China, the Democratic People’s Republic of Korea and Mongolia, where there has been a sustained long-term decline; and
• Ethiopia, where a relatively consistent decline until 2021 has been reversed, possibly as a result of active case finding efforts, with the number of notifications in 2025 comparable to 2010.

Fig. 2.1.3 Case notifications of people newly diagnosed with TB in the 30 high TB burden and 2 global TB watchlist countries, 2010–2025^a

Most notified cases of TB are among adults (Fig. 2.1.4). Of the global total of people notified as a new or recurrent TB case in 2025, 56% were men, 36% were women and 7.8% were children aged 0–14 years (the age groups related to children for which WHO routinely collects data are 0–4 and 5–14 years; it is recognized that the second category includes young adolescents). For the remainder, either age or sex were unknown. In general, notification data appear to understate the share of the total TB disease burden that is accounted for by men, since higher male to female ratios among adults have been found in national TB prevalence surveys (Section 1.4). The drop in case notifications between 2019 and 2020 and subsequent recovery was similar for men and women, while both the drop in 2020 and subsequent recovery were more pronounced for children. In contrast to adults, notifications among children fell between 2023 and 2025.

Fig. 2.1.4 Global trend in case notifications of people newly diagnosed with TB disaggregated by age and sex, 2013–2025^a

Although the global proportion of notified cases accounted for by children aged 0–14 years has been relatively stable (7–8% of total notifications) (Fig. 2.1.4 above), there is considerable variation at country level (Fig. 2.1.5 below). Among the 30 high burden countries, those with particularly low levels (approximately 5% or less) included Bangladesh, Brazil, China, the Democratic People’s Republic of Korea, India, Thailand and Viet Nam.

There are recognized issues with the diagnosis and reporting of TB in children, including the use of variable case definitions and underreporting of cases diagnosed by paediatricians in the public and private sectors. Greater attention to the quality of TB notification data for children is warranted in many countries.

Fig. 2.1.5 Percentage of people notified as a new or recurrent case of TB who were aged 0–14 years,^a by country, 2025

There is also considerable country variation in the proportion of notified cases diagnosed with extrapulmonary TB (Fig. 2.1.6). This may reflect underlying differences in TB epidemiology as well as diagnostic practices.

Among the 30 high TB burden and 2 global TB watchlist countries, the share of case notifications accounted for by people diagnosed with extrapulmonary TB was particularly high (>20%) in Bangladesh, Cambodia, Ethiopia, India, Liberia, Mongolia, Pakistan and Papua New Guinea. Even higher proportions were reported in some other parts of the world, particularly by countries in the WHO European and Eastern Mediterranean regions.

Fig. 2.1.6 Percentage of people notified as a new or recurrent case of TB who were diagnosed with extrapulmonary TB, by country, 2025

There is striking country variation in the distribution of TB case notifications according to country of origin (Fig. 2.1.7). In several countries with a low incidence of TB (Section 1.1), more than 75% of notified cases were among people of foreign origin.

Fig. 2.1.7 Percentage of people notified as a TB case (new, recurrent or re-registered^a for treatment) who were of foreign origin, by country, 2025

People housed in prisons or congregate settings have a high risk of developing TB and of having poorer TB treatment outcomes than the general population. Prisons can exacerbate ill health: for example, if there is chronic lack of investment in the justice sector, contraventions of human rights, low prioritization of health and harm reduction services in prisons, and an absence of other justice-based alternatives to incarceration. The physical infrastructure of prisons, including the risk of overcrowding and the frequent movement of prisoners, can increase the risk of transmitting airborne diseases such as TB.

Data about the number of people notified as a new or recurrent case of TB who were registered in prisons have been collected from all countries in the WHO European Region since 2014 and from all countries in the Region of the Americas since 2018. Data have been requested from all countries and areas (n=215) since 2023. In 2025, 148 countries and areas reported data. These data reveal considerable country variation in the percentage of people notified as a new and recurrent case of TB who were registered in prisons (Fig. 2.1.8), with the highest percentages in countries and areas in the Region of the Americas.

Fig. 2.1.8 Percentage of people notified as a new and recurrent case of TB who were registered in prisons, by country, 2025

Engagement of all care providers in the public and private sectors through public–private and public–public mix (PPM) initiatives can help to minimize the underreporting of people diagnosed with TB. Since 2015, the contribution of such PPM initiatives to total notifications has grown in most of the 7 countries defined as top global priorities for PPM (Fig. 2.1.9). Three countries have reported sizeable increases in the number of people diagnosed with TB through public–private mix initiatives since 2012: India, Indonesia and Pakistan.

Fig. 2.1.9 Contribution of public-private^a mix and public-public^b mix initiatives to case notifications of people diagnosed with TB in 7 global priority countries, 2010–2025

There is considerable country variation in the percentage of people notified as a TB case by public-private mix and public-public initiatives (Fig. 2.1.10).

Fig. 2.1.10 Percentage of people notified as a TB case by public-private^a mix and public-public^b initiatives, by country,^c 2025

a) Public-private mix initiatives

b) Public-public mix initiatives

Case-based digital surveillance systems enable timely reporting and use of TB data; their main advantages are highlighted in the latest WHO guidance on TB surveillance (1). In 2024, 129 countries and areas that collectively accounted for 68% of officially notified TB cases were using a case-based digital surveillance system that covered all people diagnosed with TB (Fig. 2.1.11). This was similar to the level of 2023, when 134 countries and areas that collectively accounted for 69% of officially notified TB cases were using such systems. Acceleration of progress in making the transition from paper-based reporting of aggregated TB data to case-based digital TB surveillance is particularly needed in the WHO African Region.

Fig. 2.1.11 Countries with national case-based digital surveillance systems for TB, 2024^a

Further country-specific details about TB case notifications are available in the country profiles of the Global tuberculosis report app.

Data shown on this webpage are as of 25 August 2026 (see Annex 2 of the core report document for more details).

Reference

1. Consolidated guidance on tuberculosis data generation and use: module 1: tuberculosis surveillance. Geneva: World Health Organization; 2024 (https://iris.who.int/handle/10665/376612). License: CC BY-NC-SA 3.0 IGO.

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