TB: Tip of the iceberg or a pandemic in the making - again?

<bold>Background:</bold> TB has been around since the cradle of civilisation with curative treatment available for over 78 years. A myriad of public initiatives, DOTS, DOTS +, VOTs and contact tracing, have been instrumental in tackling this scourge. However this downward trajectory may not only be stalling but possibly resurging <bold>Aim:</bold> To compare TB incidence pre- intra and post-COVID pandemic Methodology: Retrospective review of incidence of all new TB cases at a DGH and comparing to national statistics <bold>Results:</bold> TB incidence has doubled in 2023 compared to 2020(Fig 1), which is in line with national and international trends as per some reports (Fig 2). <fig><object-id>erj;64/suppl_68/PA2204/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <fig><object-id>erj;64/suppl_68/PA2204/F2</object-id><object-id>F2</object-id><object-id>F2</object-id><graphic></graphic></fig> Discussion: This may be just the tip of the iceberg or even a loco-regional issue for which several factors may be contributory: 1. Change in ethnic profile of immigration post-COVID and post-Brexit 2. Ineffective occupational health checks pre-employment especially due to pressures of worsening staffing gaps in the NHS 3. Qualitative and quantitative challenges in primary care There needs to be an urgent in-depth exploration of this issue and remedial action implemented before this resurgence potentially becomes another pandemic