Introduction The prevalence of tuberculosis is rising. Data on monitoring of bacillus Calmette–Guérin (BCG) coverage in target groups is important but often lacking. In areas of high prevalence, BCG coverage is high. This audit was done to assess BCG coverage in babies born in a low-prevalence area. In the UK, neonatal BCG is offered to infants living in areas with tuberculosis incidence greater than 40/100 000; if parents/grandparents were born in a country with a tuberculosis incidence of more than 40/100 000; contacts of known cases; if intending to live in high-prevalence countries.

Methods North Yorkshire is a low-prevalence area (2.8 per 100 000 in 2006) for tuberculosis. The need for BCG is identified antenatally by the booking midwife. We reassessed the risk by interviewing mothers in the postnatal ward at Harrogate District Hospital. Booking notes were reviewed.

Results Between 2 and 15 July 2006, 60 mothers were interviewed. 78.2% of pregnancies were assessed antenatally for BCG. 10% of babies would have needed BCG as their mothers or grandparents were born in high-risk countries. The antenatal clinic had correctly identified only 50% of at-risk babies. Those missed were white ethnicity (100%), not assessed about tuberculosis risk (46.66%), wrongly assessed (33.3%), parents were born in high incidence countries (66.6%) or spent a significant amount of time in high incidence countries (33.3%).

Conclusion In a low-prevalence area, 10% of babies need BCG. Only half are being identified. Parents’ birth in high incidence countries and time spent in high incidence countries should be considered.