The West Midlands had the second highest number of tuberculosis (TB) cases as figures rose in the UK.
The number of TB cases in the UK topped 9,000 in 2009 - the highest for nearly 30 years, figures show.
The Health Protection Agency (HPA) said its figures in the West Midlands region had risen to 1,018, which was 14 more cases than in 2008.
The HPA said regional cases appeared to have stabilised in the region, but effort was still needed.
Dr Jeremy Hawker, regional epidemiologist for the HPA, said: "While the apparent stabilisation of TB cases in the West Midlands is encouraging, the West Midlands still has the highest numbers of new diagnoses after London, and so efforts to control the disease must be kept up."
TB is an infectious bacterial disease of the lungs, causing symptoms such as coughing and chest pains.
Urban areas tend to be the worst affected, with London responsible for nearly half of England's total cases.
In the West Midlands, the number of cases of TB varied widely between primary care trusts (PCTs).
The Heart of Birmingham PCT followed by Sandwell, Birmingham East and North, Wolverhampton and Coventry Teaching PCTs had the highest rates.
The HPA said that in Birmingham TB has been included as a health protection priority "in a bid to tackle and hopefully eliminate the disease".
The HPA said diagnoses across the UK have been rising almost continuously since the 1980s, with many of the new cases thought to be among people who caught the disease abroad.
The total number of UK cases was 9,040 last year, up from just over 8,600 in 2008. Two thirds were among people born outside the UK, mostly in Africa and the Indian sub-continent.
There has also been a sharp rise in drug-resistant TB cases across the country with figures nearly doubling since 2000 to 389.