Black Africans have highest prevalence of tuberculosis in UK
Written by admin on Monday, November 13, 2006 12:53
10.8% increase in TB cases from 2004-5
Article by Robert Short in the BMJ 2006;333:988 (11 November)
The number of cases of tuberculosis in England, Wales, and Northern Ireland rose by 10.8% from 2004 to 2005, the biggest increase in any one year since 1999. The number of cases rose from 7321 to 8113.
The new figures were presented by John Watson, head of the respiratory disease department at the Health Protection Agency.
London alone had 3479 cases in 2005, 43% of the total. The regions with the biggest rises in new cases were the North West, East Midlands, and the East of England. The North East and Northern Ireland saw a fall in the number of cases, while in Wales the number was unchanged.
In 2005 72% of reported cases were among people who were born abroad. A fifth of these cases were among people who had arrived in the United Kingdom in the past two years. Dr Watson said, "This suggests that the increase is not a result of a large number of individuals arriving recently with tuberculosis but rather a combination of tuberculosis disease developing in individuals who may have been infected for some time and new infections acquired in the UK or as a result of travel to other countries where tuberculosis is common."
People of Indian, Pakistani, and Bangladeshi origin accounted for the largest proportion of cases (39%) in 2005, followed by black Africans (25%) and white people (22%).
The ethnic group with the highest prevalence was black Africans (287 cases per 100 000 people), followed by the Indian, Pakistani, and Bangladeshi ethnic group (148 per 100 000).
In 2005 7% of patients with tuberculosis were found to be resistant to isoniazid at the start of their treatment and 0.9% were multidrug resistant. These levels of resistance are unchanged from those in 2004.
John Moore-Gillon, chairman of the joint tuberculosis committee of the British Thoracic Society, the British Lung Foundation, and TB Alert, called for more resources to fight the growth in cases of the disease. He said that although the UK had developed good plans and guidance, resources were needed to implement these plans.
"We still have not got the resources to do the education and outreach work to target the high risk groups," he said.
He added that hospital and radiography facilities needed to be provided as close to people as possible. He said, "Yet there is no talk of increasing the number of tuberculosis clinics in London but of reducing the number on the grounds of economies of scale." He also said that in parts of the UK posts for specialist tuberculosis nurses were being left unfilled to save money. "We have to extend access to support and not reduce it," he said.
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