TB cases rise as NICE calls for early intervention

More than 9,000 cases of TB were reported in the UK in 2011, as NICE launched a blueprint to detect cases earlier among hard-to-reach groups.

TB: still a serious public health issue (Photograph: Du Cane Medical Imaging Ltd/SPL)
TB: still a serious public health issue (Photograph: Du Cane Medical Imaging Ltd/SPL)

Cases rose 5% last year to 9,042, according to Health Protection Agency figures released on Friday. London accounted for 40% of all cases, while three-quarters of all new TB diagnoses were in people born outside the UK.

The figures, released ahead of World TB Day on Saturday, came as NICE published plans for a new approach to identify and manage the disease among people not known to healthcare services.

NICE's guidance will encourage better oversight and commissioning of TB prevention and control.

Commissioners will need to ensure multidisciplinary TB support is available in each area, as well as the provision of rapid-access TB services. It will include improving awareness of the disease among hard-to-reach groups and health professionals.

Hard-to-reach groups include those with drug or alcohol addiction, vulnerable migrants, homeless people and prisoners. These people can all find it difficult to recognise TB symptoms and access diagnostic and treatment services, NICE said.

Professor Mike Kelly, NICE director of public health, said: 'TB is still a serious public health issue, the burden of which falls disproportionately on the most vulnerable groups in our society.'

He said the guidance demanded a 'proactive' approach, such as case-finding among homeless groups using mobile X-ray teams. These were found to be cost-effective in a BMJ study published last year.

Andrew Hayward of University College London, who chaired the team that created the guidance, said: 'Although many people think of TB as a problem of the past, levels of disease are increasing in London and other major cities. The development of multidrug resistant tuberculosis and extremely drug resistant tuberculosis threatens our ability to treat the disease in the future.'

The guidance is aimed at the newly established Public Health England and the NHS Commissioning Board, both of which will assume control of national public health commissioning from April 2013.

One untreated person with pulmonary TB can infect 10-15 people per year, NICE said.

A study in the Lancet last year called on the UK to screen more new immigrants for latent TB as a cost-effective way to reduce rising disease burden.

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