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31.07.12

Less TB screening in areas most at risk

The national programme for tuberculosis screening is not being implemented in those areas where the disease is most prevalent, new research suggests.

The Health Protection Agency (HPA) has admitted that some areas are “failing to prioritise screening” and these are statistically areas where the population is most at risk of developing the disease.

A screening programme was recommended to HPA last year by the National Institute for Health and Clinical Excellence (NICE) after the organisation found that TB was a significant problem in immigrant groups from countries where the disease was prevalent, and that latent infections were not detected by the immigration checks.

Last year, 70% of the 9,000 reported cases of TB in the country were amongst the migrant population. Approximately 80% of cases are thought to be reactivated infections of latent tuberculosis that the screening process protects against. A survey has found that 40% of primary care providers are not implementing the screening, typically in areas with large at risk migrant populations.

Professor Ajit Lavlani of Imperial College London said: “The parts of the UK with the highest burden of TB were exactly those parts doing the least screening for latent TB, so the opposite of what should be the case.

“Those areas with the highest rates are devoting all their resources to the daily burden of treating active TB disease, but what that leaves below the surface is the vast reservoir of latent TB.”

Rates of TB have been steadily increasing over the last 20 years, since the disease was all but wiped out in the UK.

Outside of London, Birmingham has the highest rate of TB cases and was not found to be screening for latent tuberculosis infections. Representatives of the city and its health care providers say that the task is too overwhelming on top of tackling active tuberculosis.

Nicola Benge, Birmingham’s director of public health, commented: “In terms of targeted screening, we are not looking for latent TB, we are looking for TB.

“We do screen groups locally but what we are not able to do is identify all new immigrants at risk, it’s just too difficult.”

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