HEALTH-BRITAIN: High TB Incidence in London

By Sanjay Suri Reprint | | Print |

Sanjay Suri

LONDON, Dec 12 2002 (IPS) - Areas within London have a rate of tuberculosis as high as in several so-called Third World countries, a new survey shows.

The London borough of Brent, the largest local authority area in Europe where about 55 per cent of the population is from the minorities, has an incidence of 116 cases per 100,000 population. "That equals the national rate in China of 113 cases per 100,000," Paul Sommerfeld, chairman of TB Alert told IPS Thursday.

The borough of Newham – also with a large minority population – has 104 cases per 100,000, followed by Hackney in north London with 87.2, Sommerfeld said. "This is at least partially a minority problem," he said.

The national rate in Britain is 13 per 100,000, which is considerably less than the national average of 42 per 100,000 in Portugal and 20 in Spain. But the average for London is 40 per 100,000. London has a population of about seven million.

"About half of all TB cases in Britain are among people from India, Pakistan and Bangladesh," Sommerfeld said. But while these are the largest number of cases, the incidence is rising much faster among immigrants and asylum seekers from Africa, particularly Somalis, he said.

TB Alert is recommending treatment of TB at two levels: an improved medical infrastructure in Britain, and secondly, to support the fight against TB in high burden countries. "We will never be able to control TB in any one place unless we can control it worldwide," Sommerfeld said.

Sommerfeld said at a meeting in the House of Commons organised by the international Stop TB Partnership Wednesday that rates in Britain are at a 10-year high. Rates in London have doubled in 15 years, with about 3,000 TB patients in London now.

That is a tiny fraction of the 3.5 million cases reported worldwide, but British authorities are worried by the rise in the number of cases. TB in Britain has increased by more than 20 per cent in the last decade, Sommerfeld says. The rate rose by 80 per cent in London over that period.

A global snapshot from a study by the World Health Organisation gives the following figures for TB cases per 100,000 people: Zimbabwe – 628, India – 178, China – 113, Romania – 138, and the Russian Federation – 133.

The findings that 60 per cent of cases are acquired abroad and that 17 per cent are among asylum seekers are expected to add fuel to a simmering controversy over migrants. "As people move back to the UK they bring the risk of TB with them," says Dr Peter Davies, founder of TB Alert.

Liam Fox, the Shadow Health Secretary from the opposition Conservative Party, has demanded that the Government introduce TB screening at ports and allow immigrants with the disease into the country only once they had been treated.

Britain has the means to treat TB but not always the skills to diagnose it, the study shows. A large number of patients who attend accident and emergency departments in London with TB are not being diagnosed.

Research at Newham Chest Clinic in east London found that among 243 cases of TB, 121 had previously been to an accident and emergency department and in 61 of these TB was not suspected. Another study at the Middlesex Hospital involving 168 TB cases found 46 patients were seen in the emergency department, but that in a third of the cases, diagnosis of TB was not even considered.

Fifty new cases of TB are now being reported in Britain every day, says the report by TB Alert. But detection is poor despite vivid systems such as high fever and coughing blood, the report says. The report cites language problems as one reason that emergency services are unable to detect TB among immigrants. The report says TB was eventually diagnosed in all the patients studied.

A study by the British Thoracic Society found that Bangladeshi patients with TB were reluctant to talk about symptoms outside their family. The report says a high level of stigma attached to the disease led in eight Bangladeshis to fear that it could affect the patient’s prospects of marriage later.

But TB Alert is warning people that the disease is not confined to the immigrant population. The disease has hit MPs and other mainstream people not expected to suffer it.

HEALTH-BRITAIN: High TB Incidence in London

By Sanjay Suri Reprint | | Print |

Sanjay Suri

LONDON, Dec 12 2002 (IPS) - Areas within London have a rate of tuberculosis as high as in several so-called Third World countries, a new survey shows.
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