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TB poses ‘significant health challenge’ for London

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Tuberculosis is a “significant public health challenge” in London, with rates of the disease in parts of the capital comparable to Iraq, a new report has warned.

The report, published today by the London Assembly, noted that the city accounts for almost 40% of all cases of TB in England.

“If we don’t get a grip on London’s TB situation now, the harder and more expensive it will be to tackle in the years to come”

Onkar Sahota

One third of London boroughs are classed as high incidence by the World Health Organization, meaning some have TB rates comparable with countries like Algeria and Iraq, highlighted the report.

It added that, for over a decade, London has had the dubious title of “TB capital of Western Europe”.

The committee spoke to specialist nurses as part of its investigation, particularly concerning vaccination.

It found evidence that only 24 out of 32 London clinical commissioning groups were offering the BCG vaccination, despite it being recommended for all babies born in the capital.

“This potentially risks the health of children who are born in low incidence boroughs but subsequently move to higher incidence areas,” the report said.

“Selective immunisation policies can also contribute to further stigmatisation of the disease. TB nurses told us that the universal policy is ‘definitely the way forward’,” stated the report.

Public Health England has previously highlighted TB as a particular issue needing urgent attention nationally, and the Queen’s Nursing Institute recently called for better care and vaccination for homeless people.

Dr Onkar Sahota, chair of the health committee and Labour assembly member for Ealing and Hillingdon, said: “We know TB disproportionately affects prisoners, homeless people and people with substance abuse issues, and high quality TB care services are not universally available to all Londoners.

“If we don’t get a grip on London’s TB situation now, the harder and more expensive it will be to tackle in the years to come,” he said. “With pressures on health budgets, we can’t afford to take our eye off the ball.”

The new report also included results from a survey commissioned by the London Assembly’s health committee. The polling company ComRes interviewed 1,006 London adults online between 14-20 August.

“It is astounding that TB is such a prevalent disease in London and that misconceptions about the disease are so common”

Onkar Sahota

It found that one in five Londoners (18%) said that they do not know what the symptoms of TB were, when presented with a list.

Over half of respondents (56%) thought TB was transmitted through spitting – untrue, yet widely believed – and an astonishing 17% of respondents thought it could be transmitted through unprotected sex.

Stigmatisation of TB was widespread – for example, only 30% of Londoners said that they would be happy to spend time with someone who has TB.

Dr Sahota added: “It is astounding that TB is such a prevalent disease in London and that misconceptions about the disease are so common.”

The committee’s report – titled Tackling TB in London – called for better public information, more outreach work and for the Mayor to take a leading role in TB control.

London Assembly health committee

Onkar Sahota

It made a number of recommendations, including that there should be a programme to educate the general public about how TB is spread and its symptoms.

The mayor should also examine the feasibility of using Team London volunteers as TB “health champions” in the community and expand the role of current London TB “ambassadors”.

In addition, the Greater London Authority should consider including TB services as part of its pan-London rough sleeping services.

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Readers' comments (1)

  • I am old enough to remember when TB was common in this country, when everyone had a routine chest x-ray periodically and all 14 year olds were vaccinated at school. I nursed open TB during my training, I especially remember a young boy who drank milk from a non tuberculin tested herd of cows at a private school. The mode of infection and transmission may have altered but the dangers are just as real. Everyone who travels on public transport, everyone who works in the community, in hospitals and schools. Surely now is the time to offer vaccination to everyone.

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