Chest doctors and lung and tuberculosis charities have joined together to criticise the UK government for failing to publish a promised TB action plan.
Figures published this week by the British Thoracic Society show that England and Wales are the only countries in the European Union to experience an increase in TB cases over the last ten years, and also show that London has become a TB “hotspot,” with nearly half the UK’s TB cases located in the capital.
Just under 6,900 TB cases were reported in the UK in 2002, and of these 3,000 were located in the capital. The east London boroughs of Tower Hamlets and Newham have a particularly high incidence of TB.
TB was highlighted as a health priority by the UK’s Chief Medical Officer in 2002 and the government promised to publish a TB action plan in response to growing concerns about the increased incidence of the disease in the UK.
Along with PCP, TB is one of the two most common AIDS-defining illnesses in the UK. Approximately 200 cases of TB are diagnosed in HIV-positive individuals each year. In many cases patients were unaware that they were infected with HIV when their TB was diagnosed. The BHIVA Association is preparing guidelines on the treatment of TB in HIV-positive patients. The draft guidelines can be viewed here.
An audit carried out by the British Thoracic Society in 43 areas with a high incidence of TB found that 90% had insufficient staff to cope with the levels of TB they were required to treat.
A lack of TB nurse-specialists in London was particularly highlighted. The British Thoracic Society recommends that there should be one nurse for every 40 TB patients. However, in the capital the number of TB nurses falls dramatically short of this target. “Unless the numbers of TB nurses are increased we will continue to see an inexorable rise in TB cases in London,” said Dr Vas Novelli, a consultant at London’s Great Ormond Street Hospital.
National guidelines on the prevention and treatment are currently being prepared by the National Institute of Clinical Excellence and are expected to be published in early 2005.