APDA, in partnership with Brent PCT and other health service providers, will identify and communicate clearly and comprehensively the framework of patient routes to health sector services for those at risk of and diagnosed with TB.  

Establish a structure that will provide support and assistance to guide patients through the system. This will be essential in order to meet the increasing demand for TB-specific health care and advice.

 Once the provision of the project’s existing 2-year funding stream is complete, APDA will work with other partners within the programme towards establishing an exit/sustainability strategy to allow further development.

The existing information on patient journey and access to TB-related health sector services will be reviewed.

This project will consider ways to improve the current information to identify ways that it can more effectively be used to meet the increasing demand for access to TB services by high risk groups.

The success of this project is dependent on an effective and collaborative partnerships. Key links must be formed between community groups and health sector services (such as the Willesden chest clinic and the Northwick Park chest clinic).

Logical argument for launch of project:

Specific high-risk groups have been identified. International hot spots are South Asia and sub-Saharan Africa. Experts say that one of the causes for the increase in TB cases seen in the UK, and particularly London, is that people come into the country after spending time in a country with high infection rates (Around 60% of the UK's TB cases are people who were born abroad, and were infected before they arrived – source: UK Coalition Website, TB in London). In fact, London has been branded the TB capital of Europe.

TB is also seen in immigrant populations, such as Asylum seekers.

 But most do not have the disease when they arrive in the UK, and develop TB because of the deprivation they live in. Poverty, poor and overcrowded housing and poor diet are contributory factors in the development of tuberculosis (source: Paul Sommerfield, head of action group TB Alert)

HIV patients are also at risk. 

HIV is a virus that attacks the immune system, therefore any other viruses or diseases such as TB that infect the body cannot be combated by the reduced capacity immune system.

TB is classically a disease of poverty. 

A study in 1995 showed that, among the homeless, levels of TB were 200 times higher than in the general population. Retired consultant from the Royal Brompton hospital in London and a former government adviser, Kenneth Citron, said in his opinion, hostels for the homeless could incubate an epidemic. " I think this present government has done a great job getting the homeless off the streets into the hostels, but that may have aggravated things. In these hostels there is an excellent chance for TB to spread. "  TB screening for all people in hostels is strongly advocated.

TB was considered a disease of the past in the UK. 

However, public health professions are now trying to increase awareness among clinical staff of the growing incidence of TB in London in order to increase early diagnosis and treatment.

The UK cannot escape the TB epidemic that is ravaging some of the poorest countries in the world and will have to get better at recognising and treating it. Ian McCartney MP stated in a House of Commons briefing that it took him, a white middle-class man, nine months to convince doctors that he was really ill and not suffering from stress. After treatment for TB, he spent further years trying to get medical help for the painful after-effects caused by scar tissue, and will now be on medication for life. A paper presented to a meeting of the British Thoracic Society showed that more than half the 121 cases of TB that arrived at an accident and emergency department in Newham were not recognised as TB, in spite of symptoms such as coughing up blood.

The Tuberculosis rate has risen by 80% in London over 10 years, to reach 40 cases per 100,000 has raised huge public concern (source: UK Coalition website, TB in London). 

And highlighting the urgent need to significantly improve the accessibility of individuals – particularly those from ‘hard-to-reach’ and socially-excluded groups. The highest TB rates in the UK are in parts of London with high levels of immigration, such as Brent, Newham, Ealing and Hackney. The TB burden in those boroughs is not dissimilar to Russia, China, and Brazil - countries with the highest rates in the world.

For Further Information contact:

Javaid Iqbal / Nitu Tuli

Joint Co-ordinators

Tel. 0800 731 3463

email. apdmcha@aol.com

TUBERCULOSIS HELP LINE

0800 731 3463

Important links:

               Brent HAZ       http://www.brenthaz.org.uk

        TB Alert          http://www.tbalert.org

          Brent PCT      http://www.brentpct.nhs.uk