An “immediate and serious long-term political and financial commitment” is needed for TB services to curb the rise of the infectious disease in London, UK, experts warn today.
The English capital has seen more than double the number of cases of the infectious disease since 1999.
Global TB expert Professor Alimuddin Zumla, of University College London, UK, said the UK was only country in Western Europe with rising rates of TB, experts warn today.
In a Comment published Online First in The Lancet, Prof Zumla said there were 9,040 of reported TB cases in 2009, 40 per cent of which were in London. TB was shown to be common in London boroughs experiencing relative deprivation. Cases of drug resistant TB are also increasing in London.
He said the situation was reminiscent of the multi-drug resistant TB outbreaks in prisons in the USA in the 1990s.
He also agreed with the recommendation of the London TB Service Review Assessment, which called for an urgent and radical re-think on delivery of NHS TB Services.
"This review, if implemented by the UK NHS, would allow standardisation of TB clinical policy and practice and improve responsiveness of London’s TB services needs,” said Prof Zumla.
“An immediate and serious long-term political and financial commitment is needed from the UK Government through the NHS if the tide is to be turned against the return of the white plague in London, and if tuberculosis is to be controlled. Such measures will erase London’s reputation as the tuberculosis capital of Europe."
Current detection methods (sputum microscopy and culture) detect only up to 70 per cent of active cases, and it is believed that the number of cases reported is underestimated.
The increase in the number of TB cases seen in the UK has largely been in non-UK born groups; in 2009 these were black African (28 per cent, Indian (27 per cent) and White (ten per cent).
Most were not in new migrants: 85 per cent of cases were in those born overseas but who had lived in the UK for two or more years. About half had lived here for five or more years.
Professor Zumla says: "Poor housing, inadequate ventilation, and overcrowding—conditions prevalent in Victorian Britain—are causes of the higher TB incidence rates in certain London boroughs.”
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