Reversing the tide of the UK tuberculosis epidemic

Research Department of Infection and Population Health, University College London, London, UK. Electronic address: .
The Lancet (Impact Factor: 45.22). 10/2013; 382(9901):1311-2. DOI: 10.1016/S0140-6736(13)62113-3
Source: PubMed
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    • "Tuberculosis (TB) was once considered to be a disease of the past in the United Kingdom in the early 1980s and TB services were reduced to a minimum. It was only in the late 1990s that there was a growing awareness about the rising incidence of TB in urban environments in major cities in the UK and Europe [1-3]. Cases of TB are over-represented in socially and economically marginalised groups in high income countries. "
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    ABSTRACT: Background Tuberculosis awareness, grounded in social cognition models of health care seeking behaviour, relies on the ability of individuals to recognise symptoms, assess their risk and access health care (passive case finding). There is scant published research into the health actions of ‘hard-to-reach’ groups with tuberculosis, who represent approximately 17% of the London TB caseload. This study aimed to analyse patients’ knowledge of tuberculosis, their experiences of symptoms and their health care seeking behaviours. Methods Qualitative interviews were conducted with 17 participants, predominantly homeless and attending a major tuberculosis centre in London, UK. Most had complex medical and social needs including drug and alcohol use or immigration problems affecting entitlement to social welfare. Analytical frameworks aimed to reflect the role of broader social structures in shaping individual health actions. Results Although participants demonstrated some knowledge of tuberculosis their awareness of personal risk was low. Symptoms commonly associated with tuberculosis were either not recognised or were attributed to other causes for which participants would not ordinarily seek health care. Many accessed health care by chance and, for some, for health concerns other than tuberculosis. Conclusions Health education, based on increasing awareness of symptoms, may play a limited role in tuberculosis care for populations with complex health and social needs. The findings support the intensification of outreach initiatives to identify groups at risk of tuberculosis and the development of structured care pathways which support people into prompt diagnosis and treatment.
    BMC Public Health 06/2014; 14(1):618. DOI:10.1186/1471-2458-14-618 · 2.26 Impact Factor

  • The Lancet 01/2014; 383(9913):215. DOI:10.1016/S0140-6736(14)60068-4 · 45.22 Impact Factor
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    The Lancet 03/2014; 383(9922):1035-6. DOI:10.1016/S0140-6736(14)60510-9 · 45.22 Impact Factor
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