Jessica L Potter

Queen Mary, University of London | QMUL · Centre for Primary Care and Public Health

Using the best available evidence and expert consensus, this document provides guidance for adverse effect monitoring in multidrug-resistant TB (MDR-TB). It includes recommendations for baseline tests, routine drug and toxicity monitoring guides as well as individual drug monographs for all drugs currently available in the UK to treat TB. These rec...

A Race Equality Foundation Briefing Paper June 2018 www.better-health.org.uk Better Health Briefing 44 2 Key Messages 1 Tuberculosis (TB) remains a significant public health issue globally. In the UK, the burden of disease is unequally distributed with immigrant populations and those from black and minority ethnic (BME) groups disproportionately af...

The BTS clinical statement for the diagnosis and management of ocular tuberculosis (TB) draws on the expertise of both TB and and ophthalmic specialists to outline the current understanding of disease pathogenesis, diagnosis and management in adults. Published literature lacks high-quality evidence to inform clinical practice and there is also a pa...

Objectives To characterise and describe the diagnostic utility of Endobronchial Ultrasound-Transbronchial needle aspiration (EBUS-TBNA) in intrathoracic tuberculosis in a cohort of patients with mediastinal lymphadenopathy of unknown aetiology. Methods Consecutive patients with intrathoracic lymphadenopathy undergoing EBUS-TBNA between 2012 and 20...

Background We aimed to retrospectively characterise and describe, in a cohort of patients with mediastinal/hilar lymphadenopathy of unknown aetiology, the diagnostic utility of EBUS-TBNA for the diagnosis of intra-thoracic tuberculosis. The study was conducted at Barts Health NHS Trust which serves a population of 2.6 million in East London which h...

Background In 2017, new regulations in England introduced upfront charging for non-urgent care within the National Health Service (NHS). Individuals from outside the European Economic Area who have not paid the immigration surcharge are chargeable for NHS care at 150% of cost. Methods A freedom of information (FOI) request was sent to 135 acute no...

Background The securitisation of borders against the threat of invading microbes, carried by immigrant bodies, is not a new phenomenon. Tuberculosis (TB), transmitted through coughing, has been a core member of the infectious diseases deemed important to control for more than a century. Following evidence suggesting airport screening for TB using c...

Background: In April 2014 the UK government launched the 'NHS Visitor and Migrant Cost Recovery Programme Implementation Plan' which set out a series of policy changes to recoup costs from 'chargeable' (largely non-UK born) patients. In England, approximately 75% of tuberculosis (TB) cases occur in people born abroad. Delays in TB treatment increa...

Background In April 2014 the UK government launched the ‘NHS Visitor and Migrant Cost Recovery Programme Implementation Plan’ which set out a series of policy changes to recoup costs from ‘chargeable’ (largely non-UK born) patients. In England, approximately 75% of tuberculosis (TB) cases occur in people born abroad. Delays in TB treatment increase...

Introduction and objectives Screening and treatment of migrants to the UK for LTBI is a key component of the TB collaborative strategy in England. The London borough of Newham is a pilot site for the national programme whereby care is delivered entirely within primary care. We sought to identify facilitators and barriers to delivery of care by unde...

Background In April 2014 the UK government launched the ‘NHS Visitor and Migrant Cost Recovery Programme Implementation Plan’ which set out a series of policy changes to recoup costs from ‘chargeable’ (largely non-UK born) patients. In England, approximately 75% of tuberculosis (TB) cases occur in people born abroad. Delays in TB treatment increase...

Objective The NHS Health Check programme is a public screening and prevention initiative in England to detect early signs of cardiovascular ill health among healthy adults. We aimed to explore patient perspectives and experiences of a personalised Risk Report designed to improve cardiovascular risk communication in the NHS Health Check. Design and...

Background In April 2014 the UK government launched the ‘NHS Visitor and Migrant Cost Recovery Programme Implementation Plan’ which set out a series of policy changes to recoup costs from ‘chargeable’ (largely non-UK born) patients. In England, approximately 75% of tuberculosis (TB) cases occur in people born abroad. Delays in TB treatment increase...

Background Not everybody living in or visiting the UK is eligible for free NHS care. Individuals from outside the European Economic Area who have not paid the immigration surcharge are chargeable for NHS care at 150% of cost. In 2017, new regulations introduced upfront charging for non-urgent care. Following this, reports of individuals being denie...

Breast tuberculosis (TB) is rare in Western Europe. This has led to a lack of awareness of the clinical features and consequent delays in diagnosis and treatment. We set out to characterise the clinical features of breast TB amongst a high prevalence UK cohort.

Contact screening in TB: is it time to re-brand? http://thorax.bmj.com/content/73/3/277.responses#contact-screening-in-tb-is-it-time-to-re-brand A comment on "Screening contacts of patients with extra-pulmonary TB for latent TB infection" by Humphries et al

Article published in Open Democracy Patients are dying as politicians use the NHS crisis to undermine what we love most about it – a service for all, free at the point of access, that protects our confidential health data. https://www.opendemocracy.net/uk/jess-potter/is-our-personal-data-fair-game-in-drive-to-create-theresa-may-s-hostile-environm...

Background Ophthalmic manifestations of tuberculosis (TB) are described as inflammatory events in one or both eyes involving the uvea, optic nerve or orbit. The diagnosis is almost always presumptive as mycobacterium are rarely cultured from ocular/periocular tissues. Ocular TB is rare in the developed world and there is a general lack of consensus...

Background In April 2014 the UK government launched the ‘Migrant and Visitor Cost Recovery Programme’ (MVCRP): a series of policy changes to recoup costs from ‘chargeable’ (largely non-UK born) patients. In England approximately 75% of tuberculosis (TB) cases occur in those born abroad. Delays in treatment increase the risk of morbidity and mortali...

New discriminatory NHS policy is bad for your health, whoever you are https://theconversation.com/new-discriminatory-nhs-policy-is-bad-for-your-health-whoever-you-are-84855

With the advent of the World Health Organization End TB strategy, there has been renewed interest in screening for active tuberculosis (TB), and particularly latent tuberculous infection (LTBI). In low-incidence countries, a high proportion of TB cases are notified among migrants, which often occurs due to LTBI reactivation.We aimed to review the e...

OBJECTIVE: To describe characteristics, presentation, time to diagnosis and diagnostic findings of patients with intestinal tuberculosis (ITB) in a low-burden country. METHOD: Retrospective study of 61 consecutive ITB patients diagnosed between 2008-2014 at a large East London hospital. RESULTS: 40 of 61 patients were male. Mean age was 34.6 years....

https://academic.oup.com/jpubhealth/article/39/2/219/3866869/Border-control-in-a-healthcare-setting-is-not-in

If an NHS doctor divulged personal information about a patient, they could be struck off. But the government pays the NHS to do just this. A patient’s name, date of birth and address are among the data which are passed on to the Home Office. If you are in the UK illegally, they can find you and force you onto a secret chartered plane before your la...

Tuberculosis (TB) continues to cause more deaths worldwide than any other single infectious disease. Even though tuberculosis appears to be decreasing in incidence globally for some time, the proportion of drug resistance is increasing, contributing to greater complexity, morbidity and mortality as well as cost. Since the advent of rifampicin in th...

Introduction More than Seventy percent of active Tuberculosis (TB) cases in England are in patients born outside the United Kingdom (UK). Lack of access to primary healthcare is often cited as a barrier to TB control. We considered how patients with TB referred directly to outpatient services initially access healthcare. Method A retrospective coh...

Introduction: Breast tuberculosis (TB) is a rare manifestation of TB. Few case series detailing presentation in a Western population are available. Methods: We conducted a retrospective study of patients treated at our institution for breast TB between 2005–2015. Results: 27 patients with breast TB were identified (all female, mean age=34). 25 pati...

Introduction: Central nervous system (CNS) tuberculosis (TB) is difficult to diagnose. There is often a delay in diagnosis and a lack of robust diagnostic criteria. Methods: We conducted a retrospective study of all patients treated at our institution for CNS TB from 2009–2014 excluding those with HIV co-infection. Data including demographics, symp...

Introduction Breast tuberculosis (TB) is rare and diagnosis may be delayed. It was first described in 1829. Incidence is highest in TB endemic areas. Here we describe a series of cases diagnosed in East London (UK). Methods We conducted a retrospective study of all patients treated at our institution for breast TB between 2005 – 2015. Data includin...

Introduction Central nervous system (CNS) tuberculosis (TB) is difficult to diagnose. There is often a delay in diagnosis and a lack of robust diagnostic criteria. Methods We conducted a retrospective study of all patients treated at our institution for CNS TB from 2009–2014 excluding those with HIV co-infection. Data including demographics, sympto...

Introduction East London has one of the UK’s largest cohorts of Drug Resistant Tuberculosis (DR-TB). This paper aims to provide insight into the recent behaviour of DR-TB in a multi-ethnic urban TB clinic. Methods A retrospective study was conducted on all patients with DR-TB between 2007 and 2013. Statistical analysis was performed using Fisher’s...

Introduction Since July 2014, the London Borough of Newham has offered latent tuberculosis (TB) screening to all recent migrants (residing in the UK less than 5 years), aged 16–50 years, from countries with a TB incidence of greater than 150/100 000 cases/year. All migrants are offered an interferon gamma-release assay (IGRA) when registering with...

To present moxifloxacin as an alternative treatment option to ethambutol in an anti-tubercular therapy (ATT) regime in patients with presumed ocular tuberculosis (TB). We identified all cases in our hospital referred for treatment of presumed ocular TB between 2009 and 2013. Age, gender, ophthalmic examination, blood tests, treatment regimens, adve...

Despite well-established treatment regimens, tuberculosis (TB) remains a public health burden; it disproportionately affects poor and marginalized populations who may not have access to social support, including migrants, homeless people and those dependent on drugs or alcohol. There is a clearly demonstrated need for housing and other appropriate...

Introduction Female genital tuberculosis (TB) is rarely encountered in the UK but early diagnosis and treatment can prevent significant morbidity. Methods We conducted a retrospective study of all patients treated at our institution for female genital TB between 2004 and 2014. Data including demographics, symptoms, microbiological and histological...

Background Screening for viral hepatitis is not routinely recommended in patients diagnosed with tuberculosis (TB). However there are significant similarities in the global distribution of TB and hepatitis B (HBV) and C (HCV). It remains unclear whether co-infection with HBV or HCV is a risk factor for hepatotoxicity in patients receiving anti-tube...

Background The number of patients we are treating for ophthalmic tuberculosis (TB) have increased year on year, from two in 2009 to twenty in 2013. A recent global review of the strategies used in the diagnosis and treatment of ophthalmic TB showed a wide disparity of diagnostic and treatment strategies. We present a review of our current practice...

Background Reactivation of latent tuberculosis infection (LTBI) occurs in a number of at-risk groups including: tuberculosis (TB) contacts, migrants from high prevalence countries and those who are immunosuppressed. The risk of hepatotoxicity in treating LTBI is thought to be low but much of this evidence is in patients treated with 6 months of iso...

A young Bangladeshi woman presented to the emergency department with vaginal discharge on a history of fevers and rigours. Although initially treated for pelvic inflammatory disease, the patient rapidly developed respiratory failure with acute respiratory distress syndrome. An axillary biopsy and a high-resolution CT of the chest confirmed miliary...

Introduction and Objectives Multi-drug resistant tuberculosis (MDR-TB) is a growing concern1. Cost of treatment is ten times that of fully sensitive TB. Treatment regimens are complex and prolonged with risk of serious adverse drug reactions (ADRs). Previously no single guidance in the UK has been available to inform clinicians on what baseline tes...

Introduction Complex treatment strategies are necessary to tackle multi-drug resistant tuberculosis (MDR-TB). Adverse drug reactions (ADRs) are well documented but currently there are very few guidelines for drug monitoring aimed specifically at the durations of treatment used in MDR-TB.1 Methods We retrospectively reviewed all MDR-TB patients see...