Further evidence supporting programmatic screening for, and treatment of latent TB Infection (LTBI) in new entrants to the UK from high TB prevalence countries
- 1Chest Clinic, Royal Blackburn Hospital, Blackburn, Lancs, UK
- 2Lancashire Postgraduate School of Medicine, University of Central Lancs, Preston, Lancs, UK
- 3University of Manchester, Manchester, UK
- Correspondence to Professor Lawrence Peter Ormerod, Department of Chest Clinic, Royal Blackburn Hospital, Blackburn, Lancs BB2 7AE, UK
- Received 7 August 2012
- Accepted 21 August 2012
- Published Online First 19 September 2012
A systematic comparison of tuberculosis (TB) cases and rates between the USA and E&W (England and Wales), shows diametrically opposed trends. Between 1993 and 2010 in the USA, active TB cases fell from 25 107 to 11 182,1 a fall of 55%. By contrast in E&W, notified TB cases rose from 5104 in 19932 ,3 to 7901 in 2010,4 an increase of 55%.
Case management is not the explanation for the difference, as both countries use rifampicin and isoniazid based 6-month short course chemotherapy, with high completion rates, 92.7% for the USA1 and 83.6% of survivors in E&W.4 Equally, different BCG policies do not account for the difference as the USA has never used BCG as a health control measure.
Both countries now have a majority of TB cases in foreign-born …