Agenda item

Mary Hall, Consultant in Public Health, will present a summary of the picture of Tuberculosis in Leicester and actions being taken.

The Public Health Consultant presented an update on Tuberculosis in the City following a development session that looked more closely at the recent increase in TB cases and how to address this. As part of the presentation it was noted that:

·       TB is an infection that mainly affects the lungs. Symptoms are dependent on where in the body is infected but is only infectious when in the lungs.

·       TB can be latent; 5-10% of individuals who have had latent TB will develop active TB.

·       The treatment for TB is very long (6 months) and uncomfortable.

·       Incidence of TB vary across the country but new notifications in Leicester are the second highest in the country.

·      80% of active TB cases in 2022 were in people born outside of the UK.  One quarter of those born in the UK with TB have at least one social risk factor.

·       The highest number of cases in the UK born population was found in those from a white background. The most common countries of birth for non-UK born residents are India, Pakistan, Romania, Bangladesh and Eritrea.

·       Rates of TB have increased since 2018, the largest increase was in 2023.

·      Over 50% cases have been in UK for over 6 years, this means a missed opportunity in the screening programme. Individuals could be screened for inactive TB when they have entered the UK.

·      Latent screening programming uptake has reduced since 2019 and there has been large variation in uptake across the City. Many more cases of latent TB could be identified.

·       The increased rates of TB could be due to changing patterns of migration, delayed diagnosis, lack of uptake of the screening programme, access to the treatment and the treatment itself, stigma within and without communities and social risk factors such homelessness, prison, alcohol and drug use.

To address the rising cases in Leicester, it was noted that:

·       There has been a GIRFT review of which they are awaiting the report.

·       There is also an LLR TB strategy and an audit of the latent TB strategy is being developed as part of an action plan.

·       There is a need to lobby for funding and raising awareness. It needs collective action and the targeting of resources where the greatest need is.

As part of discussions the current contact tracing method was outlined and it was noted that if someone has spent time with someone who had an active case of TB letters were being issued but it was highlighted that treatment is optional. Health partners enquired about what more can be done in their remits to help, and the Public Health Consultant advised this would be addressed in the strategy but suggested more visibility about signs and symptoms, the pathways of treatment and working with GP practises would be beneficial, but the resource constraints faced by the sector was noted. The issue of residential status was also raised as something that may hold people back from seeking treatment in this country.

AGREED:

·       Public Health and ICB Chief Operating Officer to follow up on a more in-depth analysis of communities and ethnicities.

·       An update to be brought to the Board in future.