NDLI: Tuberculosis at the end of the 20th century in England and Wales:results of a national survey in 1998

Content Provider	PubMed Central
Author	Rose, A. Watson, J. Graham, C. Nunn, A. Drobniewski, F. Ormerod, L. Darbyshire, J. Leese, J.
Abstract	BACKGROUND—Anational survey of tuberculosis was conducted in England and Wales in1998 to obtain detailed information on the occurrence of the diseaseand recent trends. This survey also piloted the methodology forenhanced tuberculosis surveillance in England and Wales andinvestigated the prevalence of HIV infection in adults with tuberculosis. METHODS—Clinical anddemographic data for all cases diagnosed during 1998 were obtained,together with microbiological data where available. Annual incidencerates in the population were estimated by age, sex, ethnic group, andgeographical region using denominators from the 1998 Labour ForceSurvey. Incidence rates in different subgroups of the population werecompared with the rates observed in previous surveys. The tuberculosissurvey database for 1998was matched against the Communicable DiseaseSurveillance Centre HIV/AIDS database to estimate the prevalence of HIVco-infection in adult patients with tuberculosis. RESULTS—A total of5658 patients with tuberculosis were included in the survey in Englandand Wales (94% of all formally notified cases during the same period),giving an annual rate of 10.93per 100 000 population (95% CI 10.87 to 10.99). This represented an increase of 11% in the number of casessince the survey in 1993 and 21% since 1988. In many regions casenumbers have remained little changed since 1988, but in London anincrease of 71% was observed. The number of children with tuberculosishas decreased by 10% since 1993. Annual rates of tuberculosis per100 000 population have continued to decline among the whitepopulation (4.38) and those from the Indian subcontinent, although therate for the latter has remained high at 121 per 100 000. Annual ratesper 100 000 have increased in all other ethnic groups, especially among those of black African (210) and Chinese (77.3) origin. Over 50%of all patients were born outside the UK. Recent entrants to the UK hadhigher rates of the disease than those who had been in the country formore than 5 years or who had been born in the UK. An estimated 3.3% ofall adults with tuberculosis were co-infected with HIV. CONCLUSIONS—Theepidemiology of tuberculosis continues to change in England and Walesand the annual number of cases is rising. More than one third of casesnow occur in young adults and rates are particularly high in thoserecently arrived from high prevalence areas of the world. Thegeographical distribution is uneven with urban centres having thehighest rates. The increase in the number of cases in London isparticularly large. Tuberculosis in patients co-infected with HIV makesa small but important contribution to the overall increase,particularly in London. To be most effective and to make the mostefficient use of resources, tuberculosis prevention and controlmeasures must be based on accurate and timely information on theoccurrence of disease. A new system of continuous enhanced tuberculosissurveillance was introduced in 1999, based on the methodology developedin this national survey.
Related Links	http://dx.doi.org/10.1136/thorax.56.3.173
Ending Page	179
Page Count	7
Starting Page	173
File Format	PDF
ISSN	00406376
e-ISSN	14683296
Journal	Thorax
Issue Number	3
Volume Number	56
Language	English
Publisher	BMJ Group
Publisher Date	2001-03-01
Access Restriction	Open
Rights Holder	BMJ Group
Subject Keyword	Pulmonary and Respiratory Medicine Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine

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