Tuberculosis cases continue to rise
Tuberculosis cases in England increased by 7% in the first half of 2023 compared to the same timeframe in 2022.
Data from the UK Health Security Agency (UKHSA) indicates that cases of TB in England increased by 7% in the first half of 2023 compared to the same timeframe in 2022, with 2,408 notifications compared to 2,251 in the first 2 quarters of 2022.
While England remains a low-incidence country for tuberculosis, progress towards elimination has stalled in recent years. Ahead of the United Nations (UN) High Level Meeting on tuberculosis, UKHSA is reminding people that TB is not just a problem for other countries – it is impacting increasing numbers of people in the UK.
‘TB is curable and preventable, but despite significant progress towards elimination in recent years, the disease remains a serious public health issue in the UK,’ said Dr Esther Robinson, Head of the TB Unit at UKHSA.
‘With treatment, most people will make a full recovery. It is very important that those with relevant symptoms are tested for TB and appropriate treatment is started promptly, both for the individual and for the prevention of onward transmission.’
TB notification rates in England remain highest in people who are originally from parts of the world where TB is more common, and those in large urban areas in England which are associated with higher levels of deprivation, and in inclusion health groups – a term used to describe people who are socially excluded and typically experience multiple overlapping risk factors for poor health. This includes those experiencing homelessness or contact with the criminal justice system.
‘As we head into winter, it is important to remember that not every persistent cough, along with a fever, is caused by flu or COVID-19. A cough that usually has mucus and lasts longer than 3 weeks can be caused by a range of other issues, including TB,’ added Dr Robinson.
‘Tuberculosis develops slowly, and it may take several weeks, months or even years after you were infected before you notice you're unwell. Contact your GP if you think you could be at risk so you can get tested and treated.’
‘Abysmal’ lack of testing for lung conditions is a crisis in general practice
Despite being the third biggest killer in the UK, simple tests for common lung conditions are not widely available in general practice, forcing staff to make educated guesses when it comes to diagnosis.
The analysis commissioned by Asthma + Lung UK reveals that the cost of this testing crisis in England alone amounts to an estimated £2.2 billion due to avoidable hospital stays and treatment. Early detection is crucial for treating and managing lung conditions effectively and can help slow down the progression of incurable lung diseases such as chronic obstructive pulmonary disease (COPD), which includes emphysema, or protect people from potentially life-threatening asthma attacks.
‘The barriers GP practices face are huge. These include lack of funding, workforce and training needed to carry out these tests properly and the physical space needed to do them. For people with lung conditions, it means delays to their diagnosis and sometimes progression of their lung disease to more advanced stages which can make treatment more challenging,’ said Dr Andrew Whittamore, Clinical Lead at Asthma + Lung UK.
‘In many areas of the country basic lung function tests are not easy to access. This means many healthcare professionals can't get a full picture of what might be causing someone to cough, wheeze, have frequent chest infections or shortness of breath. The ripple effect of this lack of testing means that patients are more likely to have a delay in their diagnosis or get an incorrect diagnosis leading to them being more seriously unwell.’
Every year, thousands of people with suspected lung conditions across England miss out on tests. The majority of GP practices are not funded to carry out tests that can help diagnose lung conditions, such as asthma and COPD. In contrast, testing for other common conditions, including heart failure, receive ample funding and have well-defined pathways leading to diagnosis.