Tuberculosis in London is rising

doi:10.1136/bmj.334.7593.560

BMJ 2007;334:560 (17 March), doi:10.1136/bmj.334.7593.560

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Tuberculosis in London is rising

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The rate of tuberculosis notifications has doubled in Londonsince the late 1980s, from about 20 cases per 100 000 personsin 1987 to 41.3 cases per 100 000 persons in 2003. The capitalaccounts for 45% of the total UK burden of tuberculosis; 86%of people with tuberculosis in London are non-white, and threequarters are born abroad. The highest rate—283/100 000—isin black African people. Hospitals report coinfection with HIVof 17-25%. Multidrug resistant tuberculosis accounts for about2% of cases.

The authors propose screening residents of hostels for refugees,asylum seekers, and homeless people; improved access to primarycare; and better diagnosis of coinfection. They also emphasisethe need for treatment continuity and completion, as recommendedby recently published guidelines from the UK National Institutefor Health and Clinical Excellence.

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