Research highlights undiagnosed burden of TB 

24/03/2015 00:00 
International researchers led by UCLH infectious diseases consultant Professor Ali Zumla have highlighted a huge undiagnosed burden of tuberculosis (TB) and called for more proactive screening.

Prof Zumla, whose team recently won the Contribution to World Class Research award at UCLH’s Celebrating Excellence Awards, is also a Professor of Infectious Diseases and International Health at UCL.

Tuesday 24 March is World TB Day, designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of nearly one-and-a-half million people each year.

In two sentinel papers in The Lancet journals the researchers have called for investment into proactive screening and into research into shorter, more effective treatments to reduce the burden of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis.

In an autopsy study of adult inpatients at University Teaching Hospital, Lusaka, Zambia published in Lancet Infectious Diseases, the researchers found TB was the commonest cause of death and that a huge load of TB and multi-drug resistant TB was missed ante-mortem and only diagnosed at autopsy.

These data suggest that current global estimates of TB by the World Health Organisation (WHO) at 9 million people with active tuberculosis in 2013 and 1.5 million people dying of it could be underestimates. The investigators call for a high degree of clinical awareness for diagnosing tuberculosis, and for increased governmental investments into health services for more proactive screening for tuberculosis.

In a paper on TB treatment and management, published in The Lancet Respiratory Medicine, Professor Zumla and international collaborators said treatment success rates of MDR and XDR tuberculosis were unacceptably low and the development of new, more effective tuberculosis drugs and adjunct host-directed therapies to improve treatment outcomes was urgently required.

Public Health Minister Jane Ellison chose World TB Day to see the work of UCLH’s Find & Treat van, a mobile health unit operated across London that helps thousands of vulnerable patients get access to testing for TB, HIV, Hepatitis B and C and other priority public health infections.

The Minister visited the team at the Ace of Clubs homeless centre in Clapham, one of the many venues where Find & Treat works alongside charities like The Hepatitis C Trust ( to provide care where it’s needed in local communities.

Dr Alistair Story, UCLH's clinical lead for Find&Treat, said: “Every case that we detect saves the NHS thousands, and sometimes hundreds of thousands of pounds. The rate of TB in vulnerable groups like those who are homeless is 20 times higher than in the general population, and both they and health professionals find it hard to spot the symptoms – a cough, weight loss and fever. So we take the service to them and offer state of the art point-of-care testing with results on the spot. That we can give patients the right care as quickly as possible and safeguard the health of others by preventing onward transmission.”

To read ‘Tuberculosis treatment and management—an update on treatment regimens, trials, new drugs, and adjunct therapies’ in full click here.

To read ‘Burden of tuberculosis at post mortem in inpatients at a tertiary referral centre in sub-Saharan Africa: a prospective descriptive autopsy study’ in full click here.

Public Health Minister Jane Ellison explains the importance of proactive screening for TB and other diseases in London with UCLH's Find&Treat van

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