UCLH TB van takes centre stage on World TB Day 

24/03/2014 00:00 
A van which is leading the battle against TB among homeless people in London pulled into Parliament today (March 24) to raise awareness of its work.

Beneath the chimes of Big Ben, MPs and other visitors to the Houses of Parliament, were given an insight of the work of the UCLH Find & Treat mobile TB unit on World TB Day.

On the same day, Mayor of London Boris Johnson praised the work of UCLH’s Find & Treat team for its part in helping tackle the spread of TB across the capital.

Parliamentarians from around the world have come together to call for renewed action against the disease. A statement has been signed by over 130 representatives from across the G7 countries and the European Parliament.

Every year over one million people die from a disease that many people consider to have already been eradicated. TB is airborne, infectious, global and increasingly drug-resistant, and yet in the UK, more people associate it with badgers than they do with humans.

Dr Alistair Story, clinical lead for Find & Treat, said: “TB is a disease of poverty and inequality and the highest rates of TB rates and greatest risk of onward transmission is among homeless people, drug or alcohol users, vulnerable migrants and people who have been in prison. Their lifestyle can often mask the symptoms of TB and they have problems accessing hospital based diagnostic services and completing a minimum of six months daily drug treatment.

“London is now the TB capital of Europe and has more cases annually than the Netherlands, Belgium, Greece and Norway combined. TB is curable in virtually all cases and can be effectively controlled provided cases are found early and patients can complete treatment.”

The Mayor of London Boris Johnson said: "The prevalence of TB is higher in London than elsewhere in the UK, with 40% all cases, and is higher that in many other cities around the world. Initiatives like Find & Treat have an important role to play in targeting people who are most at risk of the disease, ensuring they get the treatment they need and helping to reduce the risk of further transmission."

The Find&Treat service was set up in 2007 following an evaluation of a two year pan-London pilot to screen in hostels for homeless people, day centres, community drug and alcohol treatment services and prisons. The evaluation demonstrated that the service was highly effective in identifying cases of TB early but half of all patients referred to hospitals in London for TB treatment were lost to follow up care.

Find&Treat now supports every patient found on the MXU and about 300 other TB cases with complex social problems referred by TB clinics across London. The service screens almost 10,000 homeless and vulnerable adults for TB every year working in partnership with over 200 voluntary and statutory services in every London borough.

 “TB has killed more people than any other infectious disease in history and still kills 1.3 million people every single year. The only way that we’re going to beat the disease is if we have coordinated, global action.

Members of the UK House of Commons and House of Lords make up over half of all the politicians who have signed the statement, reflecting the fact that TB remains a significant problem here in the UK. Parts of the country have rates to match those found in some of the worst affected countries in the world, and London has the highest rates of any capital city in Western Europe.

Virendra Sharma, MP for Ealing Southall and co-chair of the All Party Parliamentary Group on Global TB, said: "The Find&Treat service is a vital resource in tackling TB on the streets of London. People often think that it’s a disease that is only a problem in other countries, but it’s a problem right here in the UK as well. In a global context we might not have many cases every year, but the treatment is extremely long and arduous, every single case is a life turned upside down.”

Dr Yvonne Doyle, regional director for PHE London, said: “Controlling the spread of TB must remain a public health priority for London where the rates are substantially higher than New York and most European cities. This is why Public Health England is calling for a concerted effort to significantly reduce the level of TB in London in the coming years. A London TB Control Board with representation from all agencies involved in preventing, controlling and treating TB, has set a goal of a 50% reduction in the TB rate in London by 2018. A strengthened London leadership can see change start to happen.

“Preventing transmission will be key to reducing TB in London and there is a need for focused commissioning and continuous monitoring of service quality. We must focus on prompt identification of active cases of disease, supporting patients to successfully complete treatment and achieving 100% contact tracing. We support the work of dedicated outreach services in London such as Find and Treat who specifically target those most in need of screening and treatment.”

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