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Tuberculosis in England & Wales. Delane Shingadia Senior Lecturer in Paediatric Infectious Diseases Barts and The London. WHO High Prevalence Countries Notifications >40/100 000 population. South Africa. Russia. Brazil. China. TB notification rates per 100,000 population, Europe, 2002.

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tuberculosis in england wales

Tuberculosis in England & Wales

Delane Shingadia

Senior Lecturer in Paediatric Infectious Diseases

Barts and The London

slide9

South Africa

Russia

Brazil

China

rate of tuberculosis per 100 000 population in england excl london london all england 1988 1998
Rate of tuberculosis per 100,000 population in England (excl. London), London & All England, 1988-1998
slide12

Tuberculosis notification rates,

England and Wales, 1982-2001

Sources: Tuberculosis notifications (PHLS/CDSC-NOIDS), population figures (ONS estimates)

tuberculosis case reports and rates by age group and sex england wales and northern ireland 2002
Tuberculosis case reports and rates by age group and sex, England, Wales and Northern Ireland, 2002

Sources: Enhanced Tuberculosis Surveillance, Office for National Statistics mid-year population estimates

tuberculosis rates by place of birth born in the uk vs born abroad england and wales 1999 2002
Tuberculosis rates by place of birth (born in the UK vs. born abroad), England and Wales, 1999 - 2002

Sources: Enhanced Tuberculosis Surveillance, Labour Force Survey population estimates

tuberculosis rates by age group england and wales 1999 2002
Tuberculosis rates by age group, England and Wales, 1999 - 2002

Sources: Enhanced Tuberculosis Surveillance, Office for National Statistics mid-year population estimates

tuberculosis rates in persons born in the uk by age group england and wales 1999 2002
Tuberculosis rates in persons born in the UK by age group, England and Wales, 1999 - 2002

Sources: Enhanced Tuberculosis Surveillance, Labour Force Survey population estimates

tuberculosis rates in persons born abroad by age group england and wales 1999 2002
Tuberculosis rates in persons born abroad by age group, England and Wales, 1999 - 2002

Sources: Enhanced Tuberculosis Surveillance, Labour Force Survey population estimates

tuberculosis case reports by ethnic group england and wales 1999 2002
Tuberculosis case reports by ethnic group (%), England and Wales, 1999 - 2002

Source: Enhanced Tuberculosis Surveillance

slide20

Tuberculosis case report rates

(per 100 000 population), by geographic origin and ethnic group, England and Wales, 1998-2000

England and Wales = 11.2

Sources: Tuberculosis case reports (1998: National TB survey, 1999, 2000: Enhanced TB surveillance), Population figures: (ONS-Labour force survey)

reasons for increase in tb
Reasons for Increase in TB
  • Immigration/Travel
  • Breakdown in TB control
  • HIV infection
  • Multi-drug resistant TB
  • Poverty
  • Overcrowding
  • Incomplete treatment
why are rates of tb in children increasing
Why are rates of TB in children increasing?
  • Parallel increase with overall rates
  • Continued transmission of TB within population
  • Poverty and overcrowding
  • Multidrug resistant TB
  • ? HIV infection
natural history of tb in children
Natural History of TB in Children

No signs/symptoms, negative tuberculin skin test

Exposure

Exposure

Months to years

No signs/symptoms but positive tuberculin skin test

Infection

Signs/symptoms or radiographic evidence of TB

Disease

outcome of primary complex
Outcome of Primary Complex
  • Resolution in the majority of children
  • Lymphadenopathy with bronchial compression
  • Caseation with progressive liquefaction and pleural/pericardial involvement
  • Haematogenous spread to lungs (miliary) and extrapulmonary sites (CNS, bone/joint, renal)
post primary tuberculosis
Post-primary Tuberculosis
  • Adult-type reactivation disease
  • Usually follows infection >7 years age
  • Cavitation and smear positive sputum
why are childhood tb cases important
Why are childhood TB cases important?
  • Children are more likely to develop progressive primary disease rather than reactivation (adult-type) disease
  • Children may develop disease more rapidly
  • Children are more likely to have extra-pulmonary disease and are usually not infectious
  • Childhood TB cases represent a sentinel event in a community suggesting recent transmission, usually from an infectious adult
and now
And now

Has it changed?

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