Resurgence of tuberculosis in an inner-city general practice in the United Kingdom

Abstract

Background: Our Practice is an innercity practice with a total of 11,900 registered patients and 60-70% of our patients are of south Asian origin. We all felt that the number of patients being diagnosed with TB had increased considerably over the last 10 years. We thought it would be good to consolidate the figures and shed light on this infectious disease. Methods & Materials: Retrospective audit using the search feature on system one. Our search criteria included all the reed codes for TB in the last ten years. Results: The incidence of TB is certainly higher than the UK figures. 57 in 100,000 compared to 13.8 in 100,000.Majority of people affected are between the ages of 21 and 60.People of Pakistani and African-Caribbean descent are the most infected. A lot of patients gave no history of being in contact with TB. Cough, cervical lymphadenopathy and chest pain remain the most common occurring symptoms. Every individual presenting with cough for more than 6 weeks should be considered high risk. TB should be ruled out along with Asthma, GORD & COPD taking the clinical picture into consideration. The trend shows either patients tend to get diagnosed with in the first 3 months or 9 months after they first present. It is worrying and maybe we need to look at why between the months of 3 and 9 we are not diagnosing more patients. In the primary care setting, Chest X-ray and T-SPOT testing remain the most useful investigations in detecting TB. Sputum cultures have a roll and should also be routinely undertaken. Conclusion: A lot of patients gave no history of being in contact with TB. This shows history taking can be unreliable sometimes and especially when asking for TB as it is still considered a taboo. The trend shows either patients tend to get diagnosed with in the first 3 months or 9 months after they first present. pulmonary TB represents 61% of all the TB diagnosed in our GP practice.