02 December 2016

What is Tuberculosis and why is it still a global epidemic?

In 1993, the World Health Organisation (WHO) declared tuberculosis (TB) a global emergency. TB is a growing global epidemic and is second to HIV and AIDS as the biggest worldwide killer. It is an ongoing problem in the UK which poses a serious public health concern.

TB is an infectious bacterial disease, spread by prolonged contact through inhaling tiny droplets from the coughs or sneezes of an infected person. Signs of TB include a persistent cough, chest pain, coughing up blood or sputum, fatigue, weight loss and a fever. TB kills approximately 2 million people worldwide each year and due to the improper use of antibiotics and the emergence of multidrug-resistant TB, WHO estimate that by the year 2020 there will be 56 million people newly infected with TB.

 

According to Public Health England, (PHE) a total of 7,892 cases of TB were notified in the UK in 2013: an incidence of 12.3/100,000. From this alarming figure 280 of these cases resulted in mortality.

TB mortality and morbidity figures predominantly exist in major cities in the UK, especially in deprived areas exacerbated by socioeconomic factors and hard-to-reach groups facing multiple social determinants of health, individuals are exposed to a higher prevalence of infectious diseases, associated with malnutrition and long periods of homelessness and limited access to
healthcare.

Subsequently, due to the severity of TB in the UK, the government have initiated several public health policies that illustrate and highlight the importance of TB prevention and intervention. The Department of Health have declared in their white paper - Healthy Lives, Healthy People, that they endeavour to minimise the risk and impact of illness and to encourage individuals to be able to make healthier choices, regardless of their circumstances by collaborating with local and national agencies to implement effective and efficient strategies. The white paper declares that PHE will be dedicated to support and collaborate with local agencies to take an integrated and dynamic approach in promoting innovation and assisting with disease control and protection.

It is apparent that the health need for TB in the UK has been identified as a serious public health concern due to enormous cost implications to the National Health Service (NHS). A regular case of TB costs around £5,000, however, can rise up to £70,000 for treatment of a single case in individuals from hard-to-reach groups and those faced with social determinants of health. Treatment for TB is lengthy and the majority of people in hard-to-reach groups do not complete treatment and are therefore at risk of relapse and developing multi-drug resistant TB, resulting in further treatment and higher costs to the NHS.

Health needs assessments play a crucial role in systematically using the data collected by local, national and international governments and agencies to enable them to implement and deliver an effective strategy to improve TB, reduce inequalities and close the gap between current policies, concepts and needs the population will benefit from.