Age In London TB is more common in younger adults aged years and peaks in the age group (3).
|
|
- Kerry Rice
- 8 years ago
- Views:
Transcription
1 4. TUBERCULOSIS INTRODUCTION Tuberculosis (TB) is an infectious, notifiable disease (meaning there is a requirement by law to report it to government authorities) caused by the bacterium Mycobacterium Tuberculosis. TB is present in many parts of the world and particularly Africa and South East Asia (1). In the 1930s, TB was one of the leading causes of death in the UK. After falling steadily, the number of TB notifications in England and Wales has increased over the past 20 years. The main underlying factor in this rise has been infection in people born outside the UK. Most people infected with TB do not go on to have active disease, although a few will develop a dormant disease which may be reactivated as they get older. TB is curable with a full course of treatment. Good management of TB involves early diagnosis, rapid identification of the strain and completion of the course of treatment. WHICH GROUPS ARE MOST AFFECTED? TB is concentrated in deprived communities in cities and predominantly affects BME and non-uk born groups, homeless people and problem drug-users (2). Age In London TB is more common in younger adults aged years and peaks in the age group (3). Place of birth, migration and ethnicity Over 80% of cases of TB in North Central London are in BME groups, with the highest incidence in Black African and Indian groups. Increasing rates of TB in people born outside the UK reflect the rising numbers of migrants arriving from high incidence areas (4). The majority of people with TB who are born abroad do not arrive with active TB but develop TB within one to five years after entry to the UK. Homeless, prisoners and substance users People who are homeless, have prison experience or are misusing drugs or alcohol have a higher prevalence of TB. These groups are often infectious, drug resistant, poorly adherent 1
2 to treatment and difficult to follow-up. Despite their relatively low numbers, they have a significant impact on TB service workloads (5). People with weakened immune systems People with compromised immune systems have increased risk of developing active TB after infection and are more likely to have poorer outcomes. The association of TB with HIV is important. HIV infection increases the risk of progression from inactive to active TB which, if untreated, is more likely to progress to severe disease and death (6). THE ISLINGTON PICTURE Incidence of TB is high in London, accounting for about 40% of notifications in England (3). Islington has a higher incidence of TB than North Central London and London as a whole. There has been a downward trend in TB cases in Islington over recent years. Figure 4.1: TB incidence rates for Islington, North Central London and London Islington NCL London TB incidence rates per 100,000 population Year Source: London TB Register (LTBR), HPA London 2
3 Table 4.1: Incidence of TB per 100,000 population for Islington, North Central London, London and England and Wales, TB rates Islington NCL London E&W Source: London TB Register (LTBR), HPA London Within Islington there is considerable geographical variation in the incidence of TB. Figure 4.2: TB notification rates per 100,000 population by ward, Islington, 2008 Rate per 100, to to to to to 25.7 Source: North Central London TB Commissioning Group. Mapping by NHS Haringey Public Health 3
4 Figure 4.3 shows that in Islington between 2003 and 2008 there was an increase in the proportion of cases of Black African ethnicity and a decrease in cases of Indian ethnicity, while in North Central London as a whole the opposite was true. Figure 4.3: TB notifications in North Central London and Islington by ethnicity, 2003 and Percentage of TB notifications NCL 2003 NCL 2008 Islington 2003 Islington Bangladeshi Black African Black Caribbean Black Other Chinese Indian Other Pakistani Unknown White Ethnic group Source: London TB Register (LTBR), HPA London Multi-Drug Resistant TB Resistance to first-line drug treatment for TB is low in the UK and alternative drug treatment options are available (7). TB control requires early and accurate diagnosis followed by completion of treatment in order to mitigate the development of drug-resistant strains of the bacteria. In multiple-drug resistant (MDR) TB the bacteria are resistant to at least Rifampicin and Isoniazid, the two most powerful TB drugs. Across North Central London, the total proportion of cases that are multi-drug or Isoniazid resistant is very small and mostly associated with an outbreak of Isoniazid-resistant TB in North Central London which mainly affected Enfield and Haringey residents (8). 4
5 SERVICES CURRENTLY PROVIDED IN ISLINGTON Vaccination Neonatal BCG vaccination is routinely offered on a universal basis to all babies resident in Islington, in line with Department of Health guidance for areas with a high incidence of TB. There is targeted vaccination of under 16 year olds within school, deemed to be at increased risk of TB. BCG is also offered to adults in high risk groups, such as new entrants to the UK from high prevalence areas and healthcare workers. Screening The Port Health Authority screens new entrants to the UK from high incidence areas who plan to stay in the UK for more than 6 months (5). A mobile X-ray screening unit provides a targeted screening service to hostels, drug and alcohol service units and refugee centres. Based on the success of the mobile screening unit at detecting TB in prisoners, five London prisons have successfully bid for static digital x-ray facilities, with installation at Pentonville Prison in 2009 (3). Screening is offered to close contacts of newly diagnosed individuals with infectious TB. Treatment Outpatient TB services are provided by one team working across five hospital sites in the North Central London sector. Co-ordination of the service in this way has enabled an increase in staff establishment, and the development of a multi-disciplinary team to better support people with TB. All new patients are risk assessed for likely treatment compliance. Directly observed treatment (DOT) is offered where appropriate. DOT involves observing a patient to ensure they take their medication in the right combination and for the correct duration. The Find and Treat multidisciplinary team locate and re-engage patients who have been lost to follow-up, support DOT and link patients with allied support services in the community. Inpatient TB services are provided at Barnet and Chase Farm Hospitals, North Middlesex Hospital, Royal Free Hospital, UCLH and The Whittington Hospital. 5
6 Pentonville prison has a specialist TB nurse post funded by the Department of Health to improve the TB pathway across all London prisons (3). Treatment completion rates for 2007/08 notifications of TB were above the London target of 85% for all PCTs in North Central London (9). The North Central London boroughs jointly fund out-patient and community TB services. In 2008/9 Islington s contribution to this was 256,305. A recent review realigned payments by PCTs to reflect the number of TB notifications for each borough to make contributions by each PCT more equitable. As a result in 2009/10 Islington s spend was reduced to 147,885. In-patient care is paid for separately. NATIONAL DRIVERS FOR SERVICE PROVISION In 2004 the Chief Medical Officer (CMO) produced a National TB Action Plan (10) outlining ten actions to bring TB under control in England, including partnership working, improvements to the organisation of care and raising awareness of TB. In 2006 the National Institute for Health and Clinical Excellence (NICE) produced guidance for the clinical diagnosis and management of TB and measures for its prevention and control. This includes a care pathway and key priorities for implementation (11). The Department of Health produced a TB Commissioning Toolkit in 2007 to support the implementation of the guidance from the CMO and NICE (12). A key recommendation of this was for commissioning and performance management of TB services to be restructured at both regional and sector levels. As a result the London TB commissioning unit, London TB Commissioning Board and London TB Clinical Reference Group were established in 2009 and support the following: Needs assessment. Strategic review of service configuration and planning. Performance management of PCT and TB services. Provider workforce development. Strengthening of communications. Cross-boundary working. Dissemination of good practice. 6
7 North Central London has a collaborative commissioning group which is supported by the London TB Commissioning Unit. This group engages the PCTs within the sector to secure investment, improve TB service delivery and patient care. This is the model which other London sectors are working towards (3). PROGRESS SINCE LAST YEAR S JSNA Progress has been made on the recommendations made in last year s JSNA. The quality of data collection has much improved. Early and prompt diagnosis has been improved through work with Occupational Health departments to review TB policies in line with NICE guidance. Awareness raising sessions were held with trainee health advocates and through community events and social marketing across the sector. Care pathways have been taken forward as part of the London TB Strategy to ensure patient experience is standardised across London. Targeted work with communities with very high rates of TB, such as the Somali community, has been undertaken. The contact tracing database is now part of the national TB database and due for implementation in OPPORTUNITIES FOR DEVELOPMENT The World Health Organisation Millennium Development Goal for TB is to halve the London 1990 TB rate by In 1990 the London TB rate was 23.4 per 100,000 population and in 2008 it was The ambitious target for the London TB Commissioning Unit is to achieve 11.7 per 100,000 population in the next six years by commissioning effective TB services. The North Central London sector is a national leader in terms of service provision and is piloting projects to improve TB service provision and the TB patient s experience, for example through the Find and Treat team. Although excellent work is well established, challenges remain. Care pathways are being developed for London and these need to be embedded in local practice. Awareness raising activity with high-risk population groups, such as the Somali community, has been ongoing for a number of years but is not having the anticipated impact on reducing TB. New approaches are needed to work with high-risk groups and tackle stigma. There are ongoing challenges in securing patient representatives to input into TB service development in North Central London. 7
8 RECOMMENDATIONS Conduct a needs assessment to gain a better understanding of the requirements of a TB service Achieve the London TB targets covering elements such as diagnostics, waiting times and treatment completion. Review paediatric TB services in North Central London to reduce the number of paediatric service providers from five to two, in order to concentrate care in specialist centres. Review provision of adult TB services in North Central London in line with World Class Commissioning standards. Implement the DOT project by funding a team to improve treatment compliance and patient support. REFERENCE LIST (1) World Health Organisation. Global tuberculosis control: surveillance, planning, financing (2) Health Protection Agency Centre for Infections. Tuberculosis in the UK: annual report on tuberculosis surveillance in the UK (3) Health Protection Agency London and NHS. Tuberculosis in London (4) Health Protection Agency Centre for Infections. Migrant health: infectious diseases in non-uk born populations in England, Wales and Northern Ireland. A baseline report (5) Health Protection Agency Centre for Infections. Migrant health: infectious diseases in non-uk born populations in England, Wales and Northern Ireland. A baseline report (6) Lienhardt C, Rodrigues LC. Estimation of the impact of the human immunodeficiency virus infection on tuberculosis: tuberculosis risks revisited? 1997(1):pp (7) Health Protection Agency Centre for Infections. Tuberculosis in the UK: annual report on tuberculosis surveillance in the UK (8) Altass L. Tuberculosis in North Central London. Annual Report for (9) Altass L. Data downloaded from the London TB Register (10) Department of Health. Stopping tuberculosis in England: An action plan from the Chief Medical Officer (11) National Institute for Health and Clinical Excellence (NICE). Tuberculosis: Clinical diagnosis and management of tuberculosis, and measures for its prevention and control
9 (12) Department of Health. Tuberculosis prevention and treatment: a toolkit for planning, commissioning and delivering high quality services in England FURTHER INFORMATION Global tuberculosis control: surveillance, planning, financing. World Health Organisation. Geneva Tuberculosis in the UK: annual report on tuberculosis surveillance in the UK. Health Protection Agency Centre for Infections ?p= Tuberculosis in London 2007: A report from HPA London and NHS London. Health Protection Agency London and NHS tuberculosis-in-london
10 10
Joint Strategic Needs Assessment In-depth Report on Tuberculosis (TB)
Joint Strategic Needs Assessment In-depth Report on Tuberculosis (TB) Section 1: Information about Tuberculosis Tuberculosis (TB) in the UK represents a major public health challenge. The UK has some of
More informationCurrent Model of TB Care in NCL
NHS North Central London Tuberculosis: developing services for the future for North Central London Introduction This report is to update the Joint Health and Overview Scrutiny Committee (JHOSC) on the
More informationMANAGEMENT OF TUBERCULOSIS IN PRISONS: Guidance for prison healthcare teams
MANAGEMENT OF TUBERCULOSIS IN PRISONS: Guidance for prison healthcare teams Document control Title Type Author/s Management of tuberculosis in prisons: Guidance for prison healthcare teams Operational
More informationTuberculosis. TB the disease, its treatment and prevention
Tuberculosis TB the disease, its treatment and prevention Tuberculosis TB (tuberculosis) is an infectious disease that usually affects the lungs, although it can affect any part of the body. About 150
More informationHow you can protect investments, reduce health inequalities and save lives in your borough
Reducing health inequalities in London by addressing hepatitis C Briefing for councillors: Reducing health inequalities in London by addressing hepatitis C How you can protect investments, reduce health
More informationChapter 8 Community Tuberculosis Control
Chapter 8 Community Tuberculosis Control Table of Contents Chapter Objectives.... 227 Introduction.... 229 Roles and Responsibilities of the Public Health Sector Providers.... 229 Roles and Responsibilities
More informationChapter 1 Overview of Tuberculosis Epidemiology in the United States
Chapter 1 Overview of Tuberculosis Epidemiology in the United States Table of Contents Chapter Objectives.... 1 Progress Toward TB Elimination in the United States.... 3 TB Disease Trends in the United
More informationTuberculosis the disease, its treatment TBand prevention
Tuberculosis the disease, its treatment TBand prevention TUBERCULOSIS TB (tuberculosis) is an infectious disease that usually affects the lungs, although it can affect almost any part of the body. About
More informationTUBERCULOSIS the disease, its treatment and prevention. mmunisation
TUBERCULOSIS the disease, its treatment and prevention mmunisation TB (tuberculosis) is an infectious disease that usually affects the lungs, although it can affect almost any part of the body. About
More informationHepatitis C Infections in Oregon September 2014
Public Health Division Hepatitis C Infections in Oregon September 214 Chronic HCV in Oregon Since 25, when positive laboratory results for HCV infection became reportable in Oregon, 47,252 persons with
More informationPediatric Latent TB Diagnosis and Treatment
Date Updated: April 2015 Guidelines Reviewed: 1. CDC Latent TB Guidelines 2. Harborview Pediatric Clinic Latent TB Management, 2010 3. Pediatric Associates Latent TB Guidelines, 2013 4. Seattle Children
More informationCapital Challenge. Tackling Hepatitis C in London
Capital Challenge Tackling Hepatitis C in London Contents Foreword 3 The current state of hepatitis C in London 4-5 Delivering improved hepatitis C outcomes in London 8-11 What next in London? 12 References
More informationHepatitis C Best Practice
FaCe It Hepatitis C Best Practice: Provision of care Name: Dr Tricia Cresswell (Executive Director of Public Health County Durham and Darlington PCTs), Dr Deb Wilson (Consultant in Health Protection, North
More informationBlack and Minority Ethnic Groups Author/Key Contact: Dr Lucy Jessop, Consultant in Public Health, Buckinghamshire County Council
Black and Minority Ethnic Groups Author/Key Contact: Dr Lucy Jessop, Consultant in Public Health, Buckinghamshire County Council Introduction England is a country of great ethnic diversity, with approximately
More informationSelf-Study Modules on Tuberculosis
Self-Study Modules on Tuberculosis Epidemiology of Tuberculosis U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for HIV/AIDS, Viral Hepatitis, STD,
More informationCOMMISSIONING FOR EQUITY SERIES EQUAL ACCESS, EQUAL CARE? Can London Deliver the Race Equality Action Plan for Mental Health?
COMMISSIONING FOR EQUITY SERIES EQUAL ACCESS, EQUAL CARE? Can London Deliver the Race Equality Action Plan for Mental Health? REVISED JUNE 2007 Paul De Ponte Dr. Bobbie Jacobson March 2007 Page 1 of 60
More informationAnalysis of survey data on the implementation of NICE PH18 guidance relating to needle and syringe provision in England
Analysis of survey data on the implementation of NICE PH18 guidance relating to needle and syringe provision in England Geoff Bates, Lisa Jones, Jim McVeigh Contents Acknowledgements... 4 Abbreviations...
More informationEthnic Minorities, Refugees and Migrant Communities: physical activity and health
Ethnic Minorities, Refugees and Migrant Communities: physical activity and health July 2007 Introduction This briefing paper was put together by Sporting Equals. Sporting Equals exists to address racial
More informationBeginner's guide to Hepatitis C testing and immunisation against hepatitis A+B in general practice
Beginner's guide to Hepatitis C testing and immunisation against hepatitis A+B in general practice Dr Chris Ford GP & SMMGP Clinical Lead Kate Halliday Telford & Wrekin Shared Care Coordinator Aims Discuss:
More informationHIV prevention and the wider UK population. What HIV prevention work should be directed towards the general population in the UK?
Shaping attitudes Challenging injustice Changing lives Policy briefing HIV prevention and the wider UK population September 2011 What HIV prevention work should be directed towards the general population
More informationAdult drug treatment plan 2007/08 Part 1 Section A: Strategic summary Section B: National targets Section C: Partnership performance expectations
name Adult drug treatment plan Part 1 Section A: Strategic summary Section B: National targets Section C: expectations Published by NTA: 2 October This strategic summary incorporating national targets
More informationJSNA Factsheet Template Tower Hamlets Joint Strategic Needs Assessment 2010 2011
JSNA Factsheet Template Tower Hamlets Joint Strategic Needs Assessment 2010 2011. Executive Summary This fact sheet considers breast cancer, with a particular emphasis on breast screening and raising awareness
More informationMortality from Prostate Cancer Urological Cancers SSCRG
1 Mortality from Prostate Cancer Urological Cancers SSCRG Headline Findings Over 10,000 men die from prostate cancer in the UK each year, nearly 9,000 in England. The rate of death from prostate cancer
More informationHealth Protection Agency position statement on the use of Interferon Gamma Release Assay (IGRA) tests for Tuberculosis (TB)
Health Protection Agency position statement on the use of Interferon Gamma Release Assay (IGRA) tests for Tuberculosis (TB) Draft Interim HPA Guidance HPA Tuberculosis Programme Board Health Protection
More informationGeneral Information on Tuberculosis
General Information on Tuberculosis ON THE MOVE AGAINST TUBERCULOSIS: Transforming the fi ght towards elimination World TB Day 2011 SAARC Tuberculosis & HIV/AIDS Centre GPO Box No 9517, Kathmandu, Nepal
More informationMANAGEMENT OF TUBERCULOSIS IN PRISONS: Guidance for prison healthcare teams
MANAGEMENT OF TUBERCULOSIS IN PRISONS: Guidance for prison healthcare teams 1 Original document control by Public Health England Title Type Author/s Management of tuberculosis in prisons: Guidance for
More informationTuberculosis in children in Europe -the ptbnet
Tuberculosis in children in Europe -the ptbnet Beate Kampmann FRCPCH PhD A/Professor in Paediatric Infection & Immunity Consultant Paediatrician Imperial College London, UK and Institute of Infectious
More informationTUBERCULOSIS CONTROL INDIA
TUBERCULOSIS CONTROL INDIA In terms of population coverage, India now has the second largest DOTS (Directly Observed Treatment, Short course) programme in the world. However, India's DOTS programme is
More informationThe ageing of the ethnic minority populations of England and Wales: findings from the 2011 census
The ageing of the ethnic minority populations of England and Wales: findings from the 2011 census A briefing paper from the Centre for Policy on Ageing June 2013 The Centre for Policy on Ageing was set
More informationDrug-resistant Tuberculosis
page 1/6 Scientific Facts on Drug-resistant Tuberculosis Source document: WHO (2008) Summary & Details: GreenFacts Context - Tuberculosis (TB) is an infectious disease that affects a growing number of
More informationTargeted Testing for Tuberculosis Infection
Targeted Testing for Tuberculosis Infection CONTENTS Introduction... 3.2 Purpose... 3.2 Policy... 3.2 When to Conduct Targeted Testing... 3.3 Approaches to increasing targeted testing and treatment for
More informationNursing and midwifery actions at the three levels of public health practice
Nursing and midwifery actions at the three levels of public health practice Improving health and wellbeing at individual, community and population levels June 2013 You may re-use the text of this document
More informationFaculty of Public Health
Faculty of Public Health Of the Royal Colleges of Physicians of the United Kingdom Working to improve the public s health OSPHE 075 Contact Investigations for TB Contact Investigations for TB CANDIDATE
More informationThe Role of the Health Service Administrator in TB Control. National Tuberculosis Control Programme
The Role of the Health Service Administrator in TB Control Goal/Objectives of NTP Mandate: To provide leadership for the health sector response to combat Tuberculosis in Ghana. Goal: To reduce the burden
More informationIntegrating NHS 111 and out-of-hours services in North Central London. Dr Denise Bavin
Integrating NHS 111 and out-of-hours services in North Central London Dr Denise Bavin NHS 111 and GP Out of Hours NHS 111 NHS 111 is a free telephone number to help people with urgent, but not lifethreatening,
More informationHARINGEY CLINICAL COMMISSIONING GROUP MAY 2013 GOVERNING BODY 2013/14 FINANCIAL PLAN
HARINGEY CLINICAL COMMISSIONING GROUP MAY 2013 GOVERNING BODY 2013/14 FINANCIAL PLAN 1. Introduction The purpose of this paper is to provide an update to the Governing Body of the CCGs 2013/14 financial
More informationTB CARE EARLY DETECTION AND PREVENTION OF TUBERCULOSIS (TB) IN CHILDREN. Risk factors in children acquiring TB:
EARLY DETECTION AND PREVENTION OF TUBERCULOSIS (TB) IN CHILDREN Risk factors in children acquiring TB: Children living in the same household as a lung TB patient (especially children under 5) Children
More informationHealth Committee. Tackling TB in London October 2015
Health Committee Tackling TB in London October 2015 Health Committee Members Dr Onkar Sahota (Chair) Andrew Boff (Deputy Chair) Kit Malthouse MP Murad Qureshi Valerie Shawcross CBE Labour Conservative
More informationNICE guideline Published: 13 January 2016 nice.org.uk/guidance/ng33
Tuberculosis NICE guideline Published: 13 January 2016 nice.org.uk/guidance/ng33 NICE 2016. All rights reserved. Last updated May 2016 Your responsibility The recommendations in this guideline represent
More informationIntegrated drug treatment system Treatment plan 2009/10. Part 1: Strategic summary, needs assessment and key priorities
Establishment: HMP Belmarsh Drugs partnership: Greenwich Primary Care Trust: Greenwich Integrated drug treatment system Treatment plan 2009/10 Part 1: Strategic summary, needs assessment and key priorities
More informationHow To Write The Joint Strategic Needs Assessment For Rutland
Rutland JSNA Executive summary Aim of the JSNA This Joint Strategic Needs assessment is the means by which Leicestershire County and Rutland PCT and Rutland County Council will describe the current and
More informationCDC TB Testing Guidelines and Recent Literature Update
Pocket Guide QuantiFERON -TB Gold CDC TB Testing Guidelines and Recent Literature Update Using IGRAs for TB screening in your patients June 2010 A full copy of the US Centers for Disease Control and Prevention
More informationEPIDEMIOLOGY OF HEPATITIS B IN IRELAND
EPIDEMIOLOGY OF HEPATITIS B IN IRELAND Table of Contents Acknowledgements 3 Summary 4 Introduction 5 Case Definitions 6 Materials and Methods 7 Results 8 Discussion 11 References 12 Epidemiology of Hepatitis
More informationControlling Immigration Regulating Migrant Access to Health Services in the UK
Controlling Immigration Regulating Migrant Access to Health Services in the UK Response from the North West Regional Strategic Migration Partnership 6 th August 2013 1. Should all temporary migrants, and
More informationFinancial Risk Share and Transitional Investment Fund North Central London Clinical Commissioning Groups 2013/14-2017/18
Financial Risk Share and Transitional Investment Fund North Central London Clinical Commissioning Groups 2013/14-2017/18 1. Background The North Central London Clinical Commissioning Groups (Barnet, Camden,
More informationQuestions and Answers About Tuberculosis
Questions and Answers About Tuberculosis 2014 Questions and Answers About Tuberculosis 2014 Questions and Answers About Tuberculosis ( TB) was written to provide information on the diagnosis and treatment
More informationDRAFT FOR CONSULTATION
Interferon Gamma Release Assay (IGRA) testing for tuberculosis (TB) - Questions & Answers (Q&As) For Health Care Workers HPA Tuberculosis Programme Board DRAFT FOR CONSULTATION October 2007 Interferon
More informationAim of Presentation. The Role of the Nurse in HIV Care. Global Epidemic 7/24/09
Aim of Presentation The Role of the Nurse in HIV Care Eileen Nixon HIV Nurse Consultant Brighton and Sussex University Hospitals Overview of key issues that affect people with HIV Identify the role of
More informationSubstance misuse and TB: Information for families affected
Substance misuse and TB: Information for families affected What is TB? TB is the short name for an infectious disease called tuberculosis. You can get TB by prolonged and close contact with someone who
More informationEmerging Infectious Disease (4): Drug-Resistant Tuberculosis
S67 Drug-Resistant Tuberculosis Emerging Infectious Disease (4): Drug-Resistant Tuberculosis Chi-Fang You, MD; Han-Ping Ma, MD; Tzong-Luen Wang, MD, PhD; Aming Chor-Min Lin, MD Abstract Before the discovery
More informationU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention National Center for HIV, STD, and TB Prevention Division of Tuberculosis Elimination Public
More informationTuberculosis OUR MISSION THE OPPORTUNITY
Tuberculosis OUR MISSION Guided by the belief that every life has equal value, the Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives. Our Global Health Program is
More informationAdult Alcohol statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2013 to 31 March 2014
Adult Alcohol statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2013 to 31 March 2014 About Public Health England Public Health England exists to protect and improve the nation's
More informationNHS Swindon and Swindon Borough Council. Executive Summary: Adult Alcohol Needs Assessment
NHS Swindon and Swindon Borough Council Executive Summary: Adult Alcohol Needs Assessment Aim and scope The aim of this needs assessment is to identify, through analysis and the involvement of key stakeholders,
More informationTuberculosis Exposure Control Plan for Low Risk Dental Offices
Tuberculosis Exposure Control Plan for Low Risk Dental Offices A. BACKGROUND According to the CDC, approximately one-third of the world s population, almost two billion people, are infected with tuberculosis.
More informationADULT HEALTH AND WELLBEING LONG-TERM NEUROLOGICAL CONDITIONS
ADULT HEALTH AND WELLBEING LONG-TERM NEUROLOGICAL CONDITIONS i. Summary The National Service Framework for long-term neurological conditions categorises neurological conditions as: Sudden-onset conditions
More informationKeeping patients safe when they transfer between care providers getting the medicines right
PART 1 Keeping patients safe when they transfer between care providers getting the medicines right Good practice guidance for healthcare professions July 2011 Endorsed by: Foreword Taking a medicine is
More informationNational Minimum Standards for Immunisation Training
National Minimum Standards for Immunisation Training Contributors The following formed the advisory group which, hosted by the Health Protection Agency, produced these Minimum Standards for Immunisation
More informationSCHEDULE 2 THE SERVICES. NHS England
SCHEDULE 2 THE SERVICES A. Service Specifications Service Specification No. Service Commissioner Lead F04 S f Operational Delivery Networks for Hepatitis C Care in Adults NHS England Provider Lead Period
More informationAnaesthetics, Pain Relief & Critical Care Services Follow-Up Study REGIONAL REPORT. Performance Review Unit
Anaesthetics, Pain Relief & Critical Care Services Follow-Up Study REGIONAL REPORT Performance Review Unit CONTENTS page I INTRODUCTION... 2 II PRE-OPERATIVEASSESSMENT... 4 III ANAESTHETIC STAFFING AND
More informationParkinson s Disease: Factsheet
Parkinson s Disease: Factsheet Tower Hamlets Joint Strategic Needs Assessment 2010-2011 Executive Summary Parkinson s disease (PD) is a progressive neuro-degenerative condition that affects a person s
More informationFOREWORD. Member States in 2014 places patients and communities at the heart of the response. Here is an introduction to the End TB Strategy.
FOREWORD We stand at a crossroads as the United Nations move from the 2015 Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs) for 2030. Integral to this transition, the world
More informationPregnancy and Tuberculosis. Patient and Public information sheet
Pregnancy and Tuberculosis Patient and Public information sheet Who is at risk of TB? Anyone can catch TB, but it is possible that pregnant women have a slightly higher risk of TB. Some people are more
More informationTB preventive therapy in children. Introduction
TB preventive therapy in children H S Schaaf Department of Paediatrics and Child Health, and Desmond Tutu TB Centre Stellenbosch University, and Tygerberg Children s Hospital Introduction Children are
More informationTuberculosis and HIV/AIDS Co-Infection: Epidemiology and Public Health Challenges
Tuberculosis and HIV/AIDS Co-Infection: Epidemiology and Public Health Challenges John B. Kaneene, DVM, MPH, PhD University Distinguished Professor of Epidemiology Director, Center for Comparative Epidemiology
More informationPregnancy and Tuberculosis. Information for clinicians
Pregnancy and Tuberculosis Information for clinicians When to suspect Tuberculosis (TB)? Who is at risk of TB during pregnancy? Recent research suggests that new mothers are at an increased risk of TB
More informationHow does the NHS buy HIV Drugs?
The April 2011 announcement of changes to HIV drugs purchasing arrangements in London highlighted the direct impact of National Health Service (NHS) drugs procurement budgets and processes on individual
More informationTB Prevention, Diagnosis and Treatment. Accelerating advocacy on TB/HIV 15th July, Vienna
TB Prevention, Diagnosis and Treatment Accelerating advocacy on TB/HIV 15th July, Vienna Diagnosis Microscopy of specially stained sputum is the main test for diagnosing TB (1 2 days) TB bacilli seen in
More informationCommissioning fact sheet for clinical commissioning groups
Commissioning fact sheet for clinical groups July 2012 This fact sheet sets out the services to be commissioned by clinical groups (CCGs) from April 2013. It also sets out the complementary services to
More informationHow has Hounslow s demographic profile changed? An analysis of the 2011 Census data based on releases available up to January 2013
How has Hounslow s demographic profile changed? An analysis of the 2011 Census data based on releases available up to January 2013 Background Since 2001 Hounslow s population has grown by 19.6% from 212,341
More informationHIV New Diagnoses, Treatment and Care in the UK 2015 report
HIV New Diagnoses, Treatment and Care in the UK 2015 report About Public Health England Public Health England exists to protect and improve the nation's health and wellbeing, and reduce health inequalities.
More informationTreatment Routes in Prostate Cancer Urological Cancers SSCRG
1 Treatment Routes in Prostate Cancer Urological Cancers SSCRG Introduction To better understand outcome measures, it is necessary to analyse what treatment pathway a patient has followed after diagnosis.
More informationX-Plain Pediatric Tuberculosis Reference Summary
X-Plain Pediatric Tuberculosis Reference Summary Introduction Tuberculosis, or TB, is a bacterial infection that causes more deaths in the world than any other infectious disease. When a child gets TB,
More informationSocial Care and Obesity
Social Care and Obesity A discussion paper Health, adult social care and ageing Introduction The number of obese people in England has been rising steadily for the best part of 20 years. Today one in four
More informationdrug treatment in england: the road to recovery
The use of illegal drugs in England is declining; people who need help to overcome drug dependency are getting it quicker; and more are completing their treatment and recovering drug treatment in ENGlaND:
More informationDrug-Resistant Tuberculosis: Old Disease New Threat (April 2013)
The Global Fund Drug-Resistant Tuberculosis: Old Disease New Threat (April 2013) This report was written by the APPG on Global Tuberculosis s Policy Adviser, Simon Logan, in close consultation with the
More informationSummary. Request for Advice
Summary Health Council of the Netherlands. Vaccination of young children against tuberculosis. The Hague: Health Council of the Netherlands, 2011; publication no. 2011/04 Even though the global prevalence
More informationNOTICE OF PUBLIC HEARING REGARDING PROPOSED CHANGES IN HEALTH CARE SERVICES PROVIDED BY FRESNO COUNTY
NOTICE IS HEREBY GIVEN that a public hearing will commence on Tuesday, September 23, 2008, at 9:00 a.m. (subject to continuance on that date of the hearing) at the Fresno County Board of Supervisors Chambers,
More informationchest series c3 TUBERCULOSIS IN THE 21ST CENTURY
chest series c3 TUBERCULOSIS IN THE 21ST CENTURY chest heart & stroke scotland improves the quality of life for people in scotland affected by chest, heart and stroke illness, through medical research,
More informationPositive corporate responses to HIV/AIDS: a snapshot of large cap South African companies
Positive corporate responses to HIV/AIDS: a snapshot of large cap South African companies Introduction The rate of HIV infection continues to grow with 2.7 million new infections recorded globally in 2007.
More informationDublin Declaration. on Partnership to fight HIV/AIDS in Europe and Central Asia
Dublin Declaration on Partnership to fight HIV/AIDS in Europe and Central Asia Against the background of the global emergency of the HIV/AIDS epidemic with 40 million people worldwide living with HIV/AIDS,
More information2012-13 Trends in Drug Treatment
Appendix: 3.4 MEETING: Clinical Commissioning Group Shadow Governing Body DATE: Thursday 22 November 2012 TITLE: Drug treatment performance report LEAD Dr Jeanelle de Gruchy, Director of Public Health
More informationReview of the involvement and action taken by health bodies in relation to the case of Baby P
Review of the involvement and action taken by health bodies in relation to the case of Baby P May 2009 This report details the findings of an intervention that was carried out by the Healthcare Commission,
More informationHip replacements: Getting it right first time
Report by the Comptroller and Auditor General NHS Executive Hip replacements: Getting it right first time Ordered by the House of Commons to be printed 17 April 2000 LONDON: The Stationery Office 0.00
More informationTreatment of TB a pharmacy perspective
Treatment of TB a pharmacy perspective Colm McDonald, Antimicrobial Stewardship Pharmacist (Acting) National TB Conference, St. James s Hospital 6 th May 2011 Overview of presentation Role of the pharmacist
More informationT()LED() Name ofpolicy: Mandatory Tuberculosis (TB) Screening of Students from World Health Organization Designated High TB Prevalence Countries
Name ofpolicy: Mandatory Tuberculosis (TB) Screening of Students from World Health Organization Designated High TB Prevalence Countries Policy Number: 3364-81-04-030 T()LED() Revision date: I 0/22/13 Approving
More informationNo. prev. doc.: 9392/08 SAN 77 DENLEG 48 VETER 5 Subject: EMPLOYMENT, SOCIAL POLICY, HEALTH AND CONSUMER AFFAIRS COUNCIL MEETING ON 9 AND 10 JUNE 2008
COUNCIL OF THE EUROPEAN UNION Brussels, 22 May 2008 9637/08 SAN 88 DENLEG 52 VETER 7 NOTE from: Committee of Permanent Representatives (Part 1) to: Council No. prev. doc.: 9392/08 SAN 77 DENLEG 48 VETER
More information2. Incidence, prevalence and duration of breastfeeding
2. Incidence, prevalence and duration of breastfeeding Key Findings Mothers in the UK are breastfeeding their babies for longer with one in three mothers still breastfeeding at six months in 2010 compared
More informationIntegrated Performance Report
Integrated Performance Report Southwark Social Services and Southwark Primary Care Trust 2003/04 Provisional Indicators Integrated Performance Report: 2003/04 Provisional Indicators 1. Recommendation 1.1
More informationTuberculosis. Clinical diagnosis and management of tuberculosis, and measures for its prevention and control
Issue date: March 2011 Tuberculosis Clinical diagnosis and management of tuberculosis, and measures for its prevention and control This updates and replaces NICE clinical guideline 33 NICE clinical guideline
More informationBorderless Diseases By Sunny Thai
Borderless Diseases By Sunny Thai Millennium Development Goal #6 6. Combat HIV/AIDS, malaria and other borderless diseases. A. Halt and begin reversing spread of HIV by 2015. B. Achieve universal access
More informationInfection Prevention and Control Policy on the Management of Patients with Tuberculosis
Infection Prevention and Control Policy on the Management of Patients with Tuberculosis To provide clinical staff with guidelines for management of TB infected cases and to identify strategies for the
More informationCSCI Regional Office Caledonia House 223 Pentonville Road London, N1 9NG
CSCI Regional Office Caledonia House 223 Pentonville Road London, N1 9NG Tel: 020 7239 0330 Fax: 020 7239 0318 Email: apa.london@csci.gsi.gov.uk Web: www.csci.org.uk Ms Irene Findlay (OBE) Adult Social
More informationA Health and Wellbeing Strategy for Bexley Listening to you, working for you
A Health and Wellbeing Strategy for Bexley Listening to you, working for you www.bexley.gov.uk Introduction FOREWORD Health and wellbeing is everybody s business, and our joint aim is to improve the health
More informationPolicy for the control and management of Tuberculosis (TB) including multi-drug resistant Tuberculosis (MDR-TB).
Policy for the control and management of Tuberculosis (TB) including multi-drug resistant Tuberculosis (MDR-TB). Author: Responsible Lead Executive Director: Endorsing Body: Governance or Assurance Committee
More informationContact centred strategies to reduce transmission of M. leprae
Contact centred strategies to reduce transmission of M. leprae Jan Hendrik Richardus, MD, PhD Department of Public Health Erasmus MC, University Medical Center Rotterdam The Netherlands Outline lecture
More informationACCESS Placements!!! Apply now and spent 2 weeks in the UK in 2012 alongside service providers in the drugs and criminal justice area!!!!
ACCESS Placements!!! Apply now and spent 2 weeks in the UK in 2012 alongside service providers in the drugs and criminal justice area!!!! Placements outline: The ACCESS project opens opportunities for
More informationDiabetes: Factsheet. Tower Hamlets Joint Strategic Needs Assessment 2010-2011. Executive Summary. Recommendations
Diabetes: Factsheet Tower Hamlets Joint Strategic Needs Assessment 2010-2011 Executive Summary Diabetes is a long term condition that affects 11,859 people in Tower Hamlets, as a result of high levels
More informationTHE QUALITY OF MATERNITY SERVICES IN LONDON: A SUMMARY OF THE HEALTHCARE COMMISSION SURVEYS KEY MESSAGES FOR LONDON:
THE QUALITY OF MATERNITY SERVICES IN LONDON: A SUMMARY OF THE HEALTHCARE COMMISSION SURVEYS KEY MESSAGES FOR LONDON: London is different: the mobility and diversity of London s pregnant mothers together
More informationHealth in Camden. Camden s shadow health and wellbeing board: joint health and wellbeing strategy 2012 to 2013
Health in Camden Camden s shadow health and wellbeing board: joint health and wellbeing strategy 2012 to 2013 2 Contents 1. Introduction - Reducing health inequalities - Building on strong partnerships
More information