NICE guidelines tackle high UK tuberculosis rates

NEW NICE guidelines on tuberculosis (TB) call for greater education and prevention targeted at people from socially deprived backgrounds, who are most vulnerable to contracting the infection in the UK.

NICE recommends that multidisciplinary teams should help professionals "working in relevant statutory, community and voluntary organisations to raise awareness of TB among under-served and other high-risk groups".

Treatment for TB is free and confidential for everyone irrespective of eligibility for other NHS care. The guidelines highlight the need for wider recognition of the signs and symptoms, lifestyle factors and the benefits of diagnosis and treatment.

More than 6,500 cases of TB were reported across England in 2014, and of these over 2,500 occurred in London. People who live in areas with high levels of social deprivation are most vulnerable to developing TB, such as the homeless, people living in poor housing and drug users.

The guidance also raises the upper age limit for the treatment and diagnosis of latent TB from 35 to 65 years and under. It recommends offering Mantoux testing to diagnose latent TB in adults aged 18 to 65 who are close contacts of a person with pulmonary or laryngeal TB. If the Mantoux test is inconclusive, the person should be referred to a TB specialist.

A course of medication for latent TB is shorter, easier to stick to and cheaper than the subsequent treatment required should the disease become active and infectious.

Professor Mark Baker, Director for the Centre of Clinical Practice at NICE, said: "TB is a disease that is treatable and curable, but it preys on the vulnerable. Those with compromised health and people suffering poor living conditions are at increased risk.

"The new NICE guidance sets out the systematic and robust approach we need to reduce the current impact of TB, effectively treat those infected and reduce its spread. This guideline, together with Public Health England’s TB strategy will undoubtedly contribute to the goal of eliminating TB from England."

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