Tuberculosis control in big cities and urban risk groups in the European Union:
a consensus statement

Hest, N. A. van; Aldridge, Robert W; Vries, Gerard de; Sandgren, Andreas; Hauer, Barbara; Hayward, Andrew; Oñate, Wouter Arrázola de; Haas, Walter; Codecasa, Luigi; Caylà, Joan A.; Story, Alistair; Antoine, D; Gori, Andrea; Quabeck, Levke; Jonsson, Jerker; Wanlin, M.; Orcau, Àngels; Rodés, Anna; Dedicoat, Martin; Antoun, F.; Deutekom, H. van; Keizer, Sytze; Abubakar, Ibrahim

doi:10.2807/1560-7917.es2014.19.9.20728

Cited by 58 publications

(58 citation statements)

References 94 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The implementation of targeted approaches was reviewed in an international survey of TB-elimination practices in low incidence European countries, and followed by a consensus statement of the European Centre for Disease Prevention and Control TB in big cities working group. This detailed recommendations to improve early case finding, case holding and treatment completion, especially among vulnerable groups [11,12]. Despite the mostly low incidence, the economic cost of TB in the EU remains considerable (total costs of €536 890 315 accumulated in 2012) [13].…”

Section: Infectious Diseasementioning

confidence: 99%

Tuberculosis in London: the convergence of clinical and social complexity

Anderson

Maguire

et al. 2016

Eur Respir J

View full text Add to dashboard Cite

In large European cities, the tuberculosis (TB) epidemic is characteristically concentrated in vulnerable and under-served populations [1]. London has the highest number and annual incidence of TB in Europe and implemented routine surveillance on homelessness, drug and alcohol misuse and imprisonment among TB patients in 2009 [2]. This paper describes the clinical, public health and epidemiological characteristics of TB cases and the public health impact of social risk factors including risk of infectiousness, onward transmission, poor treatment adherence and drug resistance.We analysed a cohort of adult London TB patients (2009 including clinical and laboratory surveillance information. This was improved by matching against the Find&Treat team's database, who support TB patients across London with complex social needs [3]. Homelessness, imprisonment, drug and alcohol misuse were defined as per national guidance [4]. Multi-drug resistant (MDR) TB was defined as per the World Health Organization (WHO), and poor treatment outcome was defined as not completing treatment within 12 months for rifampicin-sensitive patients, or within 24 months for rifampicin-resistant patients [5]. Recent migrants were defined as entering the UK less than 2 years before diagnosis. United Nations world region of birth was amended to a TB surveillance classification. Ethical approval was not required as this study was based on routine surveillance data held by Public Health England. Public Health England has Health Research Authority approval to hold and analyse national surveillance data for public health purposes. Non-adherence and not completing treatmentAlmost half of all homeless patients were non-adherent (258 out of 550), and 303 (72%) out of (420) completed treatment. Homelessness was associated with non-adherence (adjusted OR 10.2, 95% CI 7.9-13.2) 1 |

show abstract

Section: Infectious Diseasementioning

confidence: 99%

Tuberculosis in London: the convergence of clinical and social complexity

Anderson

Maguire

et al. 2016

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Tuberculosis in Europe is increasingly a problem that is concentrated in large cities [26]. This study demonstrates that outbreaks in cities, even in low incidence countries, can persist for many years through community transmission.…”

Section: Discussionmentioning

confidence: 95%

Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014

Smith

Trienekens²,

Anderson

et al. 2017

Eurosurveillance

View full text Add to dashboard Cite

An outbreak of isoniazid-resistant tuberculosis first identified in London has now been ongoing for 20 years, making it the largest drug-resistant outbreak of tuberculosis documented to date worldwide. We identified culture-confirmed cases with indistinguishable molecular strain types and extracted demographic, clinical, microbiological and social risk factor data from surveillance systems. We summarised changes over time and used kernel-density estimation and k-function analysis to assess geographic clustering. From 1995 to 2014, 508 cases were reported, with a declining trend in recent years. Overall, 70% were male (n = 360), 60% born in the United Kingdom (n = 306), 39% white (n = 199), and 26% black Caribbean (n = 134). Median age increased from 25 years in the first 5 years to 42 in the last 5. Approximately two thirds of cases reported social risk factors: 45% drug use (n = 227), 37% prison link (n = 189), 25% homelessness (n = 125) and 13% alcohol dependence (n = 64). Treatment was completed at 12 months by 52% of cases (n = 206), and was significantly lower for those with social risk factors (p < 0.05), but increased over time for all patients (p < 0.05). The outbreak remained focused in north London throughout. Control of this outbreak requires continued efforts to prevent and treat further active cases through targeted screening and enhanced case management.

show abstract

“…TB occurs more frequently in big cities where people at risk are over-represented. Recommendations for TB control programmes in these cities exist and are known to work (23).…”

Section: Low Tb Burden Country But a Higher Incidence In A Big Citymentioning

confidence: 99%

Tuberculosis Transmission in a Primary School and a Private Language School. An Estimation of Infectivity

et al. 2020

View full text Add to dashboard Cite

Conclusion: This exposure investigation of two teachers detects high transmission among family contacts and school casual contacts. Recommendations for chemoprophylactic treatment in children <5 years showed low compliance, reflecting the difficulty of communication to staff, parents, and children in a school outbreak. It is essential to develop a new approach for this vulnerable group of patients. This approach could be improved, applied, and evaluated by National TB Control Programs, involving public and private health services. Public health authorities play a role in raising public awareness about the risks of TB for young children.

show abstract

Tuberculosis control in big cities and urban risk groups in the European Union: a consensus statement

Cited by 58 publications

References 94 publications

Tuberculosis in London: the convergence of clinical and social complexity

Tuberculosis in London: the convergence of clinical and social complexity

Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014

Tuberculosis Transmission in a Primary School and a Private Language School. An Estimation of Infectivity

Contact Info

Product

Resources

About