Question to the Department of Health and Social Care:

To ask Her Majesty’s Government, in the light of the recommendations of the most recent collaborative tuberculosis strategy for England, whether they have put in place provisions for screening and treating latent tuberculosis in vulnerable and marginalised groups.

The Collaborative Tuberculosis (TB) Strategy for England, which is attached, recommends ten key areas of action, including tackling TB in underserved groups and to systematically implement new entrant latent TB screening. The systematic screening and treatment of individuals with latent tuberculosis infection (LTBI) is therefore expected to significantly decrease the incidence of TB in England. LTBI screening for new entrants from TB high incidence areas is an effective and cost effective public health intervention¹ and is recommended by the National Institute for Health and Care Excellence (NICE). The NICE Tuberculosis guideline is attached.

LTBI testing and treatment for other vulnerable groups, such as prisoners and substance abusers is more complex and requires an individualised patient-centred approach to ensure arrangements to assist with subsequent treatment completion are robust. Whilst the Collaborative Strategy supports current NICE recommendations, including the expansion of active case finding and available support for these underserved populations, arrangements for LTBI testing among these groups will be a carefully balanced decision for local health services.

Notes:

1. Pareek M, Watson JP, Ormerod LP, Kon OM, Woltmann G, White PJ, et al. Screening of immigrants in the United Kingdom for imported latent tuberculosis: a multicentre cohort study and cost-effectiveness analysis. Lancet Infect Dis. 2011 Jun;11(6):435–44.