COVID-19: Provision of tuberculosis services update
The COVID-19 guidance on Tuberculosis (TB) service provision has been updated and includes restoration of the local latent TB infection (LTBI) programme.
CCGs were advised to restart their LTBI testing and treatment programmes in October 2020 as part of the national restoration of non COVID-19 programmes. Latent TB testing is targeted at a high-risk group of patients at increased risk developing active TB.
Key concerns include:
- Increased TB numbers in 2019 c.f. previous decline, and an overall decrease in TB notifications in 2020 c.f. 2019 notifications of nearly 15% i.e. patient behaviour change due decreased access to health services and fear of COVID-19 leading to delayed presentation, increased severity of symptoms and increased transmission.
- Backlog of people eligible for LTBI test, and people positive for LTBI not treated.
- Backlog of neonatal BCG vaccinations
Tuberculosis (TB): collaborative strategy for England
NHS England has supported implementation of the Collaborative Tuberculosis (TB) Strategy (the Strategy) since it was launched in 2015. The focus for NHS England has been the latent tuberculosis (TB) testing and treatment programme for new entrants from countries of high TB incidence.
Public Health England provides support to the national TB unit and support teams in the seven TB control boards.
The aim of the strategy was to achieve a year-on-year decrease in incidence, a reduction in health inequalities, and ultimately the elimination of TB as a public health problem in England. To achieve these ambitions and deliver significant improvements in TB control, the strategy set out improvements that were required in 10 key areas and the actions to achieve these improvements. The key areas of action are:
- improving access to services and ensuring early diagnosis
- providing universal access to high quality diagnostics
- improving treatment and care services
- ensuring comprehensive contact tracing
- improving BCG vaccination uptake
- reducing drug-resistant TB
- tackling TB in under-served populations
- systematically implementing new entrant latent TB screening
- strengthening surveillance monitoring and;
- ensuring an appropriate workforce to deliver TB control.