Tuberculosis in an area bordering east London: significant local variations when compared to national data

Infection. Mar-Apr 2000;28(2):103-5. doi: 10.1007/s150100050055.

Abstract

From September 1996 to June 1997, in an area bordering East London, we prospectively collected epidemiological, clinical and microbiological data on all patients with newly diagnosed culture-positive tuberculosis and compared these to national data based on notifications. The significant differences were that tuberculosis was diagnosed almost exclusively in non-Caucasian patients (42/47 [89%]) and that there was a high percentage of extrapulmonary tuberculosis (27/47 [57%]) including four cases of tuberculous meningitis and five cases of osteomyelitis. We also observed that 19/27 (70%) of patients with extrapulmonary tuberculosis had normal chest X-rays, 3/17 (18%) sub-Saharan Africans were HIV antibody-positive and drug resistance strains were isolated from six sub-Saharan Africans and one Caucasian. Figures for treatment failures and mortality compared favorably to national averages at 6 months. National data do not accurately reflect local epidemiology and clinical presentations. Hospital-based surveillance and promoting awareness of local differences is essential to prevent delayed diagnosis, inappropriate management and poor clinical outcome.

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara / ethnology
  • Aged
  • Aged, 80 and over
  • Asia / ethnology
  • Emigration and Immigration*
  • Female
  • Humans
  • London / epidemiology
  • Male
  • Middle Aged
  • Population Surveillance
  • Prospective Studies
  • Tuberculosis / epidemiology*
  • Tuberculosis / ethnology
  • Tuberculosis, Central Nervous System / epidemiology
  • Tuberculosis, Osteoarticular / epidemiology
  • Tuberculosis, Pulmonary / epidemiology