What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?

Tuberculosis (TB) continues to increase in importance as a major Public Health issue and in 1993 the World Health Organisation declared TB as a global health emergency reflecting the seriousness of the problem.

Worldwide TB is increasing and currently infects one third of the world's population. TB causes more deaths globally than any other single infectious disease with 8 million new cases reported annually and 2 million deaths. The worst affected areas are those were rates of poverty and HIV infection are highest.

Since the mid-1980s TB notifications have increased slightly in the UK although the incidence varies widely. The numbers of reported cases are higher in inner cities and amongst immigrant groups who originate from countries where TB is endemic such as Africa and the Indian sub-continent.

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In 1999 CDSC NI reported the lowest incidence rate of TB for Northern Ireland in recent years with a total of 59 cases reported with a rate of 3.5 cases per 100,000 population. In that year the Eastern Board had the highest annual notification rate for TB with a total of 39 cases with a rate of 5.0 cases notified per 100,000.

However, prior to and including 1999, the incidence of TB within the Board area had been declining in the last decade and that downward trend has continued. In 2005 a total of 37 cases were notified, 20 pulmonary and 17 non-pulmonary.

In 2005 of the 20 cases of pulmonary disease notified one case was for a child under 15. This case highlight the importance of contact tracing as the child had been household contact of previously diagnosed individuals.

Eight cases of the disease, four pulmonary and four non-pulmonary were patients from ethnic backgrounds. While these figures are small, in the UK 50% of cases of TB occurs in people born abroad and who have developed the disease within 10 years of entry to the UK. It is important that these cases are identified and treated as quickly as possible.

Drug resistance has not been a particular problem in the Eastern Board however there is a need to be vigilant and close monitoring of compliance is essential.

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Although the incidence of multi-drug resistant TB in the UK is low this is not reflected globally. Patients infected with TB in parts of Eastern Europe and central Asia are believed to be 10 times more likely to have multi-drug resistant TB than in the rest of the world. The potential therefore exists for an increase in this problem in the UK particularly with the advent of HIV disease and the possible return of infected individuals from high-risk areas.

Enhanced surveillance of TB began in Northern Ireland in 1992 in an effort to provide more accurate data and a greater understanding of the changes in the epidemiology of the disease while at the same time providing information for action. In 1999 Northern Ireland was invited to participate in a UK wide surveillance scheme.

While the Department of Public Health collates the information relevant to the patients in their area all notifications for Northern Ireland are collated and validated centrally by the CDSC NI. This information is then included in a number of reports at, National, European and Regional level.

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