Drug resistant TB poses health and financial concern

Mycobacterium_tuberculosis_Bacteria,_the_Cause_of_TB_By NIAID [CC BY 2.0 (http-//creativecommons.org/licenses/by/2.0)], via Wikimedia Commons 2.

Photo: by NIAID CC BY 2.0

London faces a potential health care and treatment funding crisis caused by the development of drug resistant TB.

There were 2,500 cases of tuberculosis in London last year, that’s more than any other western European city. 9% of those cases were resistant to the first line of antibiotics used to fight the infection. And the Health Committee of the London Assembly warns that drug resistance is set to rise.

In its report Tackling TB in London the Health Committee highlights how the risk from TB is increased by the lack of knowledge and the social stigma attached to the disease and it calls on the Mayor to do more to raise awareness.

It also suggests a more unified and consistent approach to treating the infection across the capital. Currently, treatment and prevention is handled at a local level and the approach varies between the 30 clinics. The committee warns that this can lead to a fragmented approach. This is underlined by the fact that only 24 of the 32 boroughs offer universal vaccination against TB to babies.

Cases of TB have risen by 50% in the last 15 years. A third of boroughs have what is classified by the World Health Organisation as a high incidence – that is more than 40 cases per 100,000 people. But in some areas of Newham, Brent, Hounslow, Harrow and Ealing it is over 150, a higher level than many developing world counties such as Rwanda or Iraq.

At borough level, Newham has the highest incidence in London and England, followed by Brent. London accounts for 40% of all TB cases in England.

TB map

TB is caused by bacteria and spread through coughing and sneezing. It most commonly affects the lungs, causing serious illness, and is potentially fatal.

It is treated by a 6-month course of antibiotics that costs around £5,000. Last year £30 million was spent tackling TB in London. Drug resistant strains of the infection require complex treatments often involving hospital care and costs are typically 10 times higher or more.

TB is closely linked to social deprivation with those who are homeless, living in overcrowded conditions, misusing drugs and alcohol, or with weakened immune systems particularly vulnerable.

Many people who are exposed to the tuberculosis bacterium will fight it off or may carry it in their bodies without getting sick. This is known as latent TB.

More than 80% of the cases in London are seen in people born outside the UK, though only a small proportion in those who have recently arrived. The most common countries of origin for non-UK born cases are India, Pakistan and Somalia.

Sufferers may have contracted TB in countries with high incidence and carried the infection in latent form only for it to become active while living in London.   Chronic illness or poor housing and nutrition may have acted as a trigger in these cases.

The rate for non-UK born cases has fallen in recent years but those for UK residents have remained unchanged.

The Health Committee reports says that far from being a disease of London’s past TB continues to present a significant public health challenge.

Source data

Tackling TB in London report

Borough level data

See also

Low drug-related death rates hide middle-aged heroin problem

Sexual infection map shows problems for Lambeth and Southwark

Health and wealth – an East/West divide when it comes to a flu jab


Rise in rough sleepers adds to the problem on Westminster’s streets

© Clearvista | Dreamstime.com-2

Photo: © Clearvista | Dreamstime

The number of people sleeping on the streets has gone up by 11%. While there are people sleeping rough in every London borough the figures are dominated by the central area of Westminster which accounts for well over a third.

The Combined Homelessness and Information Network (CHAIN) says that from April to June this year 2,775 people were seen sleeping rough. That’s 11% up on the same period last year and 18% up on the previous quarter, January to March.

Of this number 1,447 were seen for the first time and new to the streets, 968 were intermittent rough sleepers, who had been seen before, and 391 people were deemed to be living on the street, including 31 of the newly identified people.

As our map shows, the scale of the problem in Westminster where more than 1,000 people were seen dwarfs the number of rough sleepers across other London boroughs. Camden has the second highest number and around 140 people were seen in Lambeth, Southwark and Tower Hamlets.

Rough sleepers Q1 2015

115 people seen at Heathrow inflate the number for Hillingdon.  14 people were judged by CHAIN to be sleeping along bus routes.  Fewer than 10 rough sleepers were seen in Kingston, Bexley and Havering.

As previously reported by Urbs, Central and Eastern Europeans make up a significant proportion of rough sleepers in London. Figures for the last quarter show that 41% of those seen were British and 36% were from Central and Eastern Europe. Of those, more than half were Romanian and about a quarter were Polish.

Source data

See also

Homeless Romanians help drive up rough sleeper numbers

Cap on benefits hits London hardest

1 in 3 kids growing up in out-of-work households in parts of London



Homeless Romanians help drive up rough sleeper numbers

Photo: © Slawek Kozakiewicz | Dreamstime.com

Photo: © Slawek Kozakiewicz | Dreamstime.com

There has been a significant increase in the number of people sleeping rough on the streets of London in the past year and the rise is largely driven by people from Central and Eastern Europe.

7,581 homeless people were seen sleeping on the streets from April 2014 to March 2015. That’s a 16% increase on the previous 12 months.  UK nationals make up 43% of that total and their numbers increased by 267 on the previous 12 months.  Central and Eastern European make up 37% of the total and their numbers increased by 728 to 2,695.  Romanians make up nearly half of this group (1,388) and their number has doubled since 2013-14.  Poles are the second largest group of Eastern Europeans.

Rough sleepers are categorised in 3 ways – new people who have not been seen before, people who have been seen a number of times recently and are considered to be living on the streets, and intermittent rough sleepers who may have had contact with support networks previously.

Rough sleepers

All categories are up in the past 12 months with the most significant increase of 20% in intermittent rough sleepers, people back on the street. There had been little change in overall numbers in the previous year.

The data was produced by the Combined Homelessness and Information Network (CHAIN) based on information supplied by outreach workers. CHAIN is funded by the GLA and managed by the charity St Mungos Broadway.

A high percentage of homeless people have problems with alcohol, drugs, mental health issues, or all 3. Outreach workers recorded that 41% needed support for alcohol problems and a similar proportion had mental health issues. 31% had drug problems.

Only 9 children were found sleeping rough in the year. People under 35 make up nearly half the number, but 710 older people, over 55, were discovered.

Nearly all the rough sleepers seen were men, 86%.   151 were former armed services members. 32% had been in prison.

A third of the rough sleepers in London are found in the central area of Westminster. Camden, Tower Hamlets, Lambeth, Southwark and City of London also have significant numbers and only Southwark saw a reduction in the period. 266 people were found sleeping rough at Heathrow Airport. That’s up by 100 on the previous year.

Outreach teams were able to get 2,197 rough sleepers into some form of accommodation. That’s 29%, down from 38% the previous year.

Source data

See also

Landlords reclaim record number of rented homes