Tuberculosis (TB) poses a highly significant public health challenge in the capital today1. A significant minority of Londoners don't know how TB is transmitted or what the symptoms are.
A new survey2 commissioned by the London Assembly Health Committee found that one in five Londoners (18%) said that they don't know what the symptoms of TB are, when presented with a list.
- Over half of respondents (56%) thought TB was transmitted through spitting - untrue, yet widely believed.
- Astonishingly, 17 per cent of survey respondents thought that TB can be transmitted through unprotected sex.
- More than two in five (43%) agreed that they would be worried if they had to tell their employer they had TB.
Stigmatisation of TB is widespread - for example, only 30% of Londoners said that they would be happy to spend time with someone who has TB. This means many people won't seek diagnosis and treatment, even when they are very unwell, which can increase the chance of wider transmission, unknowingly passing TB onto family members and friends.
Drug resistance can arise when people fail to complete the full course of antibiotics to kill the infection. It is much more complex and expensive to treat, and the number of drug-resistant cases of TB in London is set to rise.
The London Assembly Health Committee report 'Tackling TB in London' calls for better public information, more outreach work and for the Mayor to take a leading role in TB control.
The report makes a number of recommendations, including:
- The Mayor should deliver a programme to educate the general public about how TB is spread and its symptoms.
- The Mayor should examine the feasibility of using Team London volunteers as TB health champions in the community and expand the role of current London TB Ambassadors, like actress Emma Thompson.
- The Greater London Authority (GLA) should consider including TB services as part of its pan-London rough sleeping services.
Dr Onkar Sahota AM, Chair of the Health Committee, said:
"It is astounding that TB is such a prevalent disease in London and that misconceptions about the disease are so common. We know TB disproportionately affects prisoners, homeless people and people with substance abuse issues, and high quality TB care services are not universally available to all Londoners.
The Mayor needs to take more accountability for TB control in London. He is uniquely placed to drive forward measures for TB prevention, as well as better access to treatment. If we don't get a grip on London's TB situation now, the harder and more expensive it will be to tackle in the years to come. With pressures on health budgets, we can't afford to take our eye off the ball."