扒哥吃瓜

Tuberculosis (TB) screening and early detection methods, for professionals working with at-risk populations in the UK.

Tuberculosis (TB)听is an infectious disease which can have a slow onset of symptoms and cause poor outcomes for individuals if left untreated. Despite almost all forms of听TB听being curable, difficulties in detecting听TB听make screening for听TB听an important action in the UK. Globally, the estimated that 10.7 million people fell ill with TB in 2024 with听 1.23 million deaths globally, the top cause of death by an infectious disease.

Screening a population for听TB听involves identifying otherwise healthy people who are at an increased risk of developing听TB. The听听that people who are at increased risk of听TB听are screened in the UK.

Screening for听TB听can focus on detecting active听TB听disease and latent听TB听infection (LTBI). People with听LTBI听have no symptoms of disease but are at risk of their latent infection activating into active听TB 诲颈蝉别补蝉别.听LTBI听can be detected using tuberculin skin tests (TST) or interferon gamma release assays blood test (IGRA). Screening for active听TB听disease of the lungs usually involves a symptom check and chest X-rays.

The incidence of听TB听in England is听higher than most other Western European countries. It is important that awareness is raised about听TB听amongst professionals and the public. The听Tuberculosis (TB) Action Plan for England, 2021 to 2026听recognises that screening for latent and active forms of听TB, alongside awareness raising activities will contribute to lowering the incidence of听TB听in England.

TB听active case finding

Active case finding (ACF) is a strategy used to identify and treat people with听TB听who would otherwise not seek prompt medical care听.听ACF听usually focuses on detecting pulmonary听TB听using chest X-rays or performing a symptom check.

Abnormal results may lead to the collection of patient sputum for further tests. Early detection of听TB听improves treatment outcomes and prevents the spread of the disease.

In low incidence countries,听ACF听is most commonly targeted at high-risk groups听;听. In the UK,听ACF听is performed on:

• close contacts of patients with听active TB听
• people with social risk factors such as:
  • homeless people
  • people with drug and/or alcohol problems
  • prisoners
• migrants from countries where听TB听is common
• professionals at risk of听TB听(for example healthcare workers)

In some groups, especially the homeless,听mobile digital x-ray units are sometimes used for听ACF. This can offer enhanced services including detection, diagnosis and care as well as screening for other relevant conditions.

TB听awareness raising

Raising awareness makes healthcare professionals and members of the public more alert of the risk and the various clinical manifestations of听TB. This is important because:

• TB听听can be vague
• TB听can occur in many different sites in the body
• The onset of听TB听can be slow and is not always clear

Maintaining increased awareness of听TB听can be done through activities such as:

• Community group outreach events
• Training sessions
• Production and promotion of information and educational materials in various formats and languages

See below for further information:

• 听and with educational material on听TB听(available in different languages)
• and information for those affected by听TB
• for professionals working with the general population and听high-risk groups
• international awareness raising for听 (24th March)

Educational materials should be in a format and language that target groups can understand. In the UK, several organisations are involved with awareness raising activities including听.

Latent听TB听infection (LTBI)

People with听LTBI听are asymptomatic and well but can become unwell as a result of reactivation of the latent TB infection. This can occur months, years or even decades after initial infection. It is likely that听LTBI听reactivation causes most of the active cases in the UK.

Individuals who were born or spend considerable time in a country where听TB听is very common are more likely to have听LTBI. More information about听TB听in migrants can be found in the听TB听migrant health guide.

It is not feasible or cost-effective to screen an entire population for听LTBI听but听听screening for specific high-risk groups in the UK. These groups include:

• close contacts of patients with听TB
• healthcare workers
• immunosuppressed patients (for example those with听HIV)
• migrants from countries where听TB听is common

The听Tuberculosis (TB) Action Plan for England, 2021 to 2026听recommends systematic听LTBI听testing and treatment for 16 to 35 year olds who recently arrived in the UK from high incidence countries as a key strategy.

Pre-entry TB screening for migrants

The tuberculosis (TB) pre-entry screening programme has been operational in 101 countries since replacing on-entry screening at UK airports in March 2014. The programme screens for active pulmonary TB (infectious form) using chest X-ray (CXR) and symptom review, with sputum testing conducted for individuals whose CXR is considered consistent with TB.

Applicants who apply for a long-term UK visa (6 months or more) and have recently lived in a country with high TB incidence (over 40/100,000), must be screened for pulmonary TB. Visa applications can only be processed once the applicant has been issued with a certificate of clearance to show they鈥檙e free from active pulmonary TB. The TB听screening for the UK leaflet explains the processes and requirements for pre-entry screening.

Screening can only be performed by a UK-recognised and quality assured provider. UKHSA works closely with the Home Office to support the development of quality assurance systems to ensure that the pre-entry TB screening programme is 鈥榝it for purpose鈥� in providing its stated objectives. The UK tuberculosis technical instructions explain the pre-departure screening programme for applicants to the UK and provide guidance for those who conduct TB screening.

The UK is one of 5 countries (alongside Australia, Canada, New鈥痁ealand and USA) that have adopted a pre鈥慹ntry TB screening programme.

Pre-entry TB screening contributes to reduction of TB in the UK . However, pre-entry screening can only detect TB among people with active pulmonary disease at the time of screening. Therefore, it is important that migrants arriving in the UK and the professionals working with them are made aware of the issues surrounding TB and opt into latent TB screening if eligible.

For more information view Tuberculosis in England, 2025 report - 扒哥吃瓜