Report highlights concerns over TB health risk to street-sleepers and sofa-hoppers

A WORRYING note has been sounded on the presence  of  tuberculosis (TB) in parts of North East Lincolnshire.

A recently-published report states: "A range of factors associated with complex lives in white British people living in the most deprived neighbourhoods in the borough have been associated with a much greater than expected number of TB related deaths.

"Some of these deaths were linked to networks of individuals who drank together in certain pubs.  

"TB diagnosis frequently came very late and was often not suspected as a cause of the person’s symptoms.  

"Following this, awareness-raising presentations were made at a number of GP practice related forums."

The report notes that, six years ago, a pilot TB screening project had to be put on hold because of the Covid pandemic, but, with the appointment a part-time nurse,  it went ahead in September 2024 with the intention not just of securing extra screening but also of assisting in the management of any new positive cases.

Among the first 65 tested were individuals engaged in a local homeless charity. 

The report continues: "This resulted in a 12.3 per cent positive screen rate - much higher than expected, indicating that there is a significant level of undiagnosed TB in North East Lincolnshire."

The disease can be "latent" rather than "active" but it still requires monitoring, putting pressure on health services.

The project was then put on ice pending a review of a number of emerging issues and concerns.

These have included:

• Capacity in the existing TB team to perform increased screenings 

• Capacity in the existing TB team to manage increased cases, including case support, follow-up, treatment plans and adherence 

• A bottleneck in the system due to long waits both for hospital test results and for consultant-led clinic appointments for diagnosis confirmation and management/treatment planning. 

• Public health risk arising from  homelessness with some individuals sofa-hopping, using hostels and street-sleeping.

There has also been a worry about asylum-seekers slipping through the system. 

The report states: "The public health risk of this missed screening is of great concern and has the potential to result in additional demands on the TB services and the wider health system if not addressed."

In the wake of the concerns, North East Lincolnshire's Health Protection Team is actively involved in a review of the current TB service in partnership with other healthcare professionals "in the hope that these issues can be addressed".