TB Soars Among Young Black Africans in UK

TB rates in children of black African origin have risen fivefold in the last decade in England and Wales, according to a new study. Though TB is uncommon in children in Britain, with overall rates changing little from 1988-1998, TB rates rose substantially in black African children and those born abroad, according to the Health Protection Agency.

The recently analyzed figures for England and Wales show the overall TB rate rose from 3.3 per 100,000 children in 1988 to 4.2 in 1993, dropping to 3.6 in 1998. But among children of black African origin, the rate rose from 14.6 in 1988 to 34.1 in 1993 to 70.6 in 1998. The rate for children whose origins were the Indian subcontinent fell from 33 per 100,000 to 23.1 in 1998. Among white children, it fell from 1.6 in 1988 to 1.1 in 1998.

"We have seen the rates go down in white children with a corresponding rise among children from ethnic minority groups," said Peter Ormerod, study co-author and TB spokesperson for the British Thoracic Society. "Some of these are infected abroad and develop the disease when they arrive here. Others are infected by adults in their own ethnic group," he added. According to Ormerod, an earlier study had shown that some children who returned to the Indian subcontinent for visits were infected during their stay.

A spokesperson for HPA said the current rates are low compared with the 1960s. "These figures may reflect recent patterns seen in other developed countries -- namely a rise in cases of TB in people born in areas of the world where the disease is now endemic," she said. "Raising awareness of the symptoms of TB in foreign-born people and in those who work with them, and access to health care for prompt diagnosis and treatment, are crucial," she said.

The study, "A Decade of Change: Tuberculosis in England and Wales 1988-98," was published in the Archives of Disease in Childhood (2003;88:772-777).

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