Introduction Although overall TB incidence in Croydon is 18/10000, there are wards with higher rates (40–79/100000 ¹). There is dynamic influx of people from high incidence countries, especially due to the location of immigration services. Screening this high-risk group for LTBI is essential. We present a successful nurse-led LTBI screening service centrally funded by UKHSA.

Method Individuals were identified through NHS Flag 4 data (international in-migrants at new GP registration) between October 2019 to March 2022.² They had to be aged 16–35 years, have entered the UK within the past five years, never been a UK resident and have lived in a high TB incidence country for at least 3 months to be eligible for screening. Patients were invited to a nurse-led appointment where clinical history, CXR and IGRA were obtained.

Results 2525 individuals were invited for screening, 735 attended (29%), 147 were diagnosed with LTBI (20%), with 7 cases of active TB. Interestingly, 15 cases of active TB identified in the clinic had been invited through the programme but did not attend. Prior to the COVID-19 pandemic (October 2019-March 2020), there was a 52% attendance rate (522 screened, 269 attended). The service was suspended from late March-June 2020 and January –March 2021; attendance rate was poor throughout 2020 at 15.6% (1144 screened, 178 attended). To improve attendance, a leaflet about the screening programme was sent prior to appointment letters, which improved the rate to 46% in 2021 (584 screened, 269 attended).

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Abstract P157 Figure 1

Discussion Of those who attended, the LTBI rate was 20%, highlighting the importance of targeted population screening. Early identification prevents some cases developing active TB. 7 active TB cases were identified early, with improved patient outcomes and reduced contacts. Limitations are the poor uptake, partly due the COVID-19 pandemic (service suspension). Barriers include language (non-English speakers); lack of understanding about latent TB; stigma associated with TB; financial constraints; and temporary accommodation of this population, hence difficulty arranging appointments. Leaflets in different languages and work with community and religious leaders would help to raise awareness.

References

1. Tuberculosis in England 2021 report – UK Health Security Agency

2. https://www.england.nhs.uk/tuberculosis-programme/area-for-action-8-national-latent-tb-infection-testing-and-treatment-programme/