An evaluation of completeness of tuberculosis notification in the United Kingdom

Pillaye, Jayshree; Clarke, Aileen
January 2003
BMC Public Health;2003, Vol. 3 Issue 1, p31
Academic Journal
Background: There has been a resurgence of tuberculosis worldwide, mainly in developing countries but also affecting the United Kingdom (UK), and other Western countries. The control of tuberculosis is dependent on early identification of cases and timely notification to public health departments to ensure appropriate treatment of cases and screening of contacts. Tuberculosis is compulsorily notifiable in the UK, and the doctor making or suspecting the diagnosis is legally responsible for notification. There is evidence of under-reporting of tuberculosis. This has implications for the control of tuberculosis as a disproportionate number of people who become infected are the most vulnerable in society, and are less likely to be identified and notified to the public health system. These include the poor, the homeless, refugees and ethnic minorities. Method: This study was a critical literature review on completeness of tuberculosis notification within the UK National Health Service (NHS) context. The review also identified data sources associated with reporting completeness and assessed whether studies corrected for undercount using capture-recapture (CR) methodology. Studies were included if they assessed completeness of tuberculosis notification quantitatively. The outcome measure used was notification completeness expressed between 0% and 100% of a defined denominator, or in numbers not notified where the denominator was unknown. Results: Seven studies that met the inclusion and exclusion criteria were identified through electronic and manual search of published and unpublished literature. One study used CR methodology. Analysis of the seven studies showed that undernotification varied from 7% to 27% in studies that had a denominator; and 38%-49% extra cases were identified in studies which examined specific data sources like pathology reports or prescriptions for anti-tuberculosis drugs. Cases notified were more likely to have positive microbiology than cases not notified which were more likely to have positive histopathology or be surgical in-patients. Collation of prescription data of two or more anti-tuberculosis drugs increases case ascertainment of tuberculosis. Conclusion: The reporting of tuberculosis is incomplete in the UK, although notification is a statutory requirement. Undernotification leads to an underestimation of the disease burden and hinders implementation of appropriate prevention and control strategies. The notification system needs to be strengthened to include education and training of all sub-specialities involved in diagnosis and treatment of tuberculosis.


Related Articles

  • Practical issues around putting the patient at the centre of care. Dunn, Nick // Journal of the Royal Society of Medicine;Jul2003, Vol. 96 Issue 7, p325 

    The article discusses the aspects of a patient-centered care implementation on the public health systems in Great Britain. It centered on informing and involving patients and assuring proper treatment in a dignified and supportive manner. However, there are some obstacle to its enforcement like...

  • Clinical portal gives Liverpool hospitals single patient view across multiple departments.  // British Journal of Healthcare Computing & Information Management;Nov2010, p33 

    The article reports that Royal Liverpool and Broadgreen University Hospitals NHS Trust has successfully completed a proof of concept (PoC) evaluation of CSC's Clinical Information Portal. The portal has been developed as part of a pilot of the NHS Interoperability Toolkit. It is stated that the...

  • Intelligent analytics gives Torbay patient-level view for enhancing care services.  // British Journal of Healthcare Computing & Information Management;Nov2010, p32 

    The article reports that Torbay Care Trust, an integrated health and adult social care organisation, has gone live with a care pathway analytics and reporting system from MedeAnalytics. The system examines health and social care pathways for specific groups of patients and at an individual...

  • The stiff upper lip of this sceptred isle. Selby, Mary // GP: General Practitioner;6/27/2008, p24 

    The author reflects on the impact of the zero tolerance campaign developed by the National Health Service (NHS) to the patients in Great Britain. She states that one of their patients cannot complain with the new scheme because they have nothing to do with it anyway. She also adds that she...

  • Out-of-hours service 'over-reliant on GPs'.  // Pulse;Nov2016, p31 

    The article reports on the plan of the National Health Service (NHS) board to overhaul the out-of-hours service of the general practitioners (GPs) wherein the healthcare professionals will no longer see patients for urgent care across Great Britain.

  • Viewpoint: Money, media, and general practice. Rashid, Mohammed Ahmed // British Journal of General Practice;Feb2014, Vol. 64 Issue 619, p96 

    The article presents opinion of the author on the patient-doctor relationship. The author states that General Practitioners (GPs) support their patients through major life events and provide them personalised end-of-life care and that is why overwhelming majority of patients have trust and...

  • Keeping children safe in the healthcare system. Smallman, Suzan // Paediatric Nursing;Oct2003, Vol. 15 Issue 8, p20 

    Explains how the National Health Service (NHS) in Great Britain can improve its patient safety record with the establishment of the National Patient Safety Agency (NPSA) and the commitment of the nurses. Aims of the NPSA; Promotion of an open and fair culture in the NHS; Role of nurses in...

  • Evaluation of counselling in the National Health Service. Fallowfield, L. J. // Journal of the Royal Society of Medicine;Jul1993, Vol. 86 Issue 7, p429 

    The article discusses counselling evaluation in the National Health Service (NHS) in Great Britain. The author reflects on the effectiveness of counselling in NHS. He mentions the inadequate in-house training conducted by NHS and states that trainees lack communication skills. He suggests on...

  • The transparent NHS? Edwards, Nadine // AIMS Journal;2006, Vol. 18 Issue 4, p18 

    The author comments on the establishment of the Commission for Patient and Public Involvement in Health (CPPIH) under the 2001 Health and Social Care Act by the British National Health Service (NHS). According to the author, there are many criticisms regarding the new structures developed to...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics