1. Tuberculosis in Ealing - Housing

2. What is TB Tuberculosis, or TB, is a disease caused by a germ (Mycobacterium tuberculosis). TB usually affects the lungs, but can affect other parts of the body, such as the lymph nodes (glands), the bones and (rarely) the brain. Infection with the TB germ may not develop into TB disease.

3. Symptoms Fever Night sweats Persistent cough Losing weight Losing appetite Blood in your sputum (phlegm or spit) at any time

4. Infection risk Infectiousness of person with TB Environment in which exposure occurred Duration of exposure Virulence of the organism

5. NICE Close contacts of infectious cases Those who have lived in, travel to or receive visitors from places where TB is still very common Those who live in ethnic minority communities originating from places where TB is very common Those with immune systems weakened by HIV infection or other medical problems The very young and the elderly, as their immune systems are less robust Those with chronic poor health and nutrition because of lifestyle problems such as homelessness, drug abuse or alcoholism Those living in poor or crowded housing conditions, including those living in hostels.

7. Impact of housing Completion of TB treatment and stable accommodation Improved completion when stable accommodation Improved completion = less risk of TB resistant strain Recommendation from NICE Useful adherence strategies include: assisting or advising patients regarding links to social security benefits and housing/social services.

8. Conclusion Housing and TB are linked –Overcrowding increases the risk of acquiring TB disease and TB infection –Stable housing improved adherence to TB treatment –Improved adherence = less risk of resistant strain of TB

9. Experiences from Ealing TB Service People had their tenancy agreement terminated after the landlord found out the patient had TB (rare instance) Mainly single men with TB living in hostel accommodation and being moved at very short notice (also they do not appear to qualify for housing) Mother and x amount of children living in one room (=overcrowding)

10. Housing department at Ealing does not give priority or support to patients affected by TB (service issue) Where patients were referred, they were ‘forced’ to relocate to somewhere else, but not in Ealing (??) No communication from Housing department to TB Service (service issue) Experiences from Ealing TB Service

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