For the first time in the UK, clinics at Barts Health NHS Trust are offering latent tuberculosis infection (LTBI) screening for pregnant migrants in antenatal care.
The UK has one of the highest tuberculosis (TB) rates in Western Europe, with 4,655 cases in 2018, including 1,691 cases in London. People with LTBI have TB bacteria in their body but have no symptoms because the bacteria is inactive.
Women with LTBI have a high risk of developing active TB during pregnancy and postpartum after child birth, which carries a high risk of complications, and poor foetal and maternal outcomes.
The Screening for Tuberculosis in Pregnancy (STOP) programme, funded by the National Institute for Health Research (NIHR), is being offered at The Royal London Hospital, Newham Hospital and Whipps Cross Hospital and led by researchers at Queen Mary University of London. Screening for LTBI at the clinic only involves one blood test in addition to the screening tests routinely offered to patients in antenatal care.
Chief investigator Dr Heinke Kunst, honorary consultant in respiratory medicine at Barts Health NHS Trust and senior lecturer in respiratory medicine at Queen Mary University of London said: “The programme, which has already screened 200 patients, provides a unique opportunity for migrant women to be screened and treated for LTBI to avoid the risk of developing active TB.
“Treatment for LTBI is given after once breast feeding has stopped and will reduce the risk of active TB. This also allows migrant women who may not have GPs and who may not have had any contact with healthcare, to be screened for TB.”
Veronica White, clinical director for Respiratory Medicine at St Bartholomew’s Hospital said: “Screening for and then treating latent TB is an invaluable way of reducing active TB cases in the future and we are delighted that we have the funding for this project from the NIHR.”
The service is offered for pregnant women aged 16 -35 years who entered the UK from countries with high TB rates such as the Indian Subcontinent or sub-Saharan Africa. Migrants who have LTBI and come from countries with a high TB incidence, are at high risk of developing active TB after they arrive in the UK.
To be eligible for screening at this programme, patients should have entered the UK within the last five years and have been previously living in an high-incidence country for six months or longer.
Patients who have been booked for an appointment in antenatal care at the Royal London Hospital, Newham Hospital or Whipps Cross Hospital will be screened.