Enhanced tuberculosis surveillance in England & Wales: Preliminary results, 1999

A system of enhanced tuberculosis surveillance was introduced from 1 January 1999 in England & Wales (Northern Ireland joined from 1 January 2000). The purpose and methods of Enhanced Tuberculosis Surveillance were described in 1999 (Thorax 54 (S3): A51). The system was reviewed in 1999, revealing variations at local level in the methods used for collation and transfer of data to regional level. This, combined with the lack of appropriate resources at each level, compromised the completeness and availability of epidemiologically relevant surveillance data. By end July 2000, a total of 5187 cases of tuberculosis had been reported to the scheme for 1999 (84% of the number of formally notified cases). There were 2214 cases (43%) reported from London region. Most cases (36%) were aged between 25 and 44 years and 54% were male. Of the 90% of cases for whom country of birth was known, 59% were born abroad. Of the 97% for whom ethnic group information was available, 39% were of Indian Subcontinent, 33% of White and 15% of Black African ethnic group. Where site of disease was known, 60% of cases were pulmonary (with or without an extra-pulmonary site). Thirty-three per cent of pulmonary cases were reported to be sputum smear positive. These data demonstrate that Enhanced Tuberculosis Surveillance has the potential to produce a detailed and representative picture of the occurrence of tuberculosis in England & Wales. Funding has now been provided for full implementation of the scheme, enabling improvement to the completeness and quality of data. In addition it will facilitate the development of treatment outcome surveillance, which is essential to evaluate the effectiveness of the national tuberculosis programme.