Tuberculosis in Newham Borough of London the Essay

Tuberculosis in Newham Borough of London

The Urban Health Profile

It is true that as long as there have been human beings on planet earth there has been a certain amount of struggle against disease and creatures that carry disease along with bacteria and viruses. These are the types of struggles and successes which have determined whether or not civilizations would triumph or be defeated, and these are the struggles which will no doubt be a part of the human experience for years to come. Just as human beings feel like they have some sort of leverage and superiority over illness a disease such as over strains of bacteria through antibiotics, strains of bacteria eventually became resistant to antibiotics and ended up conquering this form of treatment: "A relationship based on interdependency between humans and micro-organisms exists with one achieving dominance over the other throughout history" (Choudhury & Mayo, 2003).

This paper looks at the epidemic and issue of tuberculosis in the Newham Borough of London along with the practical and theoretical work on the urban health issue that is necessary for this overall assessment. The practical aspect of this assessment includes the observation and data collection necessary, and the theoretical assessment includes the aspect which is informed by the wider scope of literature. As a result of the fact that the study concerns the Newham Borough of London, the study will be carried out there. The rationale for choosing this particular study and issue is clear: Newham not only has the highest rate of tuberculosis in London, it also has the highest rate of tuberculosis in the entire western world. Historically, the UK has long had a problem with incidences of tuberculosis, with it being highest in the 19th century, and then falling organically, even long before specific measures designed to thwart tuberculosis, such as things like chemotherapy and immunization (Choudhury & Mayo, 2003). Immigration along with an overall demographic change was some of the things which contributed to tuberculosis decline. Though Newham has been found to have the highest rate of TB in the entire UK; what's more the rates have been found to be increasing. This state of emergency indicates part of the need for serious treatment, prevention and understanding of this condition because of the fact that the condition has been increasing at such a steady rate. That statistic was issued ten years ago; today there has been progress, but the issue still remains something rather pertinent.

The media is making more and more people aware of the fact that Newham is the place to catch tuberculosis more than anywhere else in London. This is a fact which is hurting the economy of Newham, causing fewer visits and less tourism to this region as a whole. In 2012, "366 cases of TB were recorded which is 16.9 per cent more than Ealing - the next worst borough for the disease - where 313 people were diagnosed with the condition. This means that out of every 100,000 people in Newham, around 118 will contract TB - a potentially fatal, infectious disease which normally affects the lungs. The report, published on today by Public Health England, shows that around 40 per cent of all cases of TB in the country were contracted in London" (York, 2013). As Doctors in the area have reported, more and more people are seeking treatment, with 85% of people completing treatment within a year, but more needs to be done with prevention. And even more needs to be done with controlling the spread of the infection as a priority in London as a whole (York, 2013).

It was during the millennium when incidence of tuberculosis (TB) received more attention in the neighbourhoods throughout London as rates of the disease spread and more experts in the health and sciences decided to study it. Rates of the disease were climbing in places like the inner city boroughs and were being driven up by things like ethnicity and poverty (Beckhurst et al., 2000). Beckhurst and colleagues wanted to determine which factors were most salient in the distribution of cases of tuberculosis most of all. "The Borough of Newham in the East End of London is made up of 24 electoral wards and has one of the highest notification rates in the United Kingdom. Our analysis showed that the percentage of the population who were non-white made a strong contribution to the variance in TB rates between wards (p < 0.0001), but the age distribution of the population and Jarman scores for poverty did not, the latter because the entire borough is deprived. Measures to control TB should be targeted at those areas where members of the community are most at risk" (Beckhurst et al., 2000). Thus, part of all control measures regarding this disease need to be focused on containment of the condition. This means targeting the areas within Newham where people are most at risk and determining how to best protect individuals from developing this condition. Rates of Tuberculosis As already alluded to, the rates of tuberculosis are part of the reason why studying this issue in Newham is such a pressing issue. Newham and Brent are the areas just outside of London that have the highest rate of tuberculosis in the western hemisphere. "In North East London, rates in Newham increased steadily from 2002, and remain high, while rates in Hackney have declined... Rates among the UK born populations were above 20 per 100,000 populations in Haringey, Newham, Brent, Hackney and Lewisham. Rates in the non-UK born were above 150 per 100,000 in Newham, Brent, Ealing and Hounslow (Appendix A v). These figures should, however, be interpreted with caution due to the small numbers and population estimates involved" (HPA, 2011). Researchers have found that when it comes to population groups living in London, they are at a bolstered risk for getting tuberculosis, and that the absence of any rates in decline for many of them is more evidence for the fact that there is no successful strategy in controlling and minimizing the burden of tuberculosis in London. Certain areas of Newham demonstrate that there is an increased risk of tuberculosis and that the bulk of all highly targeted prevention activities need to focus on these high risk groups as targeting these groups is most cost effective (HPA, 2011). For example, one manifestation of this is that Indian ethnicities generally face and confront this affliction more than other groups. In 2007 the concentration of tuberculosis in Newham continued to be problematic and concerning. "TB is concentrated in particular areas of London ranging from a low of <8/100,000 in Havering Primary Care Trust (PCT) area in North East London (NEL) and Richmond in South West London (SWL), to 110/100,000 in Newham (NEL) in 2007. This is almost 12 times the average incidence in England & Wales outside of London" (NHS, 2007). This data demonstrates that tuberculosis in Newham is truly a hot bed of disease in this area and that the only solution for confronting it effectively is to take strategic and aggressive action. For instance, when it comes to the rate of TB incidence per 100,000 in the population, one can see that aggressive action has generally not been taken in an adequate manner. In 1999 the rate in Newham was 95.9, in 2000 it was 101.9; there was some reduction with the rate at 83.4 in 2001. Thus the average for 1999-2001 at 93.7. In 2002 the incidence rate per 100,000 people in Newham shot back down to 85.0 in 2002, before it climbed back up to 97.8 2003, staying there in 2004 at 97.3, and then climbing even higher to 104.8 in 2005, and then to 105.1 in 2006, and getting even higher to 110.2 in 2007. The overall average rate of incidences of TB in Newham from 2005-2007 was 106. 7 (NHS, 2007). Thus, these numbers demonstrate that the UK has not been able to get a better handle on this condition as time has gone by, something which there is absolutely no excuse for. In that sense, there's an aggravated need for better and more precise action when it comes to containing this condition. If one looks at the same period of years and the incidences of new TB cases which have occurred in time, there's still the same lack of progress: in 1999 there were 226 new cases in Newham; in 2000 there were 244 new cases; in 2001 there were 208 new cases; in 2002 there were 214; in 2003, there were 245 new cases; in 2004 there were.....