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UK Border Agency (Tuberculosis)

Volume 505: debated on Wednesday 10 February 2010

I would like to take this opportunity to update the House on the progress of the UK Border Agency pilot to pre-screen entry clearance applicants for active cases of tuberculosis to address the problem of imported infection. The pilot was initiated in late 2005 and has been testing pre-entry screening as a possible alternative, or supplement, to the long-established practice of X-ray screening passengers arriving at UK ports from high-risk countries. The pilot has been managed with the Department of Health and Health Protection Agency and requires those wishing to come to the United Kingdom for more than six months, from specified countries where there is a high incidence of TB, to undertake screening prior to applying for a visa overseas. The countries concerned are: Bangladesh, Ghana (which also takes applications from Burkina Faso, Côte d'Ivoire, Togo and Niger), Kenya (which also take applications from residents of Eritrea and Somalia), Pakistan, Sudan, Tanzania, and Thailand (which also takes applications from Cambodia and Laos). The International Organization for Migration, who run similar projects for other countries around the world, were contracted to provide the screening facilities.

We are currently carrying out a final evaluation of the pilot and expect to reach decisions about the future of pre-entry screening in the near future. Screening was implemented in pilot countries on a phased basis, and the screening methodology was strengthened during the pilot as a more reliable sputum culture process for detecting active tuberculosis became available. I want to share with the House the principal statistical information produced by the pilot, to inform subsequent thinking and discussion about the screening arrangements. The following table provides the total number of positive TB cases identified through the pre-entry screening programme, since inception in 2005, against the total number of individuals screened.

Pre-entry TB screening (October 2005 - September 2009)

Total Screened

Total Positive

Pre-entry TB screening Oct 2005 - September 2009

325,507

191

To place these figures in context, there were a total 8,655 cases of active tuberculosis cases in the UK in 2008. The evidence suggests that in the majority of these cases the infection originated overseas, but the available data do not show whether the carriers were returning UK residents who had visited countries with a high prevalence of TB, EEA nationals or persons subject to immigration control. Data are not currently collected centrally on the number of active TB cases detected among arriving passengers as a consequence of community health referrals made by port medical inspection teams. The advice from the Health Protection Agency is that many of those who develop actively infectious TB, do so more than two years after their last entry to the United Kingdom. There is no scientifically recognised screening method for predicting whether individuals will go on to develop active TB during their lifetime. We intend to take stock of the available evidence, together with comparative data from other countries which screen for TB as part of their immigration control arrangements, later this year. The Department of Health has in place a comprehensive action plan to detect and combat TB in the community.