Tackling TB among hard-to reach groups in London
Active case-finding with the Mobile X-ray Unit (click on the van for the current schedule of visits).
How we find
The mobile X-ray unit (MXU)
The MXU visits hostels, day centres, drop-ins and drug and alcohol projects across London twice yearly to screen hard to reach groups for active TB [homeless people, alcohol and drug users, sex workers and prisoners]. The service is also available on the request of local public health experts to support TB screening initiatives outside of London. [Contact us]
Getting screened is very quick [it takes two minutes], confidential and safe. We give the results immediately and there is no need to undress. Click here to see the screening process.
The National Institute for Health and Clinical Excellence [NICE] recommend screening using digital chest X-ray as the best method to provide fast results for likely active TB. [http://www.nice.org.uk/nicemedia/pdf/CG33quickreffguide.pdf]
Chest X-rays can detect TB before a person has symptoms and before they become infectious.
Because the symptoms of TB are very common among hard to reach groups [persistent cough, weight loss, fever and night sweats] most of the people we find have no idea that they have TB. The Health Protection Agency evaluated the first two years of the MXU and found that screening reduced the risk of hard to reach cases being infectious by two-thirds click to read the MXU_Final Evaluation_Report_November_2007.pdf
The best way to reduce the risk of TB to hard to reach groups and frontline staff is for ALL service users to be screened regularly [every six months]. It is essential that staff encourage their service users to get on the van and get screened. We rely on your expertise and rapport with service users make sure they get screened. The training, advice and Peer to Peer Education Project we provide to frontline staff greatly increases the uptake of the service and promotes awareness of TB.
Screening staff for active TB using chest X-rays is not recommended by NICE because they are at much lower risk from TB and can access hospital based services for comprehensive investigations if they become ill or are exposed to an infectious TB case. When a service user is confirmed as having infectious TB [following further tests at the local TB clinic (see Accompanied referrals ) then staff who may have been exposed are invited to a local hospital for tests. For staff the aim is to prevent them being exposed in the first instance by screening service users and prevent them from developing active TB if they are exposed.
Locating and re-engaging lost to follow up cases
Research has demonstrated that hard-to-reach groups are often lost to follow up care prior to completing diagnostic tests or while on treatment. Find & Treat will respond to any request to help re-locate and re-engage any person suspected or confirmed as having TB who is lost to follow up.
(click for more information on losttofollowup.pdf).