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I was glad to see a primary care-based study and accompanying editorial on tuberculosis (TB).1,2 For those of us working in areas where TB is no longer rare, reminders of the growing problem and diagnostic pitfalls are welcome. We know that at least one-half of TB cases are among people born abroad, in places where prevalence has always been high. In addition, among refugees arriving here, as many as 50% may be infected with TB; worldwide, over 17 000 refugees get sick with the disease every year.3 Tourism, international travel and migration are helping TB to spread. Other displaced people, such as homeless people in the UK, are at increased risk of being infected. Wherever it occurs, we need to recognise it is difficult to treat TB in mobile populations, and most of the challenge rightly falls on community and primary care services.
Yet, despite the Chief Medical Officer's action plan, there are still gaps in our management of TB in this country causing us to fall below internationally accepted standards of care. GPs deserve better, clearer guidelines on diagnosis and treatment, including:
Patients with TB want to be diagnosed and treated in the community with the support of their GP. Is it not time that the UK adopt a National TB Control Programme on international lines, and support primary care to deliver this?