Behind the scenes at Bristol’s first ever TB screening for homeless

23 Mar 2017 Nicola Rodgers

More than 200 homeless people in Bristol have been screened for TB as part of a two-day initiative run in partnership with Bristol Community Health. The project, which was funded by Public Health England and supported by University College London Hospitals’ TB ‘Find and Treat’ team, is thought to be the first mass screening to have taken place in Bristol since the 1970s and the first ever to target the city’s homeless population.

Between 21-22 February, using mobile x-ray machines provided by the Find and Treat team, Bristol Community Health’s TB nurses worked with the service and colleagues from Public Health England and local voluntary sector organisations to screen vulnerable people at five locations across the city.

Those taking part received their x-ray results on the spot. They were also offered vaccinations against flu and hepatitis B, and screening for hepatitis C by the specialist hepatitis team. Where an x-ray suggested the disease may be present, patients were seen by a TB consultant at the Bristol Royal Infirmary within two days.

TB rates in Bristol are almost double the England average: last October, the Bristol Post reported a thirteen-year high for TB diagnoses in the city. Homeless populations are particularly susceptible to the disease due to sleeping rough, exposure to cold and poor nutrition. Other risk factors include drug abuse, alcohol dependency and having spent time in prison.

Ruth King, from Bristol Community Health’s TB Nurse Service, explains: “TB rates tend to be higher among people who are homeless because their immune systems are more likely to be compromised. In spite of this, it’s often diagnosed later among those with chaotic lifestyles, by which time it’s more advanced and – as a result – more infectious.”

Details of the screenings were shared through local organisations working with the homeless and those living with drug and alcohol dependencies. This included Bristol Drugs Project, the Salvation Army and the Compass Centre, as well as Bristol Methodist Centre in Lawrence Hill, and the Wild Goose Café.

Ruth adds: “We’re especially grateful to the voluntary sector for their support with the project – it’s thanks to their hard work that we were able to encourage people to come to these screenings. Together we’ve been able to increase the profile of TB in a community which is particularly vulnerable, and we plan to continue this work with more awareness-raising initiatives in the future.

“TB can affect anyone, but for most people it’s entirely curable and can be treated with antibiotics. We hope that by encouraging everyone to ‘think TB’ we can diagnose more cases more quickly, and help to control the spread of the disease much more effectively.”

What are the signs of tuberculosis (TB)?
Symptoms of TB usually include one or more of the following:

  • A cough lasting for more than 3 weeks (may or may not be with phlegm)
  • Fevers
  • Drenching night sweats
  • Weight loss
  • Unexplained exhaustion
  • Loss of appetite
  • Unusual lumps or swellings.

Find out more
Bristol Community Health’s TB Nurse Service provides information, advice and education about TB to health professionals and the community.

Special acknowledgment and thanks to colleagues and staff at Bristol Drugs Project, Salvation Army’s Logos House, Wild Goose Café, Bristol Methodist Centre, the Compass Centre, Public Health England, University Hospitals Bristol’s viral hepatitis and TB teams, and University College London Hospitals’ Find and Treat team.