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Health Services Provision

Dáil Éireann Debate, Tuesday - 20 November 2012

Tuesday, 20 November 2012

Questions (607, 650)

Caoimhghín Ó Caoláin

Question:

607. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will outline efforts to combat TB; if he will outline the funding, resources and facilities for same for the years 2009 to 2012; if he will introduce a screening programme for vulnerable groups in particular; and if he will make a statement on the matter. [51259/12]

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Finian McGrath

Question:

650. Deputy Finian McGrath asked the Minister for Health if he will allocate €50,000 to assist the homeless in relation to the disease TB. [51617/12]

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Written answers

I propose to take Questions Nos. 607 and 650 together.

The World Health Organisation (WHO) describes countries with an incidence of less than 10 cases per 100,000 population as a low incidence country. In 2010 and 2011, the annual TB notification rates in Ireland were 9.2 per 100,000 (420 cases in 2010 and 424 cases in 2011) which is the lowest rate recorded since surveillance of TB began in the 1950s and now categorise Ireland as a low incidence country and represents a drop from 11.3 per 100,000 (480 cases) in 2007.The number of TB notifications for 2012 up to week ending November 9th is 339 cases, which is a decrease of 49 cases compared to the same period in 2011 (388 cases).

The overall rate of tuberculosis continues to decline and this decrease has prompted a review in the HSE of the continuing requirement for BCG which is currently in progress.

WHO data indicates that TB notification rates always tend to be higher in inner city locations compared to the general population as is reflected in all major cities worldwide. The rates of TB remain high in parts of inner city Dublin and North Dublin, ranging between 17 per 100,000 to 30 per 100,000 in some areas.However, LHO 7 (comprising mainly Dublin 1 and 7) has shown a decline in rates of TB from 2010 when the rate was 22.9 per 100,000 population (31 cases) to a rate of 14 per 100,000 (19 cases) in 2011. In 2011 a prison outbreak in Dublin increased the TB rate in that local area to 28/100,000.

Homeless people are at increased risk of TB, have higher default rates and worse treatment outcomes (including mortality) than the general public. In many industrialised countries, TB rates among the homeless can be up to 20 times higher than the general population.TB has also increased in other marginalised groups such as prisoners and those involved in substance misuse.

Similar to other low prevalence countries in Europe the disease is more focussed in marginalised groups such as homeless, prisoners, substance misusers, immigrants from countries of high endemicity. The recommendations of recent expert advice on the Control and prevention of TB are being reviewed and implemented. The focus on TB is being prioritised to the key high risk groups, homeless, immigrants from high endemic countries, and prisoners; and this will guide future funding and developments in services for people with TB.

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