Used in this pathway to mean adults, young people and children from any ethnic background, regardless of migration status who are at increased risk of having or contracting TB. This includes:
- people classified as under-served
- people identified as contacts according to the case finding recommendations
- new entrants from high-incidence countries
- people who are immunocompromised.
Close contacts are people who have had prolonged, frequent or intense contact with a person with infectious TB. For example, these could include household contacts those who share a bedroom, kitchen, bathroom or sitting room with the index case. Close contacts may also include boyfriends or girlfriends and frequent visitors to the home of the index case. Depending in the circumstances, occasionally co-workers are classed as close contacts although they are more usually classed as social contacts.
A new entrant is anyone coming to work or settle in the UK. This includes immigrants, refugees, asylum seekers, students and people on work permits. It also includes UK-born people, or UK citizens, re-entering the country after a prolonged stay in a high-incidence country. A high-incidence country or area has more than 40 cases of TB per 100,000 people per year. Public Health England lists high incidence countries and areas of the UK on its website.
In this pathway, immunocompromised refers to a person who has a significantly impaired immune system. For instance, this may be because of prolonged corticosteroid use, tumour necrosis factor-alpha antagonists, antirejection therapy, immunosuppression-causing medication or comorbid states that affect the immune system, for example, HIV, chronic renal disease, many haematological and solid cancers, and diabetes.