The geographical distribution of tuberculosis notifications in a national survey of England and Wales (1978-79). Report from the Medical Research Council Tuberculosis and Chest Diseases Unit.

A survey of tuberculosis notifications from 1 October 1978 to 31 March 1979 has provided a special opportunity to estimate annual notification rates in different ethnic groups for the 8 administrative areas of England and the 33 boroughs of Greater London. In addition it has been possible to calculate for each of the 54 counties and 403 local authorities of England and Wales the relative proportions of cases that were of White and non-White ethnic origin. Much of the considerable variation in the rates between the administrative areas of England, ranging from 5.2 per 100 000 in Anglia to 23.7 in the West Midlands, could be accounted for by the varying proportions of persons of Indian subcontinent ethnic origin for whom the notification rates were very high. Nevertheless the White rates also varied widely, from 4.2 per 100 000 in Anglia to 14.5 in the Northern area. The notification rate in Greater London was twice the national average, due in part to the fact that 40% of all non-White patients in the survey were resident there. Within the boroughs of Greater London the rates for all ethnic groups combined ranged from 7.0 in Bromley to 114.3 in Brent, a 16-fold difference. The highest rates occurred in the more densely populated areas. A large number of cases of Indian subcontinent ethnic origin was not necessarily associated with a high rate in the White population, nor vice versa.