Introduction
    • Define tuberculosis, types of tb and cocentratin on pulmonary tb who {age,gender, ethnicithy, include beliefs here…..it risk why   {risk factors eg location buses crowded ares, living with someone who has it and where{mention brief uk and then concentrate on London}
    •
    • Identify and present relevant epidemiology of the disease {talk about epidemiology in londont (who is at risk, why, where etc.)

    • critically analyse the biological, social and environmental factors determining the rates of infectious disease

As with most infectious diseases, tuberculosis (TB) is not randomly distributed; it thrives in specific groups and under specific conditions in association with identified and unidentified factors that confer vulnerability to the disease. Available information on the association between TB and the many known conditions and circumstances that influence vulnerability to the disease has been reviewed recently and is summarized in the Box . 1- 2 These conditions and circumstances mainly include 3 broad categories of factors: individual biological factors (eg, immunodeficiency states), social and economic circumstances (eg, crowding, poverty, poor nutrition), and environmental and institutional factors (eg, silica dust, poor ventilation).
.include immigrants tb in London journal

Environment

Tuberculosis is most prevalent in under-developed countries due to unsanitary living conditions, crowded living quarters and lower income levels. The incidence of active tuberculosis infection in western Europe is only five per 100,000 people, whereas in eastern Europe it is 50 to 100 per 100,000, according to information published in "Thorax." India is even higher, with 100 to 200 per 100,000. Those who reside in close living conditions, such as in prisons, institutions and nursing homes, are at a higher risk of infection, according to the CDC.
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