Longitudinal incidence of tuberculosis in South-East Asian refugees after re-settlement.
METHODS
A State refugee screening programme in Victoria.


OBJECTIVE
To determine the longitudinal incidence of tuberculosis (TB) in South-East Asian refugees in the first five years after re-settlement, and to determine predictors of risk.


METHODS
A retrospective cohort study of 1101 refugees from Laos, Cambodia and Vietnam screened for TB after arrival in Australia, in the 6-month period from July 1989 to January 1990. Incident cases of TB were identified by matching the refugee database with the TB notification database for 1989-1994, giving five years of follow-up data. Preventability was assessed for incident cases by reviewing medical records.


RESULTS
The development of active tuberculosis in the first five years after re-settlement.


RESULTS
The incidence of active TB was 363/100000 during the first year after re-settlement, and 109/100000/year during the first five years. There were no incident cases of TB in refugees with initial skin test reactions <10 mm. Skin test reaction size was the only predictor of risk of TB.


CONCLUSIONS
There is a high risk of tuberculosis in South-East Asian refugees, particularly in the first year after re-settlement. This risk decreases with time. Migration stress, concurrent illnesses and poor nutrition may be explanations for this observation. Refugees are at high risk for TB, even after pre- and post-migration screening, emphasising the importance of preventive therapy and follow up in this group.
MacIntyre
C R
CR
Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, Victoria, Australia. rainam@cmed.wsahs.nsw.gov.au
Plant
A J
AJ
D000328:Adult; D001210:Asia, Southeastern / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D016012:Poisson Distribution; D012036:Refugees; D012189:Retrospective Studies; D012307:Risk Factors; D014374:Tuberculin Test; D014376:Tuberculosis / Q000208:ethnology* / Q000517:prevention & control*; D014739:Victoria / Q000453:epidemiology