Effectiveness of postmigration screening in controlling tuberculosis among refugees: a historical cohort study, 1984-1998.
OBJECTIVE
This study assessed the effectiveness of postmigration screening for the control of tuberculosis (TB) among refugee migrants.


METHODS
We conducted a historical cohort study among 24 610 predominantly Southeast Asian refugees who had arrived in Sydney, Australia, between 1984 and 1994. All had been screened for TB before arrival and had radiologic follow-up for 18 months after arrival. Incident cases of TB were identified by record linkage analysis with confirmatory review of case notes.


RESULTS
The crude annual incidence rate over 10-year follow-up was 74.9 per 100 000 person-years. Only 29.6% of the cases were diagnosed as a result of routine follow-up procedures.


CONCLUSIONS
Enhanced passive case finding is likely to be more effective than active case finding for the control of TB among refugees.
Marks
G B
GB
South Western Sydney Area Health Service, Sydney, Australia. g.marks@unsw.edu.au
Bai
J
J
Stewart
G J
GJ
Simpson
S E
SE
Sullivan
E A
EA
D001210:Asia, Southeastern / Q000208:ethnology; D015331:Cohort Studies; D018563:Disease Notification; D006801:Humans; D015994:Incidence; D008400:Mass Chest X-Ray / Q000706:statistics & numerical data*; D008498:Medical Record Linkage; D009517:New South Wales / Q000453:epidemiology; D015397:Program Evaluation; D011635:Public Health Administration; D012036:Refugees / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014374:Tuberculin Test / Q000706:statistics & numerical data*; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*