title: Cohort analysis of asylum seekers in Oslo, Norway, 1987-1995: effectiveness of screening at entry and TB incidence in subsequent years.
abstract: METHODS
  Municipalities of Baerum and Oslo, Norway.
  
  
  OBJECTIVE
  To examine the effectiveness of tuberculosis (TB) screening in asylum seekers 1987-1995, and to describe TB incidence rates after arrival.
  
  
  METHODS
  Register-based, retrospective cohort study of 19912 asylum seekers with a mean follow-up of 6.3 years.
  
  
  RESULTS
  Seventy-six persons were diagnosed with TB, of whom 43 (57%) had pulmonary TB. Twenty-two cases (17 pulmonary) were found through screening at entry. Eleven persons had abnormal mass miniature X-rays (MMRs), but had inadequate follow-up and were diagnosed later through passive case finding. MMR itself had a sensitivity of 96% and a specificity of 98% for pulmonary TB, diagnosed within 1 year after arrival. TB prevalence at entry was 110/100000; for Somalis it was 577/100000. Incidence rates were stable in the total cohort after arrival, whereas rates for extra-pulmonary TB in Somalis increased.
  
  
  CONCLUSIONS
  Screening on entry should continue, but follow-up of abnormal MMRs must be improved. There should be more emphasis on treatment of latent infection.
authors.affiliation: Frogner Health Centre, Oslo, Norway. n.l.johnsen@samfunnsmed.uio.no
authors.forename: N L
authors.initials: NL
authors.lastname: Johnsen
authors.forename: T W
authors.initials: TW
authors.lastname: Steen
authors.forename: H
authors.initials: H
authors.lastname: Meyer
authors.forename: E
authors.initials: E
authors.lastname: Heldal
authors.forename: I J K
authors.initials: IJ
authors.lastname: Skarpaas
authors.forename: G B
authors.initials: GB
authors.lastname: June
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D009664:Norway / Q000453:epidemiology; D013902:Radiography, Thoracic; D012036:Refugees; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology*