Screening of new entrants for tuberculosis: responses to port notifications.
BACKGROUND
Tuberculosis in England and Wales is associated with recently arrived immigrants. Screening new entrants for tuberculosis has received considerable attention recently. Despite several calls to reorganize screening processes for new entrants because of perceived ineffectiveness, some systems at ports have remained largely unchanged, including notification arrangements.


METHODS
A postal questionnaire was sent to Consultants in Communicable Disease Control (CsCDC) who normally receive port health notification forms from London Heathrow Port Health Control Unit relating to new entrants who had either been screened and found to have a normal chest X-ray, not had an chest X-ray due to pregnancy or young age or whose examination was inconclusive (Port 101 and 102 forms).


RESULTS
Almost half of the responding CsCDC attempted to follow-up all Port 101 and 102 referrals; of these CsCDC, 46 percent reported that they were actually able to follow-up under 50 percent. CsCDC had developed their own criteria to aid decisions as to which referrals to follow-up.


CONCLUSIONS
The follow-up by CsCDC of new entrants passing through Heathrow Port Health Control Unit who have been screened and found to have a normal chest X-ray, not had an X-ray due to pregnancy or young age, or whose examination was inconclusive varies considerably and there is no consistent national practice. Substantial efforts are being expended on attempting to follow-up new entrants, many of whom may be at low risk of tuberculosis. The effectiveness (and efficiency) of this approach is probably low.
Hogan
Helen
H
North East London Strategic Health Authority, Aneurin Bevan House, 81 Commercial Road, London E1 1RD. h.hogan@doctors.org.uk
Coker
Richard
R
Gordon
Alex
A
Meltzer
Margie
M
Pickles
Hilary
H
D000465:Algorithms; D003140:Communicable Disease Control / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D003153:Community Health Services / Q000458:organization & administration*; D003266:Continuity of Patient Care; D018563:Disease Notification; D004641:Emigration and Immigration / Q000331:legislation & jurisprudence*; D005568:Forms and Records Control; D006291:Health Policy; D006801:Humans; D007373:Interinstitutional Relations; D008400:Mass Chest X-Ray / Q000706:statistics & numerical data*; D010808:Physical Examination / Q000706:statistics & numerical data*; D011635:Public Health Administration; D012017:Referral and Consultation / Q000458:organization & administration*; D012036:Refugees / Q000331:legislation & jurisprudence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000331:legislation & jurisprudence; D014376:Tuberculosis / Q000175:diagnosis / Q000517:prevention & control*; D006113:United Kingdom