title: Tuberculosis screening of asylum seekers: 1 years' experience at the Dover Induction Centres.
abstract: OBJECTIVE
  To describe the uptake and outcomes of a service for tuberculosis screening of asylum seekers.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  A tuberculosis screening service was established at the Dover Induction Centres for all asylum seekers entering the UK through ports in Kent. This study describes the uptake and completion of tuberculosis screening, the results of tuberculin skin testing and follow-up, and the cost of the service during its first year.
  
  
  RESULTS
  In 1 year, 8258 asylum seekers were screened: 94% of 8799 who were eligible. A total of 2.2% of those with completed screens were positive (on the basis of symptoms requiring further investigation or positive Heaf reaction). Eleven cases of active respiratory disease were diagnosed on the basis of symptoms, Heaf reaction plus chest X-ray, or both; three were confirmed microbiologically. One-quarter of Heaf tests were not read because of the rapid dispersal of asylum seekers. The follow-up of those requiring further investigations at their destinations was largely unknown. The service cost was 350,000 pounds.
  
  
  CONCLUSIONS
  Induction centre tuberculosis screening services for asylum seekers can achieve a high uptake, but their cost-effectiveness is questionable, particularly where the yield of active disease is low. Tuberculin skin testing is not an ideal screening procedure in this setting because it may be uncompleted and the benefit of detecting latent infections is uncertain.
authors.affiliation: Centre for Infectious Disease Epidemiology, Department of Primary Care and Population Science, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK. Richard.harling@wyreforest-pct.nhs.uk
authors.forename: R
authors.initials: R
authors.lastname: Harling
authors.forename: M
authors.initials: M
authors.lastname: Pearce
authors.forename: M
authors.initials: M
authors.lastname: Chandrakumar
authors.forename: K
authors.initials: K
authors.lastname: Mueller
authors.forename: A
authors.initials: A
authors.lastname: Hayward
mesh_terms: D000328:Adult; D001294:Attitude to Health; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D008403:Mass Screening; D010342:Patient Acceptance of Health Care; D012036:Refugees; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D006113:United Kingdom / Q000453:epidemiology