Longitudinal incidence of tuberculosis in South-East Asian refugees after re-settlement
Abstract:SETTING: 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.
DESIGN: 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.
MAIN OUTCOME: 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.
Document Type: Regular Paper
Affiliations: 1: Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, Victoria, Western Australia 2: Department of Public Health, University of Western Australia, Clifton Street, Nedlands, Western Australia
Publication date: April 1, 1999
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