Tuberculosis surveillance in immigrants through health undertakings in Western Australia
OBJECTIVE: To assess the effectiveness and efficiency of tuberculosis (TB) surveillance in immigrants.
DESIGN: Retrospective descriptive analysis of records of immigrants who first registered with the Tuberculosis Program from January 1994 to December 1995, having entered Western Australia on health undertakings (non-legal contracts signed by those determined during pre-migration screening to require post-arrival evaluation).
RESULTS: Of 1344 immigrants on health undertakings for TB in the period, 587 (44%) had findings directly related to TB through pre-migration screening, 69 of whom required treatment for active disease. Another 443 (33%) had chest X-ray changes for which TB could not be excluded. Of the remaining 314 (23%), 172 had poor quality X-rays. Post-arrival assessment and follow-up of the whole group detected four of seven additional cases of active TB, 373 persons (28%) requiring on-going surveillance, 667 (50%) with non-TB conditions and 280 (21%) with normal chest X-rays.
CONCLUSIONS: Migrant surveillance for TB in Australia is effective in detecting active disease and identifying a high-risk subgroup requiring further evaluation. Efficiency can be improved and high compliance achieved with simple administrative changes. Routine pre-migration Mantoux testing is inappropriate, and its inclusion in post-arrival assessments should be a national policy decision.
Document Type: Regular Paper
Affiliations: Tuberculosis Control Programme, Perth Chest Clinic, Western Australia
Publication date: 2000-03-01
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