The epidemiology of tuberculosis among asylum seekers in the Netherlands: implications for screening

Authors: van Burg J. L.¹; Verver S.²; Borgdorff M. W.²

Source: The International Journal of Tuberculosis and Lung Disease, Volume 7, Number 2, February 2003 , pp. 139-144(6)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

OBJECTIVE: To identify low-risk groups among asylum seekers in the Netherlands that may be excluded from tuberculosis (TB) screening at entry or during follow-up.

METHODS: A retrospective cohort study of medical records of asylum seekers entering the country between January 1994 and March 1997.

RESULTS: Medical records were available for 46424 of the 96000 asylum seekers (48%) in this period. One hundred and three pulmonary TB cases were diagnosed at entry (prevalence 222/100000). Risk factors were age >11 years, history of imprisonment and country of origin at war or with TB incidence >100/100 000. During a mean follow-up period of 10 months, 51 pulmonary TB cases were diagnosed (incidence 134/100000 person-years). Risk factors were age >11 years, old lesions on entry X-ray, and country of origin whose asylum seekers had a prevalence of TB at entry >200/100000.

CONCLUSIONS: We conclude that 1) those with abnormal X-ray at entry should receive preventive therapy after exclusion of active TB, or undergo intensive follow-up, 2) periodic screening is not indicated for immigrants from countries whose asylum seekers have a low prevalence of pulmonary TB at entry, and 3) children <12 years can be excluded from screening.

Keywords: tuberculosis; epidemiology; asylum seekers; screening

Language: English

Document Type: Regular paper

Affiliations: 1: Department of Health, Agency for the Reception of Asylum Seekers (COA), The Hague, The Netherlands 2: Royal Netherlands Tuberculosis Association (KNCV), The Hague, The Netherlands

Publication date: 2003-02-01

• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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