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Free Content Screening and management of tuberculosis in immigrants: the challenge beyond professional competence

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SETTING: Right of entry may sometimes be denied to immigrants because of the threat of tuberculosis. During 1990–2000 some 1050000 immigrants, mostly from countries highly endemic for TB, arrived in Israel, a low prevalence country. Nevertheless, TB rates in Israel have remained low.

OBJECTIVE: To emphasise the challenge beyond technical competence for TB control for immigrants from the perspective of Israel's National Tuberculosis Programme (NTP).

MATERIALS AND METHODS: We defined criteria for an NTP geared to immigration, and analysed our implementation of the European Task Force recommendations on international migration and TB control. We interviewed immigrants and health care workers to identify barriers to diagnosis, prevention and treatment of TB among immigrants. We used classical epidemiology to evaluate the impact of immigration on TB rates in the host population.

RESULTS: Until now there has been no evidence of significant spread of TB from immigrants to the host population. Successful outcome of treatment has been noted in over 75%, although a sub-population of immigrant substance abusers is proving more difficult to treat.

CONCLUSIONS: The risk of TB for the host country is very low and it seems possible to enhance TB control in immigrants with measures designed to address their cultural needs.
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Keywords: Israel; TB control policy; immigration; tuberculosis; tuberculosis epidemiology

Document Type: Regular Paper

Affiliations: 1: Department of Tuberculosis and AIDS, Jerusalem, Israel; and Public Health Services, Ministry of Health, Jerusalem, Israel 2: Public Health Services, Ministry of Health, Jerusalem, Israel

Publication date: 01 October 2003

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  • 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.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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