Post-migration screening for active tuberculosis in Victoria, Australia.

SETTING

Tuberculosis (TB) screening clinic.

OBJECTIVE

To determine TB prevalence at entry, screening yield and incidence in immigrants on a TB health undertaking (TBU) who were selected for post-migration screening due to an abnormal chest radiograph (CXR) in Victoria, Australia, in the years 1996-2006.

METHOD: Rates of notified TB calculated from linkage of a screening programme database with the Victorian TB database.

RESULTS

Prevalence at entry (cases notified between arrival in Australia and 6 months after the screening registration date) was 505 per 100,000 population; yield at entry (prevalent cases detected by the screening programme) was 420/100,000, and incidence (cases notified between 6 and 12 months after screening registration date) was 160/100,000 person-years. Persons issued a TBU after applying from within Australia (on-shore) had a prevalence of 1876/100,000, seven-fold higher than those issued a TBU outside Australia (off-shore, 254/100,000). The combination of an abnormal CXR and a tuberculin skin test ≥ 15 mm carried a prevalence of notified TB of 2907/100,000.

CONCLUSION

Selective post-migration screening can achieve a high yield of notified TB.