[Risk of tuberculosis in the inadequate handling of refugees seeking asylum].

OBJECTIVE

To describe screening for tuberculosis in a temporary centre for refugees, and contact investigation after a patient with open tuberculosis had been identified.

DESIGN

Descriptive.

SETTING

Regional Communal Health Centre Nijmegen.

METHOD: The refugees waiting for official status were housed on three cruise ships during the winter period November 1993 to April 1994. Ventilatory capacity was insufficient. The people had thorax radiograms after 10 days on average as a screening for tuberculosis. When abnormalities were found sputum was examined (Ziehl-Neelsen staining and culture). The workers of the centre were Mantoux-tested.

RESULTS

Of the 834 persons screened 4 had open tuberculosis. Contact investigation yielded three cases of infection among 5 contacts in the first ring, and 11 cases of infection and 2 cases of tuberculosis (one infiltrative pulmonary tuberculosis, the other cavernous pulmonary tuberculosis) among 215 contacts in the second ring. Fourteen of the infected persons were centre workers. The bacteria found were not resistant to tuberculostatics.

CONCLUSION

Rapid transmission of tuberculosis occurred because of insufficient ventilation and a slow screening procedure. Tuberculosis in refugee centres is a serious problem that needs adequate attention.