Premigration health screening for tuberculosis worthwhile

January 01, 0001

Premigration health screening for tuberculosis worthwhile

The aim of this study by researchers from Australia was to determine whether premigration screening for tuberculosis is worth undertaking in visa applicants, and whether screening resources are being appropriately directed towards intending migrants at highest risk of tuberculosis. It consisted of a 12-month survey of all intending migrants with tuberculosis necessitating treatment detected during the premigration health assessment process, whose medical examinations were submitted to the Department of Immigration and Citizenship’s Global Health Branch for assessment by a Medical Officer of the Commonwealth between July 2009 and June 2010.

In premigration assessments, 519 people were diagnosed with active tuberculosis (prevalence, 137 per 100,000 in examined population). The top source countries for people with tuberculosis were the Philippines (21.8%), India (16.8%), Vietnam (16.2%) and China (8.3%). Positive sputum smear test results were submitted for 12.9% cases. Positive culture test results were obtained in 44.3%, but only 41.3% of these (95) had susceptibility test results, with 83 fully susceptible. Four people had multidrug-resistant tuberculosis (prevalence, 1.06 per 100 000 population). Five people had both active tuberculosis and HIV infection. Of all those diagnosed with tuberculosis, 31.2% were intending students, 15.8% were intending visitors, and 10.2% were applicants for humanitarian (refugee and Special Humanitarian Program) visas.

The researchers concluded: "Premigration health screening of intending migrants is identifying substantial numbers of people who would have required treatment for tuberculosis after arrival in Australia. The high proportion of students, visitors and refugee and humanitarian entrants with tuberculosis validates the current screening program. The screening is of benefit to the applicants, whose tuberculosis is treated earlier than it otherwise would have been, and to the Australian population, by averting exposure to people with active tuberculosis."

This will vary from country to country, but has important public health implications.

For the full abstract, click here.

MJA 195(9):534-537, 7 November 2011 © 2011 to The Medical Journal of Australia
Is premigration health screening for tuberculosis worthwhile?. Kathleen King, Paul J Douglas and Ken Beath. Correspondence to Paul Douglas: paul.douglas@immi.gov.au

Category: R. Respiratory, HSR. Health Services Research. Keywords: premigration, screening, tuberculosis, survey, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 25 November 2011

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