Source: Annual Congress 2002 - Epidemiology outlooks of tuberculosis
Disease area: Respiratory infections

Abstract

Background: UK guidelines recommend that immigrants from outside the European Union, Canada, United States, Australia and New Zealand should be screened for tuberculosis. Partly due to a recent increase in the number of asylum-seekers, the district tuberculosis screening service in Liverpool has had difficulty completing the screening schedule currently recommended. The purpose of this study was to determine the effectiveness of the service in identifying active cases and in protecting new entrants against tuberculosis Methods: Tuberculosis screening data for new entrants from January 1999 to December 2000 were analysed. Results: In 2000, 15% of those screened were found via the Port of Arrival system. 22% were identified via the Home Office asylum-seeker system. 61% were found only by informal methods - mainly by TB Specialist Nurses visiting hostels for asylum-seekers. Over both years, 3584 new entrants were identified. 2577 or 72% were contactable. 1858 had a Heaf test read (52% of 3584). Of those whose Heaf test was read, 683 (37%) were tuberculin negative and 379 (43%) were grade 3 or 4. Only 36 people received BCG vaccination. 28 were offered chemoprophylaxis, of whom 17 completed the course. 4 cases of active TB were detected by screening and a further 7 cases in new entrants presented with symptoms to health services. Conclusions: Despite using labour-intensive methods to identify new entrants, up to half may not be fully screened. Awareness of health professionals needs to be raised about the possibility of tuberculosis occurring in new entrants presenting symptomatically to the health-services. The uptake of BCG vaccination and chemoprophylaxis amongst new entrants needs to be improved.

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E. Coffey, M. Regan, P. Davies, P. Jones, C. Williams, S. Jamieson (Liverpool, United Kingdom). Screening new entrants for tuberculosis in Liverpool; how practicable are current guidelines?. Eur Respir J 2002; 20: Suppl. 38, 273

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