OBJECTIVE: To identify low-risk groups among asylum seekers in the Netherlands that may be excluded from tuberculosis (TB) screening at entry or during follow-up. METHODS: A retrospective cohort study of medical records of asylum seekers entering the country between January 1994 and March 1997. RESULTS: Medical records were available for 46424 of the 96000 asylum seekers (48%) in this period. One hundred and three pulmonary TB cases were diagnosed at entry (prevalence 222/100 000). Risk factors were age >11 years, history of imprisonment and country of origin at war or with TB incidence >100/100 000. During a mean follow-up period of 10 months, 51 pulmonary TB cases were diagnosed (incidence 134/100 000 person-years). Risk factors were age >11 years, old lesions on entry x-ray, and country of origin whose asylum seekers had a prevalence of TB at entry >200/100 000. CONCLUSIONS: We conclude that 1) those with abnormal x-ray at entry should receive preventive therapy after exclusion of active TB, or undergo intensive followup, 2) periodic screening is not indicated for immigrants from countries whose asylum seekers have a low prevalence of pulmonary TB at entry, and 3) children <12 years can be excluded from screening.

Screening Asylum seekers tuberculosis Epidemiology

Netherlands X ray analysis immigrant mass screening follow up human middle aged priority journal Logistic Models Humans lung tuberculosis Adolescent male Tuberculosis, Pulmonary female tuberculosis risk factor Infant Risk Factors Child, Preschool medical record diagnostic approach route prevalence Article major clinical study adult cohort analysis Emigration and Immigration retrospective study Child