In 1992, the Swiss Public Health Office introduced an expanded tuberculosis screening program for refugees. In addition to routine chest X-rays, it includes tuberculosis skin testing and prophylactic treatment with isoniazid of skin test positive individuals. In addition, a vaccine program has been established which, besides routine hepatitis B vaccination of anti-HBc negative individuals, includes vaccination of all refugees against tetanus, diphtheria, polio, measles, mumps and rubella. The two-year experience of this expanded program is reported from Canton Basel-Stadt, Switzerland. During the two-year period (1992 to 1993), 289 adults and 53 children were screened. In 3.1% (n = 9) of 289 refugees who were examined by X-ray, smear positive tuberculosis was found. These 9 cases contributed 12% of all tuberculosis cases identified in Canton Basel-Stadt during the observation period. In 4.4% of all refugees prophylactic treatment with isoniazid was initiated, but 7 of the 15 cases (46.6%) did not complete the prophylaxis. In contrast, compliance with the vaccine program was better and complete vaccination was achieved in 90% of all refugees. The prevalence of anti-HBc antibodies was 28.7% and highest among refugees from Turkey (48.6%) and Africa (34.2%). X-ray screening for tuberculosis in high risk populations such as refugees is effective. However, compliance with 6 months' prophylactic treatment with isoniazid for skin test positives was only moderate.

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immigrant refugee mass screening radiography human Refugees health status BCG vaccine screening lung tuberculosis Adolescent skin test Tuberculosis, Pulmonary tuberculosis high risk population isolation and purification Article patient compliance prophylaxis adult major clinical study English Abstract isoniazid thorax radiography immunization hepatitis B core antigen Hepatitis B Core Antigens Switzerland Child