OVERSEAS SCREENING FOR TUBERCULOSIS IN IMMIGRANTS AND REFUGEES TO THEUNITED-STATES - CURRENT STATUS

The number of reported cases of tuberculosis (TB) in foreign-born pers ons in the United States during 1995 was 8,042, 36% of the national to tal. The overseas screening of immigrants and refugee visa applicants, which relies on a chest radiograph and smear microscopy is designed t o identify future U.S. residents who have active TB or who are at high risk for TB. In this commentary, we summarize current policies and re view retrospective evaluations of the screening system currently in pl ace. The system appears to detect most persons who have active TB at t he time of screening. However, active TB is actually diagnosed in <15% of persons who art identified by screening as having suspected TB and who are evaluated in the United States. To improve the system, more s ensitive and specific techniques as well as improved means of data tra nsmission to state and local health departments are needed.