COMPLIANCE OF ASYLUM SEEKERS WITH AN EXPA NDED BORDER HEALTH SCREENING-PROGRAM IN CANTON BASEL-STADT, 1992-1993

In 1992, the Swiss Public Health Office introduced an expanded tubercu losis screening program for refugees. In addition to routine chest X-r aps, it includes tuberculosis skin testing and prophylactic treatment with isoniazid of skin test positive individuals. In addition, a vacci ne program has been established which, besides routine hepatitis B vac cination of anti-HBc negative individuals, includes vaccination of all refugees against tetanus, diphtheria, polio, measles, mumps and rubel la. The two-year experience of this expanded program is reported from Canton Basel-Stadt, Switzerland. During the two-year period (1992 to 1 993), 289 adults and 53 children were screened. In 3.1% in = 9) of 289 refugees who were examined by X-ray, smear positive tuberculosis was found. These 9 cases contributed 12% of all tuberculosis cases identif ied in Canton Basel-Stadt during the observation period. In 4.4% of al l 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 vaccinati on was achieved in 90% of all refugees. The prevalence of anti-HBc ant ibodies was 28.7% and highest among refugees from Turkey (48.6%) and A frica (34.2%).X-ray screening for tuberculosis in high risk population s such as refugees is effective. However, compliance with 6 months' pr ophylactic treatment with isoniazid for skin test positives was only m oderate.