Jtr. Wilcke et al., TUBERCULOSIS IN A COHORT OF VIETNAMESE REFUGEES AFTER ARRIVAL IN DENMARK 1979-1982, The international journal of tuberculosis and lung disease, 2(3), 1998, pp. 219-224
SETTING: Department of Infectious Diseases, Rigshospitalet, Copenhagen
, Denmark. OBJECTIVE: To study the occurrence of tuberculosis (TB) in
a cohort of immigrants from a high incidence country during the years
following arrival in a low incidence country. DESIGN: Follow-up analys
is in a cohort of 1 983 Vietnamese refugees who arrived in Denmark dur
ing the period 1979-1982. The civil registration number could be ident
ified for 1 936 (98%) individuals from the original cohort. Date of po
ssible death, emigration and the development of tuberculosis were dete
rmined by checking the refugees' civil registration number in the Nati
onal Civil Register and the National Infectious Disease Registry for T
uberculosis. RESULTS: Tuberculosis notification for the 1936 individua
ls fell from 1.14% for the first 12 months to a mean of 0.08% per year
during the following 5-year period. During the 16 years of follow up,
36 of the refugees developed tuberculosis, of whom 14 (39%) had had a
bnormal chest X-ray on arrival and 14 (39%) (including one with normal
chest X-ray) had been identified as having active tuberculosis throug
h screening on arrival. CONCLUSION: Decline in tuberculosis incidence
for immigrants is very rapid if the tuberculosis infection rate is low
following arrival. With a very limited TB screening programme (chest
X-ray on arrival) and a passive diagnosis policy without preventive ch
emotherapy, it is possible to control tuberculosis among high prevalen
ce immigrants in a low incidence country.