Effectiveness of postmigration screening in controlling tuberculosis amongrefugees: A historical cohort study, 1984-1998

Objectives. This study assessed the effectiveness of postmigration screenin g for the control of tuberculosis (TB) among refugee migrants. Methods. We conducted a historical cohort study among 24610 predominantly S outheast Asian refugees who had arrived in Sydney, Australia, between 1984 and 1994. All had been screened for TB before arrival and had radiologic fo llow-up for 18 months after arrival. Incident cases of TB were identified b y record linkage analysis with confirmatory review of case notes. Results. The crude annual incidence rate over 10-year follow-up was 74.9 pe r 100000 person-years. Only 29.6% of the cases were diagnosed as a result o f routine follow-up procedures. Conclusions. Enhanced passive case finding is likely to be more effective t han active case finding for the control of TB among refugees.