摘要：Objectives . This study assessed the effectiveness of postmigration screening for the control of tuberculosis (TB) among refugee migrants. Methods . We conducted a historical cohort study among 24 610 predominantly Southeast Asian refugees who had arrived in Sydney, Australia, between 1984 and 1994. All had been screened for TB before arrival and had radiologic follow-up for 18 months after arrival. Incident cases of TB were identified by record linkage analysis with confirmatory review of case notes. Results . The crude annual incidence rate over 10-year follow-up was 74.9 per 100 000 person-years. Only 29.6% of the cases were diagnosed as a result of routine follow-up procedures. Conclusions . Enhanced passive case finding is likely to be more effective than active case finding for the control of TB among refugees. Migration from countries with a high incidence of tuberculosis (TB) is having a major effect on the epidemiology of TB in countries with lower incidence, such as Canada, the United States, and Australia, 1– 4 and has led to calls for better efforts to prevent and control the disease among immigrants. 3 State health authorities in Australia have taken an active approach to case finding among refugees settling in Australia. The primary aim of this study was to assess the effectiveness of a program of postarrival screening for active case finding in a population of refugees screened for TB before migration. A further aim was to establish whether any criterion, determined at initial screening after arrival in Australia, identified a subgroup in whom subsequent follow-up for active case finding was likely to be more effective.
