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Volume 18, Number 9—September 2012

Research

Evaluation of Immigrant Tuberculosis Screening in Industrialized Countries

Manish Pareek, Iacopo Baussano, Ibrahim Abubakar, Christopher Dye, and Ajit LalvaniComments to Author 
Author affiliations: Imperial College London, London, UK (M. Pareek, A. Lalvani); University of Leicester, Leicester, UK (M. Pareek); Univeristà degli Studi del Piemonte Orientale, Novara, Italy (I. Baussano); University College London, London (I. Abubakar); University of East Anglia, Norwich, UK (I. Abubakar); and World Health Organization, Geneva, Switzerland (C. Dye)

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Table 1

Screening practices for detecting active TB in immigrants in 29 industrialized OECD countries*

Screen for active TB No. countries positive/no. tested (%)
Yes 25/29 (86.2)
Compulsory 19/25 (76.0)
Timing of screening†

Prearrival

9/25 (36.0)

At arrival

5/25 (20.0)

Postarrival

23/25 (92.0)
Type of immigrants screened

All legal‡

16/25 (64.0)

Selected legal§

4/25 (16.0)

Refugees/asylum seekers¶

24/25 (96.0)
Selection criteria for immigrants screened

Age

2/25 (8.0)

All ages

23/25 (92.0)
TB cases/100,000 population in country of origin 6/25 (24.0)

>15

1/6 (16.7)

>40

2/6 (33.3)

>50

2/6 (33.3)

>100

1/6 (16.7)
Region of origin# 19/25 (76.0)

All

5/19 (26.3)

All except EU, North America, Australia, and New Zealand

11/19 (57.9)

Other**

4/19 (21.1)
Screening tools used in children

Clinical examination

6/25 (24.0)

Clinical examination and TST

8/25 (32.0)

Clinical examination and chest radiograph

0/25 (0.0)

Clinical examination, TST, and chest radiograph

2/25 (8.0)

TST

3/25 (12.0)

TST and chest radiograph

3/25 (12.0)

Chest radiograph

3/25 (12.0)
Screening tools used in adults

Clinical examination

1/25 (4.0)

Clinical examination and TST

1/25 (4.0)

Clinical examination and chest radiograph

9/25 (36.0)

Clinical examination, TST, and chest radiograph

2/25 (8.0)

TST

1/25 (4.0)

TST and chest radiograph

2/25 (8.0)

Chest radiograph

9/25 (36.0)

*OECD, Organisation for Economic Co-operation and Development; TB, tuberculosis; EU, European Union; TST, tuberculin skin test.
†Numbers do not add up to the total because some countries screened at >1 location.
‡Countries in which all legal immigrants (if they meet screening criteria) are screened (see Technical Appendix for more detailed categorization and definitions).
§Countries in which only selected categories of legal immigrants (if they meet screening criteria) are screened (see Technical Appendix for more detailed categorization and definitions).
¶Countries in which refugees/asylum seekers are screened (see Technical Appendix for more detailed categorization and definitions).
#Numbers do not add up to the total because the Czech Republic screened refugees/asylum seekers from all countries but legal immigrants only from selected countries.
**Congo, Czech Republic, Israel, Kenya, Moldova, Mongolia, Nigeria, North Korea, Pakistan, Slovenia, South Korea, Tajikistan,Turkmenistan, Uzbekistan, and Vietnam.

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