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Volume 28, Number 9—September 2022

Detecting Mycobacterium tuberculosis Infection in Children Migrating to Australia

Ingrid Laemmle-RuffComments to Author , Stephen M. Graham, Bridget Williams, Danielle Horyniak, Suman S. Majumdar, Georgia A. Paxton, Lila V. Soares Caplice, Margaret E. Hellard, and James M. Trauer
Author affiliations: Burnet Institute, Melbourne, Victoria, Australia (I. Laemmle-Ruff, S.M. Graham, B. Williams, D. Horyniak, S.S. Majumdar, M.E. Hellard, J.M. Trauer); Royal Children’s Hospital, Melbourne (I. Laemmle-Ruff, S.M. Graham, G.A. Paxton); University of Melbourne, Melbourne (S.M. Graham, S.S. Majumdar, G.A. Paxton, M.E. Hellard, J.M. Trauer); Monash University, Melbourne (D. Horyniak, S.S. Majumdar, M.E. Hellard, J.M. Trauer); The Alfred Hospital, Melbourne (S.S. Majumdar, M.E. Hellard, J.M. Trauer); Department of Home Affairs, Australian Government, Canberra, Australian Capital Territory, Australia (L.V.S. Caplice)

Main Article

Table 1

Australian premigration TB screening criteria within the Immigration Medical Examination*

All children completing an IME have a medical history and physical examination
Either IGRA or TST is required for:
Children 2–10 years of age who are:
Applying for a humanitarian visa
Applying for a permanent visa and from a setting placing them at higher risk for TB†
Asylum seekers within Australia
Applicants declaring close contact with TB, with signs or symptoms of TB, or who are immunocompromised (any age or migration stream)
Applicants with positive IGRA or TST results are required to have:
Posteroanterior chest radiograph (and lateral in children <11 years of age)
If abnormalities on chest radiograph, or other indication for further investigation:
Sputum testing and specialist review
Exemptions from IGRA and TST screening:
Written evidence of prior bacteriologically confirmed TB (i.e., positive smear or culture from sputum or other specimen) or a previously positive TST (>10 mm) or IGRA

*Chest radiograph screening for TB is required for all migrants >11 years applying for permanent or humanitarian visas and for temporary visas if from high-risk TB countries and staying for >6 months. TB, tuberculosis disease; IME, Immigration Medical Examination; IGRA, interferon-gamma release assay; TST, tuberculin skin test. †Prevalence >40 per 100,000 cases of TB based on 2013 World Health Organization estimates.

Main Article

Page created: July 14, 2022
Page updated: August 19, 2022
Page reviewed: August 19, 2022
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