van Burg J L, Verver S, Borgdorff M W
Department of Health, Agency for the Reception of Asylum Seekers (COA), The Hague, The Netherlands.
Int J Tuberc Lung Dis. 2003 Feb;7(2):139-44.
To identify low-risk groups among asylum seekers in the Netherlands that may be excluded from tuberculosis (TB) screening at entry or during follow-up.
A retrospective cohort study of medical records of asylum seekers entering the country between January 1994 and March 1997.
Medical records were available for 46,424 of the 96,000 asylum seekers (48%) in this period. One hundred and three pulmonary TB cases were diagnosed at entry (prevalence 222/100,000). Risk factors were age >11 years, history of imprisonment and country of origin at war or with TB incidence >100/100,000. During a mean follow-up period of 10 months, 51 pulmonary TB cases were diagnosed (incidence 134/100,000 person-years). Risk factors were age >11 years, old lesions on entry X-ray, and country of origin whose asylum seekers had a prevalence of TB at entry >200/100,000.
We conclude that 1) those with abnormal X-ray at entry should receive preventive therapy after exclusion of active TB, or undergo intensive follow-up, 2) periodic screening is not indicated for immigrants from countries whose asylum seekers have a low prevalence of pulmonary TB at entry, and 3) children <12 years can be excluded from screening.
确定荷兰寻求庇护者中的低风险群体，这些群体在入境时或后续随访中可能被排除在结核病筛查之外。
对1994年1月至1997年3月期间进入该国的寻求庇护者的病历进行回顾性队列研究。
在此期间，96000名寻求庇护者中有46424人的病历可用（48%）。入境时诊断出103例肺结核病例（患病率222/100000）。危险因素为年龄>11岁、有监禁史、来自处于战争状态的国家或结核病发病率>100/100000的国家。在平均10个月的随访期内，诊断出51例肺结核病例（发病率134/100000人年）。危险因素为年龄>11岁、入境时X线有陈旧性病变、来自其寻求庇护者入境时肺结核患病率>200/100000的国家。
我们得出结论：1）入境时X线异常者在排除活动性结核病后应接受预防性治疗或进行强化随访；2）对于其寻求庇护者入境时肺结核患病率较低的国家的移民，不建议进行定期筛查；3）12岁以下儿童可排除在筛查之外。
