Global Health Branch, Department of Immigration and Citizenship, Sydney, NSW.
Med J Aust. 2011 Nov 7;195(9):534-7. doi: 10.5694/mja11.11395.
To determine whether premigration screening for tuberculosis is worth undertaking in visa applicants, and whether screening resources are being appropriately directed towards intending migrants at highest risk of tuberculosis.
DESIGN, SETTING AND PARTICIPANTS: A 12-month survey of all intending migrants with tuberculosis necessitating treatment detected during the premigration health assessment process, whose medical examinations were submitted to the Department of Immigration and Citizenship's Global Health Branch for assessment by a Medical Officer of the Commonwealth between 1 July 2009 and 30 June 2010.
Individuals diagnosed with active tuberculosis; proportions diagnosed by sputum smear and culture tests or clinically, and with susceptibility test results; distribution of visa types among people diagnosed.
In premigration assessments, 519 people were diagnosed with active tuberculosis (prevalence, 137 per 100,000 in examined population). The top source countries for people with tuberculosis were the Philippines (21.8%), India (16.8%), Vietnam (16.2%) and China (8.3%). Positive sputum smear test results were submitted for 67 cases (12.9%). Positive culture test results were obtained in 230 cases (44.3%), but only 95 of these (41.3%) had susceptibility test results, with 83 fully susceptible. Four people had multidrug-resistant tuberculosis (prevalence, 1.06 per 100 000 population). Five people had both active tuberculosis and HIV infection. Of all those diagnosed with tuberculosis, 162 (31.2%) were intending students, 82 (15.8%) were intending visitors, and 53 (10.2%) were applicants for humanitarian (refugee and Special Humanitarian Program) visas.
Premigration health screening of intending migrants is identifying substantial numbers of people who would have required treatment for tuberculosis after arrival in Australia. The high proportion of students, visitors and refugee and humanitarian entrants with tuberculosis validates the current screening program. The screening is of benefit to the applicants, whose tuberculosis is treated earlier than it otherwise would have been, and to the Australian population, by averting exposure to people with active tuberculosis.
确定在签证申请人中进行肺结核病预筛查是否有价值，以及筛查资源是否被恰当地用于最有可能感染肺结核病的潜在移民。
设计、地点和参与者：2009 年 7 月 1 日至 2010 年 6 月 30 日的 12 个月期间，对所有因肺结核病需要治疗而在移民前健康评估过程中被发现的潜在移民进行了调查，他们的体检结果被提交给移民和公民事务部全球健康处，由联邦医疗官进行评估。
诊断为活动性肺结核的个体；通过痰涂片和培养试验或临床诊断的比例，以及药敏试验结果；诊断出的人签证类型分布。
在移民前评估中，有 519 人被诊断为活动性肺结核（受检人群中患病率为 137/10 万）。肺结核病发病率最高的来源国是菲律宾（21.8%）、印度（16.8%）、越南（16.2%）和中国（8.3%）。有 67 例（12.9%）提交了阳性痰涂片检测结果。有 230 例（44.3%）获得了阳性培养检测结果，但其中只有 95 例（41.3%）有药敏试验结果，其中 83 例完全敏感。有 4 人患有耐多药肺结核（人群患病率为 1.06/10 万）。有 5 人同时患有活动性肺结核和 HIV 感染。在所有被诊断为肺结核的患者中，162 人（31.2%）是意向学生，82 人（15.8%）是意向访客，53 人（10.2%）是人道主义（难民和特别人道主义计划）签证申请人。
对潜在移民进行移民前健康筛查可以发现大量人在抵达澳大利亚后需要治疗肺结核病。学生、访客和难民及人道主义入境者中肺结核病发病率高，证实了目前的筛查方案是合理的。筛查对申请人有益，因为他们的肺结核病得到了更早的治疗，从而避免了与活动性肺结核病人接触，也有益于澳大利亚民众。
