Goldstein G B, Reid J C, Keo L
Med J Aust. 1987 Jan 5;146(1):9-12. doi: 10.5694/j.1326-5377.1987.tb120117.x.
Public health concern in relation to refugees arriving in New South Wales is due to the high prevalence of tuberculosis, syphilis and hepatitis B infection in some refugee groups. Other infectious diseases (with the exception of malaria in the Northern Territory and Queensland) do not pose a significant threat to public health owing to their low prevalence (which may result from overseas screening and treatment) and/or low infectivity in Australian conditions. Because of overseas screening by the Commonwealth Government before the departure of the refugees, it was uncommon in 1984 for previously undetected tuberculosis to be detected when refugees were screened on arrival in Sydney (found in only one in 800 refugees who underwent screening). However, of the refugees in Sydney who had positive results of serological tests for syphilis, a substantial proportion (at times in excess of 50%) had had a negative result at the overseas screening; subsequent follow-up of those with positive serological results indicated inactive disease in almost all cases. There is a need to monitor the infectious disease prevalence and the effectiveness of overseas screening of refugees by on-arrival screening; decisions about screening procedures and the selection of particular incoming refugee groups for screening should be based on sound epidemiological and clinical analysis.
新南威尔士州接收的难民引发了公共卫生关注，原因是部分难民群体中结核病、梅毒和乙型肝炎感染的患病率很高。其他传染病（北领地和昆士兰州的疟疾除外）由于患病率较低（可能是海外筛查和治疗的结果）和/或在澳大利亚环境中的传染性较低，对公共卫生不构成重大威胁。由于联邦政府在难民离境前进行了海外筛查，1984年难民抵达悉尼接受筛查时，很少发现此前未被检测出的结核病（每800名接受筛查的难民中仅发现1例）。然而，在悉尼梅毒血清学检测呈阳性的难民中，相当一部分人（有时超过50%）在海外筛查时结果为阴性；对血清学检测呈阳性者的后续跟踪显示，几乎所有病例的疾病都不活跃。有必要通过抵达时的筛查来监测难民传染病的患病率以及海外筛查的效果；关于筛查程序的决策以及选择特定的入境难民群体进行筛查，应基于可靠的流行病学和临床分析。
