Van den Brande P, Uydebrouck M, Vermeire P, Demedts M
Division of Lung Diseases, University Hospitals Leuven, Duffel, Belgium.
Eur Respir J. 1997 Mar;10(3):610-4.
Countries with a low incidence of tuberculosis have recently been faced with the problem of tuberculosis (TB) in asylum seekers from countries with a high TB prevalence. We report on the tuberculosis case notification rate (TBCNR) in Belgium in 1993, and on the results of active screening in a group of asylum seekers. The TBCNR in Belgium in 1993 increased slightly to 14.9 per 100,000, mainly due to the nonindigenous population. The highest TBCNR (312 per 100,000) was reported among the 26,882 asylum seekers staying in Belgium in 1993. Of all new asylum seekers admitted in 1993, 4,794 agreed to undergo radiographic screening for TB at entry, of whom 123 had a chest radiograph which was suspect. Among the 123, 67 could be further investigated, and, of these, 19 cases (28%) of active TB were detected; this represents a TBCNR of 396 per 100,000 when referred to the 4,794 asylum seekers screened. In addition, 56 asylum seekers with suspect chest radiograph were lost to further investigation. From the present results it appears that: 1) in Belgium, asylum seekers constitute an important risk group for TB, with a TBCNR after screening which is approximately 30 times that in the indigenous population; and 2) there is a deficient follow-up after first screening, generating the risk of transmission of TB within the community. Our recommendations are, therefore, that in all asylum seekers screening for tuberculosis should be mandatory and follow-up of active tuberculosis should be regulated.
结核病发病率较低的国家最近面临着来自结核病高流行国家的寻求庇护者的结核病问题。我们报告了1993年比利时的结核病病例通报率（TBCNR）以及一组寻求庇护者的主动筛查结果。1993年比利时的TBCNR略有上升，达到每10万人口14.9例，主要原因是外来人口。1993年留在比利时的26,882名寻求庇护者中报告的TBCNR最高（每10万人口312例）。在1993年所有新接纳的寻求庇护者中，4,794人同意在入境时接受结核病的X光筛查，其中123人的胸部X光片可疑。在这123人中，67人可作进一步调查，其中检测出19例（28%）活动性结核病；相对于4,794名接受筛查的寻求庇护者而言，这代表的TBCNR为每10万人口396例。此外，56名胸部X光片可疑的寻求庇护者未作进一步调查。从目前的结果来看：1）在比利时，寻求庇护者是结核病的一个重要风险群体，筛查后的TBCNR约为本地人口的30倍；2）首次筛查后的后续跟进不足，有在社区内传播结核病的风险。因此，我们建议，对所有寻求庇护者都应强制进行结核病筛查，并规范对活动性结核病的后续跟进。
