Heath T C, Roberts C, Winks M, Capon A G
Western Sector Public Health Unit, Sydney, New South Wales, Australia.
Int J Tuberc Lung Dis. 1998 Aug;2(8):647-54.
New South Wales (NSW) is Australia's most populous state and is home to one third of the country's rapidly growing immigrant population.
To examine the effects of immigration upon the epidemiology of tuberculosis (TB) in a low prevalence population.
A retrospective review of state TB surveillance data in NSW from 1975-1995.
The crude notification rate for all active TB declined from 12.2 per 100000 population in 1975 to 5.2/100000 in 1986, after which the notification rate increased steadily to 7.6/100000 in 1995. Between 1975 and 1995, the proportion of all TB notifications occurring in overseas-born residents increased from 30% (178/601) to 79% (345/435). During this period, the proportion of new extra-pulmonary TB notifications increased from 13% (72/549) to 42% (171/405). Notifications amongst women increased from 31% (188/601) to 47% (218/462) of the total, while the median age at notification fell from 55 to 41 years. The pattern of TB disease has not changed for Australian-born cases, who are mostly elderly men with pulmonary disease. Multidrug-resistant TB remains uncommon (<1%), and co-infection with the human immunodeficiency virus (HIV) and TB has not emerged as a major problem (2% of notifications), but is poorly documented.
TB has re-emerged in NSW predominantly because of increased immigration from high prevalence countries. The epidemiology of TB has become dominated by overseas-born notifications, and now younger adults are primarily affected. Enhancing the effectiveness of the TB screening procedures for immigrants is a priority. Information should be provided to all immigrants and to long-term visitors from countries of high TB prevalence regarding TB infection and the TB services available in Australia.
新南威尔士州（NSW）是澳大利亚人口最多的州，该国快速增长的移民人口中有三分之一居住在此。
研究移民对低结核病（TB）流行率人群中结核病流行病学的影响。
对新南威尔士州1975 - 1995年的州结核病监测数据进行回顾性分析。
所有活动性结核病的粗报告率从1975年的每10万人12.2例降至1986年的每10万人5.2例，此后报告率稳步上升，到1995年达到每10万人7.6例。1975年至1995年间，在海外出生居民中发生的所有结核病报告比例从30%（178/601）增至79%（345/435）。在此期间，新的肺外结核病报告比例从13%（72/549）增至42%（171/405）。女性报告病例占总数的比例从31%（188/601）增至47%（218/462），而报告时的中位年龄从55岁降至41岁。对于在澳大利亚出生的病例，结核病发病模式没有变化，这些病例大多是患有肺部疾病的老年男性。耐多药结核病仍然不常见（<1%），人类免疫缺陷病毒（HIV）与结核病的合并感染尚未成为一个主要问题（报告病例的2%），但记录不完善。
新南威尔士州结核病再度出现主要是因为来自高流行率国家的移民增加。结核病流行病学已由海外出生者的报告主导，现在主要受影响的是年轻人。提高针对移民的结核病筛查程序的有效性是当务之急。应向所有移民以及来自结核病高流行率国家的长期访客提供有关结核病感染以及澳大利亚现有结核病服务的信息。
