Screening immigrants for tuberculosis in Newcastle upon Tyne

Background Successive national guidelines on the control of tuberculosis in the United Kingdom have included recommendations for screening immigrants coming from countries with a high prevalence of tuberculosis. As there has been only one other study on the process and outcome of screening immigrants at a district level the aim of this study was to assess the contribution of screening immigrants to the control of tuberculosis in Newcastle. Methods The Port of Arrival (POA) forms were used to identify all new immigrants for screening in Newcastle during 1993. The Family Health Services Authority (FHSA) register was used to identify additional new immigrants from the Indian sub-continent. For all new immigrants identified by the POA forms and FHSA register, hospital and practice records were reviewed for evidence of screening and its outcome up to the end of 1994. Results There were 252 POA forms in 1993, 100 of which were for immigrants from the Indian sub-continent. This represents less than a third of all new immigrants from the Indian sub-continent. Of all immigrants identified by POA forms, 99 (39 per cent) had been screened. This resulted in the detection of one active case of tuberculosis. Conclusions The POA system alone is inadequate for identifying immigrants for screening. The published evidence on screening immigrants for tuberculosis suggests that the system does not work well and the yield of new cases is low. To assess the effectiveness of screening immigrants a national audit is needed.