Tuberculosis screening of asylum seekers: 1 years' experience at the Dover Induction Centres

To describe the uptake and outcomes of a service for tuberculosis screening of asylum seekers.

Descriptive study.

A tuberculosis screening service was established at the Dover Induction Centres for all asylum seekers entering the UK through ports in Kent. This study describes the uptake and completion of tuberculosis screening, the results of tuberculin skin testing and follow-up, and the cost of the service during its first year.

In 1 year, 8258 asylum seekers were screened: 94% of 8799 who were eligible. A total of 2.2% of those with completed screens were positive (on the basis of symptoms requiring further investigation or positive Heaf reaction). Eleven cases of active respiratory disease were diagnosed on the basis of symptoms, Heaf reaction plus chest X-ray, or both; three were confirmed microbiologically. One-quarter of Heaf tests were not read because of the rapid dispersal of asylum seekers. The follow-up of those requiring further investigations at their destinations was largely unknown. The service cost was 350,000 pounds.

Induction centre tuberculosis screening services for asylum seekers can achieve a high uptake, but their cost-effectiveness is questionable, particularly where the yield of active disease is low. Tuberculin skin testing is not an ideal screening procedure in this setting because it may be uncompleted and the benefit of detecting latent infections is uncertain.