Post-migration follow-up programme for migrants at increased risk of developing tuberculosis: a cohort study

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Migration Health

Background:

• Migrants at high risk for tuberculosis (TB) require post-entry follow-up in Australia after pre-migration screening.
• Evaluating the effectiveness of these follow-up programs is crucial for timely TB diagnosis in migrant populations.

Purpose of the Study:

• To assess the effectiveness of post-migration TB follow-up in New South Wales for diagnosing TB in high-risk migrants.
• To determine the proportion of TB cases diagnosed through the follow-up program versus passive case finding.

Main Methods:

• Retrospective cohort study of migrants arriving in New South Wales between 2000 and 2015 referred for post-migration follow-up.
• Analysis of clinical notes for a nested cohort to identify TB diagnosis pathways.
• Calculation of TB incidence rates and time to diagnosis.

Main Results:

• Out of 32,550 referred migrants, 428 (1.3%) developed TB.
• TB incidence was 436 per 100,000 person-years in the first 2 years and 128 per 100,000 person-years over a mean of 10.3 years.
• An estimated 63% of TB cases were diagnosed via the follow-up program, with earlier diagnosis by 0.55 years for those attending follow-up.

Conclusions:

• Post-migration follow-up is effective in detecting a significant proportion (63%) of TB cases in high-risk migrants.
• The program potentially prevents delays in TB diagnosis among this population.
• Continued emphasis on structured post-migration follow-up is warranted for TB control in migrant health.