[Tuberculin reactors among refugee status claimants newly arrived in Canada]

A large number of new cases of tuberculosis are reported among immigrants to Canada every year. For public health purposes immigration policy requires that all immigrants undergo chest radiography and that those found to be infectious receive treatment and follow-up. Since 1984 the clinique Santé-Accueil of the département de Santé communautaire, hôpital Saint-Luc, Montreal, has participated in the screening of immigrants arriving in Quebec who claim refugee status. We undertook a descriptive study to determine the prevalence of tuberculous infection in this population. Of 865 tuberculin tests administered and read, 329 (38%) produced reactions 10 mm or more in diameter. The proportion of positive reactions was higher among older immigrants and varied by country of origin, from 30% for people from El Salvador to 61% for those from Haiti. A history of vaccination with bacille Calmette-Guérin or the presence of a scar was not associated with a positive reaction. Three cases of pulmonary tuberculosis were identified, for a rate of 118/100,000. Our findings underline the importance of systematically screening immigrants for tuberculous infection with the tuberculin test.