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Are health undertakings effective in the follow-up of migrants for tuberculosis?
K King1, R I Dorner, B J Hackett
1National Health Clearances Unit, Australian Government Health Service, Commonwealth Department of Human Services and Health, Sydney, NSW.
Objective:
To determine the rate of compliance of migrants issued with a health undertaking for tuberculosis requiring them to report within one month after arrival in Australia.
Design:
Compliance was monitored prospectively between 1 November 1992 and 31 October 1993.
Setting:
The Australian Government Health Service in Melbourne.
Participants:
1660 migrants with a health undertaking for tuberculosis.
Main Outcome Measure:
Compliance with the undertaking (making initial contact and presenting for examination).
Results:
The overall compliance rate was 58%, but 89% of those who made contact complied with their undertakings. There were significant differences in the compliance rates according to country of application (P < 0.001). It was estimated that about 150 people a year who require treatment for tuberculosis could be failing to comply with a health undertaking, eight of whom may require a full course of antituberculous chemotherapy.
Conclusions:
The administration of the current system of health undertakings for tuberculosis for migrants needs to be strengthened to increase compliance.