Pulmonary tuberculosis in overseas students of higher education is increasing in Edinburgh

In Edinburgh in 1991 a relative excess of pulmonary TB cases in the 15-34 year age group was recorded. Five of 17 notifications in this age group were of overseas students of higher education: three aged 21-29 from Central Africa, one 27-year-old Asian and one 26-year-old Western European. One of the African students was seropositive for HIV infection. Disease presented clinically on average 31 months after entry to the U.K. (range 6-48 months). Four students had smear positive disease. Two patients had had normal chest radiographs 1 and 2 years previously on entry to the U.K.; three students had not previously been radiologically screened. We suggest that students from countries with a high prevalence of tuberculosis should be screened on entry to their course of education and that student health services should develop and maintain a high index of suspicion for tuberculosis in these students.