Objective: To compare data of some features and treatment results of asylum seekers with TB in whom the diagnosis was made by a roentgenologic examination of the thorax a short time after arrival in the Netherlands with data of other TB-patients.
Design: Retrospective.
Setting: The Netherlands.
Method: Data of patients with tuberculosis are collected in the National Tuberculosis Register. In 1993 this register included data of 1582 patients, among them III asylum seekers in whom TB was diagnosed after obligatory roentgenologic screening a short time after arrival in the Netherlands. The reason for examination, presence of complaints, forms of tuberculosis, presence of bacteriological confirmation, drug-resistance and results of treatment of them were compared with the data of other asylum seekers (n = 169) and other TB-patients (n = 1302).
Results: The diagnosis TB in asylum seekers who are screened obligatorily was bacteriologically confirmed in 34 of III (31%) of the cases, while in 72 of 169 (43%) other asylum seekers and in 729 of 1302 (56%) of the other TB-patients (p < 0.001 for the difference between obligatory screened asylum seekers and other TB-patients). Resistance against isoniazide and streptomycin was more frequent in asylum seekers (n = 106; 13% and 19% respectively) than in Dutch patients (n = 338; 2% and 3% respectively) (p < 0.001). Obligatory screened asylum seekers with bacteriologically confirmed TB were cured in 82% of the cases and this did not differ from the other groups. Asylum seekers and other immigrants showed a higher default-rate than Dutch patients did (p < 0.001).
Conclusion: Among asylum seekers with tuberculosis discovered by the first obligatory screening was a lower percentage of bacteriological confirmation and a higher percentage of drug-resistance and defaulters. The results of treatment of asylum seekers with bacteriologically confirmed TB were good.