Design: In the spring of 1999, 864 Kosovars were directly airborne from refugee camps in Macedonia to a refugee camp in Kristiansand, Norway; 800 were examined according to official Norwegian TB screening procedures with X-ray (if more than 15 years of age) and tuberculin test shortly after arrival.
Results: The mean (SD) age was 29.2 (18.7) years of age and 29% were aged under 15 years; 79% of the refugees had escaped from urban areas in Kosovo, and 75% had an identifiable BCG scar. Among those with BCG scar, increasing age and male sex were associated with a significant tuberculin reaction: 20% had tuberculin reactions indicating latent TB infection, while 40% had negative tuberculin reactions. Approximately 4% of the refugees aged over 15 had abnormal chest X-rays, predictive of an enhanced tuberculin reaction. Four refugees had X-ray findings compatible with active TB and were treated with standard four-drug chemotherapy.
Conclusion: The Kosovar refugees had a high incidence of active tuberculosis (50/100,000). A fifth of the BCG-vaccinated refugees needed careful follow-up to monitor possible progress from latent to active TB infection after immigration, while one in seven non-BCG-vaccinated refugees had tuberculin skin reactions compatible with latent TB infection.