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Immigration screening for latent tuberculosis infection

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Epidemiologist Justin Denholm advocates universal screening of migrants from high-incidence countries

In Australia, 1222 cases of tuberculosis (TB) were notified in 2011, which represents an annual incidence of six cases per 100 000 population.1 Despite this relatively low incidence by global standards, TB disease continues to cause significant morbidity and mortality, and has a substantial impact on the health and wellbeing of affected individuals and communities.2 In addition to the direct clinical impact, effective management of TB imposes a substantial burden on health care systems and public health programs. Opportunities to reduce TB incidence further in Australia, therefore, would be welcome and should be actively pursued.

Over the past decade, 80%–90% of people who developed TB in Australia were born overseas, with by far the most common clinical pathway to presentation being reactivation of previously latent TB infection (LTBI).3 People migrating to Australia from countries with high TB incidence are at significant risk of developing TB disease, even decades after arrival.4 In 2012, the National…