Tuberculosis in migrants to Australia: Outcomes of a national screening program

Trauer, James M., Williams, Bridget, Laemmle-Ruff, Ingrid, Horyniak, Danielle, Caplice, Lila V.Soares, McBryde, Emma S., Majumdar, Suman S., Graham, Stephen, and Hellard, Margaret E. (2021) Tuberculosis in migrants to Australia: Outcomes of a national screening program. The Lancet Regional Health - Western Pacific, 10. 100135.

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Background: Few low-incidence countries are on track to achieve the ambitious target of reaching TB pre-elimination by 2035. Australia is a high-income country with a low burden of TB, which is particularly concentrated in migrant populations. As part of Australia's migration program, permanent, provisional and humanitarian visa applicants are screened for TB, along with some applicants for temporary visas.

Methods: We calculated the prevalence of all forms of active TB and bacteriologically-confirmed TB among onshore and offshore applicants for visas to Australia from July 2014 to June 2017, and investigated associated risk factors using logistic regression.

Findings: Visa applicants were predominantly young adults from various Asian countries. Among 2,381,217 applicants, 1263 cases of active TB were diagnosed, including 852 cases of bacteriologically-confirmed TB. Overall TB prevalence was 53.0 per 100,000, corresponding to one TB diagnosis for every 1887 applicants screened. TB rates increased with age and were higher among humanitarian applicants and those previously treated for TB, although most cases occurred in applicants without these risk factors. TB prevalence by country of origin was similar to WHO estimates for some countries, but considerably lower for others. For several highly represented countries of origin, rates appear to have fallen relative to earlier comparable studies.

Interpretation: Prevalence of TB among visa applicants to Australia and the consequent risk to the Australian community appear to be declining and remain low. In this context, support for TB control programs overseas and preventive interventions are likely to have the greatest impact on domestic TB burden.

Item ID: 70433
Item Type: Article (Research - C1)
ISSN: 2666-6065
Copyright Information: © 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (
Date Deposited: 07 Apr 2022 03:48
FoR Codes: 49 MATHEMATICAL SCIENCES > 4901 Applied mathematics > 490102 Biological mathematics @ 30%
42 HEALTH SCIENCES > 4202 Epidemiology > 420205 Epidemiological modelling @ 70%
SEO Codes: 20 HEALTH > 2004 Public health (excl. specific population health) > 200404 Disease distribution and transmission (incl. surveillance and response) @ 80%
20 HEALTH > 2002 Evaluation of health and support services > 200205 Health policy evaluation @ 20%
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