Tuberculosis in immigrants and visitors.

Immigrants and visitors are a significant factor in the epidemiology of tuberculosis (TB) in New Zealand, accounting for an increasing proportion of notifications in recent years. At present screening of immigrants from countries with a high incidence of TB is inadequate. There are deficiencies in procedures, inadequate screening coverage, ineffectual coordination between the Ministry of Health and New Zealand Immigration Service, incomplete follow-up on those at risk of TB, confusion over financial responsibility, inadequate data to describe the problems and monitor interventions, and a lack of commitment to assistance with TB control in neighbouring countries from which some of our TB arises. We make recommendations in all of these areas. Timely screening of high-risk immigrants should be seen as health protection for ethnic minorities.