4.1

It must be acknowledged that tuberculosis in immigrants, refugees, visitors, students and those returning from countries where tuberculosis is endemic is the major issue for tuberculosis control and elimination: before, at and after arrival.

4.2

The issue of tuberculosis should not be a reason to restrict immigration.

4.3

Current policies and strategies for the control of tuberculosis in these groups do not appear to be very effective and indicate that they need to be evaluated on a priority basis.

4.4

Strategies must be modified and/or developed as a priority to effectively detect and prevent tuberculosis in these groups.

4.5

The control of tuberculosis in these groups must consider the following issues: screening with tuberculin skin testing, HIV screening, barriers to case finding and case holding, specific procedures for individuals from high-risk countries, the relative burden of illness in particular groups, education, medical insurance, multicultural issues, involvement of affected groups, access to the health care system.