In this prospective study conducted by 9 Public Health Offices in North Rhine Westphalia 1992 to 1994, among the analysed 4058 asylum seekers aged 1-89 years the chest radiographs showed in 444 cases old specific changes and in 48 cases active tuberculosis. This was verified microbiologically. 81% of the evaluated tuberculin skin test were positive with variations between the different countries of origin, which is significantly higher than among persons born in the Fed. Rep. of Germany. A compulsory chest radiograph shortly after arrival and controlled curative or preventive chemotherapy programmes are urgently needed.