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Standard for Visa Screening
Program
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Document Title:
Standard for Visa Screening Program
Document Ref. Number:
DOH/SD/ADCPH/CD/VS/1.6
Version
V 1.6
New / Revised
Revised
Publication Date:
September, 2023
Effective Date
September, 2023
Document Control
DoH Strategy and Policies Sector
Applies To:
DoH licensed Healthcare Visa Screening Providers
Owner
Abu Dhabi Public Health Center – Infectious Disease Sector
Revision Date
July 2026
Revision Period
3 years
Contact
Communicable Disease Department phid@adphc.gov.ae
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1. Standard Scope
This standard outlines the requirements for visa screening applicants, screening tests and the visa screening
process specifications in the Emirate of Abu Dhabi to ensure high-quality, reliability, consistency, and the
integrity of the screening services. This is in accordance with the laws to protect the community from
communicable diseases imported from other countries. A medical examination is conducted for expatriates
over the age of 18 years, which is a necessary certificate to obtain or renew residency within the country.
The scope of this standard applies to DoH licensed healthcare facilities who have been contractually
approved to deliver visa screening services.
2. Definitions and Abbreviations
No.
Term / Abbreviation
Definition
2.1
ADPHC
Abu Dhabi Public Health Center
2.2
AED
Automated External Defibrillator
2.3
AFB
Acid Fast Bacillus
2.4
ATT
Anti-Tuberculosis Treatment
2.5
CDD
Communicable Disease Department
2.6
CCTV
Closed Circuit Television
2.7
CXR
Chest X-Ray
2.8
DICOM
Digital Imaging and Communications in Medicine
2.9
DoH
Department of Health
2.10
DoH IT system
Department of Health Information Technology system
2.11
DOT
Directed Observed Therapy
2.12
DST
Drug Sensitivity Testing
2.13
EID
Emirates Identification Card
2.14
HBV
Hepatitis B Virus
2.15
Hbs Ab or anti-Hbs
Hepatitis B Surface Antibody
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2.16
HCV
Hepatitis C Virus
2.17
hCG
Human Chorionic Gonadotropin
2.18
HCP
Healthcare Provider
2.19
HIV
Human Immunodeficiency Virus
2.20
IGRA
Interferon-Gamma Release Assays
2.21
KPI
Key Performance Indicator
2.22
LTBI
Latent Tuberculosis Infection
2.23
MOHAP
Ministry of Health and Prevention
2.24
MOI
Ministry of Interior
2.25
PACS
Picture Archiving and Communication System
2.26
PCR
Polymerase Chain reaction
2.27
POCT
Point of Care Testing
2.28
PTB
Pulmonary Tuberculosis
2.29
RN
Registered Nurse
2.30
TB
Tuberculosis
2.31
VS
Visa screening
2.32
UPT
Urine Pregnancy Test
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3. Standard Requirements and Specifications
3. Applicants Case Mix and Identification
3.1 All visa applicants wishing to enter the Emirate of Abu Dhabi for residency purposes (for work, study, or
residence) are required to undertake medical visa screening. To do so, applicants must either have a
residence visa or entry permit issued from the United Arab Emirates.
3.2 All applicants with an entry permit for periodical short business or work missions must also be screened.
3.3 Applicants with a visit visa are excluded from visa screening requirements.
3.4 All visa applicants are required to conduct the visa screening tests in an ADPHC/ DoH approved visa
screening healthcare provider, except in the following cases:
3.4.1 Visa screening applicants are admitted to a public or private hospital and are unable to
attend visa screening facilities. In such cases, the blood tests result and CXR film may be provided
by the admitting hospital with verified documents and must be entered into the DoH visa
screening reporting system with indication of the investigating source, and review of the CXR film
by the visa screening provider radiologists.
3.4.2 Visa screening applicants who are immobile, but not admitted to a hospital and unable to
attend the screening facility; such applicants are required to provide a medical report in support
of their health status. A specialized home care team may be arranged to facilitate the screening
investigations required for the fitness certificate and collection of blood samples. The chest x-ray
maybe replaced with IGRA test as mentioned in (Appendix 3). This is considered as enhanced visa
screening service.
3.4.3 Where a visa applicant is identified to be at risk from repeated exposures to chest x-ray,
the visa screening provider is required to follow the directions provided in (Appendix3).
3.4.4 Where either 3.4.1 or 3.4.2 applies, the approved visa screening provider must retain
copies of all external investigated cases on their records.
3.5 Approved visa screening providers must ensure that applicants present their original passport and
residence visa/EID (for residents seeking to renew their residency within the Emirate of Abu Dhabi), or
entry permit for work, residence or study, and where relevant sponsor change document from the
authorized entity. A copy of these documents must also be submitted as part of the registration process.
3.6 For all applicants who present a valid work or residency visa issued from other emirates, a valid health
insurance is required as part of the visa screening requirements (Appendix 4).
3.7 Healthcare providers approved to provide visa screening services must ensure that applicants undergoing
visa screening are:
3.7.1 Registered as either ‘new’ for applicants with an entry permit or ‘renew’ for applicants
with a valid residence visa.
3.7.2 Uniquely identified using at least two identifiers: unified number (appointed by
immigration) for new visa applicants and Emirates ID for renew visa applicants, with at least one
of the following: full name, date of birth and nationality.
4. Key stakeholder Roles and Responsibilities
4.1 Duties of Healthcare Providers
All licensed healthcare providers (facilities and healthcare professionals) involved in providing visa screening services
must:
4.1.1 Comply with the requirements and adhere to the processes as specified in this standard.
4.1.2 Obtain prior consent from applicants for visa screening (Appendix 1).
4.1.3 Educate patients on visa screening tests (Appendix 2) and related health topics in a culturally
appropriate manner and in easy-to-understand language.
4.1.4 Report and submit complete, and accurate data for all individual screening observations to
DoH/ADPHC via the visa screening reporting system in accordance with the specified format and
timeframe, and in compliance with the DoH Reporting of Health Statistics Policy and as set out in the
DoH Data Standards and Procedures (available online Standards – resources – Department of Health
(doh.gov.ae)). Reported data must include all clinical findings, radiologists’ findings, blood tests
observations and sputum smear results, including negative, reactive, and repeatedly reactive test
results.
4.1.5 Comply and cooperate with DoH/ADPHC requests for information on case investigations and follow-
up, as and when requested by DoH authorized personnel.
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4.1.6 Comply with ADPHC/ DoH policies and standards on health information retention, disposal, and
managing patient medical records requirements. This includes but is not limited to developing
effective recording systems, maintaining patient records, and maintaining confidentiality, privacy,
and security of patient information.
4.1.7 Maintain records and files pertaining to the visa screening services, including but not limited to
policies and procedures and patient records, and ensure their availability for ADPHC/ DoH audit.
4.1.8 Comply and cooperate with DoH/ADPHC delegated third party, if authorized by DoH/ADPHC for
evaluation or auditing process.
4.1.9 Adherence to strict infection control measures at all times, and to follow instructions in situations of
outbreak from ADPHC, DoH, and or MOHAP.
4.1.10 To grant the service of visa screening within the Emirates of Abu Dhabi, healthcare providers must
provide proof of offering holistic visa screening services in terms of the investigation and follow-up
for the cases when needed.
4.1.11 There must be a one-way flow entrance door, and separate exit door at any visa screening center.
4.1.12 All licensed visa screening providers must have crash cart on site that contains adult emergency
drugs and shall be used in case of life saving emergency, to be placed in high-risk locations such as in
vaccination room. Crash cart checking should be maintained by licensed RN and /or pharmacist
monthly for the emergency medications, and daily for the automated external defibrillator (AED)
and other consumables.
4.1.13 Non-applicants such as visitors, companions, and family members (adult/children) must not enter
the visa screening centers. Only visa screening applicants, sponsor and close contacts for testing or
vaccination are allowed to enter the screening centers.
4.1.14 Aside from visa screening services follow-up and contact tracing, no additional services will be
allowed in the visa screening center unless aligned and approved by the DoH licensing department
and ADPHC.
4.1.15 In visa screening centers that utilize urinary pregnancy test, female toilet must be within the
provider vicinity. If outside the vicinity, Closed-Circuit Television (CCTV) camera must be evident at
toilets entrance.
4.1.16 Adherence to safety measures among applicants, and staff are mandatory in all visa screening
centers.
4.2 ADPHC/ DoH Role
4.2.1 Establish the requirements for visa screening program in the Emirate of Abu Dhabi, including the:
4.2.1.1 Core screening tests as defined by the Federal Law no. (14) for the year 2014, the General
Secretariat of the Cabinet no. (7) for the year 2008 and their subsequent amendments.
4.2.1.2 Additional screening tests that may be determined, and mandated by ADPHC/ DoH, whenever
found necessary.
4.2.2 Develop and mandate standards to ensure the quality and integrity of screening services in support
of the visa screening program in the Emirate of Abu Dhabi
4.2.3 Provide guidance and training for healthcare providers involved in the provision of visa screening
services, to support the effective implementation of the standards and services.
4.2.4 Oversee and manage the visa screening process through site visits, continuous monitoring, audits of
services, analysis, review, and assessment of data submitted by visa screening providers.
4.2.5 Audit and inspect visa screening providers.
4.2.6 Control and authorize the issuance of fitness certificates.
4.2.7 Perform contact identification, tracing and referral for investigation, vaccination, prophylaxis, and
follow-up as applicable.
4.2.8 ADPHC/ DoH has the eligibility to terminate the visa screening services under any provider within
the Emirate of Abu Dhabi if not complying with visa screening stated laws and standards.
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5. Processes and operations
5.1 Visa Screening Tests According to Occupational Categories and Visa Status
Visa screening tests are classified into occupational categories determined by the Federal Law and Cabinet Law.
• Group A: Includes all occupational categories except those mentioned in group Bi, Bii & C.
• Group Bi: Domestic workers including Housemaids, Servants, Nannies, Private Drivers. Nursery and Kindergarten
caretakers.
• Group Bii: Barbers, Beauticians, Health club employees.
• Group C: Healthcare workers.
Visa screening providers must perform the batch of screening tests specified for each occupational category in
accordance with the visa screening process as described below at Section 5.2 and 5.3 of this Standard.
5.2 New Visa Applicants
5.2.1 Screening for new visa applicants Category A includes screening for:
• Leprosy
• Pulmonary tuberculosis
• HIV
5.2.2 Screening for new visa applicants in Category Bi includes screening for:
• Leprosy
• Pulmonary tuberculosis
• HIV
• Hepatitis B
• Syphilis
• Pregnancy test for females
• Vaccination for hepatitis B, applicants can be exempted if they provide attested HBV vaccine proof or positive
anti-HBs Ab report reviewed by the visa screening physician.
5.2.3 Screening for new visa applicants Category Bii includes screening for:
• Leprosy
• Pulmonary Tuberculosis
• HIV
• Hepatitis B & C
• Syphilis
• Vaccination for Hepatitis B, applicants can be exempted if they provide attested HBV vaccine proof or positive
anti-HBs Ab report reviewed by the visa screening physician.
5.2.4 Screening for new visa applicants Category C includes screening for:
• Leprosy
• Pulmonary Tuberculosis
• HIV
• Hepatitis B & C
• Syphilis
• Vaccination for Hepatitis B, applicants can be exempted if they provide attested HBV vaccine proof or positive
anti-HBs Ab report reviewed by the visa screening physician.
5.3 Renewal Visa Applicants
5.3.1 Screening for all renewal visa applicants Category A includes screening for:
• Leprosy
• Pulmonary Tuberculosis
• HIV
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5.3.2 Screening for renewal visa applicants Category Bi includes screening for:
• Leprosy
• Pulmonary Tuberculosis
• HIV
• Hepatitis B
• Syphilis
• Pregnancy test for females aged below 55 years old
• Hepatitis B vaccination status (verify the doses taken), start the course of vaccination if not completed.
Applicants can be exempted if they provide attested HBV vaccine proof or positive anti-HBs Ab report
reviewed by the visa screening physician.
5.3.3 Screening for Renewal visa applicants Category Bii includes screening for:
• Leprosy
• Pulmonary tuberculosis
• HIV
• Hepatitis B & C
• Syphilis
• Hepatitis B vaccination status (verify the doses taken), start the course of vaccination if not completed.
Applicants can be exempted if they provide attested HBV vaccine proof or positive anti-HBs Ab report
reviewed by the visa screening physician
5.3.4 Screening for renewal visa applicants Category C includes screening for:
• Leprosy
• Pulmonary tuberculosis
• HIV
• Hepatitis B & C
• Syphilis
• Hepatitis B vaccination status (verify the doses taken), start the course of vaccination if not completed.
Applicants can be exempted if they provide attested HBV vaccine proof or positive anti-HBs Ab report
reviewed by the visa screening physician.
5.4 Visa Screening Process Specifications
The visa screening process comprises of the following components and the screening tests differs from one
occupational visa category to other (refer to Section 5.2 & 5.3 of this Standard):
• Physical examination
• Blood tests for HIV, Hepatitis B & C, Syphilis
• Pregnancy test
• Chest X- ray
• Confirmation
• Vaccination
• Treatment
• Referral
• Follow-up of positive cases identified will be managed as in section 5.8.
Approved visa screening providers must perform all components in accordance with this standard and the process
specifications described in Appendices 4-11 and as detailed in the following sub-sections.
5.5 Physical examination to detect leprosy or any notifiable communicable diseases must fulfil the following
requirements:
5.5.1 The process follows what is outlined in physical examination in (Appendix 5).
5.5.2 The initial screening can be done by a physician or a trained registered nurse using a defined checklist.
5.5.3 If the healthcare provider is suspecting leprosy or any other notifiable communicable diseases, the case
should be referred for further evaluation by a licensed physician within the same visit. For Nurse-led centers,
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refer the client for licensed physician within 24 hours from the visit.
5.5.4 The facility must have a written procedure on how to investigate possible cases of leprosy.
5.5.5 The procedure is available and known by the medical staff investigating the applicants.
5.5.6 The procedure follows ‘Essentials of Leprosy Diagnosis & Treatment’ (AIFO), as applicable.
5.5.7 Applicants who have a history of leprosy or present with skin patches require a comprehensive history
taking, aimed at assessing the likelihood of leprosy.
5.5.8 Testing of skin sensation is part of the investigation of suspected cases of leprosy.
5.5.9 Suspected cases of leprosy must be referred to a dermatologist for confirmation.
5.5.10 Where cases of TB (suspicion of extra-pulmonary TB) or of notifiable communicable disease other than
PTB are suspected during the leprosy physical examination, they must be notified to DoH in accordance with
the DoH standards for reporting public health statistics
(https://bpmweb.doh.gov.ae/UserManagement/MainPage.html), and referred to an appropriately qualified
DoH licensed healthcare professional for diagnosis and treatment.
5.5.11 If a lesion is suspected, it must be reflected and reported in the visa screening electronic system, where
the certificate will be withheld until leprosy is ruled out.
5.6 Blood tests to detect HIV, Hepatitis B & C and Syphilis:
5.6.1 The process of screening for HIV, Hepatitis B & C and syphilis follows what is outlined in the process chart in
(Appendix 6).
5.6.2 The blood collection, storage and transportation should be in accordance with the DoH Clinical Laboratory
Standards.
5.6.3 Reactive screening test will need a second sample within 7-10 days for confirmation (Section 5.8), then action
is taken accordingly.
5.6.4 If the initial test is reactive and patient didn’t show up to provide a second sample, then the confirmation
should be carried out on the first sample, thereafter the action is taken accordingly.
5.7 Chest x-ray screening to detect pulmonary tuberculosis using digital chest x-ray must fulfil the following
requirements:
5.7.1 The process follows what is outlined in (Appendix 7) for chest x-ray – Screening for pulmonary tuberculosis.
5.7.2 All individuals must be considered for screening using digital chest x-ray. Any exclusion must follow DoH and
UAE regulations, as provided below and must be documented.
• Individuals under 18 years of age are excluded.
• Cancer patients who are regularly exposed to x-rays.
• Applicants who have 1-month gap or less between both exposures
• The chest x-ray should not be performed for pregnant women whether the pregnancy is obvious, or
if a pregnancy test is positive (qualitative detection of human chorionic gonadotropin [hCG] in blood
(CPT 84703) or blood POCT or urine pregnancy test.
5.7.3 Female applicants must be informed verbally and/or through posted signs at the facility in relevant languages
that chest x-ray may be postponed until two months after the expected date of delivery. Where postponement is
required, the visa screening provider must ensure that:
• Excluded women are given an appointment for a chest x-ray at two months after the expected date
of delivery and it must be documented in the consent form. The visa screening provider must
arrange an appointment for the visa applicant.
• The sponsor must be informed about the visa applicant pregnancy status and must sign the consent
form to release the certificate (Appendix 8),
5.7.4 The visa screening provider must establish a process to monitor, recall and track deferred chest x-ray
appointments, and must report to ADPHC- Communicable Diseases Department on all “No Show” cases within
no more than two weeks from the date of the re-scheduled appointment.
5.7.5 Digital Chest X-ray, DICOM-HL7 compliant PACS system, and T2 Internet connection must be used.
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5.7.6 DoH Hospital Standards for facility and for staff safety must be followed as applicable.
5.7.7 All chest x-ray images are evaluated and documented following DoH ‘Visa Screening for Pulmonary
Tuberculosis with Digital Chest X-ray Radiologist Reading and Reporting Format in accordance with the DoH
recognized international practices, as highlighted in (Appendix 9)
5.7.8 All digital chest x-ray images must be read by a DoH licensed radiologist.
5.7.9 The DoH format and forms specified at (Appendix 9) must be used for interpretation and reporting of all x-ray
images.
5.7.10 The digital chest x-ray is presented to the reader only with information of age and gender. Other identifiers
such as new or renewal visa, 1st, 2nd or 3rd radiologist’s reading, serial number, nationality, and name must
be kept confidential in the database, and not visible during chest x-ray evaluations.
5.7.11 All images evaluated as ‘Abnormal’ (Not PTB, Old PTB, or Suspicion of Active PTB, Extra pulmonary PTB) by
the first reader, must be evaluated by a second reader and third reader (Appendix 9). The second reader
should not be made aware of the documented findings of the first reader. Similarly, the same requirements
apply to the third reader. Each radiologist must independently interpret and record their findings from the
chest x-ray, and there should be no discussion or exchange of information between them regarding their
observation.
5.7.12 All results from visa screening chest x-ray must be processed and completed within 24 hours of an
applicant’s attendance at a visa screening center.
5.7.13 All initially negative x-ray readings must be reported via the DoH electronic system within 24 hours.
5.7.14 All excluded chest x-ray tests postponed due to pregnancy must be reported via the DoH electronic system
within 24 hours of performing the test.
5.7.15 All readings requiring a second reading must be reported via the DoH electronic system within 24 hours
from first reading, and the third reading must be reported within 48 hours of the first reading.
5.7.16 The TB PCR and TB culture must be performed in accordance with section 5.7.18.
5.7.17 Pregnancy test must be performed for all female new and renew residence visa applicants Category Bi and
must be documented prior to chest x-ray testing. The process must follow that as outlined in Appendix 10.
5.7.18 Sputum collection for detection of Mycobacterium Tuberculosis must comply with the following
requirements:
• All procedures are carefully designed to minimize the risk of infection and to maximize the detection of
Mycobacterium Tuberculosis, if present, through optimal retrieval methods and following the WHO guidelines
on TB infection prevention and control. 9789241550512-eng.pdf (who.int).
• Sputum samples must be collected and investigated with TB PCR, culture, and drug sensitivity testing for all
suspected PTB cases as outlined in Appendix 11
• A sputum microscopy will be done for all positive TB PCR to determine the infectivity of the patient and for
the in-charge physician to decide the need for admission and isolation.
• The sputum sample must be collected as soon as possible (maximum within 3 working days) after the chest x-
ray evaluation for cases reported as ‘Suspicion of PTB’; the applicant and sponsor must be contacted by the
screening provider to arrange for sputum testing and required education for precautions needed at applicant
residence and work.
• All activities to contact and schedule the applicant for sputum collection must be documented in accordance
with Appendix 12
• The visa screening provider must report to DoH/ADPHC if the applicant failed to continue the follow-up
investigation for more than 2 weeks after a case has been registered as ‘TB suspected’.
• Sputum is collected in a sputum induction booth or in an airborne infection isolation room under supervision
of a nurse or physician. A minimum volume of 3 mL sputum needs to be collected.
• Sputum production is induced by inhalation of an aerosol of warm, hypertonic saline, when needed sputum
samples are stored, refrigerated, and transported to the laboratory so the risk for spread of infection is
minimized and for the optimal retrieval of Mycobacterium Tuberculosis.
• Exempted categories from being reported to MOI as unfit, after being diagnosed with old/active PTB include
(will only be processed after providing the supportive documents to an DoH/ADPHC employee in the
Communicable Disease Department):
- First degree relative of Resident/Local (parent, spouse, child). As well as students of resident parents
sponsored by educational institutes inside the country.
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- Member of diplomatic/consulate sector with nomination from Minister of Foreign Affairs & International
Cooperation or their delegate.
- Big investors with nomination from Abu Dhabi Department of Economic Development.
5.8 Follow-up of Positive Cases Detected Through Visa Screening
5.8.1 Pulmonary Tuberculosis cases
5.8.1.1 ADPHC/ DoH -Communicable Diseases personnel will:
• Send feedback to the visa screening provider with the final recommended action.
• Initiate contact tracing if required and inform the infectious diseases clinic for contact investigations.
• Notify the Ministry of Interior if the case is unfit or applicant fails to comply with DOT treatment course.
• Further communication of data to MOHAP or others is arranged by DoH/ADPHC
• Details of final actions of visa screening are listed in Appendix 13 with the definition of the role of DoH/ADPHC
and Visa Screening Provider.
5.8.1.2 Visa screening provider will:
• Perform screening investigations and follow DoH/ADPHC visa screening standards.
• Report any suspected chest X-ray to DoH/ADPHC by filling the chest x-ray report for Tuberculosis for visa
screening (Appendix 9)
• Send results of investigations of suspected cases via electronic communication with DoH IT system
consequently according to the time frame recommended by DoH/ADPHC Standards for each test.
• The applicant is called for investigations and the first sputum sample shall be collected within 3 working days
after x-ray evaluation (TB suspicion). The patient and his/her sponsor must be given the proper education
about the patient’s status and infection control measures that must be taken until the results are finalized
(Appendix 14)
• Meanwhile, the applicant may complete remaining screening activities including physical examination, HIV,
Hepatitis B & C and Syphilis according to the occupation category.
• The results of TB PCR, TB culture and AFB smear and IGRA must be sent to DoH within 24 working hours for
further evaluation from its release.
• If the results of sputum smear for AFB are positive (in accordance with the DoH DOT Standard ), visa screening
provider has to arrange immediate admission for isolation and further management of the cases within 24
hours.
• VS provider will receive the final recommended action, and will act accordingly on certificate issuance, follow-
up of the patient, treatment, or referral to hospitals.
• VS provider should keep registry of all patients with follow-up and schedule a follow-up visit after 3 months.
• In the follow-up visits, chest x-ray should be performed, and compared with previous chest x-ray films to
detect any changes.
• If there is no change in the chest x-ray, the patient is reassured and given an appointment every 6 months for
the next 2 years. If there is change in the chest x-ray or the patient is symptomatic, then further investigations
are required to rule out active PTB.
• If the patient failed to attend follow-up visits, the visa screening provider must call and ensure to reschedule
another visit and fill the call log investigation form. (Appendix 12).
• Monthly reporting of follow-up of patients with inactive PTB is required by filling the template for follow-up
visits. (Appendix 12).
• Renewal applicants with old pulmonary tuberculosis will be given fitness certificates only if the patient and
sponsor sign the consent forms.
• Renewal of Active PTB will be given fitness certificate after initially AFB positive smear converts to negative or
a culture positive sputum initiates Anti-Tuberculosis Treatment for at least 1 week and upon approval from
the DOT team at DoH/ADPHC team.
• VS provider will provide education to both the patient and the sponsor regarding the risk of transmission and
the necessary precautions that should be taken to prevent infection transmission until the confirmation
process is complete.
5.8.2 HIV, or Hepatitis B & C Cases
5.8.2.1 ADPHC/ DoH -Communicable Diseases employee will:
• Send feedback to visa screening provider with the final recommended action.
• Initiate contact tracing and inform the infectious diseases clinic for contact investigations.
• Review the case according to the laws and policies of deportation and decide on action accordingly.
• Deportation procedures are managed by DoH/ADPHC in coordination with the sponsor and MOI.
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• Evaluate the process on monthly basis.
5.8.2.2 Visa Screening Provider will:
• Perform screening investigations and follow DoH/ADPHC visa screening standards.
• Call the patient for a second blood sample if the initial sample is reactive.
• Collect the second sample and perform the confirmatory test.
• Send the confirmation results to DoH IT system and report the case on the DoH- IDN notification system.
• HIV positive cases for new/renew visa are to be reported to MOI as unfit to reside in the country. An
exemption may be made by a decision of the Chairman of the DoH or Minister of MOHAP for cases deemed
appropriate.
• If applicants do not present a UAE government attested proof of HBV vaccination card, which is verified by the
nurse, then HBV vaccination course needs to be restarted. Confirmed HBV applicants must be notified that
they have the option to switch to a different occupation category that does not require HBV clearance within
30 days of receiving the test results. Applicants must get retested to enable their eligibility to be evaluated for
fitness.
• HCV confirmed cases for Bii category need to change their occupation within 30 days from receiving the
result.
• HCV confirmed cases for category C; new visa applicants have 30 days after being informed of the result to
change their occupation before being reported as unfit to MOI. Applicants must get retested to enable their
eligibility to be evaluated for fitness. Renew visa applicants are referred to medical board to determine their
fitness in accordance with their job responsibilities; if applicant found unfit, they have 30 days after being
informed of the medical board decision to change their occupation.
5.8.3 Syphilis Cases
5.8.3.1 ADPHC/ DoH -Communicable Diseases employee will:
• Send feedback to visa screening provider with the final recommended action.
• Initiate contact tracing and inform the infectious diseases clinic for contact investigations.
• Evaluate, monitor, and follow-up syphilis cases detected through visa screening.
5.8.3.2 Visa Screening Provider will:
• Perform screening investigations and follow DoH/ADPHC Visa screening standards.
• Call the patient for second blood sample if the initial sample is reactive.
• Collect the second sample and perform the confirmatory test.
• Send the confirmation results to DoH IT system and report the case on DoH- IDN notification system.
• Ensure that the patient is treated either in the same health care facility or refer the patient for treatment.
• Inform the sponsor about the status of the applicant for treatment and follow-up. Sponsor consent form
should be signed.
• Arrange a follow-up visit after 3 months and 6 months to review the patient status, with documentation of
follow-up and results.
5.9 Vaccination
5.9.1 Only applicants eligible for Hepatitis B vaccination (Category Bi, Bii and C) with no contraindications and in line
with DoH vaccine standards, are to be vaccinated.
5.9.2 The vaccination process must follow that as outlined in Appendix 15.
5.9.3 Each dose contains 1.0 ml vaccine (or as indicated) given as an intramuscular injection.
5.9.4 The first hepatitis B vaccine dose is given at the first visit for an applicant with a new visa. The second
hepatitis B vaccine dose is given one month after the first dose. The third hepatitis B vaccine dose is given six months
after the first dose.
5.9.5 The visa screening provider is required to arrange an appointment for the second and third vaccination.
5.9.6 The visa screening provider takes responsibility for further communications with the applicant and/or sponsor
if the applicant has failed to return within 2 months for the second vaccination or within 8 months for the third
vaccination.
5.9.7 Proof of vaccination will be required on visa renewal, the course of vaccination will be restarted for non-
compliance.
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6. Enforcement and Sanctions
6.1 Requirements for Laboratory Services
6.1.1 All laboratory services provided in support of the visa screening process must be conducted in
accordance with the DoH Clinical Laboratory Standards.
6.1.2 In situation where the processing laboratories are not located within the visa screening center:
6.1.2.1 All specimens must be handled with care and transported to the laboratory in insulated
cool boxes.
6.1.2.2 All laboratory services provided in support of the visa screening process must be conducted
in accordance with the DoH Clinical Laboratory Standards.
6.2 Use of Identifiers
6.2.1 Applicants must be checked for previous visa screening encounters during registration in the VS
center. The unique identifiers of each applicant to be sent to DoH via the web portal.
6.2.2 For new applicants if there is an existing record of a positive or pending result, the system will
generate action 11 and the process must be temporarily stopped.
6.2.3 When processing renewal applications, the unique identifiers must be utilized to verify the presence
of any existing records with positive or pending results. If such record is found, the system will generate
action 11 and the process must be temporarily halted.
6.2.4 Any visa screening application that has action 11 will be handled and reviewed by DoH/ADPHC and the
final action will depend on the pre-existing information database.
6.3 Sanctions
DoH may impose sanctions in relation to any breach of requirements under this standard in accordance
with the disciplinary regulation of the healthcare sector.
7.1 All visa screening providers must conduct a satisfaction survey for each center quarterly and report
the results to DoH/ADPHC.
7.2 All visa screening providers must report the visa screening Key Performance Indicators (KPIs) on
quarterly basis to ADPHC/ Communicable Diseases Department (Appendix 16). Performance KPIs will be
reviewed by ADPHC staff and action plans for improvement will be required for facilities that are performing
below the targets.
7.3 All visa screening providers are required to report non-compliance to DoH/ADPHC in accordance
with this standard quarterly and develop action plans to reduce non-compliance.
7.4 All visa screening providers must report to DoH/ADPHC for cases of fraud or manipulation noticed
from applicants or if fraud is committed by the employees.
7. Monitoring and Evaluation
13
Appendix 1 General consent form
8. Appendices
ADMN: __________________________________
Name: ____________________________________
Age: ______________________________________
Nationality: ________________________________
Occupation: ________________________________
Unified No.: _______________________________
(Patient Information Label)
Applicant General consent form for Visa
Screening
• DISCLAIMER: Visa screening test is a method of identifying individuals with certain diseases/conditions
early in their course. Depending on the diseases tested, if your tests have abnormal results; you will be
advised to have an appointment with a specialized doctor for further medical investigations and
treatment.
•
.
• GENERAL CONSENT: I give permission to the Visa Screening Center, their designated staff, and other
medical personnel providing services under their sponsorship to perform physical assessments or
examinations, conduct laboratory or other tests, give vaccinations where applicable.
•
• RELEASE OF INFORMATION: I further understand that all Medical Records may be released to concerned
Visa Screening Centers’ staff, Department of Health – Abu Dhabi and Abu Dhabi Public Health Center.
•
I, hereby undersigned agree that the details of the medical tests are explained well to me.
______________
Applicant’s Name Signature Date
14
Appendix 2: Visa screening general procedures for applicants
All applicants at the age of 18 years and above are required to undergo medical screening to obtain a residence visa in the
Emirate of Abu Dhabi.
The screening process is divided into four steps:
1. Registration
2. Physical Examination
3. Blood withdrawal
4. Chest X-ray
1
2
3
4
Registration
• The documents required:
- Original Passport
- Entry Permit/ Resident Visa/ EID
- Health insurance if Visa from outside
the Emirate of Abu Dhabi
• Take a picture
• Sign general consent form
•
•
•
Physical Examination
A doctor \ nurse will:
- Ask you questions about your Past
Medical History
- Ask you to expose parts of your body
for a skin examination
:
Blood withdrawal
Blood will be tested based on your
occupation:
• HIV
• Hepatitis B / C for certain job
categories
• Syphilis for certain job categories
• Pregnancy
3 doses of Hepatitis B Vaccination will
be provided to certain categories
:
•
•
•
•
Chest X-Ray
-To rule out Pulmonary Tuberculosis
-You are required to expose the upper
part of your body and remove all
accessories
-
Fitness Certificate is released once applicant is free of the infectious diseases tested and will be sent to
Federal Authority for Identity & Citizenship, Customs & Port Security automatically.
15
Appendix 3 – Acceptance of an IGRA test as a substitute for Chest X-Ray
DoH/ADPHC, at its sole discretion, may consider accepting an IGRA test as a substitute for a chest x-ray only in
the following cases and where substantiated with documentary evidence.
Eligibility criteria for DoH/ADPHC consideration
1. Cases that have repeated exposure to chest x-ray as a requirement for multiple entry work visa as
opposed to single entry. (Duration multiple exposures within one year).
2. Where a medical condition exists for which exposure to chest x-ray is contraindicated or where there
is likelihood of increased risk, e.g. breast cancer patients.
3. Unable to undergo a chest x-ray for any other specified and justifiable reason.
Notes:
a) All eligible applicants must submit documents to prove their case.
b) For all cases a chest x-ray must be performed on first entry to be eligible for a fitness certificate.
c) IGRA test can be accepted by DoH/ADPHC in the subsequent visa fitness certification providing that
the initial chest x-ray was negative.
d) Conduct all other visa screening tests as per the standard including the physical examination and the
overall visa screening process.
e) If IGRA is positive:
i) Provide a CXR report less than 1 year old.
ii) Proceed for sputum collection by induction, if failed to be referred to pulmonologist to
review the case clinically and advise further.
16
Appendix 4: Flowchart of visa screening process
17
Appendix 5: Physical examination
18
Appendix 6: Blood tests: HIV, Hepatitis B & C, Syphilis
19
Appendix 7: Chest x-ray (Pulmonary Tuberculosis Screening)
20
Sponsor Consent Form:
______________
Sponsor's Name Signature Date
ADMN: __________________________________
Name: ____________________________________
Age: ______________________________________
Nationality: ________________________________
Occupation: ________________________________
Unified No.: _______________________________
(Patient Information Label)
Patient Sponsor's consent form of
Pregnancy detected by Visa Screening
program
Appendix 08:
Pregnancy Consent Form
Witness:
I_________________________ am a facility employee who is not the patient's physician or authorized
health care provider and I have witnessed the sponsor or other appropriate person voluntarily sign this form.
___________________________________________________ _________________
Signature and Title of Witness Date
sponsor required such assistance)(to be signed by the interpreter/ translator if the Interpreter/Translator:
To the best of my knowledge the sponsor understood what was interpreted/translated and voluntarily signed
this form.
___________________________________________________ _________________
Signature of Interpreter/Translator Date
1. I have been informed that above- mentioned whom I
will sponsor is found to be pregnant during the routine
procedures of visa screening and cannot be subjected
to x-ray test, and I have no objection to issue the
fitness certificate.
2. I understand that by signing this consent form I
shall be held responsible for guaranteeing the follow
up visits for my employee on __/__/____ to perform
the chest x-ray and that this agreement will remain
in effect until the completion of the test required by
the visa screening program.
3. I understand that I would be contacted in the case
of non-attendance of the applicant (employee) for
follow-up and this is due to the importance of the test
4. I understand that my cooperation in this program
will benefit the safety and health of the community.
5. I understand that I have to inform you if I
cancelled or transferred the sponsorship.
21
Appendix 09: Chest x-ray evaluation form
Record of Special Findings noted on the applicant’s Chest X-ray image :( one option can be
selected in the same time.)
PH11 Single fibrous streak / band / scar
PH12 Bony islets
PH13 Apical pleural capping with a smooth inferior border (less than 1 cm thick at all
points)
PH14 Unilateral or bilateral costophrenic angle blunting (below the horizontal)
PH15 Calcified nodule(s) in the hilum / mediastinum with no pulmonary granulomas
PH16 Solitary granulomas (less than 1cm and of any lobe) with unremarkable hilum
PH17 Solitary granulomas (less than 1cm and of any lobe) with calcified/enlarged hilar
lymph nodes
PH18 Single/multiple calcified pulmonary nodules/micronodules with distinct borders
PH19 Calcified pleural lesions
PH20 Costophrenic angle blunting (either side above the horizontal)
PH21 Notable apical pleural capping (rough or ragged inferior border and or > 1 cm thick
at any point)
PH22 Apical fibronodular / fibrocalcific lesions or apical microcalcifications
PH23 Multiple/Single pulmonary nodules / micronodules (noncalcified or poorly defined)
PH24 Isolated hilar or mediastinal mass / lymphadenopathy (noncalcified)
PH25 Single / multiple pulmonary nodules / masses more than 1cm
PH26 Non-calcified pleural fibrosis and / or effusion
PH27 Interstitial fibrosis / parenchymal lung disease / acute pulmonary disease
PH28 ANY cavitating lesion OR 'Fluffy' or 'Soft' lesions felt likely to represent active TB
PH29 None of the above is present
Comment:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
___________________
Final evaluation:
Normal Chest X ray
Abnormal not pulmonary tuberculosis
22
Application #:
Radiologist name:
Facility name:
Signature/stamp:
Date:
Abnormal old inactive pulmonary tuberculosis
Abnormal low suspicion of active pulmonary tuberculosis
Abnormal medium suspicion of active pulmonary tuberculosis
Abnormal high suspicion of active pulmonary tuberculosis
Extrapulmonary tuberculosis
23
Appendix 10: Pregnancy test
24
Appendix 11: TB PCR test for suspected cases
25
Appendix 12
Follow up schedule
File No.: Application No.:
To whom it may concern
This patient: ……………………….
File No: …………………… Admin No: …………………………….. came to us as follow cases for
pulmonary TB. He attended on the following dates: -
Si .No
Date
The comments
1
No Change from the previous CXR
2
No Change from the previous CXR
3
No Change from the previous CXR
4
No Change from the previous CXR
He completed the follow up visits on …………………….
Please ask about the previous x-rays.
Appointment
Date
1
st
Appointment
2
nd
Appointment
3
rd
Appointment
4
th
Appointment
Applicant Name & Signature
Telephone No.
Date
Sponsor Name & Signature
Telephone No.
Date
26
Appendix 13: Final Actions of Visa Screening
27
Appendix 14: Abnormal Chest X-Ray
If the applicant is found to have abnormal chest x-ray, he/she will be required to provide 2 sputum samples for
evaluation and or a blood test (refer to appendix 3) within 3 days of the CXR finding. Hospital admission will be
required for further procedure to obtain sputum sample if the applicant fails to cough it out.
Precautions to follow prior obtaining results:
- Stay indoors and keeping the room well ventilated.
- Wear a surgical mask if you require to leave the house, avoiding crowded areas.
- Cover mouth and nose when coughing and or sneezing by elbow or tissue, ensure to throw tissues
away.
- Always wash hands with water and soap regularly
- Keep surroundings clean using disinfectant solution on commonly used areas.
- Avoid active / passive smoking.
- Medication needs to be taken regularly to ensure complete treatment of disease.
The sponsor is required:
- Provide support needed by applicant.
- Provide single room to applicant prior investigation completion.
- Support use of mask.
- Monitor compliance to instructions given.
28
Appendix 15: Vaccination
29
Appendix 16: Visa Screening Key Performance Indicators (KPI)
