Concerns have been raised about the effectiveness of tuberculosis checks for people coming to England from countries hardest hit by the disease.
X-rays can detect TB infections
The Health Protection Agency looked at arrangements at points of entry, such as airports and ports.
It expressed "considerable concern" over TB X-ray screening arrangements.
The HPA's report said that of about 270,000 people entering the UK for more than six months, only about 73,000 - or 27% - had been screened.
Of 191 sent for testing, 90 cases of TB were diagnosed but it was impossible to know how many of these were infectious, the HPA said.
The experts said there were "major doubts about the effectiveness and efficiency" of the screening programme.
It said only 68% of people coming into England from countries where TB was prevalent were sent for medical checks by the Immigration Service, and it was not clear why the remaining third were not tested.
TB is a disease of the respiratory system.
It requires prolonged close contact to spread, so those most at risk of catching TB are people living with someone who is infected.
It is highly unlikely someone could be infected by passing contact, such as sitting next to someone with TB on public transport.
The HPA made a series of recommendations which it says are necessary to ensure there was a consistent health service at all ports and airports.
Some, like Heathrow and Gatwick, had very good facilities. But other points of entry, such as some smaller airports, did not, it said.
The HPA offered to oversee arrangements for people arriving at international terminals.
Chief executive Professor Pat Troop said: "This is an important area of public health activity and the review lays the foundation for developing a comprehensive national approach to quality and standards for the service in a way that was not possible before."
There are 7,000 cases of TB diagnosed in Britain each year.
Other parts of the world have high rates of infection. TB blackspots include eastern Europe, south east Asia, three million cases a year and sub-Saharan Africa.
A Home Office spokesman welcomed the report and its recommendations, but said much of the focus for prevention work had centred on checking people before they travelled, as the volume of people coming through terminals hampered checks in the UK.
"These checks are part of UK entry requirements".
Five high-risk countries already have X-ray machines to check for TB, and more will be added later this year.
He added that efficient follow up checks by the NHS were also needed to effectively detect cases of TB.
'Vulnerable at risk'
A Department of Health spokeswoman added: "The findings of this evaluation will inform future decisions about whether, where and how to carry out TB checks".
But Shadow Home Secretary David Davis said: "We eliminated TB as a major public health risk in this country but now the government's failure is once again putting the most vulnerable people in our country at risk of infection."
Liberal Democrat home affairs spokesman Nick Clegg MP said the report┐s findings were deeply worrying.
He added: "The government must increase screening for the benefit of those concerned, as well as the wider community."
Sir Andrew Green, chairman of immigration pressure group Migration Watch, said: "The government have refused until recently to test for TB before visas are issued to those from high-risk countries.
"There is now a pilot scheme but it is essential that a fully effective regime is put in place."