Strengthened tuberculosis control programme and trend of multi-drug resistant tuberculosis rate in Osaka City, Japan. 2013

Akira Shimouchi, and Akihiro Ohkado, and Kenji Matsumoto, and Jun Komukai, and Hideki Yoshida, and Nobukatsu Ishikawa
The Research Institute of Tuberculois, Japan Anti-Tuberculosis Association (RIT JATA), Tokyo Japan .

Osaka City has the highest tuberculosis (TB) notification rates in Japan. In the period 1999-2003, the TB control programme was strengthened, and the Stop TB Strategy was implemented to reduce the number of notified cases. The objective of this study was to assess the effect of these control activities in Osaka City, including the implementation of directly observed treatment (DOT), by analysing TB surveillance and routinely collected data. We reviewed the surveillance data of all sputum smear-positive pulmonary tuberculosis (PTB) cases registered in the Osaka City Public Health Office from 2001 to 2008 and data collected from the routine TB programme. The DOT implementation rate increased from 0% in 2001 to 68% in 2008 for smear-positive PTB cases of the general public and to 61% for all PTB cases of the homeless. The proportion of smear-positive PTB cases that had treatment failure and default combined, declined from 8.0% (52 of 650) in 2001 to 3.6% (20 of 548) in 2006. The proportion of cases among the homeless with previous treatment declined from 28% in 2001 to 15% in 2008. The proportion of cases with multidrug resistant-TB (MDR-TB) among those without previous treatment declined from 1.7% in 2001 to 0.9% in 2008. It is logical that reduction in the failure and default rate would lead to the reduction of cases with previous treatment and TB transmission, including resistant TB, therefore to the reduction of MDR-TB rates.

UI MeSH Term Description Entries
D007564 Japan A country in eastern Asia, island chain between the North Pacific Ocean and the Sea of Japan, east of the Korean Peninsula. The capital is Tokyo. Bonin Islands
D011634 Public Health Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. Community Health,Environment, Preventive Medicine & Public Health,Environment, Preventive Medicine and Public Health,Health, Community,Health, Public
D006703 Ill-Housed Persons Persons without adequate housing or without permanent residence. The concept excludes nomadic peoples. Homeless Persons,Homeless Shelters,Shelterless Persons,Shelters for Homeless Persons,Street People,Unhoused Persons,Homelessness,Homeless Person,Homeless Shelter,Ill Housed Persons,Ill-Housed Person,People, Street,Person, Homeless,Person, Ill-Housed,Person, Shelterless,Person, Unhoused,Persons, Homeless,Persons, Ill-Housed,Persons, Shelterless,Persons, Unhoused,Shelter, Homeless,Shelterless Person,Shelters, Homeless,Unhoused Person
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014397 Tuberculosis, Pulmonary MYCOBACTERIUM infections of the lung. Pulmonary Consumption,Pulmonary Phthisis,Pulmonary Tuberculoses,Pulmonary Tuberculosis,Tuberculoses, Pulmonary,Consumption, Pulmonary,Consumptions, Pulmonary,Phthises, Pulmonary,Phthisis, Pulmonary,Pulmonary Consumptions,Pulmonary Phthises
D017211 Treatment Failure A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. Failure, Treatment,Failures, Treatment,Treatment Failures
D018088 Tuberculosis, Multidrug-Resistant Tuberculosis resistant to chemotherapy with two or more ANTITUBERCULAR AGENTS, including at least ISONIAZID and RIFAMPICIN. The problem of resistance is particularly troublesome in tuberculous OPPORTUNISTIC INFECTIONS associated with HIV INFECTIONS. It requires the use of second line drugs which are more toxic than the first line regimens. TB with isolates that have developed further resistance to at least three of the six classes of second line drugs is defined as EXTENSIVELY DRUG-RESISTANT TUBERCULOSIS. Tuberculosis, Drug-Resistant,Tuberculosis, MDR,Tuberculosis, Multi-Drug Resistant,Drug-Resistant Tuberculosis,MDR Tuberculosis,Multi-Drug Resistant Tuberculosis,Multidrug-Resistant Tuberculosis,Tuberculosis, Drug Resistant,Tuberculosis, Multi Drug Resistant,Tuberculosis, Multidrug Resistant
D018563 Disease Notification Notification or reporting by a physician or other health care provider of the occurrence of specified contagious diseases such as tuberculosis and HIV infections to designated public health agencies. The United States system of reporting notifiable diseases evolved from the Quarantine Act of 1878, which authorized the US Public Health Service to collect morbidity data on cholera, smallpox, and yellow fever; each state in the US has its own list of notifiable diseases and depends largely on reporting by the individual health care provider. (From Segen, Dictionary of Modern Medicine, 1992) Exposure Notification,Infectious Disease Reporting,Notification, Disease,Disease Notifications,Disease Reporting, Infectious,Disease Reportings, Infectious,Exposure Notifications,Infectious Disease Reportings,Notification, Exposure,Notifications, Disease,Notifications, Exposure,Reporting, Infectious Disease,Reportings, Infectious Disease
D023801 Directly Observed Therapy A treatment method in which patients are under direct observation when they take their medication or receive their treatment. This method is designed to reduce the risk of treatment interruption and to ensure patient compliance. Therapy, Directly Observed

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