-
- 青木 正和
- 結核予防会結核研究所
書誌事項
- タイトル別名
-
- Characteristics of tuberculosis in Japan compared with those in other developed countries.
この論文をさがす
抄録
To clarify the characteristics of the tuberculosis situation in Japan, it was analysed in comparison with those in other developed countries. The results are summarized as follows:<BR>1. The tuberculosis epidemic peaked at the end of 1910s in Eastern Japan, and in the 1940s in Western Japan. It is estimated that the annual risk of inberculosis infection was 4% or more until the end of the World War II. Tuberculosis has spread much later and was much more prevalent up through the 1940s in Japan than in other developed countries.<BR>2. A modern tuberculosis control programme including active case-finding, isolation of infectious cases, charge free medication and BCG vaccination was launched in 1951, and in 1961 an effective case-holding system was established. Tuberculosis incidence decreased rapidly thereafter. As the rate of decrease was almost the same as that of the Inuit (Eskimo) (Fig. 1), one might say that Japan is one of the countries where tuberculosis incidence decreased most rapidly.<BR>3. Incidence of tuberculosis in children is 2.1 per 100, 000 in 1991 which is lower than that of the U.S.A. (3.1 per 100, 000).<BR>4. Incidence of tuberculosis among the aged is much higher than that of other developed countries as shown in Fig. 3. Of course, this is mainly caused by the fact that a higher percentage of Japanese aged 55 years or more was infected with tubercle bacilli in the past. However, it was also shown that the rate of break-out of the disease among remote infected Japanese aged 50 years or more was several times higher than that of Dutch people.<BR>5. In Japan, the decrease of tuberculosis incidence has stagnated in the past 13 years. The annual rate of incidence reduction was 11% before 1980, and is 3.5% now. Recently, stagnation of increase in tuberculosis incidence is being observed in all prefectures in Japan and in almost all Western developed countries.<BR>It was concluded from the results of an analysis of the recent trend of incidence in each prefecture in Japan that the causes of stagnation can be summarized as follows: 1) Veryhigh prevalence of tuberculosis before 1950, 2) Rapid increase of the percentage of aged people infected with tubercle bacilli, 3) Stagnation of the rate of decrease of risk of infection by the recent longer delay in cas-finding, and 4) Increase of population in large cities and slum formation. No connection was observed for HIV infection and immigrant tuberculosis.<BR>6. The total number of HIV infected people was 1, 046 at the end of 1992, excluding HIV infection by blood coagulant infusion. Less than 10 cases of TB/HIV cases have been reported previously in Japan. However, the rate of increase of HIV infections is so rapid recently that it is estimated that the number of TB/HIV cases will increase gradually and the total number of these cases will top 600 by the year 2000.<BR>7. Number of cases of immigrant tuberculosis are increasing rapidly at an annual increase rate of 18%. However, the total number of cases only amount to 0.3% of the total new cases in 1990.<BR>8. The total number of the Japan Tuberculosis Society members is more than 2, 600, so the author has expressed his desire to strengthen society activities to promote basic research, to improve the tuberculosis control programme in Japan and to contribute more actively to worldwide tuberculosis control.
収録刊行物
-
- 結核
-
結核 68 (8), 533-538, 1993
一般社団法人 日本結核病学会