title: Strengthened tuberculosis control programme and trend of multi-drug resistant tuberculosis rate in Osaka City, Japan.
abstract: 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.
authors.affiliation: The Research Institute of Tuberculois, Japan Anti-Tuberculosis Association (RIT JATA), Tokyo Japan .
authors.forename: Akira
authors.initials: A
authors.lastname: Shimouchi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ohkado
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Jun
authors.initials: J
authors.lastname: Komukai
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshida
authors.forename: Nobukatsu
authors.initials: N
authors.lastname: Ishikawa
mesh_terms: D023801:Directly Observed Therapy; D018563:Disease Notification; D006703:Ill-Housed Persons; D006801:Humans; D007564:Japan / Q000453:epidemiology; D011634:Public Health; D017211:Treatment Failure; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control* / Q000628:therapy
references.citation: Thorax. 2007 Aug;62(8):667-71
references.pmid: 17289861
references.citation: Arch Fam Med. 1995 Jun;4(6):541-6
references.pmid: 7773431
references.citation: Kekkaku. 2000 Sep;75(9):533-44
references.pmid: 11068370
references.citation: Kekkaku. 2008 Sep;83(9):611-20
references.pmid: 18979995
references.citation: Kekkaku. 2001 Dec;76(12):749-53
references.pmid: 11806131
references.citation: Kekkaku. 2004 Jan;79(1):17-24
references.pmid: 14969084
references.citation: Kekkaku. 2016 May;91(5):519-525
references.pmid: 28661594