title: Characteristics and treatment outcomes of tuberculosis cases by risk groups, Japan, 2007-2010.
abstract: BACKGROUND
  We studied the characteristics and treatment outcomes of the following risk groups for tuberculosis (TB): those with HIV and diabetes mellitus (DM), contact cases, the homeless, foreigners, health care workers (HCW) and the elderly.
  
  
  METHODS
  A descriptive cross-sectional study was conducted by analysing the Japanese tuberculosis surveillance data of all cases registered between 2007 and 2010 (n = 96 689).
  
  
  RESULTS
  The annual proportion of TB cases by risk group was stable over the study period, although there was a slight but significant increase observed for foreigners and elderly cases. Homeless and elderly TB cases had the highest DM co-morbidity (16.6% and 15.3%). HIV co-infection was low in all TB cases (0.2%) yet highest in foreigners (1.3%). HIV status of 45% of TB cases was unknown. The proportion of multi drug resistant (MDR) TB was similar among all risk groups (0.0-0.9%) except foreigners, at 3.4%. Males in most risk groups had higher mortality than females; the mortality of all TB cases in all age groups for both males and females were 3.6-24 times higher than the general population.
  
  
  CONCLUSIONS
  Reasons for the high proportion of "HIV status unknown" should be investigated and improved. Contact tracing among foreign cases with MDR-TB should be a priority. Homeless persons should be screened for DM together with TB. Programs to enhance health and nutrition status may benefit tuberculosis prevention among the elderly. Tuberculosis screening and TB education are important for HCW.
authors.affiliation: The Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, Tokyo, Japan .
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Uchimura
authors.forename: Jintana
authors.initials: J
authors.lastname: Ngamvithayapong-Yanai
authors.forename: Lisa
authors.initials: L
authors.lastname: Kawatsu
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ohkado
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshiyama
authors.forename: Akira
authors.initials: A
authors.lastname: Shimouchi
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Ito
authors.forename: Nobukatsu
authors.initials: N
authors.lastname: Ishikawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D054242:Emigrants and Immigrants; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications*; D006282:Health Personnel; D006703:Ill-Housed Persons; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011634:Public Health; D012306:Risk; D012737:Sex Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology; D055815:Young Adult
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