title: [Tuberculosis annual report 2011--(3) case finding and condition of tuberculosis on diagnosis].
abstract: Tuberculosis (TB) case findings in 2011 were reviewed, particularly regarding how the cases were detected, the diagnostic delay, the proportion of far-advanced cavitary lesions, coexisting HIV infection and diabetes mellitus (DM), and drug susceptibility testing (DST) using the national TB surveillance database. Among the 22,681 TB patients newly notified in 2011, 82.1 % of the cases were detected when the patient sought healthcare or attended medical facilities because of other chief complaints. Among the 17,519 pulmonary TB patients, 25.6% had only respiratory symptoms, 32.2% had both respiratory and nonrespiratory symptoms, and 17.0% had only non-respiratory symptoms. The rest (24.5%) were asymptomatic. The prevalence of patient's and doctor's delays among the 13,108 symptomatic pulmonary TB cases were analyzed. A large proportion-approximately 25-30%--of symptomatic pulmonary TB patients aged 30-59 years exhibited a total delay (i.e., the sum of the patient's and doctor's delays) of over 3 months. The proportion of patients with a patient's delay of over 2 months exhibited a similar tendency to that of the total delay, decreasing after 60 years of age. Moreover, the proportion of patients aged 65 years or more with a doctor's delay of over 1 month was higher than that of patients aged below 65 years. There was a high proportion-approximately 30%--of symptomatic smear-positive TB patients aged less than 60 years with a total delay of over 3 months, caused by a longer patient's delay. Meanwhile, the proportion of patients--approximately 15%--with a doctor's delay of over 1 month was almost stable across all age groups. The proportion of cases with far-advanced cavities in the lungs of pulmonary TB patients increased from 1.5% in 1975, remained stable at approximately 2% from 1985-2007, and decreased slightly thereafter until 2011 to 1.8%. From 2007-2011, there were 304 newly notified TB cases with HIV infection, 263 (86.5%) and 41 (13.5%) of which were men and women, respectively, including 67 (22.0%) foreigners. The proportion of newly notified TB cases with DM in 2011 was 13.7% (3,117/22,681) in total, 16.1% (2,250/3,117) in men, and 10.0% (867/3,117) in women. The results of DST were obtained for 8,046 (73.7%) out of 10,915 culture-positive pulmonary TB cases through the surveillance system in 2011. In previously untreated cases, the proportions of multi-drug resistant TB, any isoniazid resistance, and any rifampicin resistance were 0.5%, 4.1%, and 0.8%, respectively; meanwhile, in previously treated cases, the proportions were 3.3%, 12.1%, and 4.2%, respectively. In previously untreated cases, the proportions mentioned above have been stable over the past 5 years (2007-2011). Meanwhile, in previously treated cases, the proportions have decreased over the past 5 years, except for those exhibiting any isoniazid resistance (11.4% in 2010 to 12.1% in 2011).
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology