title: ROLES OF PUBLIC HEALTH CENTERS (HOKENJO) IN TUBERCULOSIS CONTROL IN JAPAN.
abstract: Public health centers (PHCs,hokenjoin Japanese) are local government authorities responsible for public health in Japan. PHCs have an important role in tuberculosis (TB) control. Typically, their responsibilities include 1) the recommendation to admit infectious TB patients to an isolation ward, 2) health checkups with chest X-ray of those in a close contact with infectious TB patients, and 3) public subsidy of medical expenses for TB treatments. Facing the emergence of multi-drug resistant tuberculosis (MDR-TB), the national TB control program was drastically changed; the Japanese version of the Directly Observed Treatment in Short-course (DOTS) strategy was started in 2005. New roles were added to PHCs' responsibilities; 1) active screening of latent TB infection by interferon gamma release assays for those in a close contact with infectious TB patients, 2) community DOTS to promote treatment adherence to outpatients, 3) cohort analysis of outcomes of TB treatment, and 4) national MDR-TB surveillance. These roles are important in preventing MDR-TB and eliminating TB in Japan.
authors: Nagoya Meito Health Center, Nagoya, Japan.
authors: Nobuyuki
authors: N
authors: Katsuda
authors: Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Tomoya
authors: T
authors: Hirosawa
authors: Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Joshua A
authors: JA
authors: Reyer
authors: Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Nobuyuki
authors: N
authors: Hamajima
keywords: DOTS strategy; Infectious Disease Act.; latent tuberculosis infection; multi-drug resistant tuberculosis; public health center