Vol.63 No.6 November 2015
The current status of tuberculosis in Japan, including refractory cases and drug resistant cases
Department of Respiratory Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, Japan
Abstract
Although tuberculosis is often misunderstood as an old disease in Japan, tuberculosis remains one of the three most widespread infections in the world. Japan still demonstrates a medium incidence of tuberculosis cases compared to European and North American countries. There are several problems that remain, not just concerning the incidence, but also concerning the diagnosis and treatment. Since the number of physicians trained to medically treat tuberculosis is decreasing, a delay in an accurate diagnosis of tuberculosis still frequently occurs. Although the standard treatment regimens for tuberculosis have been established, the results remain poor, especially regarding elderly patients. One of the reasons is the high incidence of concomitant diseases (e.g., cerebral infarction, cardiac diseases) other than tuberculosis in elderly patients. There are many factors associated with tuberculosis that still have to be improved in modern Japan, including the nutritional status, and the introduction of surgery in cases of treatment failure. We therefore need to improve several aspects associated with TB in addition to treating other diseases that frequently occur in the elderly. Cases of tuberculosis resistant to multiple drugs (multi-drug resistant tuberculosis; MDR-TB) also represent big problem. The incidence of MDR-TB in Japan is not high, namely 0.7% in untreated patients, and 9.8% in previously treated patients. However, the incidence of extensively drug-resistant tuberculosis (XDR-TB) is extremely high, with a rate of 29% among MDR-TB patients. It is therefore necessary to prevent the occurrence of such drug resistance and to pay close attention to these trends. In this issue, the current status of tuberculosis in Japan is summarized, while focusing especially on refractory tuberculosis and MDR-TB.
Key word
tuberculosis, intractable tuberculosis, multidrug-resistance
Received
August 11, 2015
Accepted
August 20, 2015
Jpn. J. Chemother. 63 (6): 540-543, 2015
