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Free Content Factors associated with declining numbers of chronic tuberculosis excretors in Japan

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SETTING: Japan's National Tuberculosis Programme (NTP).

OBJECTIVES: To determine and assess the chronological change of chronic excretors.

DESIGN: We compared two groups of chronic excretors (continuous excretion of TB bacilli in the last 2 years) classified by time of registration; the first group was registered from 1991 to 1997, and the second from 1998 to 2004. The epidemiological situation and the NTP were also compared.

RESULT: There were 481 cases in the first group, comprising 0.17% of registered cases, and 159 cases in the second group, comprising 0.06%. Stratified analysis by treatment regimen and TB category confirmed a decrease in the ratio of chronic excretors in all sub-groups. Human factors such as non-adherence, no drug susceptibility testing (DST) on initiation of treatment and inadequate modification of treatment in new sputum smear-positive cases were more frequent in the first group than in the second (37.0% vs. 28.9%, 19.5% vs. 10.7%, 36.8% vs. 19.5%, P < 0.05). Other known risk factors, such as interruption due to side effects and complication of diabetes and/or alcoholism, were similarly distributed.

CONCLUSION: The decline in chronic excretors has been associated with the DOTS strategy, baseline DST and appropriate modification of treatment regimen in new sputum smear-positive cases.
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Keywords: DOTS; chronics; tuberculosis

Document Type: Regular Paper

Affiliations: Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan

Publication date: 01 February 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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