Yoshiyama T, Ishikawa N, Hoshino H, Ohkado A
Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan.
Kekkaku. 1999 Sep;74(9):667-75.
In Japan, the proportion of foreign patients among the total tuberculosis patients is still very small, but their problems in tuberculosis case finding and treatment require intensive control activities as in other low prevalence countries with higher proportion of foreign-born cases. The latest national survey for the foreign tuberculosis patients conducted in 1996 shows the epidemiological status between 1990 and 1993. The number of foreign tuberculosis patients in 1993 was 484, consisting of 1.0% of the total new patients in Japan. The new case rate among foreigners was estimated to be 53 per 100,000 against 38 for whole Japan in 1993. Compared with the figure in the 1993 survey, the number of foreign patients declined from 585 in 1992 to 484 in 1993. However, the number of bacillary positive tuberculosis patients in 1992 was 230 and almost the same as in 1992. The decline or stagnation of total number of tuberculosis patients can be due either to the decrease in the foreign population inflow into Japan (real decline), or partially to the reduction of overdiagnosis in X ray examination and the possible loss of some cases in the 1996 survey method. A manual sorting method from the registration cards was used at each public health center, since there is no item of country of origin in the routine tuberculosis surveillance system, and some cards might have already been displaced by the time of the survey for patients who were excluded from the registry, either cured, died or defaulted. The average treatment completion rate (1991-93) among foreign patients was 51%, which was much lower than the national figure of 81% for the same years. Moreover the rate showed deteriorating trend by year. For more accurate information, the foreigner's data must be taken in the national tuberculosis surveillance system and control activities for foreigners need to be strengthened.
在日本，外国患者在结核病患者总数中所占比例仍然很小，但他们在结核病病例发现和治疗方面的问题，如同其他外国出生病例比例较高的低发病率国家一样，需要加强管控措施。1996年针对外国结核病患者开展的最新全国调查显示了1990年至1993年期间的流行病学状况。1993年外国结核病患者人数为484人，占日本新发病例总数的1.0%。1993年外国人中的新发病率估计为每10万人中有53例，而全日本为每10万人中有38例。与1993年调查中的数字相比，外国患者人数从1992年的585人降至1993年的484人。然而，1992年痰菌阳性结核病患者人数为230人，与1992年几乎相同。结核病患者总数的下降或停滞，可能是由于流入日本的外国人口减少（实际下降），或者部分原因是X线检查中过度诊断的减少以及1996年调查方法可能导致一些病例遗漏。由于常规结核病监测系统中没有国籍这一项目，每个公共卫生中心都采用了从登记卡中手工分类的方法，而且对于那些已从登记中剔除的患者，即治愈、死亡或失访的患者，在调查时一些卡片可能已经丢失。外国患者（1991 - 1993年）的平均治疗完成率为51%，远低于同年全国81%的数字。此外，该比率呈逐年恶化趋势。为获取更准确的信息，必须将外国人的数据纳入国家结核病监测系统，并且需要加强针对外国人的管控措施。
