Hoshino Hitoshi, Ohmori Masako, Okada Masaji
Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo.
Kekkaku. 2010 Sep;85(9):697-702.
TB among foreigners is presently a serious issue in some developed countries and could become so in Japan. The purpose of this report is to assess the epidemiological situation of TB among foreigners in Japan.
The trend of TB reporting among foreigners in Japan was examined with regard to work status.
The number of reported TB cases among employees and students in Japan increased between 1998 and 2008, but that among housekeepers was level throughout the same period. The increase among employees and students might be due to the increased numbers of foreign employees and students. In the case of housekeepers, the increase in the number of permanent residents did not lead to an increase in TB among these housekeepers. Estimates of TB reporting rates decreased during the study period, so the changes in reporting rates would not have caused the increase in TB cases. This downward trend may have been caused by an increase in longer-term residents and a decrease in TB incidence in home countries. Even though the TB reporting rate is decreasing, the rates in those countries are much higher than in Japan in the same work categories.
To control the spread of TB, it is important to identify high-risk individuals. The Japanese TB control program should further strengthen mass health examination programs for foreign housekeepers and employees (especially temporary and daily employees), case-finding based on individuals' access to hospitals or clinics when suffering from TB symptoms, and flexible and periodic adjustment of TB control activities for foreigners according to future changes in the number and distribution of foreigners in Japan. Furthermore, improving the TB epidemiological situation in home countries might contribute to the downward trend of TB reporting rates among foreigners in Japan. Therefore, Japanese assistance in TB control activities in surrounding countries such as China, South Korea, and the Philippines might contribute to TB control activities for foreigners in Japan.
在一些发达国家，外国人中的结核病目前是一个严重问题，在日本也可能成为严重问题。本报告的目的是评估日本外国人中的结核病流行情况。
根据工作状况研究了日本外国人结核病报告的趋势。
1998年至2008年期间，日本雇员和学生中报告的结核病病例数有所增加，但家政服务人员中的病例数在此期间保持稳定。雇员和学生中病例数的增加可能是由于外国雇员和学生数量的增加。在家政服务人员中，永久居民数量的增加并未导致这些家政服务人员中结核病病例数的增加。研究期间结核病报告率估计有所下降，因此报告率的变化不会导致结核病病例数的增加。这种下降趋势可能是由于长期居民数量的增加以及其本国结核病发病率的下降。尽管结核病报告率在下降，但在相同工作类别中，这些国家的报告率远高于日本。
为控制结核病的传播，识别高危个体很重要。日本的结核病控制计划应进一步加强针对外国家政服务人员和雇员（特别是临时工和日工）的大规模健康检查计划，基于个体在出现结核病症状时前往医院或诊所就诊情况进行病例发现，并根据日本外国人数量和分布的未来变化，灵活且定期地调整针对外国人的结核病控制活动。此外，改善其本国的结核病流行情况可能有助于降低日本外国人中的结核病报告率。因此，日本在中国、韩国和菲律宾等周边国家开展的结核病控制援助活动可能有助于日本针对外国人的结核病控制活动。
