[Management of nontuberculous mycobacteriosis in health centers and tuberculosis surveillance system].

Nontuberculous Mycobacteriosis (NTM) is a different disease from tuberculosis, but in Japan most of them are still obliged to be treated as tuberculosis under medical insurance scheme and included statistically in the number of tuberculosis. In this investigation, patients of NTM who were at first registered as tuberculosis and diagnosed later as NTM or found to be positive for nontuberculous mycobacteria were analysed from the standpoint of tuberculosis statistics and activities at health centers. Out of 1207 newly registered tuberculosis in 1993 at 23 health centers (HCs) or its branches in Hiroshima Prefecture, 482 cases were bacteriologically positive, and among them 40 cases were found to be NTM later. Under the current tuberculosis surveillance system, 4 cases from 1 HC were omitted from the tuberculosis registry, 10 cases from 4 HCs were kept on the tuberculosis registry as 'culture positive for nontuberculous mycobacterium', 15 cases from 7 HCs were registered as 'tuberculosis with nontuberculous mycobacteriosis as a complication' and in 11 cases no informations on NTM were entered into the registry. Only 6 smear positive cases which were registered as 'culture positive for nontuberculous mycobacteria' were excluded from the number of smear positive tuberculosis under the surveillance system. In other investigation made by hospitals in the same area on NTM, 59 patients with definite NTM were reported in 1993. At least 52 were registered first as tuberculosis, thus NTM occupies at least 4.3 percent of all newly reported tuberculosis and 10.8 percent of new smear positive cases.(ABSTRACT TRUNCATED AT 250 WORDS)