8. Present tuberculosis situation in Japan
Tbc. was very prevalent after the World War II, and the incidence were near 700/100,000 up to 1960 as can be seen in Fig.5. After the enactment of new Anti-Tbc. Low, all the persons concerned have participated actively and promoted the successful implementation of tbc. control. As the number of tbc. patients was so huge that only one disease, tbc. spent 27% of all the medical expense in 1953. All the modern tbc. control measures including case-holding has been launched in 1961, and tbc. decreased smoothly with the annual reduction rate of 11% (one of the most rapid decreaee of tbc. in the world ), in other words, tbc, incidence became half every 6 years.
However, tbc. decrease has stagnated thereafter mainly by the rapid increase of aged people who had been infected with tbc. bacilli before, in, or soon after the World War II. The annual reduction rate is 3.2% now. Main tbc. indices were as follows in 1998;
Incidence of al forms of tbc. 32,4/100,000 Actual number 26,683
Smear positive incidence 10.6 Actual number 13,405
Tbc. mortality 2.2 Actual number 2,795
Estimated risk of infection 0.05%
"Leseon from Japanese experience"
Japan has clearly shown the fact that it is possible to reduce tbc. incidence very rapidly when the risk of tbc. is high, and the majority of tbc. patients are those who had been infected recently. The reasons of success of tbc. control were that not only the central government as well as local government had worked very actively but also private sector as well as even voluntary organizations such as "Anti-tbc. women's society" had cooperated for tbc. control actively.
At present, 54% of newly registered cases were patients aged 60 years old or more who had been infected with tbc. bacilli 20〜40 years ago. In such a situation, it is difficult to reduce tbc. incidence so rapidly.
