Japan\rqs National Tuberculosis Control Strategies with Economic Considerations

We made a bibliographic search for Japanese and non-Japanese literature on tuberculosis control programs to study the current public health policies for tuberculosis control in Japan especially in regard to cost-effectiveness. Then, we compared the Japanese strategies for tuberculosis control with those in other countries including the United States, and those recommended by World Health Organization (WHO). The current trend of tuberculosis incidence in the Japanese community demonstrates major differences from the situation that had prompted installation of tuberculosis control measures several decades ago. The tuberculosis control measures should be targeted to the elderly people (over 65 years old) because of the following three aspects. (1) A continuing decline of tuberculosis in the young Japanese population, particularly children who might attain benefits from BCG immunization; (2) The enhancement of the prevalence among the elderly people who are not covered by a uniform national surveillance strategy; (3) Cost-ineffectiveness of Mass Miniature Radiography (MMR) being used as a means to screen for tuberculosis. The cost-effectiveness issue must be considered more seriously, and the WHO recommendations especially in regard with the DOTS (directly-observed treatment, short course) strategy need to be incorporated more effectively into the national program since the incidence of drug resistant tuberculosis in Japan has been recently increasing. Finally, we propose to limit BCG immunization further and to discontinue annual MMR in the young population, and instead to develop effective strategies of both active and passive case finding in the elderly through public and community health services.

Japan's national tuberculosis control strategies with economic considerations

We made a bibliographic search for Japanese and non-Japanese literature on tuberculosis control programs to study the current public health policies for tuberculosis control in Japan especially in regard to cost-effectiveness. Then, we compared the Japanese, strategies for tuberculosis control with those in other countries including the United States, and those recommended by World Health Organization (WHO). The current trend of tuberculosis incidence in the Japanese community demonstrates major differences from the situation that had prompted installation of tuberculosis control measures several decades ago. The tuberculosis control measures should be targeted to the elderly people (over 65 years old) because of the following three aspects. (1) A continuing decline of tuberculosis in the young Japanese population, particularly children who might attain benefits from BCG immunization; (2) The enhancement of the prevalence among the elderly people who are not covered by a uniform national surveillance strategy; (3) Cost-ineffectiveness of Mass Miniature Radiography (MMR) being used as a means to screen for tuberculosis. The cost-effectiveness issue must be considered more seriously, and the WHO recommendations especially in regard with the DOTS (directly-observed treatment, short course) strategy need to be incorporated more effectively into the national program since the incidence of drug resistant tuberculosis in Japan has been recently increasing. Finally, we propose to limit BCG immunization further and to discontinue annual MMR in the young population, and instead to develop effective strategies of both active and passive case finding in the elderly through public and community health services.

Survey Research on Prevalence, Aim and Image of Acupuncture and Moxibustion in Japan(1): Prevalence and Aim of Acupuncture and Moxibustion / 全日本鍼灸学会雑誌

[Objective] To clarify the prevalence and aim of acupuncture and moxibustion treatment as well as reasons for choosing this remedy in Japan.<BR>[Methods] We conducted direct interviews with 2, 000 adults (aged 20 years or older) in a stratified two stage sampling in March, 2003.<BR>[Results] Of those interviewd, 71% (1, 420 / 2, 000) responded to the survey of demographics, experience, aim and reasons for choosing acupuncture and/or moxibustion. A total of 7.5% of the population had used Acupuncture and/or Moxibustion during the past 12 months and a total of 26.4% had experienced at least one of these treatment during their lifetime. The most frequent symptoms being treated involved musculoskeletal prob-lems (81.6%), and the most frequent reason for choosing the treatment was the recommendation of family or friends (58.7%).<BR>[Conclusion and Discussion] The prevalence of choosing acupuncture and moxibustion in Japan was higher than that in the U. S. or Europe, which might reflect the history of these methods as popular folk remedies in Japan. The most frequent reason for choosing these remedy might be related to the treatment methods requiring direct contact and stimulation of the body.