Abstract
Foreign-born persons are considered one of the high-risk populations for tuberculosis (TB), and numerous studies have discussed the potential role of pre-entry TB screening for immigrants. However, rates of TB disease among immigrants can remain high several years after entry. In Japan, approximately 50% of TB among foreign-born persons occurs among those who have entered Japan more than five years before being diagnosed, i.e. non-recent immigrants. However, little attention has been paid so far to the issue of TB control among the non-recent immigrants. A detailed analysis of the Japan Tuberculosis Surveillance data was therefore conducted to describe the characteristics of TB among non-recent immigrants and discuss policy implications in terms of post-entry interventions in Japan. The main findings were as follows: 1) the proportion of pulmonary TB cases aged 65 years and older was higher among non-recent than recent immigrants (9.8% vs 1.2%); 2) the proportion of those with social risk factors including homelessness and and being on social welfare assistance was higher among non-recent than recent immigrants; and 3) the proportion of those detected via routine screening at school or workplace was significantly lower among non-recent immigrants aged between 25 and 64 than among recent immigrants in the same age group (15.4% vs 28.7%). Our results suggested the need to increase the opportunities for and simultaneously improve the take-up rate of community-based screening for non-recent immigrants.
Highlights
The proportion of tuberculosis (TB) borne by foreign-born persons, especially in low-incidence countries, has been increasing.[1]
Discussions have begun regarding the possible impact of pre-entry TB screening if it were introduced in Japan, little attention has been paid so far to the issue of TB control among these non-recent immigrants
Our objective was to describe and analyse the characteristics of TB among non-recent immigrants compared with recent immigrants who had entered Japan within five years of being diagnosed and to discuss policy implications in terms of post-entry interventions in Japan
Summary
The proportion of tuberculosis (TB) borne by foreign-born persons, especially in low-incidence countries, has been increasing.[1]. Japan is a TB medium-burden country with a notification rate of 14.4 per 100 000 population in 2015.7 the proportion of foreign-born persons among the total cases is relatively small compared to industrialized countries, between 2005 and 2014, it steadily increased by approximately 1.7 times (from 3.5% to 5.8%) and among those aged 20 to 29 by 2.5 times (from 17.8% to 44.1%).[7] It has been estimated that the TB notification rate per 100 000 population among foreign-born persons increased from 40.7 in 2007 to 56.2 in 2016, in contrast to the decreasing notification rate among the general population.[8] data from the Japan TB Surveillance (JTBS) indicate that approximately 50% of TB among foreign-born persons occurs among those who entered Japan more than five years before being diagnosed.[9] discussions have begun regarding the possible impact of pre-entry TB screening if it were introduced in Japan, little attention has been paid so far to the issue of TB control among these non-recent immigrants.
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