Abstract
Japan is still a medium-burden tuberculosis (TB) country. We aimed to examine trends in newly notified active TB incidence and TB-related mortality in the last two decades in Japan. This is a population-based study using Japanese Vital Statistics and Japan Tuberculosis Surveillance from 1997 to 2016. We determined active TB incidence and mortality rates (per 100 000 population) by sex, age and disease categories. Joinpoint regression was applied to calculate the annual percentage change (APC) in age-adjusted mortality rates and to identify the years showing significant trend changes. Crude and age-adjusted incidence rates reduced from 33.9 to 13.9 and 37.3 to 11.3 per 100 000 population, respectively. Also, crude and age-adjusted mortality rates reduced from 2.2 to 1.5 and 2.8 to 1.0 per 100 000 population, respectively. Average APC in the incidence and mortality rates showed significant decline both in men (-6.2% and -5.4%, respectively) and women (-5.7% and -4.6%, respectively). Age-specific analysis demonstrated decreases in incidence and mortality rates for every age category, except for the incidence trend in the younger population. Although trends in active TB incidence and mortality rates in Japan have favourably decreased, the rate of decline is far from achieving TB elimination by 2035.
Highlights
Tuberculosis (TB) continues to be one of the leading infectious causes of death globally
In the World Health Organization (WHO)’s End TB Strategy, the WHO proposed the reduction of TB incidence to
Data used to determine newly notified active TB incidence were obtained from the Tuberculosis Surveillance Center in Japan [20]
Summary
Tuberculosis (TB) continues to be one of the leading infectious causes of death globally. In 2016, the global incidence of all forms of TB was 10.4 million, leading to 1.3 million annual deaths worldwide [1]. The emergence of multidrug-resistant TB, caused by various gene mutations [2], is a growing global public health concern [3]. The TB burden is a major public health issue predominantly in low- and middle-income countries. It continues to be a persistent problem in highincome countries, among various vulnerable populations in each society
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