Tuberculosis and its control programme in developing countries and the role expected to be played by Japan. In the intensification of tuberculosis programme in these countries. Endo, S. Kekkaku, 57(8):447–451, 1982.
Tuberculosis and its control programme in developing countries and the role expected to be played by Japan. In the intensification of tuberculosis programme in these countries [link]Paper  abstract   bibtex   
Approximately 3 billion people live in developing countries and 4 to 5 million new smear positive tuberculosis cases come out every year. More than 3 million patients die from tuberculosis yearly. The annual risk of tuberculosis infection, a new reliable index to measure the magnitude of the tubercolosis problem, is on the level of 0.1 to 0.3% in technically developed countries, and it has been decreasing at the annual rate of 10 to 15%, while the rate is 2 to 5% in the majority of developing countries, and there has been no or only a slight decline. Thus, tuberculosis is still a serious problem in the developing world. The objective of the national tuberculosis control programme is to reduce the tuberculosis problem in the community as fast as possible with a minimum budget. WHO set the following guidelines for a tuberculosis programme. The tuberculosis programme should be nationwide and cover rural areas where the majority of the population are living. The programme should be permanent and be continued for several decades. It should be integrated into the primary health care system. Technical supervision for primary health care workers is essential. Methods used in the programme should be simple, easily feasible, effective, not costly and must be acceptable. Priority of the programme should be given to smear positive pulmonary tuberculosis. WHO recommends BCG vaccination, case-finding by sputum microscopy for symptomatics and domiciliary treatment for detected smear positive cases with standardized regimen of chemotherapy. In the Western Pacific Region of WHO, a systemic BCG vaccination programme is being carried out in 17 countries (84%), and the coverage is as high as 80% in the majority of countries, and it reaches the level of 95% in newborn babies in Singapore and Hong Kong. Factors contributed to the high coverage of BCG vaccination are the production of heat-stable freeze-dried vaccine, extensive use of direct vaccination, simultaneous vaccination with other vaccination such as small pox or DPT, and the integration of BCG vaccination into the expanded programme of immunization. Technical supervision of BCG vaccination is to be intensified, and studies on the effectiveness of BCG vaccination in children should be encouraged. Treatment and case-holding are one of the major problems in the region, as the default rate is generally high. Experiences in the Philippines clearly indicate the superiority of the integrated programme to the specified programme in obtaining a high completion rate of treatment. Tuberculosis has been decreasing in Korea, a part of China, Hong Kong, Malaysia, Singapore and Vietnam, but the decline is slower than in the developed countries. No decline was found in the Philippines, East Malaysia, Papua New Guinea and a part of the South Pacific Islands. Slow or no decline of tuberculosis in the above countries can be explained first by weak health infrastructure and second by the poor programme management. The number of tuberculosis experts is very low in technically advanced countries, but fortunately, there are still a good number of tuberculosis experts in Japan as tuberculosis has been a major problem until recently. Such an expert should be utilized for technical cooperation to developing countries. The Japan International Cooperation Agency (JICA) has been sponsoring the International Tuberculosis Course held in the Research Institute of Tuberculosis, JATA, in the English language. Since 1967 when WHO came to cosponsor the course, 250 doctors from 34 countries have been trained in the course, and working as a top leader of tuberculosis programme in the respective countries. JICA has also a bilateral cooperation project in tuberculosis control with Afghanistan, Nepal and Tanzania. The Department of Tuberculosis, National Institute of Health, has been serving as the WHO reference laboratory for the identification of mycobacteria. The Research Institute of Tuberculosis, JATA, has been making cooperative research with Korean Institute of Tuberculosis to improve the case-finding and case- olding activities under the sponsorship of WHO. The institute will be designated as a WHO collaborating centre in the near future and to serve as a coordinating centre for operational and health service research on tuberculosis in the region. Dr. T. Hashimoto has been contributing a lot to improve the production of BCG vaccine in the world. Technical cooperation is needed to reduce the tuberculosis problem in developing countries, and it is expected that Japanese experts contribute to the improvement of the tuberculosis programme in developing countries.
@article{endo_tuberculosis_1982,
	title = {Tuberculosis and its control programme in developing countries and the role expected to be played by {Japan}. {In} the intensification of tuberculosis programme in these countries},
	volume = {57},
	issn = {0022-9776},
	url = {http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed3&NEWS=N&AN=13249640},
	abstract = {Approximately 3 billion people live in developing countries and 4 to 5 million new smear positive tuberculosis cases come out every year. More than 3 million patients die from tuberculosis yearly. The annual risk of tuberculosis infection, a new reliable index to measure the magnitude of the tubercolosis problem, is on the level of 0.1 to 0.3\% in technically developed countries, and it has been decreasing at the annual rate of 10 to 15\%, while the rate is 2 to 5\% in the majority of developing countries, and there has been no or only a slight decline. Thus, tuberculosis is still a serious problem in the developing world. The objective of the national tuberculosis control programme is to reduce the tuberculosis problem in the community as fast as possible with a minimum budget. WHO set the following guidelines for a tuberculosis programme. The tuberculosis programme should be nationwide and cover rural areas where the majority of the population are living. The programme should be permanent and be continued for several decades. It should be integrated into the primary health care system. Technical supervision for primary health care workers is essential. Methods used in the programme should be simple, easily feasible, effective, not costly and must be acceptable. Priority of the programme should be given to smear positive pulmonary tuberculosis. WHO recommends BCG vaccination, case-finding by sputum microscopy for symptomatics and domiciliary treatment for detected smear positive cases with standardized regimen of chemotherapy. In the Western Pacific Region of WHO, a systemic BCG vaccination programme is being carried out in 17 countries (84\%), and the coverage is as high as 80\% in the majority of countries, and it reaches the level of 95\% in newborn babies in Singapore and Hong Kong. Factors contributed to the high coverage of BCG vaccination are the production of heat-stable freeze-dried vaccine, extensive use of direct vaccination, simultaneous vaccination with other vaccination such as small pox or DPT, and the integration of BCG vaccination into the expanded programme of immunization. Technical supervision of BCG vaccination is to be intensified, and studies on the effectiveness of BCG vaccination in children should be encouraged. Treatment and case-holding are one of the major problems in the region, as the default rate is generally high. Experiences in the Philippines clearly indicate the superiority of the integrated programme to the specified programme in obtaining a high completion rate of treatment. Tuberculosis has been decreasing in Korea, a part of China, Hong Kong, Malaysia, Singapore and Vietnam, but the decline is slower than in the developed countries. No decline was found in the Philippines, East Malaysia, Papua New Guinea and a part of the South Pacific Islands. Slow or no decline of tuberculosis in the above countries can be explained first by weak health infrastructure and second by the poor programme management. The number of tuberculosis experts is very low in technically advanced countries, but fortunately, there are still a good number of tuberculosis experts in Japan as tuberculosis has been a major problem until recently. Such an expert should be utilized for technical cooperation to developing countries. The Japan International Cooperation Agency (JICA) has been sponsoring the International Tuberculosis Course held in the Research Institute of Tuberculosis, JATA, in the English language. Since 1967 when WHO came to cosponsor the course, 250 doctors from 34 countries have been trained in the course, and working as a top leader of tuberculosis programme in the respective countries. JICA has also a bilateral cooperation project in tuberculosis control with Afghanistan, Nepal and Tanzania. The Department of Tuberculosis, National Institute of Health, has been serving as the WHO reference laboratory for the identification of mycobacteria. The Research Institute of Tuberculosis, JATA, has been making cooperative research with Korean Institute of Tuberculosis to improve the case-finding and case- olding activities under the sponsorship of WHO. The institute will be designated as a WHO collaborating centre in the near future and to serve as a coordinating centre for operational and health service research on tuberculosis in the region. Dr. T. Hashimoto has been contributing a lot to improve the production of BCG vaccine in the world. Technical cooperation is needed to reduce the tuberculosis problem in developing countries, and it is expected that Japanese experts contribute to the improvement of the tuberculosis programme in developing countries.},
	language = {Japanese},
	number = {8},
	journal = {Kekkaku},
	author = {Endo, S.},
	year = {1982},
	keywords = {*BCG vaccine, *developing country, *drug therapy, *lung tuberculosis, *tuberculosis, epidemiology, geographic distribution, human, lymphatic system, nervous system, prevention, respiratory system, short survey, therapy},
	pages = {447--451}
}

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