Characteristics and Treatment Outcomes among Migrants with Pulmonary Tuberculosis: A Retrospective Cohort Study in Japan, 2009-2018

Int J Environ Res Public Health. 2022 Oct 2;19(19):12598. doi: 10.3390/ijerph191912598.

Abstract

This study aimed to describe characteristics and treatment outcomes of overseas-born pulmonary tuberculosis (PTB) patients in Japan, and identify the factors associated with "treatment non-success". We conducted a retrospective analysis of overseas-born patients with drug-susceptible PTB using cohort data of PTB cases newly registered in the Japan tuberculosis (TB) surveillance system between 2009 and 2018. Overall, 9151 overseas-born PTB cases were included in this study, and 70.3% were aged 34 years old or younger. "Students of high school and higher" (28.6%) and "regular workers other than service related sectors" (28.5%) accounted for over half of the study population, and they have continued to increase. Overall, the treatment success rate was 67.1%. Transferred-out constituted the largest proportion (14.8%) among the treatment non-success rate (32.9%). Multiple logistic regression analysis revealed patients whose health insurance type was "others and unknown", including the uninsured (adjusted OR (AOR) = 3.43: 95% Confidence Intervals (CI) 2.57-4.58), those diagnosed as TB within "one year" (AOR = 2.61, 95% CI 1.97-3.46) and "1-5 years" (AOR = 2.44, 95% CI 1.88-3.17) of arrival in Japan, and males (AOR = 1.34, 95% CI 1.16-1.54), which were the main factors associated with treatment non-success. These findings imply that Japan needs to develop TB control activities considering the increasing trends of overseas-born PTB patients, the majority of whom are young and highly mobile. There is a need to pay greater attention to overseas-born PTB patients diagnosed within a short duration after entering Japan, who may be socially and economically disadvantaged for their treatment completion.

Keywords: Japan; foreign-born; migrant; overseas-born; treatment outcome; tuberculosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Tuberculosis* / epidemiology
  • Tuberculosis, Pulmonary* / drug therapy
  • Tuberculosis, Pulmonary* / epidemiology

Grants and funding

This work was supported by the Intramural Research Fund of National Center for Global Health and Medicine (NCGM), grant number 19A1027.