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  • Title: [Current situation of contacts examination and chemoprophylaxis for persons exposed to multi-drug resistant tuberculosis in ordinance-designated cities in Japan].
    Author: Sasaki Y, Yamagishi F, Yagi T.
    Journal: Kekkaku; 2005 Oct; 80(10):637-42. PubMed ID: 16296391.
    Abstract:
    PURPOSE: To evaluate the current situation of contacts examination and chemoprophylaxis for those who were exposed to multi-drug resistant tuberculosis (MDR-TB) in Japan. OBJECT AND METHOD: The questionnaire survey was conducted about the MDR-TB patients and their contacts examination enforced in the ordinance-designated cities in Japan from 1998 to 2002. RESULT: Nine cities out of total 13 ordinance-designated cities replied to the questionnaire (69.2%). The cases newly diagnosed as MDR-pulmonary tuberculosis were 189 cases from 1998 to 2002. Out of 189 cases, 34 MDR pulmonary tuberculosis patients were the source of MDR-TB infection. Among 659 individuals who were exposed to 34 MDR-TB, 58 persons (8.8%) were diagnosed as the contacts who were infected with MDR-TB. Out of 58 persons, 41 had chemoprophylaxis; 18 with isoniazid (INH), 3 with Ethionamide (TH), 2 with INH + Rifampin (RFP) + Ethambutol (EB), and each one with EB + Pyrazinamide (PZA) + TH, PZA + TH, PZA + Levofloxacin, PZA + EB. In 6 persons, INH was changed to other medicines, and 8 persons were treated with unknown prescription. Thirteen contacts developed MDR-TB, and out of them, 9 cases had several problems when they developed MDR-TB. Those problems were the delay in detection, infection from hospitalization refused cases, infection at the time of bacteriological relapse, and no use of chemoprophylaxis. CONCLUSION: MDR-TB bacilli produce the tuberculosis infection similarly as the sensitive tubercle bacilli, and it is necessary to re-examine the action plan of contacts examination including chemoprophylaxis.
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