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[DOTS in Japan--Tokyo area].

¹Department of Respiratory Disease, International Medical Center of Japan, Tokyo, Japan.

Kekkaku : [Tuberculosis]

|January 25, 2002

Summary

Directly Observed Therapy, Short-Course (DOTS) has shown over 90% treatment completion for tuberculosis (TB) in specific Tokyo wards. Expanding DOTS beyond the homeless population is crucial for effective TB control in Japan.

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Area of Science:

Public Health
Infectious Disease Control
Epidemiology

Background:

Tuberculosis (TB) resurgence necessitates effective control strategies in Japan.
The World Health Organization's Directly Observed Therapy, Short-Course (DOTS) strategy has demonstrated global success since 1995.
DOTS implementation in Tokyo urban areas, particularly for TB hotspots, began showing positive results.

Discussion:

DOTS implementation in Sanya (Taito-ku) and Arakawa-ku achieved over 90% treatment completion rates starting in 1997.
DOTS was extended in 2000 to homeless TB patients in Shinjuku-ku, Yokohama, Kawasaki, and Nagoya.
Current DOTS application is limited to homeless individuals, despite a broader need due to poor patient adherence.

Key Insights:

High treatment completion rates (>90%) were observed in specific Tokyo wards utilizing DOTS.
DOTS has proven effective in diverse settings, including developed countries.
A significant gap exists between the number of individuals needing DOTS and its current application.

Outlook:

Re-evaluating the cost-efficiency of DOTS for comprehensive TB control in Japan is essential.
Expanding DOTS to non-homeless populations with adherence issues is recommended.
Further research into optimizing DOTS delivery and accessibility is warranted for nationwide TB control.

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