[A study on patients with tuberculosis among foreigners overstayed in Japan after expiration of visa--activities over three years]

An analysis of thirty-two cases of foreign patients with tuberculosis (TB) who had overstayed their residence permits was done at Minatomachi Medical Center over the past three years. The ratio of male to female patients was 2.5 to 1; the age of the subjects was evenly distributed. By country of origin, 87% of the cases were from Southeast Asia and East Asia. As none of the patients belonged to health insurance schemes because of their illegal status, their access to medical care was restricted, and the delay in visiting clinics was notable. As 22% of the cases were diagnosed as a result of programs to provide free TB screening for foreigners, it is important to ensure easy access to TB screening and medical facilities for early detection of TB. Amongst the cases, the proportion of cases of extrapulmonary tuberculosis occupied 28%, which is higher than that of Japanese. Although the defaulting rate among patients during the nine years period from 1990 to 1998 was high (41%), it decreased to 12% during the past three years of this study. The following active measure was vital for preventing defaulting from treatment and ensuring clinical cure: 1. Utilization of the Tuberculosis Prevention Law to reduce the economic burden of the patients. 2. Interpreters available in various native languages. 3. Provision of adequate information of TB before starting treatment. 4. Strict follow-up of patients to ensure coherence to treatment. 5. Establishment of an international network of governmental organizations, NGOs, and medical facilities to exchange informations on preventive and curative cares in the home and host countries.