[A study on preventive measures against tuberculosis in care facilities for the elderly in a Tokyo metropolitan...

To promote early detection of tuberculosis (TB) in care facilities for the elderly, we studied the pattern of occurrence of TB cases and the preventive measures taken against TB at the care facilities in a Tokyo Metropolitan District in 2008.

Registration cards and contact examination records of the public health center of the district were reviewed. We also made a self-administered questionnaire survey to gather information about the preventive measures against TB at 40 facilities in our district. (The questionnaire response rate was 100%.)

A total of 4 TB cases were reported in 3 facilities in the study period. Two of the 3 facilities were fee-based homes. Adequate implementation of preventive measures against TB was not found at any of these 3 facilities. Secondary infection to care workers was also reported. Of the 40 facilities, 90% undertook annual routine TB examination with radiophotography. However, several facilities did not perform comparative X-ray readings, and had residents who did not comply with the examination. In regard to daily health monitoring, many facilities did not check for fever and/or respiratory symptoms. Many fee-based homes did not implement sufficient preventive measures against TB.

In the care facilities for the elderly in this district, the TB prevention program was not adequately implemented, so that new TB cases were not rare, leading to the transmission of infection to the facility staff. Especially, fee-based homes' practice was poor. It is an important mission of a public health center to provide these facilities in the district with information about current TB problem and its prevention, as well as technical support for it.