[Tuberculosis Annual Report 2009--Series 5. case findings]

The mode of detection, delays in detection, patient's occupation and so on were examined using the tuberculosis (TB) surveillance data from 2009. Of the 24,170 TB patients newly notified in 2009, 82.1% were detected at medical institutions. Of those, 11.4% were detected during hospitalization with a disease other than TB and 9.2% were detected as outpatients with a disease other than TB. On the other hand, a significant proportion of adolescents and young adults were also detected by active case findings (mass screening+contact examination). For example, 23.0% of TB patients aged 15-19 years were detected by periodic school mass screening, and 23.7% of TB patients aged 25-29 years were detected by periodic health examinations for employees. The proportion of TB patients detected by contact examination was only 2.6%; this figure was larger among younger TB patients. For example, 43.9% of those aged 0-14 years were detected by contact examinations. In terms of the symptoms of 18,912 pulmonary TB patients, 28.0% had only respiratory symptoms, 30.9% had both respiratory and other symptoms, and 16.1% had only nonrespiratory symptoms. The proportion of TB patients having only non-respiratory symptoms increased among the elderly. More than 20.0% of symptomatic pulmonary TB patients over 75 years had only non-respiratory symptoms. Regarding the delay of case detection among 14,511 symptomatic pulmonary TB patients, the patient's delay was shorter while the doctor's delay longer in the older age group, compared with the younger age group. Generally, sputum smear-positive symptomatic pulmonary TB patients showed longer total delays. The proportion and number of nurses/public health nurses among female patients of 20-59 years were 10.2% and 322, increasing slightly from 9.3% and 300, respectively, in 2008.