[A new approach to tuberculosis case management]

Some characteristics of the Japan's recent tuberculosis epidemiology are discussed. Slowing-off of the decreasing trend of the incidence during the last 10 years has not been well explained. Furthermore, the incidence of bacteriologically confirmed cases has remained almost constant during these period, and the incidence of smear positive cases is even on the increasing trend among old ages. These newly shown features of tuberculosis cast a shadow on the prospects of tuberculosis elimination of the county. The generation gap in the prevalence of tuberculosis infection is very sharp today, and it will be more in the future, which will lead to the greater chance of outbreak of tuberculosis microepidemics in the future. The coverage of chemoprophylaxis as shown by the number of new infections and the registered chemoprophylaxis cases is estimated as about 15%. The contact examination should be more important in the future. The number of examinations in relation to one index case is increasing.