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[Tuberculosis Annual Report 2011--(4) Tuberculosis treatment and treatment outcomes].

The frequency of re-treatment among newly notified tuberculosis (TB) patients might be an indicator of inadequate prior treatment. In 2011, 22,681 patients were notified with TB, of which, 1,687 patients had received prior TB treatment (7.6% of those patients who presented with unknown treatment history were excluded). Nearly half of the re-treatment cases had received previous treatment after 2000 (n = 766). A standardized treatment regimen is the key to TB control. As for the initial treatment regimen, a combination of isoniazid, rifampicin, pyrazinamide, and ethambutol (or streptomycin) is recommended; this regimen was initially used for the treatment of approximately > or = 85% of all forms of TB in patients aged 15-54 years (patients with an unknown treatment regimen were excluded). Of the 11,556 patients who underwent TB treatment regimen with pyrazinamide and completed the course of treatment by the end of 2011, approximately 10% were unable to complete the 2-month-long regimen with pyrazinamide. In 2011, 17,519 patients were newly notified with pulmonary TB (PTB). The proportion of patients who were hospitalized on the commencement of anti-TB treatment increased as the age increased above 30 years. The median duration of hospitalization among newly notified TB patients in 2010 was 70 days for new sputum-smear positive PTB patients, 71 days for re-treatment sputum-smear positive PTB patients, 43 days for other bacteriologically positive PTB patients, 41.5 days for bacteriologically negative and other patients, and 46 days for extra-pulmonary TB patients. As of end-of-year 2011, the median treatment duration for all forms of TB patients, newly notified in 2010, was 272 days. The treatment success rates for new sputum-smear-positive PTB patients (n = 8,242), re-treatment PTB patients (n = 794), other bacteriologically positive PTB patients (n = 6,358), and bacteriologically negative and other patients (n = 2,883), registered in 2010 were 52.0%, 42.7%, 59.6%, and 60.4%, respectively. The proportion of new sputum-smear-positive PTB patients, registered in 2009 and 2010, who died by the end of the following years were 26.9% and 27.8%, respectively. The cause of death among TB patients, usually determined by physicians, has been collected through a TB surveillance system in Japan. The proportion of deaths caused by TB within one month of registration, among both the newly notified TB patients and the new sputum-smear-positive PTB patients, tended to be higher than that caused by other reasons (48.5% vs. 17.3% and 51.5% vs. 19.7%, respectively).