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[Strategy of tuberculosis control and achievement in Okinawa].

After fierce battles in World War II, Okinawa was occupied by military of U.S.A. and consequently was administrated by USCAR (United States Civil Administration of Ryukyus). During 27 years from April 1945 to May 1972, reversion to Japan, the public Health Activities including T.B. control were performed by Ryukyus Government indirectly controlled by USCAR. The first issue of T.B. statistics was made in 1950. It revealed remarkable reduction of T.B. death rate, a quarter of that before the war. The main reasons of the reduction were considered due to the over-death in battles. But epidemic of T.B. had increased rapidly, especially since the Korean War occurred in 1950. Constructions of the military base were booming, and T.B. infection was spread among laborers, employees, and also their families. Then, Ryukyus Government enacted a temporary law of T.B. prevention and control in 1954. Home-care treatment of T.B. patient was started with registration and management in newly constructed Public Health Centers. Because of shortage of government budget, man-power including doctor and poor institutes, a system of short-termed admission treatment (6 months) and home cared chemotherapy were started. Public Health Nurses (PHN) took care the patient at home, and medical fee of T.B. treatment was free in charge to patients. So activities of PHN were very important. In 1962, Dr. Shoukou Imamura, from JATA, came to study the system of home care treatment. And 7,000 cases under supervision of Public Health Center were investigated. He reported that this system was fairly efficacious in Okinawa. In 1976, after reversion to Japan, study of T.B. surveillance control system was advised and introduced by Dr. Masakazu Aoki and Dr. Tooru Mori (JATA). By this modern system of surveillance, T.B. control is improved progressively in Okinawa.