TUBERCULOSIS IN JAPAN
What is TB?

Sex and age distribution

Tuberculosis (TB) is caused by bacteria
called “Mycobacterium tuberculosis” and isspread from person to person mainly
through air.

In 2021, 58.4% of the 11,519 notified TB
patients were males (n=6,726). The largest
number of patients were diagnosed among
those aged 80 to 89 years old (n=3,440).
The number of patients was consistently
higher among males than females in all age
groups but 90+ years old (Figure 2).

TB usually attacks the lungs, but it can also
damage any part of the body, such as thelymph nodes, pleura, brain, kidneys, orspine. TB is curable and preventable, but aperson with TB can die without appropriate
treatment.

No. of newly notified cases

Figure 2. Number of TB patients by age and sex, 2021
n=11,519

The symptoms of TB disease of the lungs
include cough, chest pain, and sputum
expectoration with or without blood. The
general symptoms of TB disease also include
feelings of sickness or weakness, weight loss,
fever, and night sweats.

age groups

TB among the foreign-born

TB in JapanInformation regarding place of birth (Japanborn or foreign-born) was known for 96.6%of the newly notified TB patients (11,122 /11,519) in 2021. Of those, 11.8% was born
outside Japan (n=1,313).
The number of foreign-born patientsdecreased by 98 from 1,411 (2020) to 1,313(2021). However, the proportion of foreignborn patients was 13.4%, up from 11.1% in
2020, 10.7% in 2019.
The largest number of foreign-born TB
patients were diagnosed among those aged
20 to 29 years old (n=675), followed bythose aged 30-39 years old (n=276). The
proportion of foreign-born of the total newly
notified TB patients was higher among theyounger age group, with the proportion
reaching 51.4% among those aged 20-29
years old (Figure 3).

The most recent data show that a total of
11,519 persons with active TB disease
were newly notified in Japan in 2021 (9.2
cases per 100,000 population). Both thenumber of newly notified TB patients andrates per 100,000 have continued to decline(Figure 1). The notification rate reached thenational target of below 10 per 100,000 in2021. However, the influence of the globalepidemic of Covid-19 must be taken into
account, as the number and proportions ofpatients detected via health screening at
workplaces and schools have decreased
dramatically, and it is probably too early tomake conclusions regarding whether or not
the decline in the notification would continue.

Rate per 100,000

No. of newly notified cases

Figure 1. Number and notification rate per 100,000
population, 2001-2021

Figure 3. Foreign-born TB patients by age and sex, 2021
n=1,313

age groups

The Philippines was the most frequent
country of birth for foreign-born TB patientsreported in 2021 (n=284), followed by
Vietnam(n=263),
China(n=152),
Indonesia (n=134), Nepal (n=113), andMyanmar (n=85) (Figure 4).
Figure 4. Foreign-born TB proportion by county of birth,2021 n=1,313

Treatment outcome
Treatment of TB disease requires multiple
drugs that need to be taken at least for six
to nine months. Among 12,739 active TB
patients notified (including new andretreatment) in 2020, treatment outcome
was available for 12,641 patients (99.8%).
Amongthose,65.3%(n=8,240)
successfully completed the treatment and
24.0% (n=3,022) died during treatment
course due to any cause. This highmortality rate is due to the high proportionof elderly TB patients in Japan (Figure 5).
In fact, 82.3% of patients aged under 60
years old successfully completed thetreatment.
Figure 5. Treatment outcomes by age, 2020, n=12,641

MDR-TBn=3,482

n=9,159

n=12,641

Multidrug-resistant (MDR) TB is a TB disease
that is resistant to at least isoniazid andrifampicin. MDR-TB accounted for 0.9% ofculture-confirmed pulmonary TB cases withknown drug susceptibility test results (41 /4,551).
Proportions of those with resistance for INH,
for RFP, and MDR were higher among
retreatment than new cases.

HIV/TBHIV is a significant risk factor for TB disease.
In 2021, HIV test results were known only
for 7.4% (847 / 11,519) of the newly
notified TB patients. Of those 847 patientswith known test results, 30 (3.5%) were HIV
positive and 817 (96.5%) were HIV negative.

Latent TB Infection
Persons with latent TB infection do not haveactive TB disease and therefore do notpresent with any symptoms. About 5 to 10
percent of infected persons without
treatment is estimated to develop active TB
disease at some time in their lives. A total of
5,140 persons with latent TB infection
applicable to the preventive TB treatment
were newly notified in 2021 in Japan.

All data in the factsheet is based on the statistics published inThe Tuberculosis Surveillance Center
https://jata-ekigaku.jp/
The annual report of tuberculosis in Japan in 2022 will bealso available soon.
For more information and inquiry, please contact:
Tuberculosis Surveillance Center (TSC),The Research Institute of Tuberculosis (RIT),
Japan Anti-Tuberculosis Association (JATA)
Email: tbsur@jata.or.jp
Published in September 2022