Director Greeting

Strengthening the functions of research and networking towards global TB elimination

Nobukatsu Ishikawa, M.D, MSc. PhD
Director
Nobukatsu Ishikawa, M.D, MSc. PhD Director

Since its foundation in 1939, when tuberculosis (TB) was extremely prevalent in Japan, RIT has been functioning essentially as a national institute with the mission of promoting an effective nationwide TB programme through innovative basic and applied research, training and education, programme support and international cooperation. The incidence of TB in Japan has declined dramatically during the last 70 plus years, but it will take another 10-15 years for Japan to reach the status of low incidence (10 cases per 100,000 population). In addition it might take an entire century to eliminate TB (a rate of one case in a million) without better preventive, diagnostic, curative and operational technologies.

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Even among the developed countries, none has ever completely eliminated TB. Immigrants and socially vulnerable populations such as the homeless have a much higher risk for TB, and other risk factors for TB such as HIV, diabetes or smoking are contributing to the occurrence of TB.

Though the number of TB cases may gradually decrease, the importance of risk management for TB in our society will increase. TB will remain for a long time, particularly among the high risk populations, and there could sometimes be unexpected outbreaks in school or workplaces. TB could also become drug-resistant without proper treatment and drug taking.

We would like to work harder to complete our mission, accelerating progress in research towards low incidence and elimination of TB both in Japan and in the world. We also must strengthen our function as a global base, and in networking in the fight against TB in the world.

Brief History of the Institute

May.1939 Establishment of JATA by special Decree from Her Imperial Majesty the Empress,with Princess Chichibu as Patroness
Nov.1939 Establishment of the Research Institute of Tuberculosis (RIT) in Higashimurayama Tokyo
Nov.1943 RIT moved to Kiyose Tokyo
Nov.1947 Establishment of the RIT-Attached Sanatorium (now known as Fukujuji Hospital)
Feb.1948 First Trainig Course for TB specialists was held
1953 First tuberculosis prevalence survey was conducted
Sep.1954 First publication of “Statistics of TB”
Apr.1958 Separation of RIT-Attached Sanatorium (now known as Fukujuji Hospital)
Jun.1963 First International Training Course in Tuberculosis Control for doctors from developing countries was held
Sep.1973 Hosting the 22nd World TB Congress in Tokyo
Aug.1982 Designation of RIT as WHO Collaborating Centre for Tuberculosis Research and Training
Apr.1988 Establishment of Department of International Cooperation
Apr.1992 Establishment of International Tuberculosis Information Centre
Feb.1995 First International Training Course on AIDS Prevention and Care in Asia was held
Mar.1999 Establishment of Department of Programme support
Apr.2003 Establishment of Department of Research, and Department of Mycobacterium Reference Centre
Sep.2008 Establishment of Department of Epidemiology and Clinical Research , and Department of Mycobacterium Reference and Research
Apr.2013 Establishment of Department of Mycobacterium Reference and Research, Department of Pathophysiology and Host Defense, and Department of Centre for International Cooperation and Global TB Information

Tuberculosis fact sheet

Tuberculosis (TB) used to be the biggest killer in Japan, affecting 590,000 people with 93,000 deaths in 1951. The situation has dramatically changed in the past several decades, with the number of TB cases registered declining to 20,000 people with 2000 deaths in 2013.

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TB is caused by bacteria (Mycobacterium tuberculosis) and most often affects the lungs. TB is curable and preventable. TB spreads from person to person through the air. When a patient with pulmonary TB coughs, sneezes, spits, or even talks and sings, TB germs are exhaled into the air. A person is infected with TB by inhaling these TB germs in the air. However, only 5-15% of people infected with TB actually develop TB disease in their lifetime. If a person is also infected with HIV, he or she is much more likely to develop TB disease. When a person develops active TB disease, the symptoms (cough, fever, night sweats, weight loss etc.) may be mild for many months. This can lead to delays in seeking care, and leads to the transmission of the bacteria to others. Without adequate treatment, up to two thirds of people affected by TB die. TB mostly affects young adults in their most productive years. However, since almost all the young people in Japan have not yet been infected with TB and most elderly people over the age of 70 have TB germs in their lungs from their youth, over a half of TB patients are over 65 years old. Common symptoms of active pulmonary TB are a cough with sputum and blood at times, chest pains, weakness, weight loss, fever, and night sweats. However, elderly patients may not have these respiratory symptoms. For this reason, it can be difficult to diagnose TB in the elderly.

Sputum smear microscopy is one of the most important laboratory tests to diagnose TB. Laboratory technicians look at sputum samples under a microscope to see if TB bacteria are present. With such tests, diagnosis can be made within a day, but this test does not always detect cases of less infectious forms of TB. TB germs are also cultured in an incubator for three to eight weeks with various media. Since the late 1990s, liquid media have become more popular for culturing TB germs, with a faster incubation period (at least two to six weeks). Polymerase chain reaction (PCR) is another important method for detecting TB germs in sputum with a much more rapid turnaround time (at most one day, normally 4-5 hours). Active, drug-sensitive TB disease is treated with standard six- to nine-month courses of four or three antimicrobial drugs. The vast majority of TB cases can be cured when medicines are provided and taken properly.

Multidrug-resistant TB Standard anti-TB drugs have been used for decades, and resistance to the medicines is widespread. Disease strains that are resistant to a single anti-TB drug have been documented in every country surveyed. Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to, at least, isoniazid and rifampicin, the two most powerful, first-line (or standard) anti-TB drugs. The primary cause of MDR-TB is inappropriate treatment. Inappropriate or incorrect use of anti-TB drugs, or use of poor quality medicines, can all cause drug resistance. Disease caused by resistant bacteria fails to respond to conventional, first-line treatment. MDR-TB is treatable and curable by using second-line drugs. However, second-line treatment options are limited, and recommended medicines are not always available. The extensive chemotherapy required (up to two years of treatment) is more costly and can produce severe adverse drug reactions in patients. In some countries, such as China, Russian Federation, and the Republic of the Philippines, 3 to 20% of the TB patients are MDR, while in Japan, less than 1% of the cases are MDR.

Organization

News Letter from Kiyose

Access

RIT the Research Institute of Tuberculosis,
Japan Anti-tuberculosis Association
WHO Collaborating Centre

Address: 3-1-24 Matsuyama, Kiyose-shi, Tokyo 204-8533 Japan
Phone: +81-42-493-5711
Facsimile: +81-42-492-4600
URL: http://www.jata.or.jp

3-1-24 Matsuyama, Kiyose-shi, Tokyo 204-8533 Japan