Department of Epidemiology and Clinical Research

Overview

The Department of Epidemiology and Clinical Research conducts a wide range of epidemiological and clinical research and work related to tuberculosis (TB) control and national tuberculosis surveillance in Japan. Currently we have 5 research staff, and 2 supporting staff.

Our mission

Our mission is to conduct research and works which contribute to national and global efforts in fighting TB.

Our strategy

Our mission

The Department’s three areas of activity are research, development of monitoring tools, and international cooperation.

  • Research: aside from epidemiological research, we also perform operational research, policy studies, and molecular epidemiology studies. Some of our current research topics include smoking and TB, TB among the elderly, TB among the prison population, and TB among foreign-born persons.
    Find out more on our research projects here: Research projects by themes.
  • Development of monitoring tools: we constantly develop and review various indicators to monitor TB control activities at national, prefectural, and local levels.
  • International cooperation: some of our staff are also involved in international projects in countries such as the Philippines and Myanmar.

Organizational Structure

Division of Epidemiological Surveillance

The Division of Epidemiological Surveillance within the Department supports development, improvement and operation of the electronic Japan Tuberculosis Surveillance system (JTBS), by closely working with the Ministry of Health, Labor and Welfare. The Division also conducts series of analyses of the surveillance data – these are fed-back into action through publishing of monthly and annual statistical reports.

Tuberculosis Surveillance Center

The Department also runs the Tuberculosis Surveillance Center, which is responsible for disseminating our works and other related information, and also for answering enquiries regarding the JTBS and TB statistics, which we receive via phones and through our website.
Find out more: Tuberculosis Surveillance Center

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.

Tuberculosis in Japan : Annual Report - 2017

Tuberculosis in Japan Annual Report 2017

Tuberculosis in Japan (Tables) zip (Excel)

Tuberculosis in Japan (Figure) (pptx)

read more

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.

Staff profile

Akihiro Ohkado
Akihiro Ohkado (Head of Department)
Specializes in: public health, epidemiology, international health
Contact: ohkadoa (atmark) jata.or.jp
Kazuhiro Uchimura
Kazuhiro Uchimura (Deputy head of Department)
Specializes in: statistics, mathematical epidemiology
Contact: uchimura (atmark) jata.or.jp
Yuko Yamauchi
Contact: yamauchi (atmark) jata.or.jp
Lisa Kawatsu
Lisa Kawatsu (Senior epidemiologist)
Specializes in: social epidemiology, qualitative research, international health
Contact: kawatsu (atmark) jata.or.jp
Kiyohiko Izumi
Kiyohiko Izumi (Researcher)
Specializes in: epidemiology、international health
Contact: kizumi (atmark) jata.or.jp
Supporting staff
Kishitsugu Otake (Mr.)
Kazue Isokado (Ms.)

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