Tuberculosis among urban population, especially among marginalized population (such as foreigners without valid visa and homeless population) is serious.
The case detection ratio (with active case finding) of TB among homeless was 1.91% and that among foreigners from prevalent countries was 0.57%, in contrast to 0.01% among the general population. And the proportion of default and death was high. So to tackle with these problems, the objective of this project is to analyze the epidemiological situation of tuberculosis and to investigate the methods for the improvement of tuberculosis control in urban settings where tuberculosis epidemic is getting worse in comparison to rural area. The method of investigation is to do RFLP analysis in Shinjuku and Kawasaki and the topics for the improvement of TB control are the investigation of details of utilization of DOTS in TB urban poor, the usage and evaluation of educational intervention to foreign born cases, and the evaluation of home visiting for DOT by nursing staff.