Risk groups for tuberculosis in Japan: Analysis of relative risk and population attributable fraction

Abstract

[Objective]: Despite the decreasing trend in tuberculosis (TB) cases reported within the general population, TB incidence remains high in certain high-risk groups in Japan. Many of the previous discussions and studies have concentrated mainly on the elderly and those with clinical risks; however, no comprehensive evaluation has been conducted to date. Our study thus sought to estimate the relative risk (RR) and the population attributable fraction (PAF) of selected risk groups in Japan and discuss their relevance to programming future research needs and policies. [Method]: PAF and RR were calculated for patients with human immunodeficiency virus infection, diabetes, rheumatoid arthritis, those on dialysis, the elderly, health care workers, the homeless, people receiving public assistance, foreigners, prisoners, smokers, and those with alcohol problems, and were grouped into "high PAF" (PAF ≥5%), "middle PAF" (5% > PAF ≥ 1 %), and "low PAF" (PAF < 1 %) groups. [Results]: The elderly and patients with diabetes showed the highest PAF and RR and should thus be prioritized for policies.