Our study is the first to evaluate the performance of TB contact investigations in Japan using standardised indicators; the study indicated performance gaps, especially in the treatment for latent tuberculous infection among contacts.

Our results showed the potential of a betweenness score in prioritising contacts during TB contact investigation.

SETTING: Japan, an intermediate TB burden country.OBJECTIVE: To review TB-related technical enquiries received at the Research Institute of Tuberculosis, Japan, from January 2017 to December 2019.DESIGN: This was a cohort study.RESULTS: A total of 2,197 enquiries were analysed. On average, 61.0 enquiries/month (range: 42–81) were received. The enquiry rates were highest for the Yamanashi (4.65/100,000 population) and Ishikawa (4.55) Prefectures, and lowest in the Yamagata (0.46) and Tochigi (0.56) Prefectures. The main organisations the enquirers belonged to were local governments (n = 1,585, 72.1%) and healthcare facilities (n = 307, 14.0%). The enquirers were medical doctors (n = 391, 17.8%), nurses (n = 1,207, 54.9%), other healthcare professionals (n = 57, 2.6%), the general public (n = 168, 7.6%) and others/unknown (n = 374, 17.0%). The most frequent enquiries were about TB diagnosis and treatment (n = 501, 22.8%), including laboratory diagnosis (n = 88, 4.0%), TB treatment in general (n = 93, 4.2%) and management of comorbidities (n = 86, 3.9%), followed by contact investigations (n = 385, 17.5%) and TB in foreigners (n = 344, 15.7%).CONCLUSION: As the most frequent enquiries were about diagnosis and treatment of TB, the health ministry of Japan should maintain a few specialised TB institutions with TB physicians to provide technical assistance.

T he Great East Japan Earthquake and subsequent tsunami hit the Pacific Ocean side of north-eastern Japan on 11 March 2011, 1 resulting in more than 18 000 deaths and missing people in three prefectures: Iwate, Miyagi and Fukushima. 2 Of those deaths, 65% were aged 60 years and older, and more than 90% were caused by drowning. 3 The earthquake also destroyed nuclear power plants in Fukushima, causing high levels of radioactive contamination. 4As a result, there were 386 739 evacuees staying in 2182 temporary shelters such as community centres, schools and gymnasiums one week after the disaster. 5In Japan, tuberculosis (TB) control activities are conducted by public health centres (PHCs) and treatment support is provided by public health nurses (PHNs). This study describes the TB situation in the affected areas and assesses the effectiveness of Japan's TB control efforts after the disaster. METHODSWe obtained data on casualties of the disaster from the National Police Agency team visits. 6 TB outbreaks were confirmed by the interferon- release assay as reported elsewhere. 7,8TB notification data at PHCs were obtained with permission of local governments. TB notification rates were compared between disaster-affected and nonaffected areas using the chi-square test. Analysis was conducted using Microsoft Excel (Microsoft Excel 2010, Redmond, USA). A P-value < 0.05 was considered statistically significant. Ethical approval was obtained from the Research Institute of Tuberculosis, JATA. RESULTSThere were 96 TB patients on treatment in the eight PHC areas at the time of the disaster. The consultation meetings revealed that no TB patients had defaulted from treatment in these areas. Death of TB patients from disasterSeven TB patients died during the disaster (five from PHC D, one from PHC G and one from PHC H). Mortality of TB patients (7.3%) was higher than that of the general population (1.3%) in these areas. In the PHC D area, mortality of TB patients was much higher than that of the general population (23.8% versus 2.7%) ( Table 1). Mortality of TB patients aged 60 years or older (30.7%, 4/13) was higher than that of those younger than age 60 (12.5%, 1/8) in this area. TB outbreak in sheltersTwo TB outbreaks in different shelters were reported in the disaster-affected PHC areas in 2011. The first

The aim of this study was to describe the current situation of smokeless tobacco (SLT) consumption and its oral health impact in Myanmar. Methods This study reviewed the published data, reports and research findings on prevalence, factors influencing