The management for tuberculosis control in Greater London in comparison with that in Osaka City: lessons for improvement of TB control management in Osaka City urban setting
Section snippets
Objectives
This paper aims to derive some lessons mainly for Osaka City for management change and organisational development learnt from the experiences in Greater London through describing the TB epidemiology, the organisational structure of TB control in the two cities focusing on the care of the high-risk groups for TB.
Introduction and background
Tuberculosis (TB) is still one of the leading causes of death in adults, and it is the largest killer as a single infectious agent in the world [1]. Taking this serious situation into account, WHO declared a global TB emergency in 1993 [2]. Though TB affects mainly people in the developing countries, it also affects people in the developed world. It has been recognised as one of the re-emerging infectious diseases in many developed countries [3]. In the U.S.A., for instance, as in many European
Method and measurements
This is a descriptive and comparative epidemiological review regarding TB control management in the two cities, Greater London in England and Osaka City in Japan, through published and unpublished literature review as well as interviews with health professionals.1
Population and homeless
Population of Greater London by Census 2001 indicates 7.2 million comprised of 3.5 million males and 3.7 million females [16]. It is estimated that there are homeless people, who live in the street as rough sleepers or live in temporary housing such as hostels, cheap bed and breakfast accommodation, and shelters, ranging from 100,000 to 237,000 in Greater London [17]. Greater London is also well renowned by the high unemployment rate [12]. Besides, over 85% of the UK's asylum seekers and
Discussion
The comparison of health care systems in efficiency and equity between different areas such as countries or cities or clinical institutions is not straightforward to do because of its complexity [121]. Some trials to compare the health care systems between countries have been achieved aside from methodological proposals [122], [123], [124], [125], [126], [127], [128], [129], [130], [131], [132], [133], which derived some arguments on their methodologies and implications [134], [135], [136]. The
Acknowledgements
We would like to extend special thanks to all interviewees whom we had interviewed to derive their wonderful expertise for illustrating the TB control in Greater London. We would like to thank Mr. Joe Rowan and Mr. Hideki Tomita who gave helpful suggestions to the draft of this paper. We are also very grateful to the anonymous reviewers to make constructive comments and suggestions on this draft paper.
This study is partly funded by the emerging and re-emerging infectious diseases research
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