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Current Situation of Tuberculosis and Its Control in Korea

Article information

J Korean Med Assoc. 2006;49(9):762-772
Publication date (electronic) : 2006 September 30
doi : https://doi.org/10.5124/jkma.2006.49.9.762
Hee Jin Kim, MD
Department of Technical Cooperation, Korean Institute of Tuberculosis, Korean National Tuberculosis Assciation, Korea. hatchingbird@yahoo.co.kr

Abstract

The prevalence of tuberculosis (TB) has declined owing to the establishment of national tuberculosis (TB) program in 1962, introduction of short course chemotherapy in mid 1980's, economic development, and nationwide medical insurance system. However, it is assumed that 18,000 (0.039%) smear positive and 224,000 (0.32%) radiologically active TB patients are present in 2006 by the extrapolating the figures from the prevalence surveys during the period 1980~1995. The prevalence survey was shifted to an Internet-based notification system in June 2000, and a total of 46,969 (97.3/105) patients were notified in 2005. Among them, 72.3% were registered from private sector. The proportion of patients treated at private sector is increasing year by year. Among the 35,269 (73.0/105) newly diagnosed patients, 11,638 (24.1/105) were smear positive pulmonary TB. The number of newly diagnosed extra-pulmonary TB patients was 5,171 (10.7/105). The age distribution curve showed a peak in the young generation, which implies that TB is still prevalent in Korea. A total of 2,948 (6.1/105) patients died of TB in 2004. The median age increased from 49 in 1983 to 70 in 2004. The initial drug resistance rate had been 10.4% in 1994 and rose to 12.8% in 2004. In addition, the rate of initial multi-drug resistance was significantly increased from 1.6% to 2.7% during the same period. The treatment success rate in public sector is around 80%, but it is lower in private sector due to the difficulties in the management of active diseases. To accelerate the elimination of TB, it is important to intervene in the management of patients under treatment at private sector through public-private collaborations and active investigations on the preventive therapy to manage latent infection.

Keywords: Tuberculosis; Notification; Prevalence; Drug resistance

References

1. World Health Organization. WHO Report 2006. Global Tuberculosis Control. Surveillance, Planning, Financing. World Health Organization 2006. WHO/HTM/TB; 362.
2. Ministry of Health and Welfare. Korean National Tuberculosis Association. Report on the 7th tuberculosis prevalence survey in Korea. 1995. 1996. Seoul: Ministry of Health and Welfare, Korean National Tuberculosis Association; (Korean).
3. Hong YP, Kim SJ, Lew WJ, Lee EK, Han YC. The seventh nationwide tuberculosis prevalence survey in Korea, 1995. Int J Tuberc Lung Dis 1998. 227–36.
4. Bleiker MA, Sutherland I, Styblo K, ten Dam HG, Misljenovic O. Guidelines for estimating the risk of tuberculosis infection from tuberculin test results in a representative sample of children. Bull Union Tuberc Lung Dis 1989. 64(2)7–12.
5. Styblo K. Selected paters, Vol 24 Epidemiology of tuberculosis 1991. Hague, The Netherlands: Royal Netherlands Tuberculosis Association;
6. Kim SJ, Hong YP, Lew WJ, Yang SC, Lee EG. Incidence of pulmonary tuberculosis in Korean civil servants. Tubercle and Lung Disease 1995. 76534–539.
7. Bai GH, Kim SJ, Lee EK, Lew WJ. Incidence of pulmonary tuberculosis in Korean civil servants: second study, 1992 - 1994. Int J Tuberc Lung Dis 2001. 5346–353.
8. Korea Centers for Disease Control and Prevention. Korean Institute of Tuberculosis. . Annual report on the notified tuberculosis patients in Korea. 2005 (Based on Korean Tuberculosis Surveillance System) Korea Centers for Disease Control and Prevention 2006. Korean Institute of Tuberculosis;
9. Kim CH, Koh WJ, Kwon OJ, Ahn YM, Lim SY, et al. The accuracy of tuberculosis notification reports at a private genereal hospital after enforcement of new Korean tuberculosis surveillance system. Tuberc Respir Dis 2003. 54178–190.
10. Korea National Statistical Office. 2004 Annual report on the cause of death statistics (Based on vital registration) Korea National Statistical Office 2005. Seoul:
11. World Health Organization. WHO/TB/97. 229. Anti-tuberculosis drugs resistance in the world. The WHO/IUATLD global project on anti-tuberculosis drug resistance surveillance. WHO Global Tuberculosis Programme Geneva:
12. World Health Organization. WHO/TB/2000. 278. Anti-tuberculosis drugs resistance in the world Report No.2 Prevalence and trends. The WHO/IUATLD global project on anti-tuberculosis drug resistance surveillance 2000. Communicable diseases World Health Organization:
13. Bai GH. Anti-tuberculosis drug resistance in Korea. CDMR 2005. 16101–107.
14. Chang CL, Lee EY, Park SK, Jeong SH, Park YK, et al. A Trend in Acquired Drug Resistances of Tuberculosis Patients Registered in Health Centers from 1981 to 2004. Tuberc Respir Dis 2005. 59619–624.
15. Kim DK, Kim MO, Kim TH, Sohn JW, Yoon HJ, et al. The Prevalence and Risk Factors of Drug Resistant Pulmonary Tuberculosis Investigated at One University Hospital in Seoul. Tuberc Respir Dis 2005. 58243–247.
16. Jung YJ, Park IN, Hong SB, Oh YM, Lim CM, et al. The clinical characteristics, diagnosis, treatment, and outcomes of patients with tuberculosis at a private university hospital in Korea. Tuberc Respir Dis 2006. 60194–204.
17. Son CH, Yang DG, No MS, Jeong JS, Lee H, Lee GN, et al. Prevalence of drug-resistances in patients with pulmonary tuberculosis and its association with clinical characteristics at one tertiary referral hospital in Pusan, Korea. Tuberc Respir Dis 2001. 51416–425.
18. Kim JH, Kim JH, Jang TW, Jung MH. Drug-resistant pulmonary tuberculosis in Kosin Medical Center. Tuberc Respir Dis 1995. 42831–837.
19. Hong YP, Kim SJ, Lew WJ, Lee SH, Lee EK. Cohort analyses of the treatment of smear-positive pulmonary tuberculosis patients under programme conditions in Korea, 1983-1994. Int J Tuberc Lung Dis 1998. 5. 2365–371.
20. Korean Institute of Tuberculosis. A follow up study for the transferred out and defaulters among the bacteriologically positive patients under the national tuberculosis programme 1999. Seoul: Korean Institute of Tuberculosis;
21. Jang DJ, Jin BW. An Analysis of Tuberculosis Patient Management in Private Sector. Tuberc Respir Dis 1990. 37399–406.
22. Hong YP, Kim SJ, Lee EG, Lew WJ, Bai JY. Treatment of bacillary pulmonary tuberculosis at the chest clinics in the private sector in Korea, 1993. Int J Tuberc Lung Dis 1999. 3695–702.
23. Kim YO, Yang WH, Bae JM. A survey of the controlling system for the pulmonary tuberculosis in Jejudo, 2002. Tuberc Respir Dis 2004. 56356–363.
24. Koh WJ, Kwon OJ, Kim CH, Ahn YM, Lim SY, et al. Clinical characteristics and treatment outcomes of patients with pulmonary tuberclosis at a private general hospital. Tuberc Respir Dis 2003. 55154–164.
25. Kim HJ, Bai GH, Kang MK, Kim SJ, Lee JK, et al. An intervention trial of a public-private collaboration model for improving treatment outcomes of tuberculosis patients in the private sector in Korea. Int J Tuberc Lung Dis 2005. 9Suppl 1. S55.
26. World Health Organization. WHO/HTM/TB/2004.338. Public-Private Mix for DOTS. Global progress. Report of the Second Meeting of the PPM Subgroup for DOTS Expansion World Health Organization;
27. Korea Center for Disease Control and Prevention. Tuberculosis Guidelines. 2006. Korea Center for Disease Control and Prevention. KCDC 06-15 2006. Seoul: 5. (Korean).

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Copyright © 2006 Korean Medical Association

Figure 1

Figure 1

Trend of new case notification rate per 100,000 by age group, 2001~2005

Figure 2

Figure 2

Tuberculosis death rate and median age of the patients died of tuberculosis

Figure 3

Figure 3

Annual trend of tuberculosis patients registered at the health centers and private sector

Table 1

Trend of tuberculosis situation according to the national prevalence surveys

Table 1

Italics are estimated figure

Estimation of annual risk of infection; calculated by the regression equation using infection rate of 5~9 years old; LnY=6.37253-0.07485

*X (R-square: 0.96)

Estimation of prevalence; calculated by the age-specific reduction rate using the 1980~1995 year survey.

Table 2

Distribution of notified tuberculosis cases, 2005

Table 2

*Treatment after Failure, †Treatment after Default, ‡Transferred-In, §Pulmonary tuberculosis, **Extra-pulmonary tuberculosis

Table 3

Drug resistance rates (%) of the patients registered at the health centers

Table 3

*2004; Unpublished data

Table 4

Treatment Regimen based on the surveillance System, 2005

Table 4

H; Isoniazid, R; Rifampin, Z; Pyrazinamide, E; Ethambutol, S; Streptomycin