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6 "Latent tuberculosis"
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Tuberculosis control in the Republic of Korea
Kyung Sook Cho
Epidemiol Health. 2018;40:e2018036.   Published online August 2, 2018
DOI: https://doi.org/10.4178/epih.e2018036
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The incidence and mortality rates of tuberculosis (TB) in the Republic of Korea are 77 and 5.2 per 100,000 people, respectively (2016), which are the highest among the member countries of the Organization for Economic Cooperation and Development. Recently, the incidence of TB among teens and individuals in their 20s in the Republic of Korea decreased significantly. The decrease is largely attributed to the TB screening and contact investigation efforts targeting schools over the past few years. However, the incidence of TB among elderly individuals remains high, and it is even increasing compared to that in the past 10 years. Older individuals account for 42% of all TB cases and 82% of TB-related deaths. The success rate of TB treatment in the Republic of Korea has gradually increased due to various programs, such as control of non-compliance, insurance coverage for TB diagnosis and treatment, and TB public–private mix models. This study suggests that policy makers should focus their efforts on policies that prioritize a significant reduction in the incidence of TB based on the 2nd National Strategic Plan for Tuberculosis Control (2018–2022).
Summary
Korean summary
2016년 한국의 결핵 발생률은 인구 10만명당 77명이고, 결핵 사망률은 인구 10만명당 5.2명으로 경제협력개발기구(OECD) 회원국 중 가장 높은 수준이다. 본 연구는 지난 수 십 년간 한국의 결핵 발생률, 유병률 및 사망률의 변화 추이와 그간 한국 정부가 시행해 온 다양한 결핵 관리 정책들을 분석하고 향후 개선방안을 제시하고자 하였다.

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Perspectives
Vitamin D supplementation as a control program against latent tuberculosis infection in Korean high school students
Eun Hee Kim, Jong-Myon Bae
Epidemiol Health. 2018;40:e2018035.   Published online July 27, 2018
DOI: https://doi.org/10.4178/epih.e2018035
  • 12,436 View
  • 238 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The prevalence of latnet Mycobacterium tuberculosis infection (LTBI) in the first-grade high school students in South Korea was 2.1%, which was the lowest level at congregated settings in 2017. For LTBI cases refusing anti-tuberculosis (TB) medication or having poor compliance, additional support should be considered. Eight systematic reviews concluded that vitamin D (VD) deficiency is a risk factor for TB. While three of four South Korean adolescents were VD deficiency, VD supplementation could be a practical remedy to protect LTBI students of refusing anti-TB medication or having poor compliance.
Summary
Korean summary
잠복결핵검진 검사 양성자이면서 항결핵제 복용을 거부하는 고1학생에 대한 사후 조치가 필요하다. 그동안의 연구결과들에 근거할 때, 잠복결핵이 활동성결핵으로의 전환을 억제하기 위해서 비타민 D 보충제의 투여를 검토해 볼 수 있다.

Citations

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  • Vitamin D and the risk of latent tuberculosis infection: a systematic review and meta-analysis
    Yan Cao, Xinjing Wang, Ping Liu, Yue Su, Haotian Yu, Jingli Du
    BMC Pulmonary Medicine.2022;[Epub]     CrossRef
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    Shang-Yi Lin, Yi-Wen Chiu, Hui-Ru Yang, Tun-Chieh Chen, Min-Han Hsieh, Wen-Hung Wang, Yen-Hsu Chen
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    Bijay Maharjan, Ram Sharan Gopali, Ying Zhang
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An opposing view on including high school students in a latent tuberculosis infection control program in Korea
Jong-Myon Bae
Epidemiol Health. 2017;39:e2017015.   Published online March 31, 2017
DOI: https://doi.org/10.4178/epih.e2017015
  • 14,823 View
  • 201 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The Korea Centers for Diseases Control and Prevention (KCDC) has announced a control program against latent <i>Mycobacterium tuberculosis</i> infection (LTBI), for a “TB-safe country” this year with the goal of a “TB-free Korea” by 2025. The program includes high school students as one target group; however, some school health teachers and parents have expressed their opposition to this. The 2015 World Health Organization guidelines do not recommend inclusion of asymptomatic high school students in LTBI control programs. Based on this guideline, the KCDC should consider excluding this population from the program.
Summary
Korean summary
질병관리본부는 결핵안심국가를 만들기 위하여 고등학교 1학년생을 포함한 잠복결핵감염 검사사업을 2017년 추진하기로 공고하였다. 그러나 2015년에 발표된 WHO 지침에 따르면 해당 대상자들은 검사대상자로 제시되어 있지않다. 근거중심의 보건정책 추진을 위해서 사업 대상 선정을 재검토할 필요가 있다.

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  • The cascade of care for latent tuberculosis infection in congregate settings: A national cohort analysis, Korea, 2017–2018
    Jinsoo Min, Hyung Woo Kim, Helen R. Stagg, Molebogeng X. Rangaka, Marc Lipman, Ibrahim Abubakar, Yunhee Lee, Jun-Pyo Myong, Hyunsuk Jeong, Sanghyuk Bae, Ah Young Shin, Ji Young Kang, Sung-Soon Lee, Jae Seuk Park, Hyeon Woo Yim, Ju Sang Kim
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    찬병 박
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Original Articles
Prevalence of latent tuberculosis infection among tuberculosis laboratory workers in Iran
Mahshid Nasehi, Abdolrazagh Hashemi-Shahraki, Amin Doosti-Irani, Saeed Sharafi, Ehsan Mostafavi
Epidemiol Health. 2017;39:e2017002.   Published online December 30, 2016
DOI: https://doi.org/10.4178/epih.e2017002
  • 18,169 View
  • 367 Download
  • 11 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The risk of transmission of <i>Mycobacterium tuberculosis</i> from patients to health care workers (HCWs) is a neglected problem in many countries, including Iran. The aim of this study was to estimate the prevalence of latent tuberculosis (TB) infection (LTBI) among TB laboratory staff in Iran, and to elucidate the risk factors associated with LTBI.
METHODS
All TB laboratory staff (689 individuals) employed in the TB laboratories of 50 Iranian universities of medical sciences and a random sample consisting of 317 low-risk HCWs were included in this cross-sectional study. Participants with tuberculin skin test indurations of 10 mm or more were considered to have an LTBI.
RESULTS
The prevalence of LTBI among TB laboratory staff and low-risk HCWs was 24.83% (95% confidence interval [CI], 21.31 to 27.74%) and 14.82% (95% CI, 11.31 to 19.20%), respectively. No active TB cases were found in either group. After adjusting for potential confounders, TB laboratory staff were more likely to have an LTBI than low-risk HCWs (prevalence odds ratio, 2.06; 95% CI, 1.35 to 3.17).
CONCLUSIONS
This study showed that LTBI are an occupational health problem among TB laboratory staff in Iran. This study reinforces the need to design and implement simple, effective, and affordable TB infection control programs in TB laboratories in Iran.
Summary

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    Mazin Barry, Stefano Centanni
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    NazaninZahra Sepehri, Seyed Mohammad Saghanezhad, Farshad Khoddami, Amin Arasteh, Marziyeh Delirakbariazar, Azad Khaledi
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Comparison of the tuberculin skin test and the QuantiFERON-TB Gold test in detecting latent tuberculosis in health care workers in Iran
Ehsan Mostafavi, Mahshid Nasehi, Abdolrazagh Hashemi Shahraki, Saber Esmaeili, Ebrahim Ghaderi, Saeed Sharafi, Amin Doosti-Irani
Epidemiol Health. 2016;38:e2016032.   Published online July 24, 2016
DOI: https://doi.org/10.4178/epih.e2016032
  • 16,444 View
  • 220 Download
  • 9 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT) are used to identify latent tuberculosis infections (LTBIs). The aim of this study was to determine the agreement between these two tests among health care workers in Iran.
METHODS
This cross-sectional study included 177 tuberculosis (TB) laboratory staff and 67 non-TB staff. TST indurations of 10 mm or more were considered positive. The Student’s t-test and the chi-square test were used to compare the mean score and proportion of variables between the TB laboratory staff and the non-TB laboratory staff. Kappa statistics were used to evaluate the agreement between these tests, and logistic regression was used to assess the risk factors associated with positive results for each test.
RESULTS
The prevalence of LTBIs according to both the QFT and the TST was 17% (95% confidence interval [CI], 12% to 21%) and 16% (95% CI, 11% to 21%), respectively. The agreement between the QFT and the TST was 77.46%, with a kappa of 0.19 (95% CI, 0.04 to 0.34).
CONCLUSIONS
Although the prevalence of LTBI based on the QFT and the TST was not significantly different, the kappa statistic was low between these two tests for the detection of LTBIs.
Summary

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    Devasahayam J. Christopher, N. Priya, Deepa Shankar, Barney Isaac, Andrea DeLuca, Sonali Sarkar, Senbagavalli Prakash Babu, Prasanna Samuel, Adithya Cattamanchi, Amita Gupta, Jerrold Ellner, Sudha Srinivasan, Samyra Cox, Balamugesh Thangakunam
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    Mohammad Hossein YektaKooshali, Farahnaz Movahedzadeh, Ali Alavi Foumani, Hoda Sabati, Alireza Jafari, HASNAIN SEYED EHTESHAM
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    Mahshid Nasehi, Abdolrazagh Hashemi-Shahraki, Amin Doosti-Irani, Saeed Sharafi, Ehsan Mostafavi
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Review
Do the tuberculin skin test and the QuantiFERON-TB Gold in-tube test agree in detecting latent tuberculosis among high-risk contacts? A systematic review and meta-analysis
Erfan Ayubi, Amin Doosti-Irani, Ehsan Mostafavi
Epidemiol Health. 2015;37:e2015043.   Published online October 3, 2015
DOI: https://doi.org/10.4178/epih/e2015043
  • 18,982 View
  • 219 Download
  • 11 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The QuantiFERON-TB Gold in-tube test (QFT-GIT) and the tuberculin skin test (TST) are used to diagnose latent tuberculosis infection (LTBI). However, conclusive evidence regarding the agreement of these two tests among high risk contacts is lacking. This systematic review and meta-analysis aimed to estimate the agreement between the TST and the QFT-GIT using kappa statistics.
METHODS
According to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, scientific databases including PubMed, Scopus, and Ovid were searched using a targeted search strategy to identify relevant studies published as of June 2015. Two researchers reviewed the eligibility of studies and extracted data from them. The pooled kappa estimate was determined using a random effect model. Subgroup analysis, Egger’s test and sensitivity analysis were also performed.
RESULTS
A total of 6,744 articles were retrieved in the initial search, of which 24 studies had data suitable for meta-analysis. The pooled kappa coefficient and prevalence-adjusted bias-adjusted kappa were 0.40 (95% confidence interval [CI], 0.34 to 0.45) and 0.45 (95% CI, 0.38 to 0.49), respectively. The results of the subgroup analysis found that age group, quality of the study, location, and the TST cutoff point affected heterogeneity for the kappa estimate. No publication bias was found (Begg’s test, p=0.53; Egger’s test, p=0.32).
CONCLUSIONS
The agreement between the QFT-GIT and the TST in diagnosing LTBI among high-risk contacts was found to range from fair to moderate.
Summary

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