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Original article Nationwide trends in incidence of tuberculosis among people with disabilities in South Korea: a nationwide serial cross-sectional study
Min Jinsoo2orcid , Kim So Young3orcid , Park Jong Eun4orcid , Kim Yeon Yong5orcid , Park Jong-Hyock1orcid
Epidemiol Health 2022;e2022098
DOI: https://doi.org/10.4178/epih.e2022098 [Accepted]
Published online: October 28, 2022
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1College of Medicine, Chungbuk National University, Cheongju, Korea
2College of Medicine, The Catholic University of Korea, Seoul, Korea
3Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, Korea
4Institute of Health & Science Convergence, Chungbuk National University, Cheongju, Korea
5Drug Evaluation Department, National Institute of Food and Drug Safety Evaluation, Cheongju, Korea
Corresponding author:  Park Jong-Hyock,
Email: jonghyock@gmail.com
Received: 9 July 2022   • Revised: 19 October 2022   • Accepted: 28 October 2022

Objectives
Studies on the association between disability and tuberculosis (TB) are scarce. We aimed to assess the risk of active TB disease among people with disabilities.
Methods
We conducted a nationwide serial cross-sectional study using national registry linkage databases from 2008 to 2017. The crude and age, sex-standardized incidence rates of TB were analyzed for each year according to the presence, type, and severity of disabilities. The crude incidence rate and odds of developing TB disease were examined by a multivariable logistic regression model using data in 2017.
Results
The overall incidence of active TB decreased between 2008 and 2017. Age, sex-standardized incidence rates of TB disease among people with disabilities were significantly higher than among those without disabilities throughout all observed years (P < 0.001). As of 2017, the population with disabilities had a higher crude incidence rate of active TB disease than that without disability (119.9/100,000 vs. 48.5/100,000 person-years, P < 0.001), regardless of sex, income level, and place of residence. Compared to those without disability, those with disabilities had higher odds of active TB (adjusted odds ratio [aOR], 1.19; 95% confidence interval [CI], 1.15–1.24). Mental disability (aOR, 1.51; 95% CI, 1.24–1.84) had the highest odds of active TB incidence, followed by developmental disability (aOR, 1.30; 95% CI, 1.09–1.55).
Conclusions
People with disabilities are at a greater risk of developing TB disease. Active screening and care for TB cases would be beneficial for people with disabilities.


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