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15 "Tuberculosis"
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Original Articles
Delays in the diagnosis and treatment of tuberculosis during the COVID-19 outbreak in the Republic of Korea in 2020
Jiyeon Yang, Yunhyung Kwon, Jaetae Kim, Yoojin Jang, Jiyeon Han, Daae Kim, Hyeran Jeong, Hyekyung Park, Eunhye Shim
Osong Public Health Res Perspect. 2021;12(5):293-303.   Published online September 23, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0063
  • 3,378 View
  • 130 Download
  • 2 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
We investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on tuberculosis (TB) management in the Republic of Korea (ROK).
Methods
This retrospective cross-sectional study used nationwide ROK TB notification data (98,346 cases) from 2017 to 2020. The median time from the onset of TB symptoms to treatment initiation and the compliance rates with the required timing for notification and individual case investigations were measured and compared across periods and regions affected by the COVID-19 epidemic.
Results
TB diagnosis during the COVID-19 pandemic was delayed. The median time to TB treatment initiation (25 days) in 2020 increased by 3 days compared to that of the previous 3 years (22 days) (p<0.0001). In the outbreak in Seoul, Incheon, and Gyeonggi province during August, the time to TB diagnosis was 4 days longer than in the previous 3 years (p=0.0303). In the outbreak in Daegu and Gyeongbuk province from February to March 2020, the compliance rate with the required timing for individual case investigations was 2.2%p points lower than in other areas in 2020 (p=0.0148). For public health centers, the rate was 13%p lower than in other areas (80.3% vs. 93.3%, p=0.0003).
Conclusion
TB diagnoses during the COVID-19 pandemic in the ROK were delayed nationwide, especially for patients notified by public-private mix TB control hospitals. TB individual case investigations were delayed in regional COVID-19 outbreak areas (Daegu and Gyeongbuk province), especially in public health centers. Developing strategies to address this issue will be helpful for sustainable TB management during future outbreaks.
Army Soldiers’ Knowledge of, Attitude Towards, and Preventive Behavior Towards Tuberculosis in Korea
Yun Choi, Geum Hee Jeong
Osong Public Health Res Perspect. 2018;9(5):269-277.   Published online October 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.5.09
  • 2,860 View
  • 135 Download
  • 3 Citations
AbstractAbstract PDF
Objectives

The aim of this study was to gather information about Korean Army soldiers’ attitude towards tuberculosis to enable the development of an informed educational program and potential intervention plans.

Methods

There were 500 male soldiers serving in the Korean Army who responded to questionnaires regarding knowledge of, attitudes towards, and preventive behavior towards tuberculosis. The questionnaires were collected between September 10 until October 1, 2014. Participants’ characteristic that influenced differences in knowledge, attitudes, and preventive behavior towards tuberculosis were compared by t test. Variables that influenced preventive behavior were identified by multiple regression analysis.

Results

The mean scores assessing knowledge of, attitude, and preventive behavior towards tuberculosis were 11.64 (± 4.03) out of 20 points, 3.21 (± 0.38) out of 4 points, and 2.88 (± 0.42) out of 4 points, respectively. Non-smokers were more knowledgeable about tuberculosis than smokers. Participants who had family or friends with tuberculosis had better knowledge and a more productive attitude to tuberculosis. Participants who were educated or obtained information about tuberculosis, received better scores in all areas of knowledge, attitude and preventive behavior compared to other participants. Non-smoking, family or friends who have had tuberculosis, obtaining information about tuberculosis, and positive attitudes towards treatment and preventive education had an explanatory power of 24.6% with regard to preventive behavior against tuberculosis.

Conclusion

More relatable, systemized education should be provided regularly to improve soldiers’ knowledge of, attitudes towards, and prevention against tuberculosis in the Republic of Korea Army.

Cost of Tuberculosis Treatment: Evidence from Iran’s Health System
Vahid Bay, Payam Tabarsi, Aziz Rezapour, Sima Marzban, Ehsan Zarei
Osong Public Health Res Perspect. 2017;8(5):351-357.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.09
  • 2,416 View
  • 26 Download
  • 4 Citations
AbstractAbstract PDF
Objectives

This study aimed to estimate the cost of smear-positive drug-susceptible pulmonary tuberculosis (TB) treatment of the patients in the Azadshahr district, Golestan Province, Iran.

Methods

In this retrospective study, all new smear positive pulmonary TB patients who had been registered at the district’s health network between April, 2013 and December, 2015 and had successfully completed their treatment were entered into the study (45 patients). Treatment costs were estimated from the provider’s perspective using an activity-based costing (ABC) method.

Results

The cost of treating a new smear-positive pulmonary TB patient was US dollar (USD) 1,409.00 (Iranian Rial, 39,438,260), which can be divided into direct and indirect costs (USD 1,226.00 [87%] and USD 183.00 [13%], respectively). The highest cost (58.1%) was related to care and management of TB patients (including 46.1% human resources costs and 12% directly-observed treatment, short course implementation) and then respectively related to hospitalization (12.1%), supportive activity centers (11.4%), transportation (6.5%), medicines (5.3%), and laboratory tests and radiography (3.2%).

Conclusion

Using disease-specific cost studies can help the healthcare system management to have correct insight into the financial burden created by the disease. This can subsequently be used in prioritization, planning, operational budgeting, economic evaluation of programs, interventions, and ultimately in disease management.

Low Levels of Extensively Drug-resistant Tuberculosis among Multidrug Resistant Tuberculosis Isolates and Their Relationship to Risk Factors: Surveillance in Tehran, Iran; 2006 to 2014
Alireza Hadizadeh Tasbiti, Shamsi Yari, Mostafa Ghanei, Mohammad Ali Shokrgozar, Abolfazl Fateh, Ahmadreza Bahrmand
Osong Public Health Res Perspect. 2017;8(2):116-123.   Published online April 30, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.2.03
  • 1,958 View
  • 23 Download
  • 3 Citations
AbstractAbstract PDF
Objectives

Extensively drug-resistant tuberculosis (XDR-TB) is more expensive and difficult to treat than multidrug-resistant tuberculosis (MDR-TB), and outcomes for patients are much worse; therefore, it is important that clinicians understand the magnitude and distribution of XDR-TB. We conducted a retrospective study to compare the estimated incidence of and risk factors for M/XDR-TB with those of susceptible TB controls.

Methods

Sputum culture and drug susceptibility testing (DST) were performed in patients with known or suspected TB. Strains that were identified as MDR were subjected to DST for second-line drugs using the proportion method.

Results

Among 1,442 TB patients (mean age, 46.48 ± 21.24 years) who were culture-positive for Mycobacterium tuberculosis, 1,126 (78.1%) yielded isolates that were resistant to at least one first-line drug; there were 33 isolates (2.3%) of MDR-TB, of which three (0.2%) were classified as XDR-TB. Ofloxacin resistance was found in 10 (0.7%) isolates. Women were 15% more likely than men to yield M/XDR-TB isolates, but this difference was not significant. In a multivariate analysis comparing susceptible TB with X/MDR-TB, only one variable—the number of previous treatment regimens—was associated with MDR (odds ratio, 1.06; 95% confidence interval, 1.14–21.2).

Conclusion

The burden of M/XDR-TB cases is not sizeable in Iran. Nonetheless, strategies must be implemented to identify and cure patients with pre-XDR-TB before they develop XDR-TB. Our results provide a greater understanding of the evolution and spread of M/XDR-TB in an environment where drug-resistant TB has a low incidence.

Tuberculosis Notification Completeness and Timeliness in the Republic of Korea During 2012–2014
Hae-Young Kang, Hyosoon Yoo, Wonseo Park, Unyeong Go, Eunkyeong Jeong, Ki-Suck Jung, Hyunjin Son
Osong Public Health Res Perspect. 2016;7(5):320-326.   Published online October 31, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.08.002
  • 1,885 View
  • 22 Download
  • 15 Citations
AbstractAbstract PDF
Objectives
Completeness and timeliness are key attributes of accurate disease surveillance. This study aimed to evaluate the completeness and timeliness of tuberculosis (TB) notification in the Republic of Korea, by comparing notification data from the Korean National Tuberculosis Surveillance System and reimbursement data from the National Health Insurance.
Methods
We evaluated reimbursement data from 103,075 cases (2012–2014) and surveillance data from 215,055 cases (2011–2015); cases were matched using Resident Registration Numbers. Completeness was evaluated using notifications that were reported within 365 days of the corresponding insurance claim. Timeliness was evaluated using the delay between starting TB treatment and the corresponding notification. Multivariate logistic regression analysis was used to analyze factors that affected completeness (e.g., sex, age, institution type, and nationality).
Results
The completeness values were 90.0% in 2012 (33,094/36,775), 93.0% in 2013 (31,445/33,803), and 94.0% in 2014 (30,537/32,497). The rates of notification within 7 days of the corresponding claim were 81.6% in 2012 (27,323/33,489), 79.8% in 2013 (25,469/31,905), and 80.4% in 2014 (24,891/30,978). Increases over time were observed in the sex-, age-, institution type-, and nationality-specific analyses. Multivariate analyses revealed that completeness was affected by institution type [hospitals: odds ratio (OR) = 1.82, p < 0.001; general hospitals: OR = 4.18, p < 0.001] and nationality (native Korean status: OR = 1.48, p < 0.001).
Conclusion
Notification completeness exhibited a 4.0% increase during 2012–2014 in Korea, and institution type and nationality significantly affected the completeness of TB notifications.
Rapid Detection of Rifampicin- and Isoniazid-Resistant Mycobacterium tuberculosis using TaqMan Allelic Discrimination
Davood Darban-Sarokhalil, Mohammad J. Nasiri, Abbas A.I. Fooladi, Parvin Heidarieh, Mohammad M. Feizabadi
Osong Public Health Res Perspect. 2016;7(2):127-130.   Published online April 30, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.01.003
  • 1,443 View
  • 16 Download
  • 1 Citations
AbstractAbstract PDF
Objectives
Multidrug-resistant tuberculosis (MDR-TB) is a global problem that many countries are challenged with. Rapid and accurate detection of MDR-TB is critical for appropriate treatment and controlling of TB. The aim of the present study was to evaluate the TaqMan allelic discrimination without minor groove binder (MGB) as a rapid, efficient, and low-cost method for detection of drug resistant strains of Mycobacterium tuberculosis.
Methods
A total of 112 M. tuberculosis isolates from cases with diagnosed TB were subjected to drug susceptibility testing (DST), using the proportion method. Resistant isolates were tested for characterization of mutations in the rpoB and KatG genes by TaqMan genotyping.
Results
Of 112 M. tuberculosis isolates for which DST was performed, three, one, and two isolates were MDR, rifampin (RIF) resistant, and isoniazid (INH) resistant, respectively. According to the threshold cycle (Ct) and curve pattern of mutants, TaqMan probes detect all of the mutations in the analyzed genes (katG 315, AGC→ACC, rpoB 531, TCG→TTG, and rpoB 531, TCG→TGG).
Conclusion
The present study suggests that drug-resistant strains of M. tuberculosis can be detected by pattern’s curve or Ct with TaqMan probes without MGB in real-time polymerase chain reaction (PCR).
Trends and Characteristics of HIV Infection among Suspected Tuberculosis Cases in Public Health Centers in Korea: 2001–2013
Meekyung Kee, Kyoung-Ho Lee, Sae-Young Lee, Chun Kang, Chaeshin Chu
Osong Public Health Res Perspect. 2014;5(Suppl):S37-S42.   Published online December 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.11.002
  • 1,483 View
  • 16 Download
  • 1 Citations
AbstractAbstract PDF
Objectives
The Republic of Korea reports approximately 35,000 new tuberculosis (TB) patients each year, and the number of HIV-infected individuals is steadily increasing. Public health centers (PHCs) conduct TB diagnosis and treatment for risk groups in communities. This study aimed to identify possible trends and characteristics of HIV infection among suspected TB cases in PHCs.
Methods
Study subjects were suspected TB cases in PHCs who agreed to be tested for HIV from 2001 to 2013. Trends in HIV seroprevalence were assessed through a series of annual cross-sectional analyses. We analyzed suspected TB cases, and HIV-infected individuals among suspected TB cases, by gender, age, nationality, and region.
Results
The number of suspected tuberculosis cases who took an HIV test in PHCs was approximately 6,000 each year from 2001 to 2013. Among the suspected TB cases who took an HIV test, the number of those aged 20–39 is gradually decreasing, while the number of those aged 50–69 is increasing. During this period, 32 HIV-infected individuals were identified; the majority were men (94%), aged 30–49 (68%), Korean (94%), and residents in a metropolitan area (53%). HIV seroprevalence decreased from 8.2 per 10,000 persons in 2001 to 1.9 per 10,000 persons in 2013.
Conclusion
This study has identified trends and characteristics of HIV infection among suspected tuberculosis cases in PHCs. This national data provides a basis for public health policy for HIV and tuberculosis infections.
A Study on the Relapse Rate of Tuberculosis and Related Factors in Korea Using Nationwide Tuberculosis Notification Data
Hyungmin Lee, Jusang Kim
Osong Public Health Res Perspect. 2014;5(Suppl):S8-S17.   Published online December 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.11.001
  • 1,414 View
  • 20 Download
  • 9 Citations
AbstractAbstract PDF
Objectives
From the perspective of public health, tuberculosis (TB) remains an important issue that threatens health. Korea is an intermediate burden country with a TB incidence of 97/100,000 individuals. Among many TB control measures, a relapse rate of TB is one indicator that can be used to indirectly assess the level of TB control in countries and in communities. Relapse TB has an approximately 12% yearly incidence in Korea. This study aims to estimate the relapse rate of TB and to investigate the associated factors by using nationwide TB notification data in Korea.
Methods
The nationwide TB notification data in 2005 was used with the exclusion criteria of duplicated reporting, foreign-born patients, outcome–died, and outcome–diagnosis changed. The data were double-checked as to whether they were reported again during 2006–2010 and the estimated relapse rate of TB. Associated factors were analyzed by multivariate logistic regression with the variables of age, sex, registration type, results of sputum smear test, medication, and outcome of treatment.
Results
Among 45,434 TB patients in 2005, 4,371 patients were again reported as TB patients from 2006 to 2010. Five hundred and sixty-four patients were reported more than twice and the cumulative number of relapses was 5,072 cases. The 5-year relapse rate was estimated as 9.62%. The relapse rate decreased yearly: 4.8% in 2006, 2.4% in 2007, 1.6% in 2008, 1.4% in 2009, and 1.0% in 2010. Age, sex, registration type, tuberculosis type, and medication were independently associated with a relapse of TB. In the multivariate logistic regression analysis, the following factors were related: male sex, 40–49 years old; registration type, relapse, treatment after failure, treatment after default, transfer in, and other, the sputum smear-positive pulmonary TB, and medications (including individuals taking 2–5 drugs).
Conclusion
This study has estimated a 5-year relapse rate of TB in Korea that is slightly lower than the rate of relapse TB in the annual reports. This study could be conducted and cross-checked with data from the National Health Insurance in the future.
Results of Tuberculosis Contact Investigation in Congregate Settings in Korea, 2013
Yunhyung Kwon, So Jung Kim, Jieun Kim, Seol-yi Kim, Eun Mi Song, Eun Jung Lee, Yun Choi, Yejin Kim, Byoung ok Lim, Da Sul Kim, Duksun Choi, Hye Sung Kim, Ji Eun Park, Ji-eun Yun, Jin A. Park, Jong Rak Jung, Joo-kyoung Kim, Sang Hee Kang, Seo Yean Hong, Seung Jae Lee, Soo Jin Park, Sun Hwa Park, Sunhye Yoon, Yoonsun Kim, Yunjeong Choi, Yun Jeong Seo, Yul A Seo, Jiseon Park, Minhee Sung, Minjang Shin, Hyunjin Son, Yeonkyeng Lee, Unyeong Go, Geun-Yong Kwon
Osong Public Health Res Perspect. 2014;5(Suppl):S30-S36.   Published online December 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.10.010
  • 1,621 View
  • 17 Download
  • 5 Citations
AbstractAbstract PDF
Objectives
This study aimed to check the status of the contact investigation in congregate settings to eradicate tuberculosis (TB) in the Republic of Korea.
Methods
The “Integrated System for Disease and Public Health Management” is used for care and follow-up for patients and contacts of TB. We downloaded data for contact investigations conducted from January to December 2013.
Results
A total of 1,200 contact investigations in congregate settings were carried out by 25 field investigators in 2013. We performed the status of contact investigation, TB, and LTBI rate by age, accept rate of LTBI treatment, and complete rate of LTBI treatment during 2013. A total of 1,547 index TB patients, 149,166 contacts, and 259 additional TB patients were found through the investigation. Kindergartens showed the highest LTBI rate, 19.8%, among educational facilities. The second highest was in elementary schools and the subtotal LTBI rate of educational facilities was 7.8%. Social welfare/correctional facilities and workplaces showed relatively high LTBI rates of 23.8% and 23.6%, respectively. By age, individuals >35 years showed the highest LTBI rate, followed by those aged 0–4 years, 30–34 years, and 5–9 years, with rates of 18.1%, 16.4%, and 15.4% respectively. When comparing the tuberculin skin test (TST) positive conversion ratio by facility, middle school and high school were relatively high compared to the others. The accept rate of LTBI treatment in the workplace was lowest at 63% and the complete rate in elementary schools was lowest at 76.5%.
Conclusion
TB contact investigation is considered as a meaningful strategy for preventing TB outbreaks in congregate settings and decreasing the prevalence of TB in young people. Results of this study could be used to establish the LTBI management policy.
The Usefulness of the Tuberculosis Skin Test and the Interferon-gamma Release Assay in the Diagnosis of Latent Tuberculosis Infection in South Korea
Ju Young Jang, In Won Park, Byoung Whui Choi, Jae Chol Choi
Osong Public Health Res Perspect. 2014;5(Suppl):S18-S23.   Published online December 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.10.009
  • 1,361 View
  • 19 Download
  • 3 Citations
AbstractAbstract PDF
Objectives
South Koreans receive the bacillus Calmette-Guerin (BCG) vaccination, which influence the result of the tuberculin skin test (TST); however, only a few studies have described the usefulness of the TST and interferon-γ release assay (IGRA) for diagnosing latent TB infection (LTBI). Therefore, our aim was to determine the usefulness of the TST and IGRA for diagnosing LTBI in a household contacts investigation.
Methods
We reviewed the 329 household contacts who visited Chung-Ang University Hospital (Seoul, Korea) from May 1, 2011 to February 28, 2014. To evaluate the effectiveness of TST and IGRA for the diagnosis of LTBI, we examined the concordance rate between the two tests, based on age. We also evaluated the risk factors for LTBI.
Results
The concordance rate between the two tests in individuals 0–24 years, 25–54 years, and over 55 years were 82.6% (κ = 0.64, p < 0.01), 68.9% (κ = 0.40, p < 0.01), and 68.4% (κ = 0.35, p < 0.01), respectively. The ratio of positive TST to negative IGRA was higher in individuals 25–44 years old, whereas the ratio of negative TST to positive IGRA was higher in individuals older than 55 years old. Based on the TST, the risk factor for LTBI was a cavity (p < 0.01). When using IGRA, the risk factors were contact time (p = 0.04) and age over 55 years old (p = 0.02).
Conclusion
The concordance rate between TST and IGRA was not good after the age of 25 years. The IGRA test reflects the known risk factors more exactly.
Brief Report
Activities of the Korean Institute of Tuberculosis
Sungweon Ryoo, Hee Jin Kim
Osong Public Health Res Perspect. 2014;5(Suppl):S43-S49.   Published online December 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.10.007
  • 1,386 View
  • 17 Download
  • 12 Citations
AbstractAbstract PDF
The Korean National Tuberculosis Association (KNTA) set up the Korean Institute of Tuberculosis (KIT) in 1970 to foster research and technical activities pertaining to tuberculosis (TB). The KNTA/KIT had successfully conducted a countrywide TB prevalence survey from 1965 to 1995 at 5-year intervals. The survey results (decline in TB rates) established Korea as a country that had successfully implemented national control programs for TB. The KIT developed the Korea Tuberculosis Surveillance System and the Laboratory Management Information System, both of which were transferred to the Korea Centers for Disease Control and Prevention after its establishment. The KIT functions as a central and supranational reference TB laboratory for microbiological and epidemiological research and provides training and education for health-care workers and medical practitioners. Recently, the KIT has expanded its activities to countries such as Ethiopia, Laos, and Timor-Leste to support TB control and prevention. The KIT will continue to support research activities and provide technical assistance in diagnosing the infection until it is completely eliminated in Korea.
Original Articles
Evaluation and Comparison of Molecular and Conventional Diagnostic Tests for Detecting Tuberculosis in Korea, 2013
Sang-Hee Park, Chang-Ki Kim, Hye-Ran Jeong, Hyunjin Son, Seong-Han Kim, Mi-Sun Park
Osong Public Health Res Perspect. 2014;5(Suppl):S3-S7.   Published online December 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.10.006
  • 1,322 View
  • 16 Download
  • 7 Citations
AbstractAbstract PDF
Objectives
A fast and accurate diagnosis is necessary to control and eliminate tuberculosis (TB). In Korea, TB continues to be a serious public health problem. In this study, diagnostic tests on clinical samples from patients suspected to have TB were performed and the sensitivity and specificity of the various techniques were compared. The main objective of the study was to compare various diagnostic tests and evaluate their sensitivity and specificity for detecting tuberculosis.
Methods
From January 2013 to December 2013, 170,240 clinical samples from patients suspected to have TB were tested with smear microscopy, acid-fast bacilli culture, and real-time polymerase chain reaction (PCR). The test results were compared and data were analyzed.
Results
A total of 8216 cultures tested positive for TB (positive detection rate, 4.8%). The contamination rate in the culture was 0.6% and the isolation rate of nontuberculous mycobacteria was 1.0%. The sensitivity and specificity of smear microscopy were 56.8% and 99.6%, respectively. The concordance rate between the solid and liquid cultures was 92.8%. Mycobacterium isolates were not detected in 0.4% of the cases in the liquid culture, whereas no Mycobacterium isolates were detected in 6.8% of the cases in the solid culture. The sensitivity and specificity of real-time PCR for the solid culture were 97.2% and 72.4%, respectively, whereas the corresponding data for the liquid culture were 93.5% and 97.2%.
Conclusion
The study results can be used to improve existing TB diagnosis procedure as well as for comparing the effectiveness of the assay tests used for detecting Mycobacterium tuberculosis isolates.
What Does a Mathematical Model Tell About the Impact of Reinfection in Korean Tuberculosis Infection?
Sara Kim, Seoyun Choe, Junseong Kim, Sanga Nam, Yeon Shin, Sunmi Lee
Osong Public Health Res Perspect. 2014;5(1):40-45.   Published online February 28, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.01.002
  • 1,420 View
  • 14 Download
  • 7 Citations
AbstractAbstract PDF
Objectives
According to the Korea Centers for Disease Control and Prevention, new active tuberculosis (TB) cases have increased since 2001. Some key factors explain and characterize the transmission dynamics of Korean TB infection, such as a higher ratio of latent individuals and a new reporting system implemented in 2001, among others.
Methods
We propose a mathematical TB model that includes exogenous reinfection to gain a better understanding of the recent trend for TB incidence. We divide the simulation time window into two periods, 1970–2000 and 2001–2012, according to the implementation date of a new TB detection system.
Results
Two sets of parameters, including the transmission rate, the latent period, the recovery rate, and the proportion of exogenous reinfection, are estimated using the least-squares method and calibrated to data on the incidence of active TB.
Conclusion
Among some key parameters in the model, the case finding effort turned out to be the most significant impacting component on the reduction in the active TB cases.
Statistical Evaluation of Two Microbiological Diagnostic Methods of Pulmonary Tuberculosis After Implementation of a Directly Observed Treatment Short-course Program
Shakti Rath, Debasmita Dubey, Mahesh C. Sahu, Sudhanshu S. Mishra, Rabindra N. Padhy
Osong Public Health Res Perspect. 2013;4(1):45-51.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2012.12.004
  • 1,578 View
  • 16 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
To evaluate the diagnostic accuracy of smear and culture tests of clinical samples of pulmonary tuberculosis after the introduction of the directly observed treatment short-course (DOTS) program.
Methods
Using sputum samples from 572 individuals as a self-selected population, both Ziehl–Neelsen staining and culturing on Lowenstein–Jensen medium were carried out as diagnostic procedures. Using Bayes’ rule, the obtained data set was analyzed.
Results
Of the 572 samples, 33 (0.05769) were true positive (results of both tests positive) cases; 22 samples (0.03846) were false positive (smear test positive and culture test negative) cases; 62 samples (0.10839) were false negative (smear test negative and culture test positive) cases; and 455 samples (0.79545) were true negative (results of both tests negative) cases. Values of test statistics, sensitivity, and specificity were used to compute several inherent other Bayesian test statistics. The a priori probability or prevalence value of tuberculosis in the targeted population was 0.166. The a posteriori probability value computed arithmetically was 0.6614 and that obtained by the graphical method was 0.62.
Conclusions
The smear test was found to be dependable for 95.4% with stable TB infections, and it was not dependable for 34.7% without stable TB infections. The culture test could be regarded as the gold standard for 96.15% as seen with the data set, which was obtained after the implementation of the DOTS program.
Articles
Effect of Maternal Immune Status on Responsiveness of Bacillus Calmette-Gurin Vaccination in Mouse Neonates
Jong Su Choi, Ryang Yeo Kim, Semi Rho, Fanny Ewann, Nathalie Mielcarek, Man Ki Song, Cecil Czerkinsky, Jae-Ouk Kim
Osong Public Health Res Perspect. 2012;3(2):68-73.   Published online June 30, 2012
DOI: https://doi.org/10.1016/j.phrp.2012.01.008
  • 1,343 View
  • 17 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
Bacillus Calmette-Guérin (BCG) vaccination has proven to be efficient in immunologically naïve infants; however, it has not been investigated that maternal natural exposure to Mycobacterium and/or BCG vaccine could influence the characteristics of immune responses to BCG in newborns. In this study, we analyzed whether the maternal immune status to M tuberculosis (M tb) can affect neonatal immunity to BCG using a mouse model.
Methods
Neonates were obtained from mice that were previously exposed to live BCG, to live M avium, or to heat-killed M tb H37Rv, and from naïve control mothers. One week after birth, the neonates were divided into two subgroups: one group immunized with live BCG via the subcutaneous route and the other group of neonates sham-treated. Interferon-gamma (IFNγ) secretion in response to in vitro stimulation with heat-killed BCG or purified protein derivative (PPD) was examined. Protection against M tb infection was evaluated by challenging mice nasally with live M tb H37Rv followed by counting colonies from spleen and lung homogenates.
Results
BCG-immunized neonates showed increased IFNγ secretion in response to heat-killed BCG or PPD. All mice in BCG-immunized neonates subgroups showed reduced bacterial burden (colony forming unit) in the lungs when compared with control naive neonate mice. However, no statistically significant difference was observed when comparing BCG-immunized mice born from mothers previously exposed to M avium or immunized with either heat-killed H37Rv or live BCG and mice born from naïve mothers.
Conclusion
The maternal immune status to M tb does not appear to impact on the immunogenicity of BCG vaccine in their progeny in our experimental conditions

PHRP : Osong Public Health and Research Perspectives