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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
  • 4,491 View
  • 146 Download
  • 4 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.

Citations

Citations to this article as recorded by  
  • Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study
    Jinsoo Min, Yousang Ko, Hyung Woo Kim, Hyeon-Kyoung Koo, Jee Youn Oh, Yun-Jeong Jeong, Hyeon Hui Kang, Kwang Joo Park, Yong Il Hwang, Jin Woo Kim, Joong Hyun Ahn, Yangjin Jegal, Ji Young Kang, Sung-Soon Lee, Jae Seuk Park, Ju Sang Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Time trend prediction and spatial–temporal analysis of multidrug-resistant tuberculosis in Guizhou Province, China, during 2014–2020
    Wang Yun, Chen Huijuan, Liao Long, Lu Xiaolong, Zhang Aihua
    BMC Infectious Diseases.2022;[Epub]     CrossRef
  • Real-world association of adherence with outcomes and economic burden in patients with tuberculosis from South Korea claims data
    Sun-Hong Kwon, Jin Hyun Nam, Hye-Lin Kim, Hae-Young Park, Jin-Won Kwon
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • The Impact of the COVID-19 Pandemic on Tuberculosis Case Notification and Treatment Outcomes in Eswatini
    Hloniphile Victory Masina, I-Feng Lin, Li-Yin Chien
    International Journal of Public Health.2022;[Epub]     CrossRef
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
  • 5,035 View
  • 139 Download
  • 4 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.

Citations

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  • Knowledge, Attitudes, and Preventative Behavior Toward Tuberculosis in University Students in Indonesia
    Irma Melyani Puspitasari, Rano Kurnia Sinuraya, Arini Nurhaqiqi Aminudin, Rika Rahmi Kamilah
    Infection and Drug Resistance.2022; Volume 15: 4721.     CrossRef
  • Factors Affecting Preventive Behavior related to Tuberculosis among University Students in Korea: Focused on Knowledge, Attitude and Optimistic Bias related to Tuberculosis
    Myung Soon Kwon, Yun Choi
    Journal of Korean Academy of Fundamentals of Nursi.2020; 27(3): 236.     CrossRef
  • Assessment of knowledge, attitude and practice on tuberculosis among teacher trainees of Samtse College of Education, Bhutan
    Thinley Dorji, Tandin Tshering, Kinley Wangdi, Ritesh G. Menezes
    PLOS ONE.2020; 15(11): e0241923.     CrossRef
  • The Infectivity of Pulmonary Tuberculosis in Korean Army Units: Evidence from Outbreak Investigations
    Chang-gyo Yoon, Dong Yoon Kang, Jaehun Jung, Soo Yon Oh, Jin Beom Lee, Mi-Hyun Kim, Younsuk Seo, Hee-Jin Kim
    Tuberculosis and Respiratory Diseases.2019; 82(4): 298.     CrossRef
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
  • 3,101 View
  • 28 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.

Citations

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  • Spatio-temporal epidemiology of the tuberculosis incidence rate in Iran 2008 to 2018
    Behzad Kiani, Amene Raouf Rahmati, Robert Bergquist, Soheil Hashtarkhani, Neda Firouraghi, Nasser Bagheri, Elham Moghaddas, Alireza Mohammadi
    BMC Public Health.2021;[Epub]     CrossRef
  • An Analysis of the Survival Probability of Tuberculosis Patients with Right Censored and Interval Censored Observation in Zahedan during 2014 - 2016
    Mohammad Hossein Dehghan, Seyyed Mohammad Hashemi Shahri, Mojgan Salari
    Zahedan Journal of Research in Medical Sciences.2019;[Epub]     CrossRef
  • Extent and determinants of catastrophic health expenditure for tuberculosis care in Chongqing municipality, China: a cross-sectional study
    Weixia Duan, Wen Zhang, Chengguo Wu, Qingya Wang, Ya Yu, Hui Lin, Ying Liu, Daiyu Hu
    BMJ Open.2019; 9(4): e026638.     CrossRef
  • Demographic, socio-economic and behavior as risk factors of tuberculosis in Malaysia: a systematic review of the literature
    Nur Adibah Mohidem, Zailina Hashim, Malina Osman, Rafiza Shaharudin, Farrah Melissa Muharam, Punitha Makeswaran
    Reviews on Environmental Health.2018; 33(4): 407.     CrossRef
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
  • 2,508 View
  • 24 Download
  • 4 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.

Citations

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  • Mycobacterium tuberculosis PPE7 Enhances Intracellular Survival of Mycobacterium smegmatis and Manipulates Host Cell Cytokine Secretion Through Nuclear Factor Kappa B and Mitogen-Activated Protein Kinase Signaling
    Jing Suo, Xinyan Wang, Rongchuan Zhao, Pengjiao Ma, Liang Ge, Tao Luo
    Journal of Interferon & Cytokine Research.2022; 42(10): 525.     CrossRef
  • The burden of pre-extensively and extensively drug-resistant tuberculosis among MDR-TB patients in the Amhara region, Ethiopia
    Agumas Shibabaw, Baye Gelaw, Wondwossen Gebreyes, Richard Robinson, Shu-Hua Wang, Belay Tessema, Shampa Anupurba
    PLOS ONE.2020; 15(2): e0229040.     CrossRef
  • Spoligotype and Drug Susceptibility Profiles of Mycobacterium tuberculosis Complex Isolates in Golestan Province, North Iran


    Noormohamad Mansoori, Farzam Vaziri, Sirus Amini, Sharareh Khanipour, Shahin Pourazar Dizaji, Masoumeh Douraghi
    Infection and Drug Resistance.2020; Volume 13: 2073.     CrossRef
  • A comparative study of phenotypic and genotypic first- and second-line drug resistance testing of Mycobacterium tuberculosis
    Fatemeh Sakhaee, Morteza Ghazanfari, Nayereh Ebrahimzadeh, Farzam Vaziri, Fatemeh Rahimi Jamnani, Mehdi Davari, Safoora Gharibzadeh, Fatemeh Hemati Mandjin, Abolfazl Fateh, Seyed Davar Siadat
    Biologicals.2017; 49: 33.     CrossRef
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
  • 2,596 View
  • 22 Download
  • 17 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.

Citations

Citations to this article as recorded by  
  • Cohort Profile: Korean Tuberculosis and Post-Tuberculosis Cohort Constructed by Linking the Korean National Tuberculosis Surveillance System and National Health Information Database
    Dawoon Jeong, Hee-Yeon Kang, Jinsun Kim, Hyewon Lee, Bit-Na Yoo, Hee-Sun Kim, Hongjo Choi
    Journal of Preventive Medicine and Public Health.2022; 55(3): 253.     CrossRef
  • Hidden loss to follow-up among tuberculosis patients managed by public–private mix institutions in South Korea
    Hyung Woo Kim, Sohee Park, Jinsoo Min, Jiyu Sun, Ah Young Shin, Jick Hwan Ha, Jae Seuk Park, Sung-Soon Lee, Marc Lipman, Ibrahim Abubakar, Helen R. Stagg, Ju Sang Kim
    Scientific Reports.2022;[Epub]     CrossRef
  • Assessing the Quality of Reporting to China’s National TB Surveillance Systems
    Tao Li, Lijia Yang, Sarah E. Smith-Jeffcoat, Alice Wang, Hui Guo, Wei Chen, Xin Du, Hui Zhang
    International Journal of Environmental Research an.2021; 18(5): 2264.     CrossRef
  • Quality and Utility of Information Captured by Surveillance Systems Relevant to Antimicrobial Resistance (AMR): A Systematic Review
    Mustafa Al-Haboubi, Rebecca E. Glover, Elizabeth Eastmure, Mark Petticrew, Nick Black, Nicholas Mays
    Antibiotics.2021; 10(4): 431.     CrossRef
  • Risk of tuberculosis in patients with cancer treated with immune checkpoint inhibitors: a nationwide observational study
    Seongman Bae, Ye-Jee Kim, Min-ju Kim, Jwa Hoon Kim, Sung-Cheol Yun, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sung-Han Kim, Sang-Ho Choi, Yang Soo Kim, Sang-Oh Lee
    Journal for ImmunoTherapy of Cancer.2021; 9(9): e002960.     CrossRef
  • Underreporting of patients diagnosed with tuberculosis in the Region of Southern Denmark
    Frederik D. Thrane, Peter H. Andersen, Isik S. Johansen, Inge K. Holden
    Scandinavian Journal of Public Health.2020; 48(8): 870.     CrossRef
  • Effects of particulate air pollution on tuberculosis development in seven major cities of Korea from 2010 to 2016: methodological considerations involving long-term exposure and time lag
    Honghyok Kim, Sarah Yu, Hongjo Choi
    Epidemiology and Health.2020; 42: e2020012.     CrossRef
  • Latent tuberculosis infection screening and treatment in congregate settings (TB FREE COREA): protocol for a prospective observational study in Korea
    Jinsoo Min, Hyung Woo Kim, Helen R Stagg, Marc Lipman, Molebogeng X Rangaka, Jun-Pyo Myong, Hyeon Woo Yim, Jeong Uk Lim, Yunhee Lee, Hyeon-Kyoung Koo, Sung-Soon Lee, Jae Seuk Park, Kyung Sook Cho, Ju Sang Kim
    BMJ Open.2020; 10(2): e034098.     CrossRef
  • Tuberculosis Surveillance and Monitoring under the National Public-Private Mix Tuberculosis Control Project in South Korea 2016–2017
    Jinsoo Min, Hyung Woo Kim, Yousang Ko, Jee Youn Oh, Ji Young Kang, Joosun Lee, Young Joon Park, Sung-Soon Lee, Jae Seuk Park, Ju Sang Kim
    Tuberculosis and Respiratory Diseases.2020; 83(3): 218.     CrossRef
  • Prediction of treatment failure and compliance in patients with tuberculosis
    Hyeon-Kyoung Koo, Jinsoo Min, Hyung Woo Kim, Joosun Lee, Ju Sang Kim, Jae Seuk Park, Sung-Soon Lee
    BMC Infectious Diseases.2020;[Epub]     CrossRef
  • Impact of COVID-19 Pandemic on the National PPM Tuberculosis Control Project in Korea: the Korean PPM Monitoring Database between July 2019 and June 2020
    Jinsoo Min, Hyung Woo Kim, Hyeon-Kyoung Koo, Yousang Ko, Jee Youn Oh, Jaetae Kim, Jiyeon Yang, Yunhyung Kwon, Young-Joon Park, Ji Young Kang, Sung-Soon Lee, Jae Seuk Park, Ju Sang Kim
    Journal of Korean Medical Science.2020;[Epub]     CrossRef
  • Clinical profiles of early and tuberculosis-related mortality in South Korea between 2015 and 2017: a cross-sectional study
    Jinsoo Min, Ju Sang Kim, Hyung Woo Kim, Ah Young Shin, Hyeon-Kyoung Koo, Sung-Soon Lee, Yang-Ki Kim, Kyeong-Cheol Shin, Jung Hyun Chang, Gayoung Chun, Joosun Lee, Mi Sun Park, Jae Seuk Park
    BMC Infectious Diseases.2019;[Epub]     CrossRef
  • Treatment outcomes and factors affecting treatment outcomes of new patients with tuberculosis in Busan, South Korea: a retrospective study of a citywide registry, 2014–2015
    Jeongha Mok, Daeseong An, Seoungjin Kim, Miyoung Lee, Changhoon Kim, Hyunjin Son
    BMC Infectious Diseases.2018;[Epub]     CrossRef
  • Tuberculosis prevention and care in Korea: Evolution of policy and practice
    Unyeong Go, Misun Park, Un-Na Kim, Sodam Lee, Sunmi Han, Joosun Lee, Jiyeon Yang, Jieun Kim, Shinyoung Park, Youngman Kim, Hyosoon Yoo, Jeongok Cha, Wonseo Park, Haeyoung Kang, Hwon Kim, Guri Park, Minjung Kim, Ok Park, Hyunjin Son, Enhi Cho, Kyoungin Na,
    Journal of Clinical Tuberculosis and Other Mycobac.2018; 11: 28.     CrossRef
  • The relationship between multiple chronic diseases and depressive symptoms among middle-aged and elderly populations: results of a 2009 korean community health survey of 156,747 participants
    JooYeon Seo, BoYoul Choi, Shinah Kim, HyeYoung Lee, DongHoon Oh
    BMC Public Health.2017;[Epub]     CrossRef
  • Vitamin D Deficiency among Adults with History of Pulmonary Tuberculosis in Korea Based on a Nationwide Survey
    Mi Joo, Mi Han, Sun Park, Hwan Shin
    International Journal of Environmental Research an.2017; 14(4): 399.     CrossRef
  • Tuberculosis Control in the Republic of Korea
    Cho, Kyung Sook
    Health and Social Welfare Review.2017; 37(4): 179.     CrossRef
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
  • 1,994 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).

Citations

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  • The Value of the inhA Mutation Detection in Predicting Ethionamide Resistance Using Melting Curve Technology
    Yanhua Song, Guirong Wang, Qiang Li, Rongmei Liu, Liping Ma, Qi Li, Mengqiu Gao
    Infection and Drug Resistance.2021; Volume 14: 329.     CrossRef
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
  • 1,987 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.

Citations

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  • Is Tuberculosis Still the Number One Infectious Disease in Korea?
    Hae-Wol Cho, Chaeshin Chu
    Osong Public Health and Research Perspectives.2014; 5: S1.     CrossRef
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
  • 1,935 View
  • 20 Download
  • 10 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.

Citations

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  • Risk factors associated with tuberculosis recurrence in South Korea determined using a nationwide cohort study
    Hin Moi Youn, Moon-Kyung Shin, Dawoon Jeong, Hee-Jin Kim, Hongjo Choi, Young Ae Kang, Jun Hyeok Lim
    PLOS ONE.2022; 17(6): e0268290.     CrossRef
  • Predicting the impact of control strategies on the tuberculosis burden in South and North Korea using a mathematical model
    Hyunwoo Cho, Youngmok Park, Jeongjoo Seok, Joon Sup Yeom, Jun Yong Choi, Hee Jin Kim, Young Ae Kang, Jeehyun Lee
    BMJ Global Health.2021; 6(10): e005953.     CrossRef
  • Preferred product characteristics for therapeutic vaccines to improve tuberculosis treatment outcomes: Key considerations from World Health Organization consultations
    Johan Vekemans, Michael James Brennan, Mark Hatherill, Lewis Schrager, Bernard Fritzell, Kathryn Rutkowski, Beatrice De Vos, Matteo Zignol, Georges Thiry, Ann M. Ginsberg, Barry Walker
    Vaccine.2020; 38(2): 135.     CrossRef
  • Rate and risk factors of recurrent tuberculosis in Yemen: a 5-year prospective study
    Mohammed Saif Anaam, Alian A. Alrasheedy, Saud Alsahali, Saeed O. Alfadly, Adel H. Aldhubhani
    Infectious Diseases.2020; 52(3): 161.     CrossRef
  • Small Animal Model of Post-chemotherapy Tuberculosis Relapse in the Setting of HIV Co-infection
    Matthew B. Huante, Tais B. Saito, Rebecca J. Nusbaum, Kubra F. Naqvi, Sadhana Chauhan, Robert L. Hunter, Jeffrey K. Actor, Jai S. Rudra, Mark A. Endsley, Joshua G. Lisinicchia, Benjamin B. Gelman, Janice J. Endsley
    Frontiers in Cellular and Infection Microbiology.2020;[Epub]     CrossRef
  • Proteomic analysis of infected primary human leucocytes revealed PSTK as potential treatment-monitoring marker for active and latent tuberculosis
    Benjawan Kaewseekhao, Sittiruk Roytrakul, Yodying Yingchutrakul, Kanin Salao, Wipa Reechaipichitkul, Kiatichai Faksri, HASNAIN SEYED EHTESHAM
    PLOS ONE.2020; 15(4): e0231834.     CrossRef
  • The association between proton pump inhibitor use and the risk of tuberculosis: A case-control study
    Hyun Jin Song, Haesuk Park, Susan Park, Jin-Won Kwon
    Pharmacoepidemiology and Drug Safety.2019; 28(6): 830.     CrossRef
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    In Young Jung, Moo Hyun Kim, Woo Yong Jeong, Mi Young Ahn, Yong Duk Jeon, Hea Won Ahn, Jin Young Ahn, Je Eun Song, Dong Hyun Oh, Yong Chan Kim, Eun Jin Kim, Su Jin Jeong, Nam Su Ku, June Myung Kim, Jun Yong Choi
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  • Is Tuberculosis Still the Number One Infectious Disease in Korea?
    Hae-Wol Cho, Chaeshin Chu
    Osong Public Health and Research Perspectives.2014; 5: S1.     CrossRef
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
  • 2,176 View
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  • 6 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.

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  • Latent Tuberculosis Cascade of Care Among Healthcare Workers: A Nationwide Cohort Analysis in Korea Between 2017 and 2018
    Jinsoo Min, Hyung Woo Kim, Joon Young Choi, Ah Young Shin, Ji Young Kang, Yunhee Lee, Jun-Pyo Myong, Hyunsuk Jeong, Sanghyuk Bae, Hyeon-Kyoung Koo, Sung-Soon Lee, Jae Seuk Park, Hyeon Woo Yim, Ju Sang Kim
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    Jae Seuk Park
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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
  • 1,860 View
  • 20 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.

Citations

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  • Household tuberculosis contact investigation in a tuberculosis-prevalent country
    Jung Seop Eom, Insu Kim, Won-Young Kim, Eun-Jung Jo, Jeongha Mok, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee
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    Selam Niguse, Kassu Desta, Gebremdihin Gebremichael, Atsebeha Gebrezgeaxier, Mulluwork Getahun, Desta Kassa
    BMC Research Notes.2018;[Epub]     CrossRef
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    Youn Jeong Kim, Ji Young Kang, Sang Il Kim, Mee Soo Chang, Yang Ree Kim, Yeon Joon Park
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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
  • 1,956 View
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  • 14 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.

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    Amer Kareem, Haiming Liu, Paul Sant
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    Ilona Karpiel, Ana Starcevic, Mirella Urzeniczok
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    Shashank Shetty, Ananthanarayana V S., Ajit Mahale
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    Mehreen Sirshar, Taimur Hassan, Muhammad Usman Akram, Shoab Ahmed Khan
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    Daniel A. Moses
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    Wasif Khan, Nazar Zaki, Luqman Ali
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    Da Eun Kwon, Sang Hoon Han, Kyung Do Han, Yeonju La, Kyoung Hwa Lee
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    Hye-jin Kim, Myung Kyung Lee
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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
  • 1,829 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.

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  • The Xpert® MTB/RIF diagnostic test for pulmonary and extrapulmonary tuberculosis in immunocompetent and immunocompromised patients: Benefits and experiences over 2 years in different clinical contexts
    Ana Paula de Oliveira Tomaz, Sonia Mara Raboni, Gislene Maria Botão Kussen, Keite da Silva Nogueira, Clea Elisa Lopes Ribeiro, Libera Maria Dalla Costa, Padmapriya P. Banada
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    Narda Medina, Ana Alastruey-Izquierdo, Danicela Mercado, Oscar Bonilla, Juan C. Pérez, Luis Aguirre, Blanca Samayoa, Eduardo Arathoon, David W. Denning, Juan Luis Rodriguez-Tudela
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    Nuntita Singpanomchai, Yukihiro Akeda, Kazunori Tomono, Aki Tamaru, Pitak Santanirand, Panan Ratthawongjirakul
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    Davood Darban-Sarokhalil, Mohammad J. Nasiri, Abbas A.I. Fooladi, Parvin Heidarieh, Mohammad M. Feizabadi
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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
  • 1,913 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.

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  • Mathematical analysis of a two-strain tuberculosis model in Bangladesh
    Md Abdul Kuddus, Emma S. McBryde, Adeshina I. Adekunle, Lisa J. White, Michael T. Meehan
    Scientific Reports.2022;[Epub]     CrossRef
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    Sunmi Lee, Hae-Young Park, Hohyung Ryu, Jin-Won Kwon
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    Md Abdul Kuddus, Michael T. Meehan, Lisa J. White, Emma S. McBryde, Adeshina I. Adekunle, Hasnain Seyed Ehtesham
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    Hae-Wol Cho, Chaeshin Chu
    Osong Public Health and Research Perspectives.2014; 5: S1.     CrossRef
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    Hae-Wol Cho, Chaeshin Chu
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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
  • 2,090 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.

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    Ya He, Ziying Gong, Xiaokai Zhao, Daoyun Zhang, Zhongshun Zhang
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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
  • 1,821 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

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    Lone Graff Stensballe, Henrik Ravn, Nina Marie Birk, Jesper Kjærgaard, Thomas Nørrelykke Nissen, Gitte Thybo Pihl, Lisbeth Marianne Thøstesen, Gorm Greisen, Dorthe Lisbeth Jeppesen, Poul-Erik Kofoed, Ole Pryds, Signe Sørup, Peter Aaby, Christine Stabell B
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    Thomas Nørrelykke Nissen, Nina Marie Birk, Jesper Kjærgaard, Lisbeth Marianne Thøstesen, Gitte Thybo Pihl, Thomas Hoffmann, Dorthe Lisbeth Jeppesen, Poul-Erik Kofoed, Gorm Greisen, Christine Stabell Benn, Peter Aaby, Ole Pryds, Lone Graff Stensballe
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PHRP : Osong Public Health and Research Perspectives