Tuberculosis (TB) in Korea remains a serious health problem with an estimated 77 per 100,000 incidence rate for 2016. This makes Korea as the only OECD country with high incidence of TB. The government has increased budgets and strengthened patient management policies since 2011. The management of latent tuberculosis was added to the response with strengthened and extensive contact investigations in the five-year tuberculosis control plan (2013–2017) and implementation was established in 2013. Due to these efforts Korea has achieved an average 5.2% reduction annually in tuberculosis incidence rate between 2011 and 2016. To further expedite the reduction of the TB burden the government has introduced additional measures including mandatory screening of latent tuberculosis infection for community workers in congregate settings including daycare centers for children, kindergarten, and teachers in schools and health care workers in clinics and hospitals to solve the problems identified through contact investigations in 2017.Providing high quality free diagnosis and treatment of active TB including for multidrug resistant TB combined with active contact investigations is the mainstay of the current programmatic response in Korea. However, the limitation of existing tools for LTBI pose challenge including absence of best mechanism for effective communication with professionals and the public, the need for at least 3 months of treatment and the risk of side effects. Developing effective tools will help to overcome these challenges.
We report the first 7,755 patients with confirmed COVID-19 in Korea as of March 12 th , 2020. A total of 66 deaths have been recorded, giving a case fatality proportion of 0.9%. Older people, and those with comorbidities were at a higher risk of a fatal outcome. The highest number of cases of COVID-19 were in Daegu, followed by Gyeongbuk. This summary may help to understand the disease dynamics in the early phase of the COVID-19 outbreaks, and may therefore, guide future public health measures.
Contact investigation is an important and effective active case-finding strategy, but there is a lack of research on congregate settings in countries with an intermediate incidence. this study determined the incidence of and risk factors for tuberculosis (tB) development after exposure in congregate settings. This retrospective cohort study included 116,742 contacts identified during the investigation of 2,609 TB cases diagnosed from January to December 2015. We searched the Korean National Tuberculosis Surveillance System tB registry to identify contacts that developed active tB during follow-up until May 2018. During the mean observation period of 2.9 years, 499 of 116,742 contacts (0.4%) developed new active TB. From these contacts, 404 (81.0%) developed TB within 2 years after exposure. The 2-year Kaplan-Meier cumulative risk for tB was the highest in contacts aged ≥65 years [1%; 95% confidence interval (CI), 0.8-1.3]. Contacts with LTBI who completed chemoprophylaxis exhibited a lower risk of active TB development than those without chemoprophylaxis (adjusted hazard ratio, 0.16; 95% CI, 0.08-0.29). Aggressive contact investigation is effective for the early detection and prevention of TB in congregate settings. the risk of progression to active tB among contacts with LtBi can be minimised by the completion of chemoprophylaxis. Tuberculosis (TB) imposes a high global disease burden, with more than 10 million new patients and 1.6 million annual deaths worldwide 1. The global burden of latent TB infection (LTBI) was 23.0%, amounting to approximately 1.7 billion people. WHO SouthEast Asia, Western-Pacific, and Africa regions had the highest prevalence and accounted for approximately 80% of those with LTBI 1,2. Although the incidence of TB in the Republic of Korea (ROK) has decreased from 89 per 100,000 in 2013 to 70 per 100,000 in 2017, it remains greater than that in any other country within the Organization for Economic Cooperation and Development nations 1,3. Generally, 5-10% individuals with LTBI develop active TB in their lifetime, with 50% developing active disease within 2 years after infection 4-6. Thus, the management of recent contacts of patients with infectious TB is important for the overall management of TB. The World Health Organization (WHO) recommends that tests and treatments for LTBI should be prioritised for contacts of TB patients 7. The Korea Centers for Disease Control and Prevention (KCDC) established a TB epidemic investigation team in 2013. Between 2013 and 2017, there were 12,447 investigations with about 700,000 contacts 8. However, follow-up research addressing TB incidence among contacts residing in areas with intermediate-level TB incidence is lacking, and most studies have addressed household contacts, with a lack of discussion regarding the TB incidence and relevant risk factors among contacts in congregate settings 9-11. The present study aimed to analyse the TB incidence in individuals who had contact with TB cases in congregate settings and evaluate the risk factors that influ...
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