Clinical profiles and outcomes of pulmonary tuberculosis patients with delayed treatment at a tertiary hospital in South Korea

Kim, Sun‐Hyung; Min, Jinsoo; Cho, Jun Yeun; Kang, Hyeran; Yang, Bumhee; Shin, Yongjin; Choe, Kang Hyeon; Lee, Ki Man

doi:10.21037/apm-20-1521

Cited by 9 publications

(8 citation statements)

References 20 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Presentation delays in our result were similar to the findings of a previous Korean single-center study, which was conducted before the COVID-19 pandemic. 12 It is assumed that since TB and COVID-19 share similar symptoms, patients presenting these symptoms have become a high alert during the pandemic and thus had priority and relatively easy access to hospitals during the early pandemic in Korea. This could also be ascribed to Korea’s ability to have rapidly achieved disease control in early 2020 without a lockdown.…”

Section: Discussionmentioning

confidence: 99%

Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study

Min

Kim

et al. 2022

J Korean Med Sci

Self Cite

View full text Add to dashboard Cite

Background The coronavirus disease 2019 (COVID-19) pandemic caused disruptions to healthcare systems, consequently endangering tuberculosis (TB) control. We investigated delays in TB treatment among notified patients during the first wave of the COVID-19 pandemic in Korea. Methods We systemically collected and analyzed data from the Korea TB cohort database from January to May 2020. Groups were categorized as ‘before-pandemic’ and ‘during-pandemic’ based on TB notification period. Presentation delay was defined as the period between initial onset of symptoms and the first hospital visit, and healthcare delay as the period between the first hospital visit and anti-TB treatment initiation. A multivariate logistic regression analysis was performed to evaluate factors associated with delays in TB treatment. Results Proportion of presentation delay > 14 days was not significantly different between two groups (48.3% vs. 43.7%, P = 0.067); however, proportion of healthcare delay > 5 days was significantly higher in the during-pandemic group (48.6% vs. 42.3%, P = 0.012). In multivariate analysis, the during-pandemic group was significantly associated with healthcare delay > 5 days (adjusted odds ratio = 0.884, 95% confidence interval = 0.715–1.094). Conclusion The COVID-19 pandemic was associated with healthcare delay of > 5 days in Korea. Public health interventions are necessary to minimize the pandemic’s impact on the national TB control project.

show abstract

Section: Discussionmentioning

confidence: 99%

Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study

Min

Kim

et al. 2022

J Korean Med Sci

Self Cite

View full text Add to dashboard Cite

show abstract

“…Delayed diagnosis of TB is an important issue in healthcare settings, because it increases the morbidity and mortality rates of patients and in-hospital transmission of TB [ 3 , 4 , 5 ]. The WHO reported that the risk of TB infection in healthcare workers (HCWs) was 2–10 times higher than that in the general population [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors and Clinical Impacts of Delayed Isolation of Tuberculosis during Hospital Admission

Lee

Kang

Chin

et al. 2023

JCM

View full text Add to dashboard Cite

Delayed isolation of tuberculosis (TB) can cause unexpected exposure of healthcare workers (HCWs). This study identified the predictive factors and clinical impact of delayed isolation. We retrospectively reviewed the electronic medical records of index patients and HCWs who underwent contact investigation after TB exposure during hospitalization at the National Medical Center, between January 2018 and July 2021. Among the 25 index patients, 23 (92.0%) were diagnosed with TB based on the molecular assay, and 18 (72.0%) had a negative acid-fast bacilli smear. Sixteen (64.0%) patients were hospitalized via the emergency room, and 18 (72.0%) were admitted to a non-pulmonology/infectious disease department. According to the patterns of delayed isolation, patients were classified into five categories. Among 157 close-contact events in 125 HCWs, 75 (47.8%) occurred in Category A. Twenty-five (20%) HCWs had multiple TB exposures (n = 57 events), of whom 37 (64.9%) belonged to Category A (missed during emergency situations). After contact tracing, latent TB infection was diagnosed in one (1.2%) HCW in Category A, who was exposed during intubation. Delayed isolation and TB exposure mostly occurred during pre-admission in emergency situations. Effective TB screening and infection control are necessary to protect HCWs, especially those who routinely contact new patients in high-risk departments.

show abstract

“…Unfortunately, these findings are not informative for South Korea, a high-income country with intermediate burden. Moreover, no nationwide epidemiological study on this topic has been conducted in Korea, and it has only been reported based on regional data 21 , 22 .…”

Section: Introductionmentioning

confidence: 99%

Time delays and risk factors in the management of patients with active pulmonary tuberculosis: nationwide cohort study

Min

Kim

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

Estimating the time delay and identifying associated factors is essential for effective tuberculosis control. We systemically analysed data obtained from the Korea Tuberculosis Cohort in 2019 by classifying delays as presentation and healthcare delays of pulmonary tuberculosis (PTB). Of 6593 patients with active PTB, presentation and healthcare delays were recorded in 4151 and 5571 patients, respectively. The median presentation delay was 16.0 (5.0–40.0) days. Multivariable logistic regression analysis showed that longer presentation delays were associated with neuropsychiatric disease [adjusted odds ratio (OR) 2.098; 95% confidence interval (CI) 1.639–2.687; p < 0.001] and heavy alcohol intake (adjusted OR 1.505; 95% CI 1.187–1.907; p < 0.001). The median healthcare delay was 5.0 (1.0–14.0) days. A longer healthcare delay was associated with malignancy (adjusted OR 1.351; 95% CI 1.069–1.709; p = 0.012), autoimmune disease (adjusted OR 2.445; 95% CI 1.295–4.617; p = 0.006), and low bacterial burden manifested as an acid-fast bacillus smear-negative and tuberculosis polymerase chain reaction-negative status (adjusted OR 1.316; 95% CI 1.104–1.569; p = 0.002). Active case-finding programmes need to focus on patients with heavy alcoholism or neuropsychiatric diseases. To ensure early PTB detection, healthcare providers must carefully monitor patients with malignancy, autoimmune disease, or a high index of suspicion for PTB.

show abstract

Clinical profiles and outcomes of pulmonary tuberculosis patients with delayed treatment at a tertiary hospital in South Korea

Cited by 9 publications

References 20 publications

Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study

Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study

Predictive Factors and Clinical Impacts of Delayed Isolation of Tuberculosis during Hospital Admission

Time delays and risk factors in the management of patients with active pulmonary tuberculosis: nationwide cohort study

Contact Info

Product

Resources

About