Journal of Society of Preventive Korean Medicine (대한예방한의학회지)

Society of Preventive Korean Medicine (대한예방한의학회)
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Prevalence size and risk factors for latent tuberculosis infection among Korean Medicine workers

한의의료기관 종사자의 잠복결핵감염 유병규모 및 위험인자

  • Hojung Lee (Department of Applied Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University) ;
  • Chunhoo Cheon (Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kwan-Il Kim (Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University Medical Center, Kyung Hee University) ;
  • Joowon Hwang (Chungpoong Korean Medical Clinic) ;
  • Bo-Hyoung Jang (Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University)
  • 이호정 (경희대학교 대학원 한의과대학 한방응용의학과) ;
  • 전천후 (경희대학교 한의과대학 예방의학교실) ;
  • 김관일 (경희대학교한방병원 폐장호흡내과) ;
  • 황주원 (청풍한의원) ;
  • 장보형 (경희대학교 한의과대학 예방의학교실)
  • Received : 2024.07.25
  • Accepted : 2024.08.23
  • Published : 2024.08.31
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Abstract

Background : Tuberculosis (TB) remains a significant public health issue worldwide, particularly among healthcare workers (HCWs) at high risk of exposure. Latent tuberculosis infection (LTBI) is a state where individuals are infected with Mycobacterium tuberculosis but do not show clinical symptoms. Early detection and treatment of LTBI are crucial to prevent progression to active TB. This study aimed to investigate the prevalence and risk factors of LTBI among Korean Medicine (KM) workers in Seoul, South Korea. Methods : This study analyzed 368 adults aged 19 and over working in Korean medicine institutions in Seoul by September 2023. Participants underwent a tuberculin skin test (TST) and completed a survey collecting demographic information, occupation, work duration, smoking status, BCG vaccination, TB history, and comorbidities. Data were analyzed using descriptive statistics and chi-square tests, with significance set at p < 0.05. Results : The average age of participants was 43.1 years, with an LTBI prevalence rate of 3.5%. Significant risk factors included age and history of TB, Older age and a history of TB were associated with higher LTBI positivity. Conclusion : The study identified the prevalence and risk factors of LTBI among Korean medicine workers in Seoul. The findings highlight the need for targeted LTBI screening and preventive measures, especially for older workers and those with a history of TB. While the prevalence was lower than in other healthcare settings, the results emphasize the importance of regular LTBI testing and prevention education for KM workers. Future large-scale studies are needed to confirm these findings and further understand the relationship between various risk factors and LTBI in KM settings.

Keywords

Acknowledgement

자료수집에 도움을 주신 서울시한의사회 감염병위원회(남호문, 박지나, 양운호) 및 강오석, 곽도원, 김경태, 김동묵, 김성민, 사원창, 양태규, 윤홍일, 이세연, 이종안, 정유옹, 최동일, 최원철 원장님께 감사드립니다.

References

  1. World Health Organization. Global tuberculosis report 2023. Geneva: World Health Organization; 2023.
  2. Korea Disease Control and Prevention Agency, Tuberculosis Policy Division. 2024 National Tuberculosis Control Guidelines. Seoul: Korea Centers for Diseases Control and Prevention Agency; 2024.
  3. World Health Organization. Latent Tuberculosis Infection: Updated and Consolidated Guidelines for Programmatic Management. Geneva: World Health Organization; 2018.
  4. Corbett EL, Muzangwa J, Chaka K, Daborn E, Munyati SS, Churchyard GJ, et al. Nursing and community rates of Mycobacterium tuberculosis infection among students in Harare, Zimbabwe. Clin Infect Dis. 2007;44(3): 317-23. https://doi.org/10.1086/509926
  5. Szturmowicz M, Broniarek-Samson B, Demkow U. Prevalence and Risk Factors for Latent Tuberculosis in Polish Healthcare Workers: The Comparison of Tuberculin Skin Test and Interferon-Gamma Release Assay (IGRA) Performance. J Occup Med Toxicol. 2021;16:38-49. https://doi.org/10.1186/s12995-021-00326-y
  6. Yang H, Park H. Factors Influencing the Initiation and Adherence of LTBI Treatment in Healthcare Workers: A Systematic Review. Arch Environ Occup Health. 2022;77(1):76-85. https://doi.org/10.1080/19338244.2021.1943642
  7. Uden L, Barber E, Ford N, Cooke GS. Risk of Tuberculosis Infection and Disease for Health Care Workers: An Updated Meta-Analysis. Open Forum Infect Dis. 2017;4(3):ofx137.
  8. Jeon D. Latent Tuberculosis Infection: Recent Progress and Challenges in South Korea. Korean J Intern Med. 2020;35(2):269-83. https://doi.org/10.3904/kjim.2020.029
  9. Kim S, Choi H, Jang YJ, Park SH, Lee H. Prevalence of and Factors Related to Latent Tuberculous Infection among all Employees in a Referral Hospital. Int J Tuberc Lung Dis. 2018;22(11):1329-35. https://doi.org/10.5588/ijtld.18.0047
  10. Yeon JH, Seong H, Hur H, Park YS, Kim YA, Park YS, et al. Prevalence and Risk Factors of Latent Tuberculosis among Korean Healthcare Workers using Whole-Blood Interferon-γ Release Assay. Sci Rep. 2018;8(1):10113.
  11. Park JS. The Prevalence and Risk Factors of Latent Tuberculosis Infection among Health Care Workers Working in a Tertiary Hospital in South Korea. Tuberc Respir Dis (Seoul). 2018;81(4):274-80. https://doi.org/10.4046/trd.2018.0020
  12. Kim SY, Park MS, Kim YS, Kim SK, Chang J, Yong D, et al. Tuberculin Skin Test and Boosted Reactions among Newly Employed Healthcare Workers: An Observational Study. PLoS One. 2013;8(5):e64563.
  13. Min J, Kim HW, Choi JY, Shin AY, Kang JY, Lee Y, et al. Latent Tuberculosis Cascade of Care among Healthcare Workers: A Nationwide Cohort Analysis in Korea between 2017 and 2018. J Korean Med Sci. 2022;37(20):e164.
  14. Lee JB, Choi JS. Analysis of Prevalence and Risk Factors for Latent Tuberculosis Infection among Healthcare Workers. J Korean Biol Nurs Sci. 2019;21(4):300-8.
  15. Lee S, Lee YL, Kim YC, Kim EJ, Heo JY, Choi YH. Prevalence and risk factors of latent tuberculosis infection among healthcare workers. Korean J Healthc Assoc Infect Control Prev. 2019;24(2):52-9. https://doi.org/10.14192/kjicp.2019.24.2.52
  16. Kim YJ, Chi YH, Lee JY, Lee HJ, Kang JY, Kim YR, et al. In-Hospital Contact Investigation among Health Care Workers After Exposure to Pulmonary Tuberculosis in an Intermediate Tuberculosis Prevalence Area: A Prospective Study. Arch Environ Occup Health. 2017;72(2):112-8. https://doi.org/10.1080/19338244.2016.1217823
  17. Getahun H, Matteelli A, Chaisson RE, Raviglione M. Latent Mycobacterium tuberculosis infection. N Engl J Med. 2015;372(22):2127-35. https://doi.org/10.1056/NEJMra1405427
  18. Carranza C, Pedraza-Sanchez S, De OyarzabalMendez E, Torres M. Diagnosis for Latent Tuberculosis Infection: New Alternatives. Front Immunol. 2020;11:2006.
  19. Smith R, Cattamanchi A, Steingart KR, Denkinger C, Dheda K, Winthrop KL, Pai M. Interferon-γ release assays for diagnosis of latent tuberculosis infection: evidence in immune-mediated inflammatory disorders. Curr Opin Rheumatol. 2011 Jul;23(4):377-84. https://doi.org/10.1097/BOR.0b013e3283474d62
  20. Loureiro RB, Maciel ELN, Caetano R, Peres RL, Fregona G, Golub JE, et al. Cost-effectiveness of QuantiFERON-TB Gold in-tube versus tuberculin skin test for diagnosis and treatment of latent tuberculosis infection in primary health care workers in Brazil. PLoS One. 2019;14(11):e0225197.
  21. Zwerling A, van den Hof S, Scholten J, Cobelens F, Menzies D, Pai M. Interferon-gamma release assays for tuberculosis screening of healthcare workers: a systematic review. Thorax. 2012;67(1):62-70. https://doi.org/10.1136/thx.2010.143180
  22. Mattos de Souza F, Nascimento do Prado T, dos Santos Pinheiro J, Peres RL, Lacerda TC, Loureiro RB, et al. Comparison of Interferon-γ Release Assay to Two Cut-Off Points of Tuberculin Skin Test to Detect Latent Mycobacterium tuberculosis Infection in Primary Health Care Workers. PLoS One. 2014;9(8):e102773.
  23. Sterling TR, Villarino ME, Borisov AS, Shang N, Gordin F, Bliven-Sizemore E, Hackman J, Hamilton CD, Menzies D, Kerrigan A, Weis SE, Weiner M, Wing D, Conde MB, Bozeman L, Horsburgh CR Jr, Chaisson RE; TB Trials Consortium PREVENT TB Study Team. Three months of rifapentine and isoniazid for latent tuberculosis infection. N Engl J Med. 2011;365(23):2155-66. https://doi.org/10.1056/NEJMoa1104875
  24. Casas I, Esteve M, Guerola R, Latorre I, Villar-Hernandez R, Mena G, et al. Serial testing of health care workers for tuberculosis infection: a prospective cohort study. PLoS One. 2020;15(7):e0235986.
  25. Rangaka MX, Wilkinson KA, Glynn JR, Ling D, Menzies D, Mwansa-Kambafwile J, Fielding K, Wilkinson RJ, Pai M. Predictive value of interferon-γ release assays for incident active tuberculosis: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(1):45-55. https://doi.org/10.1016/S1473-3099(11)70210-9
  26. Arguello Perez E, Seo SK, Schneider WJ, Eisenstein C, Brown AE. Management of Latent Tuberculosis Infection Among Healthcare Workers: 10-Year Experience at a Single Center. Clin Infect Dis. 2017;65(12):2105-11. https://doi.org/10.1093/cid/cix725
  27. Kunst H, Khan KS. Age-related risk of hepatotoxicity in the treatment of latent tuberculosis infection: a systematic review. Int J Tuberc Lung Dis. 2010;14(11):1374-81.
  28. Zhang X, Jia H, Liu F, Pan L, Xing A, Gu S, et al. Prevalence and Risk Factors for Latent Tuberculosis Infection among Health Care Workers in China: A Cross-Sectional Study. PLoS One. 2013;8(6):e66412.
  29. Diefenbach-Elstob TR, Alabdulkarim B, DebRinker P, Pernica JM, Schwarzer G, Menzies D, et al. Risk of latent and active tuberculosis infection in travellers: a systematic review and meta-analysis. J Travel Med. 2021;28(2):taaa214.
  30. Diel R, Nienhaus A. Risk of tuberculosis transmission by healthcare workers to children - a comprehensive review. Pneumologie. 2020;74(12):758-70.
  31. Cho Y, Sohn Y, Hyun J, Baek Y, Kim M, Kim J, Ahn J, Jeong S, Ku N, Yeom J, Choi J. A retrospective descriptive study on the status of active tuberculosis among healthcare workers in a tertiary hospital. Korean J healthc assoc Infect Control Prev. 2021;26(2):89-95. https://doi.org/10.14192/kjicp.2021.26.2.89
  32. Jo K, Hong Y, Park JS, Bae I, Eom JS, Lee S, Cho O, Choo EJ, Heo JY, Woo JH, Shim TS. Prevalence of latent tuberculosis infection among health care workers in south korea: A multicenter study. Tuberc Respir Dis. 2013;75:18-24 https://doi.org/10.4046/trd.2013.75.1.18
  33. Youssef E, Wooltorton E. Serious allergic reactions following tuberculin skin tests. Canadian Medical Association Journal. 2005;173 (1):34.
  34. Whitaker JA, Mirtskhulava V, Kipiani M, Harris DA, Tabagari N, Kempker RR, Blumberg HM. Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers. PLoS ONE. 2013;8(3):e58202.
  35. Nasreen S, Shokoohi M, Malvankar-Mehta MS. Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis. PLoS One. 2016;11(10):e0164034.
  36. Apriani L, McAllister S, Sharples K, Alisjahbana B, Ruslami R, Hill PC, Menzies D. Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review. Eur Respir J. 2019;53(4):1801789.
  37. Mongkolrattanothai T, Lambert LA, Winston CA. Tuberculosis among healthcare personnel, United States, 2010-2016. Infect Control Hosp Epidemiol. 2019;40(6):701-704. https://doi.org/10.1017/ice.2019.76