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The National Status of Tuberculosis Using Nationwide Medical Records Survey of Patients with Tuberculosis in Korea

  • Park, Yoon-Sung;Hong, Sung-Jin;Boo, Yoo-Kyung;Hwang, Eun-Suk;Kim, Hyun Jung;Cho, Seung-Hee;Na, Kyung-In;Cho, En-Hi;Shin, Sang-Sook
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.1
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    • pp.48-55
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    • 2012
  • Background: The epidemiology of tuberculosis (TB) has been assessed based on the data of the analysis of TB patients notified to the surveillance system in Korea. However, the national status of TB is not validated through this surveillance system. The objective is to determine the epidemiology of TB and to understand the accurate status of TB patients treated in private institutions. Methods: Medical records of 53,579 patients who had been diagnosed with TB in 2008 were analyzed. Results: Among 53,579 patients, the number of sputum smear positive cases was 15,639(29.2%) and the number of new cases was 39,191 (73.1%). The drug resistance rate of new cases was 5.3%, while the rate stood at 13.3% for TB patients with treatment history. The number of multi-drug resistant TB (MDR-TB) patients was 2,472 (4.6%), which consists of 2.9% of new cases and 9.3% of TB patients with prior treatment history. The number of extensively drug-resistant TB patients was 749 (1.4%), consisting of 1.1% of new cases and 2.2% of TB patients with prior treatment history. In terms of treatment outcomes, 66.4% of all TB patients, 70.5% of new cases, 64.4% of relapse cases, and 46.8% of MDR-TB cases were cured or completed. It was inferred that in 2008, the total number of TB patients reached 70,767, 145.6 per 100,000 people (95% confidence interval, 145.5~145.7). Conclusion: We conclude that the medical records review of the Health Insurance Review and Assessment Service (HIRA) data can be very effective in promoting the understanding of the current status of TB in private institutions.

Diagnosis and treatment of multidrug-resistant tuberculosis

  • Jang, Jong Geol;Chung, Jin Hong
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.277-285
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    • 2020
  • Tuberculosis (TB) is still a major health problem worldwide. Especially, multidrug-resistant TB (MDR-TB), which is defined as TB that shows resistance to both isoniazid and rifampicin, is a barrier in the treatment of TB. Globally, approximately 3.4% of new TB patients and 20% of the patients with a history of previous treatment for TB were diagnosed with MDR-TB. The treatment of MDR-TB requires medications for a long duration (up to 20-24 months) with less effective and toxic second-line drugs and has unfavorable outcomes. However, treatment outcomes are expected to improve due to the introduction of a new agent (bedaquiline), repurposed drugs (linezolid, clofazimine, and cycloserine), and technological advancement in rapid drug sensitivity testing. The World Health Organization (WHO) released a rapid communication in 2018, followed by consolidated guidelines for the treatment of MDR-TB in 2019 based on clinical trials and an individual patient data meta-analysis. In these guidelines, the WHO suggested reclassification of second-line anti-TB drugs and recommended oral treatment regimens that included the new and repurposed agents. The aims of this article are to review the treatment strategies of MDR-TB based on the 2019 WHO guidelines regarding the management of MDR-TB and the diagnostic techniques for detecting resistance, including phenotypic and molecular drug sensitivity tests.

Respiratory Review of 2014: Tuberculosis and Nontuberculous Mycobacterial Pulmonary Disease

  • Park, Cheol Kyu;Kwon, Yong Soo
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.4
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    • pp.161-166
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    • 2014
  • Since tuberculosis (TB) remains a major global health concern and the incidence of multi-drug resistant (MDR)-TB is increasing globally, new modalities for the detection of TB and drug resistant TB are needed to improve TB control. The Xpert MTB/RIF test can be a valuable new tool for early detection of TB and rifampicin resistance, with a high sensitivity and specificity. Late-generation fluoroquinolones, levofloxacin, and moxifloxacin, which are the principal drugs for the treatment of MDR-TB, show equally high efficacy and safety. Systemic steroids may reduce the overall TB mortality attributable to all forms of TB across all organ systems, although inhaled corticosteroids can increase the risk of TB development. Although fixed dose combinations were expected to reduce the risk of drug resistance and increase drug compliance, a recent meta-analysis found that they might actually increase the risk of relapse and treatment failure. Regarding treatment duration, patients with cavitation and culture positivity at 2 months of TB treatment may require more than 6 months of standard treatment. New anti-TB drugs, such as linezolid, bedaquiline, and delamanid, could improve the outcomes in drug-resistant TB. Nontuberculous mycobacterial lung disease has typical clinical and immunological phenotypes. Mycobacterial genotyping may predict disease progression, and whole genome sequencing may reveal the transmission of Mycobacterium abscessus. In refractory Mycobacterium avium complex lung disease, a moxifloxacin-containing regimen was expected to improve the treatment outcome.

Tuberculosis Infection and Latent Tuberculosis

  • Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.201-206
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    • 2016
  • Active tuberculosis (TB) has a greater burden of TB bacilli than latent TB and acts as an infection source for contacts. Latent tuberculosis infection (LTBI) is the state in which humans are infected with Mycobacterium tuberculosis without any clinical symptoms, radiological abnormality, or microbiological evidence. TB is transmissible by respiratory droplet nucleus of $1-5{\mu}m$ in diameter, containing 1-10 TB bacilli. TB transmission is affected by the strength of the infectious source, infectiousness of TB bacilli, immunoresistance of the host, environmental stresses, and biosocial factors. Infection controls to reduce TB transmission consist of managerial activities, administrative control, engineering control, environmental control, and personal protective equipment provision. However, diagnosis and treatment for LTBI as a national TB control program is an important strategy on the precondition that active TB is not missed. Therefore, more concrete evidences for LTBI management based on clinical and public perspectives are needed.

Diagnosis of Pulmonary Tuberculosis: Recent Advances and Diagnostic Algorithms

  • Ryu, Yon Ju
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.64-71
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    • 2015
  • Pulmonary tuberculosis (TB) persists as a great public health problem in Korea. Increases in the overall age of the population and the rise of drug-resistant TB have reinforced the need for rapid diagnostic improvements and new modalities to detect TB and drug-resistant TB, as well as to improve TB control. Standard guidelines and recent advances for diagnosing pulmonary TB are summarized in this article. An early and accurate diagnosis of pulmonary TB should be established using chest X-ray, sputum microscopy, culture in both liquid and solid media, and nucleic acid amplification. Chest computed tomography, histopathological examination of biopsy samples, and new molecular diagnostic tests can be used for earlier and improved diagnoses, especially in patients with smear-negative pulmonary TB or clinically-diagnosed TB and drug-resistant TB.

The Luminescence Properties of YAG:$Tb^{3+}$ Phosphor Prepared by Hydrothermal Synthesis (YAG:$Tb^{3+}$ 형광체 분말의 수열합성과 발광 특성)

  • 김상문;지성훈;구자인;김태옥
    • Journal of the Korean Ceramic Society
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    • v.37 no.8
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    • pp.745-750
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    • 2000
  • YAG:Tb3+ as green phosphor were studied for the development of low voltage FED phosphor prepared by hydrothermal synthesis. We changed the concentration of luminescence center ion Tb3+ in hydrothermal reaction of which conditions were at 8M NH4OH as mineralizer, at 35$0^{\circ}C$ for 12hrs. As results, we could finally get the YAG:Tb3+ (Y3-xTbxAl5O12) powder of which particle size was about 0.2~1.0${\mu}{\textrm}{m}$. The excitation spectra and the green emitted spectra of YAG:Tb3+ phosphor powder were observed. When we doped 0.25 mol Tb to YAG, we could observe the maximum cathodoluminescence from YAG:Tb3+ phosphor and the chromaticity coordinate of the phosphor was shown x=0.35, y=0.56 in CIE1931 diagram.

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Superconductivty and Magnetic Properties of Tb-substituted $RuSr_2(Eu_{1.34}Ce_{0.66})Cu_2O_z$ (Tb이 치환된 $RuSr_2(Eu_{1.34}Ce_{0.66})Cu_2O_z$ 계의 초전도 및 자기적 특성)

  • Lee, H.K.;Lee, M.S.
    • Progress in Superconductivity
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    • v.14 no.2
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    • pp.110-115
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    • 2012
  • Samples with nominal compositions of $RuSr_2(Eu_{1.34-x}Tb_xCe_{0.66})Cu_2O_z$ (x = 0, 0.67) were prepared and their superconductivity and magnetic properties were compared to shed light on the effect of Tb substitution for Eu. X-ray diffraction measurements indicate that the Tb substitution resulted in a decrease in both a and c lattice parameters in consistent with ionic size difference between Eu and Tb. Contrary to the Tb-free sample, no superconducting transition behavior is observed in the Tb-sustituted sample. It is also found that the Tb substitution for Eu significantly increases the weak-ferromagnetic component of the field-cooled magnetic susceptibility as well as an increase in the magnetic ordering temperature. These results suggest that the magnetic state of the Ru sublattice is significantly affected by the Tb substitution for Eu.

Electrical Conduction and Emission Properties of (tb-PMP)3Tb-(Ph3PO) Single Layer OLEDs ((tb-PMP)3Tb-(Ph3PO) 단일층 OLEDs의 전기전도 및 발광 특성)

  • Moon, Dae-Gyu
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.19 no.9
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    • pp.878-882
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    • 2006
  • We have fabricated single organic layer devices of the organolanthanide complex, terbium tris-(1-phenyl-3-methyl-4-(tertiarybutyry)pyrazol-5-one)triphenylphosphine oxide [$(tb-PMP)_{3}Tb-(Ph_{3}PO)$] for the investigation of its light emission and electrical conduction properties. The thickness of ($(tb-PMP)_{3}Tb-(Ph_{3}PO)$) layer was varied to 60, 75, 95 nm. Mg and Ca layers were used for the cathode contact. The electrical conduction in the $(tb-PMP)_{3}Tb-(Ph_{3}PO)$ single layer devices was dominated by the injection of electrons into the organic layer from the cathode. A higher current density at much lower voltages can be attained with Ca cathode because of the enhanced electron injection. The device shows very sharp emission at 548 nm. The FWHM of the strongest emission peak was 12 nm.

A Pilot Project of Systematic Tuberculosis Screening in the Elderly in a South Korean Province

  • Kim, Hyunwoo;Kim, Hee-Jin;Oh, Kyung-Hyun;Oh, Hwan-Wook;Choi, Hongjo
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.3
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    • pp.194-200
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    • 2019
  • Background: Tuberculosis (TB) is a major infectious disease in South Korea causing substantial disease burden, particularly in the elderly. This study aimed to identify the case detection rate of mobile TB screening for the elderly conducted in the Jeollanam-do region and to analyze risk factors of active TB. Methods: We screened the elderly population (${\geq}65$ years old) in Jeollanam-do from August to December 2017. Chest radiography was performed for all participants. Participants with TB presumptive signs were asked to submit sputum specimen(s). Sputum smear, culture, and polymerase chain reaction analyses were performed. Cascade analysis, chi-squared tests, and Fisher exact tests were used to evaluate screening performance. Results: In total, 12,402 participants were screened, and 211 (1.7%) were suspected to have active TB; 181 of the suspected patients (85.8%) underwent sputum smear test, and 16 (8.8%) patients were confirmed to have TB. The TB prevalence among the elderly was bacteriologically confirmed to be 129 per 100,000 individuals, which was similar to national TB notification data for the same age groups. The proportion of active TB cases increased with age, and differed based on sex and past TB history. However, TB-related symptoms, comorbidity status, and TB screening history within 12 months were not predictive of active TB. Conclusion: This study identified that the prevalence rate was similar to national TB notification data from the same age groups. Periodic, community-based, systematic TB screening among the elderly population is recommended.