• Tuberculosis and Respiratory Diseases
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• v.86 no.3
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• pp.234-244
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• 2023

Background: Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting. Methods: The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included. Results: The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success). Conclusion: A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options.

• Journal of Korean Clinical Nursing Research
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• v.24 no.1
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• pp.103-112
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• 2018

Purpose: This study was to investigate the factors affecting smoking behavior in patients with pulmonary tuberculosis. Methods: The participants were 130 pulmonary tuberculosis patients at a national tuberculosis hospital. Using a descriptive survey design, data were collected from January to March in 2016 and were analyzed using binominal logistic regression. Results: As a result of a correlation analysis of the data, depression had a significant positive correlation with smoking (r=.19, p=.030), stress (r=.54, p<.001), respectively. And depression had a significant negative correlation with smoking-related self-efficacy (r=-.20, p=.023). Smoking-related self-efficacy, smoking (r=-.79, p<.001), and stress (r=-.23, p=.008) had a significant negative correlation with each other, respectively. The factors affecting the smoking behavior were smoking-related self-efficacy (OR=1.46, p<.001), sex (OR=67.36, p=.001), occupation (OR=17.51, p=.014), and depression (OR=1.16, p=.024). Those factors explained 84.7% (Negelkerke's $R^2=.847$) of pulmonary tuberculosis patients' smoking behavior. Conclusion: Developing and applying a prevention eduction for reducing depression and enhancing smoking-related self-efficacy may become a venue toward good prognosis of the patients with pulmonary tuberculosis.

• Journal of Preventive Medicine and Public Health
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• v.55 no.3
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• pp.253-262
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• 2022

We aimed to review the current data composition of the Korean Tuberculosis and Post-Tuberculosis Cohort, which was constructed by linking the Korean Tuberculosis Surveillance System (KNTSS; established and operated by the Korean Disease Control and Prevention Agency since 2000) and the National Health Information Database (NHID; established by the National Health Insurance Service in 2012). The following data were linked: KNTSS data pertaining to patients diagnosed with tuberculosis between 2011 and 2018, NHID data of patients with a history of tuberculosis and related diseases between 2006 and 2018, and data (obtained from the Statistics Korea database) on causes of death. Data from 300 117 tuberculosis patients (177 206 men and 122 911 women) were linked. The rate of treatment success for new cases was highest in 2015 (86.7%), with a gradual decrease thereafter. The treatment success rate for previously treated cases showed an increasing trend until 2014 (79.0%) and decreased thereafter. In total, 53 906 deaths were confirmed among tuberculosis patients included in the cohort. The Korean Tuberculosis and Post-Tuberculosis Cohort can be used to analyze different measurement variables in an integrated manner depending on the data source. Therefore, these cohort data can be used in future epidemiological studies and research on policy-effect analysis, treatment outcome analysis, and health-related behaviors such as treatment discontinuation.

• Research in Community and Public Health Nursing
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• v.32 no.3
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• pp.312-324
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• 2021

Purpose: Tuberculosis is an infectious condition with a high disease burden, and the stigma in patients with tuberculosis causes negative health outcomes. The purpose of this study was to define and clarify the concept of self-stigma among patients with tuberculosis. Methods: The analysis was conducted using Walker and Avant's conceptual approach. Twenty-seven studies met the selection criteria. Results: Self-stigma in patients with tuberculosis can be defined by the following attributes: 1) self-esteem decrement; 2) fear; 3) negative emotions to oneself; 4) social withdrawal; and 5) discrimination. The antecedents identified were 1) inappropriate knowledge of tuberculosis, 2) spread of improper health information through media and social communications, 3) stereotypes and prejudices, 4) visibility due to symptoms appearing, 5) recognizing the risk of infection, and 6) low financial status. The consequences were 1) concealing the disease, 2) treatment delay, 3) poor treatment adherence, 4) poor quality of life, and 5) deterioration in or lack of social activities. Conclusion: The definition and attributes of self-stigma identified by this study can be applied to enhance the understanding of stigma in tuberculosis patients and to improve communications between healthcare providers and researchers. It can also be used to develop theories and measurements related to stigma in patients with tuberculosis.

• The Journal of the Korean Society for Microbiology
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• v.17 no.1
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• pp.87-93
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• 1982

Two cases of pulmonary disease in a 54 year-old female and a 70 year-old male patient due to Mycobacterium avium-intracellulare complex(MAIC) and a case of pulmonary infection ina 69 year-old male patient due to M. fortuitum(MF) were found recently in this institute. All three patients had a long history of anti-tuberculous chemotherapy because they were initially diagnosed as pulmonary tuberculosis. A 70 year-old male patient infected with MAIC had an unsuccessful chemotherapy history of isoniazid(INH), para-aminosalicylic acid(PAS) and streptomycin(SM) with an incomplete, temporary, symptomatic improvement, for three years since 1964 when he was first diagnosed as pulmonary tuberculosis on physical examination. A 54 year-old female patient infected with MAIC also had an unsuccessful chemotherapy history with the various anti-tuberculous drugs since 1958. Both patients discharged large number of MAIC in their sputum specimens for at least more than one year, but no M. tuberculosis at all. A 69 year-old male patient infected with MF was diagnosed as moderately advanced pulmonary tuberculsis in 1977. Combined chemotherapy with INH+PAS+pyrazinamide(PZA) improved his clinical symptoms, however, his chest radiograph was deteriorated again in 1980 one year after he stopped therapy. Therefore he started chemotherapy again with INH+ethionamide(TH)+cycloserine(CS) but no improvement was noticed. MF was cultured from his sputum in August 1981 and he continuously discharged the same bacilli until last examination of January 1982. Whether all three patients were initially !infected with nontuberculous mycobacteria or complicated with predisposing tuberculosis was not clear because there were no reliable bacteriological examination records.

• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.243-247
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• 2005

Background : The prevalence of tuberculosis is slowly decreasing in Korea. However, the drug-resistance of pulmonary tuberculosis is a major risk factor of treatment failure. Moreover, the National Surveillance System has recently been discontinued. Therefore, a continuous survey is necessary for the exact detection of the rate of drug resistance. We studied the recent 4-year drug resistance rate of tuberculosis at a single University hospital in Seoul. Materials and Methods : The study included 239 pulmonary tuberculosis patients performed with a tuberculosis culture and a drug-sensitivity test at Hanyang University Medical Center from March 1999 to March 2003. Results : Of the 239 patients included in the study during the 4-year period, 52 patients showed resistance to one or more anti-tuberculosis drug (21.8%). The rate of multi-drug resistance was 12.6%. The resistance rates to isoniazid, rifampin, ethambutol, streptomycin and pyrazinamide were 18.4%, 13.8%, 11.7%, 6.7% and 8.4%, respectively. Ninety patients had a history of previous anti-tuberculosis treatment, and the rates of the overall drug resistance and multi-drug resistance of these patients were 36.7% and 25.6%, respectively. The patients with drug-resistance showed a higher rate of a previous tuberculosis treatment history (63.5%) than the drug-sensitive group patients (30.5%). Conclusion : The rate of drug resistant tuberculosis is 21.8%, and multi-drug resistant tuberculosis is 12.6%. The rate of drug resistance is higher in those previously treated for tuberculosis.

• Journal of Korean Biological Nursing Science
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• v.22 no.4
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• pp.288-296
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• 2020

Purpose: The purpose of this descriptive study was to identify factors influencing pulmonary tuberculosis patients' self-care behaviors. Methods: The patients were 125 adults over the age of 19 who were diagnosed with pulmonary tuberculosis, receiving care at the National tuberculosis hospital. The survey questions measured family support, multidimensional scale of perceived social support (MSPSS), stigma and self-care behaviors. Results: The average score for self-care behaviors was 3.91, ranging from 2.22 to 5.00. There was a significant positive correlation between self-care behaviors and support system. There was a significant negative correlation between self-care behaviors and stigma. The significant variables influencing self-care behaviors were family support (β = .33, P< .001), smoking (β= -.23, p= .002), age (β= .22, p= .005) and experience of stopping treatment (β= -.17, p= .040). These factors explain 36% of pulmonary tuberculosis patients' self-care behaviors. Conclusion: Family support is very important to improve selfcare for tuberculosis patients. However, those in their fifties, men, and those who do not have a job and have underlying diseases have low family support, so they need active support at the national level. The study results suggest that a educational and nursing programs must be designed to reduce stigma and promote support system in order to enhance self-care behaviors.

• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.555-568
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• 1993

The purposed of this study was to identify compliance with sick role behavoir and support by families of patients with pulmonary tuberculosis and to identify factors affecting these variables md factors that increase compiance with sick role behavoior This study was a survey design done in K. general hospital from 1992. 7 1 to 1992. 7. 20. The data were collected through personal interviews with 70 subjects who had pulmonary tuberculosis. A questionnaire was used to collect the data. 1. Demographic characteristics of the subjects The factor causing the tuberculosis for 28.6% of the subjects was that they lived with another family member who had pulmonary tuberculosis, 11.4％ of the subjects had a family member who died of tuberculosis, 24.3% of the subjects had experienced an adverse reaction to medication. Gastroenteric disorders(28.6%) had the highest rate for this kind of adverse reaction to medication. 2. Support by families for patients with pulmonary tuberculosis The items which showed high support for compliance were taking medicine regularly(80.0% ) eat-ing a balanced diet(80.0%), loving them(84.3%), taking care of them(82.8%), getting the support from people for being sick(81.1%) The items which showed low support for compliance were meeting relatives or clergymen(20%), talking with the people suffering from pulmenary tuberculosis to relieve frustrated because they were not recovering. 3. General characteristics and family support The degree of family support showed that 75 was highest score and 30, the lowest score with 55.5(74. 1%)the average score. The degree of family support appeared similar in cases where the person was married and where the person did not have a family member with pulmonary tuberculosis(P〈.01) 4. The degree of compliance with sick role behavior by patients with pulmonary tuberculosis The degree of compliance with sick role behavior showed that 100 was the highest scoure47, the low-est score and 76.4, the average score out of a Possible score of 100. 5. Correlation between compliance with sick role behavior and family support The compliance with sick role behavior and family support showed a positive correlation(r=.2094 p〈.5) So for patients with pulmonary tuberculosis. compliance with sick role behavior is related to the sup-port given by their families.

• The Journal of the Korean Society for Microbiology
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• v.18 no.1
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• pp.99-110
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• 1983

Four cases of pulmonary pseudallescheriasis in patients with healed pulmonary tuberculosis are described. All four patients had a long history of antituberculous chemotherapy for pulmonary tuberculosis, but continuous sputum negativity for acid fast bacilli indicated apparent recovery from tuberculosis. They, however, complained continued intermittent hemoptysis and chronic cough. Although their chest roentgenograms did not show a clearcut mycetomal shadows in preformed cavitary lung lesions, Pseudallescheria boydii or Scedosporium apiospermum was repeatedly isolated from serial sputum specimens collected at different days for a period of over half an year or two years and their serial serum specimens produced precipitin bands with home-made antigen from 8-week old culture filtrate of P. boydii. Second fungus was isolated from sputum specimens of two patients and one was Candida albicans and the other was Aspergillus fumigatus. Sera from both patients reacted with antigens of those second fungi. Unfortunately pulmonary function of three patients did not allow surgical excision of the infected area and one patient refused surgery.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.198-204
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• 2009

Background: First-line drugs, if sensitive, are the most potent drugs in the treatment of multidrug-resistant tuberculosis (MDR-TB). This study examined the frequency and risk factors associated with acquired drug resistance to first-line drugs during a standardized treatment using first-line drugs in patients with MDR-TB. Methods: This study included patients who were diagnosed with MDR-TB at the National Masan Tuberculosis Hospital between January 2004 and May 2008, treated with standardized first-line drugs, and for whom the preand post-treatment results of the drug susceptibility test were available. Their medical records were reviewed retrospectively. Results: Of 41 MDR-TB patients, 14 (34.1%) acquired additional resistance to ethambutol (EMB) or pyrazinamide (PZA). Of 11 patients initially resistant to isoniazid (INH) and rifampicin (RFP), 3 (27.3%) acquired additional resistance to both EMB and PZA, and 3 (27.3%) to PZA. Of 18 patients initially resistant to INH, RFP and EMB, 6 (33.3%) acquired additional resistance to PZA. Of 6 patients initially resistant to INH, RFP and PZA, 2 (33.3%) acquired additional resistance to EMB. Ten of the 41 MDR-TB patients (24.4%) changed from resistant to susceptible. No statistically significant risk factors associated with acquired resistance could be found. Conclusion: First-line drugs should be used cautiously in the treatment of MDR-TB in Korea considering the potential acquisition of drug resistance.