Journal List > J Korean Med Assoc > v.49(9) > 1080684

Kim: Current Situation of Tuberculosis and Its Control in Korea

Abstract

The prevalence of tuberculosis (TB) has declined owing to the establishment of national tuberculosis (TB) program in 1962, introduction of short course chemotherapy in mid 1980's, economic development, and nationwide medical insurance system. However, it is assumed that 18,000 (0.039%) smear positive and 224,000 (0.32%) radiologically active TB patients are present in 2006 by the extrapolating the figures from the prevalence surveys during the period 1980~1995. The prevalence survey was shifted to an Internet-based notification system in June 2000, and a total of 46,969 (97.3/105) patients were notified in 2005. Among them, 72.3% were registered from private sector. The proportion of patients treated at private sector is increasing year by year. Among the 35,269 (73.0/105) newly diagnosed patients, 11,638 (24.1/105) were smear positive pulmonary TB. The number of newly diagnosed extra-pulmonary TB patients was 5,171 (10.7/105). The age distribution curve showed a peak in the young generation, which implies that TB is still prevalent in Korea. A total of 2,948 (6.1/105) patients died of TB in 2004. The median age increased from 49 in 1983 to 70 in 2004. The initial drug resistance rate had been 10.4% in 1994 and rose to 12.8% in 2004. In addition, the rate of initial multi-drug resistance was significantly increased from 1.6% to 2.7% during the same period. The treatment success rate in public sector is around 80%, but it is lower in private sector due to the difficulties in the management of active diseases. To accelerate the elimination of TB, it is important to intervene in the management of patients under treatment at private sector through public-private collaborations and active investigations on the preventive therapy to manage latent infection.

Figures and Tables

Figure 1
Trend of new case notification rate per 100,000 by age group, 2001~2005
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Figure 2
Tuberculosis death rate and median age of the patients died of tuberculosis
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Figure 3
Annual trend of tuberculosis patients registered at the health centers and private sector
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Table 1
Trend of tuberculosis situation according to the national prevalence surveys
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Italics are estimated figure

Estimation of annual risk of infection; calculated by the regression equation using infection rate of 5~9 years old; LnY=6.37253-0.07485

*X (R-square: 0.96)

Estimation of prevalence; calculated by the age-specific reduction rate using the 1980~1995 year survey.

Table 2
Distribution of notified tuberculosis cases, 2005
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*Treatment after Failure, Treatment after Default, Transferred-In, §Pulmonary tuberculosis, **Extra-pulmonary tuberculosis

Table 3
Drug resistance rates (%) of the patients registered at the health centers
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*2004; Unpublished data

Table 4
Treatment Regimen based on the surveillance System, 2005
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H; Isoniazid, R; Rifampin, Z; Pyrazinamide, E; Ethambutol, S; Streptomycin

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