PHWR Public Health Weekly Report

Vol.13 No.12, March 19, 2020 Article TypeEpidemiology and SurveillanceOriginal Articles

• Epidemiology and Surveillance 2020-03-19

  0 194 42

  Results of the 2019 Pilot Project on the Tuberculosis (TB) Screening for Residents in Chok Bang (Shabby One-room) in South Korea

  Park AhYoung, Shin JeeYeon, Kong Insik, On JinHee, Oh KeunYoung, Choi HongJo

  Public Health Weekly Report 2020; 13(12): 654-668

  

  

  Abstract

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  The Korea Centers for Disease Control and Prevention (KCDC) conducted a tuberculosis (TB) screening pilot project in 2019 in local regions. The aim was to develop screening and treatment protocols for strengthening TB management among homeless people. Homeless people have a high risk of developing and spreading TB to socially and economically vulnerable populations.
  Out of the 500 people targeted for the project, 483 participated. As a result of chest X-ray examinations (482) and sputum examinations (141), 3 TB patients (621 people per 100,000 population) were found. This is about 12 times higher than the incidence of TB in the general population (51.5 per 100,000 people, based on 2018 data), and about 4 times higher than the incidence of TB in the elderly population, which accounts for 46 percent of the country's new TB patients (163 per 100,000 people, based on 2018 data). The results of each test were abnormal findings rate of chest X-ray 20.1% (97/482), smear-positive 0.7% (1/141), culture-positive 2.1% (3/141), tuberculosis-polymerase chain reaction(PCR) test-positive 2.1% (3/141), Xpert MTB/RIF test-negative 100% (1/1), and the rapid resistance and drug susceptibility tests were both resistant 66.7% (2/3). The 3 patients who were diagnosed with TB were medical care recipients and ineligible for health insurance. They were 40-50-year-old Korean males with histories of smoking, drinking, and underlying diseases. As patients with no TB history, 2 patients were diagnosed with extensive drug resistance and isoniazid monoresistance TB.
  For the early detection and successful treatment of individuals living on the periphery of society, which is a blind spot for TB prevention management, it is essential to secure access to examinations with mobile chest X-ray equipment and to create a treatment support environment by providing housing and living expenses for confirmed TB patients. The KCDC plans to expand and promote TB screening projects nationwide for the homeless and residents of Chok Bang in 2020 and will strengthen the treatment support system, including housing costs and food support linked to local governments' welfare projects.

• Epidemiology and Surveillance 2020-03-19

  0 193 51

  Design of Multi-Center Prospective Cohort Study of Pulmonary Tuberculosis (COSMOTB)

  Min Jinsoo, Lee Ki Man

  Public Health Weekly Report 2020; 13(12): 669-673

  Abstract

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  One of the reasons for treatment failure is the development of drug resistance by gene mutation. Among these, disputed mutations that cause discrepancies between phenotype and susceptibility test results may lead to failure of initial standard treatment or inadequate treatment. It mainly induces low-level resistance; however, the effect of anti-tuberculosis drugs might be diminished, which may lead to prolonged duration of treatment or development of multi-drug resistance.
  We conducted a propspective observational cohort study to enroll adult patients with pulmonary TB between November 2016 and September 2018 at three university-affiliated tertiary hospitals in South Korea. The purpose of this study was (1) to describe clinical characteristics of drug resistance and identify gene mutations related to drug resistance, (2) to compare results of phenotypic and genotypic drug susceptibility tests and identify discordant results, and (3) to assess treatment outcome of Mycobacterium tuberculosis with disputed mutation. This cohort study will explore ways to improve TB diagnosis and treatment according to types of drug resistance mutation. This manuscript introduces the establishment and operation of the TB cohort study.

• Original Articles 2020-03-19

  0 103 205

  The Current State and Prevention Strategies of Traumatic Brain Injury (TBI) in Korea

  Lee Sanghun

  Public Health Weekly Report 2020; 13(12): 674-691

  

  

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  Traumatic brain injury (TBI) is one of the major causes of death and disability. Understanding the epidemiologic characteristics of TBI is the first step for developing prevention strategies, educating the public and optimizing care systems and rehabilitation strategies.
  The Korean Centers for Disease Control and Prevention (KCDC) collect in-depth and sustained data through thorough investigations of TBI patients in emergency departments. This study analyzed the results from 2008 to 2017 to confirm the current state of TBI in Korea. Over the past ten years, the number of TBI patients who visited the emergency departments of twenty-three participating hospitals gradually increased; from 2,084 TBI patients in 2008 to 26,395 TBI patients in 2017. This study found that the proportion of men (60.5%) was higher than women (39.5%), and unintentional injury accounted for 94.9% of the cases. TBI was higher in children aged 0-4 years and in adults aged 45-54 years, but hospitalization and mortality increased with age. Motor vehicle crashes were identified as the most common causes in adolescents and adults. Falls (39.6%) were the most common causes across all ages. However, falls were most prevalent in children and the elderly.
  While developed countries have prevention programs for preventing and recognizing the early signs of TBI, in Korea, there is still a lack of public awareness and related data and prevention programs are still incomplete. It is time to establish a TBI prevention infrastructure by increasing public awareness and education about the incidence of brain injury and developing traumatic brain injury prevention programs, textbooks, and guidelines.