PHWR Public Health Weekly Report

Vol.15 No.20, May 19, 2022 Article TypeEpidemiology and SurveillanceNoncommunicable Disease StatisticsOriginal Articles

• Epidemiology and Surveillance 2022-05-19

  0 102 63

  Results of the elderly aged ≥65 years tuberculosis (TB) screening project 2021 in the Republic of Korea

  HeeAe Kim, AhYoung Park, HyeKyung In, Youmi Kim, JeeYeon Shin, JinHee On, WeonJung Joe, Yunsoo Kim

  Public Health Weekly Report 2022; 15(20): 1330-1341

  

  

  Abstract

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  The Korea Disease Control and Prevention Agency (KDCA) conducted an early-stage tuberculosis (TB) screening project for the elderly in 2021. The aims of the project were to ultimately prevent transmission, and to detect TB in seniors who are over the age of 65 living in regions with high TB incidences regions with high TB-related deaths.
  Among the 167,135 participated in the project. Chest x-rays (167,135 cases) and sputum tests (22,920 cases) were performed, and 120 TB patients (71.3 per 100,000) were reported. This was about 2.0 times higher than the incidence of TB in the general population (35.7 people per 100,000 population, 18,335 people). In the case of males, the elderly, the underweight, individuals with symptoms of TB, histories of TB, and medical care (112.5 per 100,000).
  In particular, 78.3% of tuberculosis patients responded that they had no symptoms, confirming the importance of regular check-ups and tuberculosis checkups for vulnerable groups regardless of tuberculosis symptoms. In addition, 70.0% (84/120) of TB confirmed patients were identified as having inactive TB chest X-ray examinations.
  The KDCA continued its elderly aged ≥65 years TB screening project in 2022. This will strengthen the management of TB by supporting various health links to expand the TB screening among elderly and to improve the success rate of treatment for TB patients.

• Original Articles 2022-05-19

  0 78 72

  Prevalence and prognosis of refractory hypertension diagnosed using ambulatory blood pressure measurements

  Minjae Yoon, Chan Joo Lee, Sungha Park, Joung-Won Lee, Seung Hee Lee, Won-Ho Kim

  Public Health Weekly Report 2022; 15(20): 1342-1351

  

  

  Abstract

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  The prognosis of refractory hypertension is largely unknown due to its low prevalence. This study aimed to investigate the prognosis of refractory hypertension and compare it with those of resistant and non-resistant hypertension. We retrospectively analyzed the data of 16,284 participants with hypertension who underwent ambulatory blood pressure (BP) monitoring between 2012 and 2019 at a tertiary center. Uncontrolled BP was defined as a 24-h BP ≥130/80 mmHg on ambulatory BP monitoring. Resistant hypertension was defined as uncontrolled BP despite the use of three antihypertensive medications including a diuretic or the use of ≥4 drugs regardless of BP control. Refractory hypertension was defined as uncontrolled BP despite the use of ≥5 antihypertensive medications. Among 16,284 patients with hypertension (mean age 59.2 ± 15.5 years, 52.7% men), the patients with resistant and refractory hypertension were 1501 (9.2%) and 150 (0.9%), respectively. The prevalence of chronic kidney disease, end-stage renal disease, heart failure, previous stroke, left ventricular hypertrophy, and the riser/non-dipper patterns of circadian BP rhythm progressively increased from patients with non-resistant hypertension to patients with resistant hypertension to patients with refractory hypertension. During a median follow-up of 3.9 years, the risk of cardiovascular mortality progressively increased from patients with non-resistant hypertension to patients with resistant hypertension (hazard ratio 1.62, 95% confidence interval 1.16–2.26) to patients with refractory hypertension (hazard ratio 5.22, 95% confidence interval 3.04–8.96). In conclusion, refractory hypertension, defined as uncontrolled ambulatory BP levels, was associated with higher risk of all-cause and cardiovascular mortality than non-resistant or resistant hypertension.

• Original Articles 2022-05-19

  0 120 69

  Lessons and experiences from Gwangmyeong City’s Registration and Education Center for Hypertension and Diabetes Mellitus non-contact education project during the COVID-19 pandemic period

  Younghee Heo, Jiyoon Lee, Yujin Park, Songhwa Kim, Myeongjoo Kwon, Weon-Young Lee

  Public Health Weekly Report 2022; 15(20): 1352-1362

  

  

  Abstract

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  In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic Gwangmyeong City’s Registration and Education Center for Hypertension and Diabetes Mellitus (DM) (GRECHD) shifted from a contact education program to a non-contact education program. The GRECHD expected the non-contact program to increase the participation of hypertension or diabetes mellitus (DM) patients aged 30 to 50. The GRECHD developed and implemented four types of non-contact education programs. First, it provided non-contact education services for residents and registered patients with hypertension and DM by opening a GRECHD YouTube channel.
  By the time of writing, 147 video clips were created and uploaded and 49,925 hits were recorded. Second, it developed a website for patients to learn self-management practices and , at the time of writing, 1,126 patients had received the online education service. Third, several ZOOM-based educations programs for disease self-management were developed and implemented. Lastly, an online campaign for the prevention of hypertension and DM was run on KakaoTalk, a social media messenger service. This study concluded that, in the future, non-contact education programs as well as contact education services should be developed and delivered to patients aged 30 to 50

• Original Articles 2022-05-19

  0 79 91

  Current Status of Cardiac Rehabilitation in Regional Cardiocerebrovascular Center - Nationwide Investigation of Cardiac Rehabilitation Program -

  Chul Kim, Seung Hee Lee, Won-Ho Kim

  Public Health Weekly Report 2022; 15(20): 1363-1376

  

  

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  The Regional Cardiocerebrovascular Center (RCC), an initiative of the Korean government, is working to reduce the medical disparity between regions, and the Cardiac Rehabilitation (CR) program is expected to become a model for post-acute care for the CR program in Korea. The purpose of this study is to evaluate the current state of RCC's CR program and to provide data that can be used to develop strategies to revitalize the CR program in Korea. To gather data, a survey on CR status, activity, and barriers was conducted for 12 RCCs in different provinces. The annual number of AMI admissions, CR candidates, CR capacity of the centers, and CR density showed significant disparities among the 12 RCCs. In particular, the CR capacity and CR density showed a large difference in the ranges of 50~500 and 0.42~7.36, respectively. Although the 12 RCCs were well equipped with many components necessary for the CR program, as well as the facilities, equipment, and personnel required for CR, there are still problems with low rates of psychological evaluation and vocational counseling, so improvement efforts are urgently needed. The rate of CR referral (97%) and patient education (78%) were high. However, the rate of inpatient CR exercise training (56%) was inadequate. The rate of outpatient CR enrollment (47%) and adherence (17%) were much lower and there were significant differences between centers. Studies have shown that the main causes of low outpatient CR enrollment and adherence are time/distance/transport issues, patient burden of CR costs, and a lack of recommendation to attend outpatient CR programs by cardiologists and cardiac surgeons. Therefore, in order to solve the current problems of CR in the RCCs, the attention and resources of the medical staff, hospital management, and standardization of CR programs in the RCCs are required. In addition, patient-oriented CR programs should be actively implemented to increase outpatient CR compliance. However, effective policies and financial support from the government are required for this strategy to be realized. The activation of CR is the fundamental purpose and direction of Act on the Prevention and Management of Cardio-Cerebrovascular Diseases, which should be prioritized to protect people's right to life.

• Original Articles 2022-05-19

  0 87 73

  Factors related to the successful treatment of the patient in the Tuberculosis Relief Belt Project

  Younghyun Kim, Ji Yeon Lee, Joon-Sung Joh, Ji yeon Han, Su Yeon Kim, Yun Hyung Kwon, You Mi Kim

  Public Health Weekly Report 2022; 15(20): 1377-1385

  Abstract

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  The Korea Disease Control and Prevention Agency (KDCA) established a cooperative system among public hospitals in 2014 to improve treatment accessibility and treatment success rates for vulnerable tuberculosis (TB) patients. The ‘Tuberculosis Relief Belt Project’ supported medical, transportation, nursing, outpatient treatment, nutritional snacks and other expenses.
  Although the incidence and mortality rates of TB in the Republic of Korea are on the decline, the Tuberculosis Relief Belt Project report found that the number of recipients of TB-related medical expense support among vulnerable TB patients increased 3.8 times in 2019 compared to 2017. This study analyzed the factors contributing to the successful treatment of vulnerable TB patients using data from patients who received treatment expense support through the Tuberculosis Relief Belt Project for five years from 2014 to 2018.
  The aim of this study was to confirm the effectiveness of the policy to support vulnerable TB patients and to establish a basis for continuous project promotion.
  Looking at the analysis results of factors affecting treatment success, the number of comorbidities, type of residence, and nationality were factors significantly affecting the TB treatment success of vulnerable groups. Compared to the cases in which there were no comorbidities, the possibility of successful treatment in all 1 (OR: 0.202), 2 (OR: 0.147), or ≥3 (OR: 0.070) comorbidities was reduced and statistically significant. In terms of the type of residence, the probability of TB treatment success was significantly lower among those living alone (OR: 0.097) and among homeless people (OR: 0.053) compared to those cohabitating (in a facility, workplace, or an acquaintance's house). In terms of nationality, the probability of TB treatment success was significantly higher among Koreans (OR: 8.512) than among foreigners.
  Based on the results of this study, it was confirmed that the high rate of comorbidty of vulnerable TB patients, unstable housing types, and being a foreigner had a negative effect on TB treatment. This shows that the Tuberculosis Relief Belt Project, which provides integrated services such as treatment costs for economically vulnerable patients, including unqualified and undocumented foreign TB patients, plays an important role in improving the treatment success rate. In addition, this study recommended that the trends of TB patients with mental illnesses at Seobuk Hospital in Seoul be analyzed, that TB patient vulnerability be evaluated, and that customized case management projects be promoted.

• Noncommunicable Disease Statistics 2022-05-19

  0 55 61

  Awareness, treatment, and control of hypertension, 2010-2020

  Public Health Weekly Report 2022; 15(20): 1386-1387

  

  

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