Journal of Preventive Medicine and Public Health

Original Articles

Social Contact Patterns Associated With Tuberculosis: A Case-control Study in Southwest Iran: Neda Amoori, Bahman Cheraghian, Payam Amini, Seyed Mohammad Alavi; J Prev Med Public Health. 2022;55(5):485-491. Published online September 30, 2022; DOI: https://doi.org/10.3961/jpmph.22.335

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Objectives
Tuberculosis (TB) is a major public health concern worldwide. Social contact patterns can affect the epidemiology and risk of airborne diseases such as TB. This study was designed to investigate the social contact patterns associated with TB.
Methods
In this case-control study, groups of participants with and without TB were matched by age and sex. Participants reported the nature, location, frequency, and average duration of social contacts over 1 month. The duration and number of social and spatial contacts were compared between groups using the chi-square test and the t-test. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to quantify the relationship between social contact time and TB status. Data were analyzed using Stata version 11 statistical software. A p-value of <0.05 was considered to indicate statistical significance.
Results
In this study, 80 patients with TB and 172 control participants were included, and a total of 3545 social contacts were registered. Social contact with family members (OR, 1.72; 95% CI, 1.10 to 2.40), contact with a person with TB (OR, 1.53; 95% CI, 1.16 to 2.01), and contact at the participant’s home (OR, 1.42; 95% CI, 1.19 to 1.82) were significantly associated with TB status.
Conclusions
The duration of long-term social contact, rather than the number of contacts, may be the main contact-related factor associated with TB transmission in this population. The focus of contact-tracing efforts should be on finding and treating both family members and long-term contacts in non-household settings.

Summary

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Collaboration and involvement of village heads, public health officer, and village midwives in improving adherence of tuberculosis patients
Nixson Manurung, R. Hamdani Harahap, Fazidah A. Siregar, Lita Sri Andayani
Clinical Epidemiology and Global Health.2024; 26: 101528. CrossRef
Investigating the intensity of social contacts associated with tuberculosis: a weighted networks model
Neda Amoori, Payam Amini, Bahman Cheraghian, Seyed Mohammad Alavi
BMC Pulmonary Medicine.2023;[Epub] CrossRef

Knowledge and Attitudes of Indonesian General Practitioners Towards the Isoniazid Preventive Therapy Program in Indonesia: Wira Winardi, Widhy Yudistira Nalapraya, Sarifuddin Sarifuddin, Samsul Anwar, Amanda Yufika, Adityo Wibowo, Iziddin Fadhil, Hendra Wahyuni MS, Yunita Arliny, Dewi Behtri Yanifitri, Teuku Zulfikar, Harapan Harapan; J Prev Med Public Health. 2022;55(5):428-435. Published online August 5, 2022; DOI: https://doi.org/10.3961/jpmph.22.248

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Abstract PDF: Objectives
The Indonesian Ministry of Health launched isoniazid preventive therapy (IPT) in 2016, with general practitioners (GPs) at the frontline of this program. However, the extent to which GPs have internalized this program remains uncertain. The aim of this study was to identify the knowledge and attitudes of GPs towards the IPT program in Indonesia.
Methods
This study used an online, self-administered questionnaire distributed via e-mail and social messaging services. A logistic regression model was employed to identify the explanatory variables influencing the level of knowledge and attitudes toward IPT among GPs in Indonesia. An empirical analysis was conducted separately for each response variable (knowledge and attitudes).
Results
Of the 418 respondents, 128 (30.6%) had a good knowledge of IPT. Working at a public hospital was the only variable associated with good knowledge, with an adjusted odds ratio (aOR) of 1.69 (95% confidence interval [CI], 1.02 to 2.81). Furthermore, 279 respondents (66.7%) had favorable attitudes toward IPT. In the adjusted logistic regression analysis, good knowledge (aOR, 0.55; 95% CI, 0.34 to 0.89), 1-5 years of work experience (aOR, 2.09; 95% CI, 1.21 to 3.60), and having experienced IPT training (aOR, 0.48; 95% CI, 0.25 to 0.93), were significantly associated with favorable attitudes.
Conclusions
In general, GPs in Indonesia had favorable attitudes toward IPT. However, their knowledge of IPT was limited. GPs are an essential element of the IPT program in the country, and therefore, adequate information dissemination to improve their understanding is critical for the long-term viability and quality of the IPT program in Indonesia.; Summary

Special Article

Cohort Profile: Korean Tuberculosis and Post-Tuberculosis Cohort Constructed by Linking the Korean National Tuberculosis Surveillance System and National Health Information Database: Dawoon Jeong, Hee-Yeon Kang, Jinsun Kim, Hyewon Lee, Bit-Na Yoo, Hee-Sun Kim, Hongjo Choi; J Prev Med Public Health. 2022;55(3):253-262. Published online April 22, 2022; DOI: https://doi.org/10.3961/jpmph.21.635

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Abstract Summary PDF Supplementary Material

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.

Summary

Korean summary
TB Post 코호트(Korean Tuberculosis and Post-Tuberculosis Cohort)는 한국의 결핵 모니터링 및 관리에 대한 인구집단 수준에서의 새로운 근거를 마련하고자 구축한 우리나라 결핵 환자 코호트입니다. 국가 결핵감시체계의 일환으로 구축된 질병관리청의 결핵신고자료와 국민건강보험공단의 국민건강정보DB 자료, 통계청 사망원인 자료의 연계로 구축되었으며, 각 자료원이 보유한 정보를 활용하여 통합적인 결핵 환자 연구가 가능할 것으로 기대하고 있습니다. 결핵의 정책 효과 연구뿐만 아니라, 치료 성공, 실패, 중단 등 치료결과에 대한 영향 요인 및 환자들의 건강 관련 행태에 대한 역학 연구 등 향후 다양한 연구에 활용될 수 있을 것으로 기대됩니다.

Citations

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A Quasi-experimental Study on the Effect of Pre-entry Tuberculosis Screening for Immigrants on Treatment Outcomes in South Korea: A Difference-in-Differences Analysis
Sarah Yu, Dawoon Jeong, Hee-Yeon Kang, Young Ae Kang, Gyeong In Lee, Hongjo Choi
Journal of Epidemiology and Global Health.2024;[Epub] CrossRef
Relationship between metformin use and mortality in tuberculosis patients with diabetes: a nationwide cohort study
Eunki Chung, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Heejin Kim, Heesun Kim, Hongjo Choi, Young Ae Kang
The Korean Journal of Internal Medicine.2024; 39(2): 306. CrossRef
Sex differences in the impact of diabetes mellitus on tuberculosis recurrence: a retrospective national cohort study
Dararat Eksombatchai, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Hongjo Choi, Young Ae Kang
International Journal of Infectious Diseases.2023; 127: 1. CrossRef
Nationwide Treatment Outcomes of Patients With Multidrug/Rifampin-Resistant Tuberculosis in Korea, 2011–2017: A Retrospective Cohort Study (Korean TB-POST)
Hongjo Choi, Jeongha Mok, Young Ae Kang, Dawoon Jeong, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Doosoo Jeon
Journal of Korean Medical Science.2023;[Epub] CrossRef
Prevalence and associated factors of diabetes mellitus among patients with tuberculosis in South Korea from 2011 to 2018: a nationwide cohort study
Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Jeong Mi Seo, Hongjo Choi, Young Ae Kang
BMJ Open.2023; 13(3): e069642. CrossRef
Impact of Anti-Tuberculosis Drug Use on Treatment Outcomes in Patients with Pulmonary Fluoroquinolone-Resistant Multidrug-Resistant Tuberculosis: A Nationwide Retrospective Cohort Study with Propensity Score Matching
Hongjo Choi, Dawoon Jeong, Young Ae Kang, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Jeongha Mok
Tuberculosis and Respiratory Diseases.2023; 86(3): 234. CrossRef
Retreatment after loss to follow-up reduces mortality in patients with multidrug/rifampicin-resistant tuberculosis
Hongjo Choi, Jeongha Mok, Young Ae Kang, Dawoon Jeong, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Doosoo Jeon
ERJ Open Research.2023; 9(4): 00135-2023. CrossRef
Association between diabetes mellitus and cause of death in patients with tuberculosis: A Korean nationwide cohort study
Se Hyun Kwak, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Hongjo Choi, Young Ae Kang, Frederick Quinn
PLOS ONE.2023; 18(12): e0295556. CrossRef

Perspective

Proposal to Revise the Screening Test for Latent Tuberculosis Infection in Close Contacts at Elementary Schools in Korea: Jong-Myon Bae; J Prev Med Public Health. 2019;52(4):272-275. Published online May 8, 2019; DOI: https://doi.org/10.3961/jpmph.19.043

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Abstract Summary PDF Supplementary Material: The 2018 National Guideline for Tuberculosis Control, which was published by the Korea Centers for Diseases Prevention and Control (KCDC), mandates conducting an epidemiological survey among close contacts of active tuberculosis patients at public institutions such as schools. In the procedure for these surveys, the tuberculin skin test (TST) is mandated as the screening test for latent tuberculosis infection in elementary school students. However, several guidelines recommend using the interferon-gamma releasing assay (IGRA) for contacts aged over 5 years with a Bacillus Calmette–Guérin vaccination history. The main reason for this is that IGRA has a higher specificity and lower false positive rate than TST. In addition, IGRA requires only a single visit to draw blood and the results are available within 24 hours. These advantages could promote cooperation from both parents and students in conducting these surveys. Thus, these findings regarding the benefits of IGRA for surveys of close contacts at elementary schools should be incorporated into the KCDC guideline.; Summary

Korean summary
집단시설에서의 결핵환자 발생시 수행하는 역학조사 지침에는 잠복결핵감염자의 검진을 위해 초등학생에게 투베르쿨린 피부반응검사 (TST)를 시행하도록 되어 있다. 그러나, 6세 이상의 초등학생들은 필수적으로 BCG 예방접종을 받았다는 점과, 역학조사 수행의 협조 등을 고려할 때 TST 대신 인터페론감마 분비검사 (Interferon-gamma releasing assay, IGRA)를 우선 시행하는 것이 보다 더 근거중심적, 가치중심적 으로 타당하다.

Original Article

Knowledge, Attitudes, and Practices Regarding Tuberculosis in Timor-Leste: Results From the Demographic and Health Survey 2016: Supa Pengpid, Karl Peltzer; J Prev Med Public Health. 2019;52(2):115-122. Published online February 18, 2019; DOI: https://doi.org/10.3961/jpmph.18.170

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Abstract PDF

Objectives
The aim of this study was to assess knowledge, attitudes, and practices regarding tuberculosis (TB) in the general population in Timor-Leste.
Methods
In the nationally representative cross-sectional 2016 Timor-Leste Demographic and Health Survey, 4622 men (aged 15-59 years) and 12 607 women (aged 15-49 years) were randomly selected using stratified multistage sampling and interviewed.
Results
Overall, 66.9% of men and 62.8% of women were aware of TB, 4.4% of men and 12.6% of women had TB courtesy stigma, and 83.3% of men and 88.6% of women reported intention to receive TB treatment. The mean±standard deviation overall TB knowledge score was 3.9±2.0 (out of 8) among men and 3.0±1.8 among women. In a multivariable linear regression analysis, among both men and women, older age, higher education, rural residence, and sources of TB information (family/friends, school/workplace, health care provider, Internet, television, and newspaper) were associated with higher TB knowledge scores. In addition, among women, higher wealth status and having heard about TB from the radio were associated with higher TB knowledge scores. Negative associations with TB courtesy stigma were found for urban residence and having heard about TB from family or friends among men, and for older age, higher TB knowledge, and TB information sources (family/friends and school/workplace) among women. Among both men and women, higher TB knowledge scores and having heard of TB from a health care provider were associated with intention to receive TB treatment.
Conclusions
This study identified socio-demographic risk factors for deficiences in population-based TB knowledge in Timor-Leste; these findings should be considered when designing TB communication, prevention, and control strategies.

Summary

Citations

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Determinants of correct knowledge on tuberculosis transmission and self-reported tuberculosis prevalence among general population aged 15–49 years in Myanmar
Pyae Linn Aung, Kyawt Mon Win, Htet Myet Win Maung, Kyaw Lwin Show, Seo Ah Hong
PLOS ONE.2023; 18(8): e0290470. CrossRef
Knowledge, Attitudes, and Perceptions of Tuberculosis in Indonesia: A Multi-Center Cross-Sectional Study
Silma Kaaffah, Ikhwan Yuda Kusuma, Fransiskus Samuel Renaldi, Yovita Endah Lestari, Arik Dian Eka Pratiwi, Muh Akbar Bahar
Infection and Drug Resistance.2023; Volume 16: 1787. CrossRef
Tuberculosis related barriers and facilitators among immigrants in Atlantic Canada: A qualitative study
Isdore Chola Shamputa, Moira A. Law, Clara Kelly, Duyen Thi Kim Nguyen, Tatum Burdo, Jabran Umar, Kimberley Barker, Duncan Webster, Sanghyuk S. Shin
PLOS Global Public Health.2023; 3(6): e0001997. CrossRef
An insight from National Family Health Surveys on changing trends in prevalence and knowledge regarding T.B. in India
Ankeeta Menona Jacob, Jeni Jacob
Indian Journal of Tuberculosis.2023;[Epub] CrossRef
Dengue in Timor-Leste during the COVID-19 phenomenon
Zito Viegas da Cruz, Afonso Lima Araujo, Alexis Ribas, Choosak Nithikathkul
Frontiers in Public Health.2023;[Epub] CrossRef
Knowledge, Attitudes, and Stigma: The Perceptions of Tuberculosis in Equatorial Guinea
Marta Vericat-Ferrer, Alba Ayala, Policarpo Ncogo, Juan Eyene-Acuresila, Belén García, Agustín Benito, María Romay-Barja
International Journal of Environmental Research and Public Health.2022; 19(14): 8227. CrossRef
Determinants of self-reported correct knowledge about tuberculosis transmission among men and women in Malawi: evidence from a nationwide household survey
Peter A. M. Ntenda, Razak Mussa, Steve Gowelo, Alick Sixpence, Andy Bauleni, Atusayi Simbeye, Alfred Matengeni, Ernest Matola, Godfrey Banda, Christopher C. Stanley, Susan Banda, Owen Nkoka
BMC Infectious Diseases.2021;[Epub] CrossRef
INQUÉRITO DE CONHECIMENTO, ATITUDE E PRÁTICA: O AUTOCUIDADO E CONDUTAS DE PACIENTES EM TRATAMENTO PARA TUBERCULOSE
Ana Caroline Cavalcante de Menezes, Valdízia Mendes e Silva, Jéssica Lins de Oliveira, Mona Laura de Sousa Moraes, Tânia Maria Ribeiro Monteiro de Figueiredo
Revista interdisciplinar em saúde.2021; 8(Único): 498. CrossRef
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Kassahun Alemu Gelaye, Getu Debalkie, Tadesse Awoke Ayele, Sintayehu Daba Wami, Malede Mequanent Sisay, Destaw Fetene, Haileab Fekadu Wolde, Temesgen Yihunie Akalu
BMC Infectious Diseases.2020;[Epub] CrossRef
Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey
Adedapo Olufemi Bashorun, Christopher Linda, Semeeh Omoleke, Lindsay Kendall, Simon D. Donkor, Ma-Ansu Kinteh, Baba Danso, Lamin Leigh, Sheriff Kandeh, Umberto D’Alessandro, Ifedayo Morayo O. Adetifa
BMC Public Health.2020;[Epub] CrossRef
The Effectiveness of the Environmental Health Services in the Primary Health Care Against the Prevention of Pulmonary Tuberculosis in the Regency of Banyuwangi
Rachman Setiawan, Endang Sri Lestari, Jojok Mukono, Endro Sukmono
JURNAL KESEHATAN LINGKUNGAN.2020; 12(3): 211. CrossRef
The Impact of Environmental Health Services in Primary Health Care on Improving the Behavior of Pulmonary Tuberculosis Patients in Banyuwangi Regency
Sheilla Mufidha Wahyuningtyas, Endang Sri Lestari, Jojok Mukono, Endro Sukmono
JURNAL KESEHATAN LINGKUNGAN.2020; 12(3): 181. CrossRef
Awareness about tuberculosis and RNTCP services among rural people in Nalgonda district, Telangana
Sreeharshika Dumpeti, KishoreYadav Jothula, NavyaK Naidu
Journal of Family Medicine and Primary Care.2020; 9(7): 3281. CrossRef

Brief Report

Notified Incidence of Tuberculosis in Foreign-born Individuals in Jeju Province, Republic of Korea: Dae Soon Kim, Jong-Myon Bae; J Prev Med Public Health. 2019;52(1):66-70. Published online December 21, 2018; DOI: https://doi.org/10.3961/jpmph.18.246

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Abstract Summary PDF Supplementary Material: Objectives
In the Republic of Korea (ROK), the notified incidence of tuberculosis in foreign-born individuals (NITFBI) has increased recently, as has the rate of multidrug-resistant (MDR) and rifampicin-resistant (RR) tuberculosis in foreigners staying in the ROK. As Jeju Province in ROK has a no-visa entry policy, control programs for NITFBI should be consolidated. The aim was to evaluate the status of NITFBI, with a focus on the distribution of MDR/RR tuberculosis by nationality.
Methods
Data on tuberculosis incidence in individuals born in Jeju Province and in foreign-born individuals were extracted from the Korean Statistical Information Service of Statistics Korea, and the Infectious Disease Surveillance Web Statistics of the Korea Centers for Disease Control and Prevention, respectively.
Results
Among all notified incident cases of tuberculosis, the proportion of NITFBI increased from 1.46% in 2011 to 6.84% in 2017. China- and Vietnam-born individuals accounted for the greatest proportion of the 95 cases of NITFBI. Seven cases of MDR/RR tuberculosis were found, all involving patients born in China.
Conclusions
In Jeju Province, ROK, NITFBI might become more common in the near future. Countermeasures for controlling active tuberculosis in immigrants born in high-risk nations for tuberculosis should be prepared in Jeju Province, since it is a popular tourist destination.; Summary

Korean summary
제주도는 국제자유도시를 천명하면서, 30일 무비자 입국을 허용하고 있다. 이에 따라 외국인 결핵환자가 증가하고 있다. 제주도 결핵 신환자 신고 중 외국인의 분율은 2011년 1.46%에서 2017년 6.84%로 증가했으며, 약제 내성에 있어서는 총 7건이었다. 향후 제주도내 외국인 결핵환자 신고수가 증가하는 가운데 약제내성 결핵환자도 증가할 수 있음을 예측하고, 외국인에 대한 활동성 결핵관리 정책을 보완하고 지침을 강화할 필요가 있다.

Original Articles

An Analysis of Infectious Disease Research Trends in Medical Journals From North Korea: Do-Hyeon Park, Min-Ho Choi, Ah-Young Lim, Hee Young Shin; J Prev Med Public Health. 2018;51(2):109-120. Published online March 30, 2018; DOI: https://doi.org/10.3961/jpmph.17.145

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Abstract PDF

Objectives
This study aimed to investigate the current status of infectious disease research in North Korea by analyzing recent trends in medical journals from North Korea in comparison with research from South Korea. Methods: Three medical journals (Preventive Medicine, Basic Medicine, and Chosun Medicine) were analyzed from 2012 to 2016. Articles on tuberculosis (TB), malaria, and parasitic diseases were selected and classified by their subtopics and study areas. Two medical journals published in the South Korea were selected for a comparative analysis of research trends. Results: Of the 2792 articles that were reviewed, 93 were extracted from North Korea journals. TB research in North Korea was largely focused on multi-drug resistant TB and extrapulmonary TB, whereas research in South Korea more frequently investigated non-tuberculous mycobacteria. Research on parasitic diseases in North Korea was focused on protozoan and intestinal nematodes, while the corresponding South Korea research investigated various species of parasites. Additionally, the studies conducted in North Korea were more likely to investigate the application of traditional medicine to diagnosis and treatment than those conducted in South Korea. Conclusions: This study presents an analysis of research trends in preventive medicine in North Korea focusing on infectious diseases, in which clear differences were observed between South and North Korea. Trends in research topics suggest a high prevalence of certain parasitic diseases in North Korea that are no longer widespread in South Korea. The large proportion of studies examining traditional medicine implies a lack of affordable medicine in North Korea.

Summary

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Seroprevalence of scrub typhus, murine typhus and spotted fever groups in North Korean refugees
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Towards Understanding Tuberculosis-Related Issues in North Korea: A Narrative Review of North Korean Literature
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Prevalence of Positive Carriage of Tuberculosis, Methicillin-resistant Staphylococcus aureus, and Vancomycin-resistant Enterococci in Patients Transported by Ambulance: A Single Center Observational Study: Young Sun Ro, Sang Do Shin, Hyun Noh, Sung-Il Cho; J Prev Med Public Health. 2012;45(3):174-180. Published online May 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.3.174

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Abstract PDF

Objectives

An ambulance can be a potential source of contagious or droplet infection of a community. We estimated the prevalence of positive carriage of tuberculosis (TB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococci (VRE) in patients transported by ambulance.

Methods

This was a retrospective observational study. We enrolled all patients who visited a tertiary teaching hospital emergency department (ED). Blood, sputum, urine, body fluid, and rectal swab samples were taken from patients when they were suspected of TB, MRSA, or VRE in the ED. The patients were categorized into three groups: pre-hospital ambulance (PA) group; inter-facility ambulance (IA) group; and non-ambulance (NA) group. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated using a multivariable logistic regression model for the prevalence of each infection.

Results

The total number of patients was 89206. Of these, 9378 (10.5%) and 4799 (5.4%) were in the PA and IA group, respectively. The prevalence of TB, MRSA, and VRE infection were 0.3%, 1.1%, and 0.3%, respectively. In the PA group, the prevalence of TB, MRSA, and VRE were 0.3%, 1.8%, and 0.4%. In the IA group, the prevalence of TB, MRSA, and VRE were 0.7%, 4.6%, and 1.5%, respectively. The adjusted ORs (95% CI) of the PA and IA compared to the NA group were 1.02 (0.69 to 1.53) and 1.83 (1.24 to 2.71) for TB, 2.24 (1.87 to 2.69) and 5.47 (4.63 to 6.46) for MRSA, 2.59 (1.78 to 3.77) and 8.90 (6.52 to 12.14) for VRE, respectively.

Conclusions

A high prevalence of positive carriage of TB, MRSA, and VRE in patients transported by metropolitan ambulances was found.

Summary

Citations

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C. Ruscher
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Infection Prevention in the Emergency Department
Stephen Y. Liang, Daniel L. Theodoro, Jeremiah D. Schuur, Jonas Marschall
Annals of Emergency Medicine.2014; 64(3): 299. CrossRef

Multicenter Study

Cigarette Smoking, Alcohol Consumption, Tuberculosis and Risk of Lung Cancer: The Korean Multi-center Cancer Cohort Study.: Jisuk Bae, Jin Gwack, Sue Kyung Park, Hai Rim Shin, Soung Hoon Chang, Keun Young Yoo; J Prev Med Public Health. 2007;40(4):321-328.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.321

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Abstract PDF

OBJECTIVES
The aim of this study was to evaluate the roles of cigarette smoking, alcohol consumption, tuberculosis, and their interactions in the risk of lung cancer in a Korean cohort. METHODS: The study subjects comprised 13,150 males and females aged above 20 years old. During the follow up period from 1993 to 2002, 79 lung cancer cases were identified by the central cancer registry and the national death certificate database. Information on cigarette smoking, alcohol consumption and the history of physiciandiagnosed tuberculosis was obtained by interview. Indirect chest X-ray findings were also evaluated to ascertain tuberculosis cases. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) after adjusting for age and gender. RESULTS: Cigarette smoking was statistically significantly associated with an increased risk of lung cancer [for current smokers, RR = 2.33 (95% CI = 1.23 - 4.42) compared to non-smokers]. After further adjustment for cigarette smoking, both alcohol consumption and tuberculosis showed no statistically significant association with the risk of lung cancer [for current drinkers, RR = 0.80 (95% CI = 0.48 - 1.33) compared to non-drinkers] [for tuberculosis cases, RR = 1.17 (95% CI = 0.58 - 2.36) compared to noncases]. There was no statistically significant interaction between cigarette smoking and alcohol consumption (pinteraction = 0.38), or cigarette smoking and tuberculosis (p-interaction = 0.74). CONCLUSIONS: Although cigarette smoking was confirmed as a risk factor of lung cancer in this cohort study, this study suggests that alcohol consumption and tuberculosis may not be associated with the risk of lung cancer.

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Original Articles

Medical Care Utilization of Tuberculosis Patients in Private Sector.: Gil Won Kang, Seok Jun Yoon, Chang Yup Kim, Young Soo Shin; Korean J Prev Med. 1998;31(4):814-827.

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Abstract PDF: In this study we analyzed the insurance claims data to investigate the medical care utilization pattern of tuberculosis patients in private sector. We selected the claims of principal or secondary diagnosis with tuberculosis from claims database of National Federation of Medical Insurance, from December 1995 to November 1996. Both spell-based analysis and person-based analysis were carried out. In spell-based analysis, type and location of treatment facilities, distribution of diagnoses, number of outpatient/inpatient treatments were analyzed. Additionally in person-based analysis, number of tuberculosis patients, demographic characteristics, number of treatments per person, frequency and pattern of change in source of care were analyzed. The results were as follows 1. The number of treatments with tuberculosis was 863,641 from 1 December 1995 to 30 November 1996. The number of patients was 313.964. 2. Most of tuberculosis patients in private sector were treated in general hospital(45.8%) and clinics(42.2%) 3. About 77.7% of tuberculosis patients who were treated more than two times did not change the source of carey. 18,9% of tuberculosis patients changed source of care only once. Even when we limited tuberculosis patient to those who were treated more than five times and whose treatment period were longer than six months, 94.7% of patients did not change source of care at all, or changed treatment facility only once. 4. The probability of change in source of care was higher in pulmonary tuberculosis, in twenties, and in rural area respectively than other tuberculosis. In conclusion, healer shopping of tuberculosis patients was not serious as expected. However special attention is needed to pulmonary tuberculosis in twenties and rural area; Summary

Factors Influencing Compliance with Anti-Tuberculosis Therapy.: Cheon Tae Kim, Kyeong Soo Lee, Pock Soo Kang; Korean J Prev Med. 1996;29(1):79-90.

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Abstract PDF: The purpose of the study was to determine factors influencing compliance with anti-tuberculosis therapy. The study subjects were 104 tuberculosis patients who have received the initial treatment in 3 health centers of Kyongju-city, Dalseong-Gun in Teagu and Kumi-city. Data were collected between september and october 1995. The patients were classified into the improved group and the non-improved group according to outcomes of 3 month treatment with short-term therapeutic regimen. To find factors influencing compliance with anti-tuberculosis therapy, multiple logistic regression was made. There was no significant differences between the improved group and the non-improved group in sex, age, education level, occupation, family pattern, and habitual change regarding smoking and drinking. The level of knowledge about anti-tuberculosis therapy in the improved group was significantly higher than the non-improved group(p<0.01). Multiple logistic regression analysis revealed that family support for not forgetting medication(p<0.05) was a predictor of improvement and knowledge about anti-tuberculosis therapy (p=0.054), regularity of medication(p=0.062), and consultation to family, doctor and nurse(p=0.075)were marginal predictors of improvement. Treatment must be given to every patient confirmed as having tuberculosis and must be given free of charge to the patients. The requirements for adequate chemotherapy are prescribed in the correct dosage and taken regularly by the patient for a sufficient period to prevent relapse of the disease after cure. It is suggested that education to the patients should be reinforced and connectedness between patients and tuberculosis control workers and family should be solidated.; Summary

Drug Sensitivity and Relapsed Period of Relapsed Pulmonary Tuberculous Patients registered in Some Public Health Offices, in Seoul.: Hye Sook Park, Eun Hee Ha, Cha Hyung Wie, Ji Yong Kang; Korean J Prev Med. 1996;29(1):67-78.

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Abstract PDF: The purpose of this study was examine the general characteristics of relapsed pulmonary tuberculous patients (i.e. age, sex, weight, occupation, previous forms of treatment, drug sensitivity, and the frequency of relapse) in order to improve future treatments of tuberculosis as well as to perpetuate health education. The data was obtained from the medical records of 186 relapsed pulmonary tuberculosis patients who were registered for treatment at various public health officers in Seoul during the year of 1994. The major findings obtained from the study were as follows; l) The male to female ratio of relapsed pulmonary tuberculous patients was about 7:3, more specifically 23.7% of the men and 30.9% of the women were between 20 and 29 years of age. 2) Comparing initial less aggravated states to relapsed states, patients with minimal x-ray findings later proved moderately advanced X-ray findings. Furthermore, patients with negative sputum AEB findings later proved positive sputum AFB findings. 3) of the l86 patients studied, 91.9% suffered, relapse and 8.1% suffered 2 or more relapses. Of the patients who suffered at least 1 relapse, 54.8% received short-term treatment, 26.9% received long-term treatment, and 18.3% received treatment of an unknown during their initial tuberculosis treatment periods. 4) Fifty five point four percent of the patients had no reaction to the drug treatment(not available), 25.9% of the patients had sensitive reaction to the drug treatment, 18.7% of the patients had resistant reaction to the drug treatment. Drug resistance was higher in patients to exhibited positive X-ray findings as well as in patients that exhibited positive sputum findings furthermore, patients receiving treatment of an unknown nature(35.5%) exhibited higher drug resistance than those receiving short-term treatment(13.6%) and long-term treatment(l7.0%). 5) Of the 160 patients who suffered relapses, 8.8% suffered a relapse within 1 year after treatment and 91.2% suffered a relapse at least 1 year after treatment. Furthermore, our study showed that women, under 30, who received short-term treatment and encounterd complications during their primary treatment suffered relapses faster than any other groups studied. In addition, minimal X-ray findings and sputum AFB findings were not correlated to the time relapse occurred. Therefore, the greater efforts are needed to prevent relapsed pulmonary tuberculosis.; Summary

A study on results of short-course chemotherapy of patients with pulmonary tuberculosis registered at Seoul city health centers.: Hye Sook Park, Eun Hee Ha, Cha Hyung Wie; Korean J Prev Med. 1995;28(2):487-496.

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Abstract PDF: This study was performed for the comparison of the therapeutic efficiency between 6-month (2tHER/4HER) and 9-month (9HER) short-course chemotherapy under the programe conditions for pulmonary tuberculosis in terms of sputum AFB negative conversion rate, remedial interruption rate and cost effectiveness analysis. Two hundreds and ninty three patients treated with 9HER and 641 treated with 2HERZ/4HER had been discharged from 22 health centers in Seoul from May 1, 1993 to April 30, 1994. Seven hundreds and seventeen was subsequently analysed excluding 217 patients due to remedial interruption. The results: 1. Bacteriological negative conversion rate in 9HER regimen and 2HERZ/4HER regimen was 97.8% and 96.4% respectively (p>0.05). But the early treatment period, negative conversion rate in 2HERZ/4HER regimen was very higher than in 9HER regimen(p<0.01). 2. Remedial interruption rate for 9HER regimen and 2HERZ/4HER regimen was 34.1% and 13.6% respectively. The primary reason for the interruption was transfering to other clinics and this interruption was high within 3months. 3. Cost effectiveness for 2HERZ/4HER regimen was higher than 9HER regimen. The difference cost effectiveness ratio was 2.33 at the first sputum test and 1.69 at the last sputum test.; Summary

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