Estimating the burden of nosocomial exposure to tuberculosis in South Korea, a nationwide population based cross-sectional study

Kim, Hyung Woo; Myong, Jun‐Pyo; Kim, Ju Sang

doi:10.3904/kjim.2020.144

Cited by 10 publications

(7 citation statements)

References 44 publications

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“…HCWs avoided unexpected exposure because the patients were admitted to the ward and did not require an aerosol-generating procedure. This is in line with the findings of Kim et al, who reported that more patients with TB in the intensive care unit underwent high-risk procedures than those in the general ward [ 30 ]. Thus, during admission, respirators should be considered for high-risk situations, such as cough-inducing and aerosol-generating procedures [ 28 ].…”

Section: Discussionsupporting

confidence: 92%

Predictive Factors and Clinical Impacts of Delayed Isolation of Tuberculosis during Hospital Admission

Lee

Kang

Chin

et al. 2023

JCM

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Delayed isolation of tuberculosis (TB) can cause unexpected exposure of healthcare workers (HCWs). This study identified the predictive factors and clinical impact of delayed isolation. We retrospectively reviewed the electronic medical records of index patients and HCWs who underwent contact investigation after TB exposure during hospitalization at the National Medical Center, between January 2018 and July 2021. Among the 25 index patients, 23 (92.0%) were diagnosed with TB based on the molecular assay, and 18 (72.0%) had a negative acid-fast bacilli smear. Sixteen (64.0%) patients were hospitalized via the emergency room, and 18 (72.0%) were admitted to a non-pulmonology/infectious disease department. According to the patterns of delayed isolation, patients were classified into five categories. Among 157 close-contact events in 125 HCWs, 75 (47.8%) occurred in Category A. Twenty-five (20%) HCWs had multiple TB exposures (n = 57 events), of whom 37 (64.9%) belonged to Category A (missed during emergency situations). After contact tracing, latent TB infection was diagnosed in one (1.2%) HCW in Category A, who was exposed during intubation. Delayed isolation and TB exposure mostly occurred during pre-admission in emergency situations. Effective TB screening and infection control are necessary to protect HCWs, especially those who routinely contact new patients in high-risk departments.

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Section: Discussionsupporting

confidence: 92%

Predictive Factors and Clinical Impacts of Delayed Isolation of Tuberculosis during Hospital Admission

Lee

Kang

Chin

et al. 2023

JCM

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“…In our study, weight loss was signi cantly associated with delayed diagnosis. Inadequate TB awareness and knowledge about TB in elderly has been reported in some countries [34,35]. Interventions designed to explore the awareness and knowledge about TB disease and its symptoms in older Saudi citizens is warranted.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 years and Older

Alsehali,

Alrajeh,

AL-Jahdali

et al. 2024

Preprint

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Introduction Tuberculosis is a significant contributor of morbidity and mortality. With a progressively aging population, TB is increasingly encountered in older adults. Understanding the clinical presentation and optimal treatment strategies for TB in this population is essential. Method Clinical, radiological features, treatment and outcome of TB in patients aged 75 years or older was evaluated retrospectively. Results Among 92 elderly tuberculosis patients, most were male (76.1%) with a mean age of 82.5 years. Pulmonary TB was diagnosed in 52.2% of patients, Extra Pulmonary TB in 32.6%, and Disseminated TB in 15.2%. Comorbidities included Diabetes Mellitus (59.8%) and Congestive Heart Failure (41.3%). The most common presentation symptoms included cough (51.1%), fever (43.5%), dyspnea (39.1%), and weight loss (31.5%). Delay of TB diagnosis for up to 3 months was observed in 31.5% of patients. Weight loss and male gender were significant predictors of delayed diagnosis. Laboratory findings varied among TB types, with disseminated TB showing higher eosinophilia and thrombocytopenia. Completion of an initial RIPE treatment protocol achieved in 67.6% of patients. Mortality during treatment occurred in 23.9% of patients. Pulmonary TB was associated with higher mortality compared to extrapulmonary TB (p=0.007). Conclusion Tuberculosis is associated with high mortality in patients above age of 75. There is still a substantial delay in TB diagnosis in elderly. RIPE regimen is frequently changed due to side effect. Alternative regimen choices were quite variable. More studies on tuberculosis in this patient’s population is needed to define the best effective therapeutic approach.

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“…Individuals with higher CCI scores were more likely to die or use medical resources. Each comorbidity had weighted scores of 1 to 6 based on the adjusted risk of death or medical resource utilization [ 22 ]. The CCI score was calculated using the ICD-10 code entered within 1 year of enrollment, and the sum of CCI scores was recategorized into four groups (0, 1, 2, and 3 or more).…”

Section: Methodsmentioning

confidence: 99%

Disparities in cause-specific mortality by health insurance type and premium: evidence from Korean NHIS-HEALS cohort study, 2002–2019

Kim,

Kim

et al. 2024

BMC Public Health

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Background Although one’s socioeconomic status affects health outcomes, limited research explored how South Korea’s National Health Insurance (NHI) system affects mortality rates. This study investigated whether health insurance type and insurance premiums are associated with mortality. Methods Based on the National Health Insurance Service-Health Screening cohort, 246,172 men and 206,534 women aged ≥ 40 years at baseline (2002–2003) were included and followed until 2019. Health insurance type was categorized as employee-insured (EI) or self-employed-insured (SI). To define low, medium, and high economic status groups, we used insurance premiums at baseline. Death was determined using the date and cause of death included in the cohort. Cox proportional hazard models were used to analyze the association between insurance factors and the overall and cause-specific mortality. Results The SI group had a significantly higher risk of overall death compared to the EI group (adjusted hazard ratio (HR) [95% confidence interval]: 1.13 [1.10–1.15] for men and 1.18 [1.15–1.22] for women), after adjusting for various factors. This trend extended to death from the five major causes of death in South Korea (cancer, cardiovascular disease, cerebrovascular disease, pneumonia, and intentional self-harm) and from external causes, with a higher risk of death in the SI group (vs. the EI group). Further analysis stratified by economic status revealed that individuals with lower economic status faced higher risk of overall death and cause-specific mortality in both sexes, compared to those with high economic status for both health insurance types. Conclusion This nationwide study found that the SI group and those with lower economic status faced higher risk of overall mortality and death from the five major causes in South Korea. These findings highlight the potential disparities in health outcomes within the NHI system. To address these gaps, strategies should target risk factors for death at the individual level and governments should incorporate such strategies into public health policy development at the population level. Trial registration This study was approved by the Institutional Review Board of Chungbuk National University Hospital (CBNUH-202211-HR-0236) and adhered to the principles of the Declaration of Helsinki (1975).

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Estimating the burden of nosocomial exposure to tuberculosis in South Korea, a nationwide population based cross-sectional study

Cited by 10 publications

References 44 publications

Predictive Factors and Clinical Impacts of Delayed Isolation of Tuberculosis during Hospital Admission

Predictive Factors and Clinical Impacts of Delayed Isolation of Tuberculosis during Hospital Admission

Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 years and Older

Disparities in cause-specific mortality by health insurance type and premium: evidence from Korean NHIS-HEALS cohort study, 2002–2019

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