Experiences of Latent Tuberculosis Infection Treatment for the North Korean Refugees

Abstract

BackgroundTuberculosis (TB) is increasing in immigrants. We aimed to investigate the current status of latent tuberculosis infection (LTBI) treatment for North Korean Refugees (NKR) compared to South Koreans Contacts (SKC).MethodsTB close contacts in a closed facility of SKC and NKR who underwent LTBI screening in a settlement support center for NKR were analyzed retrospectively.ResultsAmong tuberculin skin test (TST) ≥10 mm (n=298) reactors, the males accounted for 72.2% in SKC (n=126) and 19.5% in NKR (n=172) (p<0.01). The mean age was higher in South Korea (42.8±9.9 years vs. 35.4±10.0 years, p<0.01). Additionally, the mean TST size was significantly bigger in NKR (17.39±3.9 mm vs. 16.57±4.2 mm, p=0.03). The LTBI treatments were initiated for all screened NKR, and LTBI completion rate was only 68.0%. However, in NKR, LTBI treatment completion rate was significantly increased by shorter 4R regimen (odds ratio [OR], 9.296; 95% confidence interval [CI], 4.159–20.774; p<0.01) and male (OR, 3.447; 95% CI, 1.191–9.974; p=0.02).ConclusionLTBI treatment compliance must be improved in NKR with a shorter regimen. In addition, a larger study regarding a focus on LTBI with easy access to related data for NKR should be conducted.

Initiation and completion of treatment for latent tuberculosis infection in migrants globally: a systematic review and meta-analysis

“…The 39 included publications contained data on 31 598 migrants positive for LTBI. Studies were done in 13 countries, across three WHO regions (European region, region of the Americas, and Western Pacific region): Australia (n=4 studies), [31][32][33][34] Canada (n=3), [35][36][37] Germany (n=1), 38 Israel (n=1), 39 Japan (n=1), 40 the Netherlands (n=2), 41,42 Norway (n=2), 43,44 South Korea (n=1), 45 Spain (n=3), [46][47][48] Sweden (n=1), 49 Switzerland (n=1), 50 UK (n=4), [51][52][53][54] and USA (n=15). [55][56][57][58][59][60][61][62][63][64][65][66][67][68][69] In total, 25 studies with outcome data on 8764 migrants were used to calculate the proportion of individuals initiating treatment.…”

“…52 35 studies with outcome data on 25 629 migrants (of whom 15 516 completed treatment) were used to calculate the proportion of individuals completing treatment subsequent to initiation. [32][33][34][35][36][37][38][39][40][41][42]44,45,[47][48][49][50][51][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69] The pooled estimate for the true proportion of LTBI treatment completion among migrants initiating treatment was 74% (95% CI 66- Analysing by treatment regimen, migrants treated with 4 months of rifampicin were significantly more likely to complete treatment (89% [95% CI 67-97]; p=0•020) than migrants prescribed 9 months of isoniazid (ref); no other treatment regimen showed significant differences (table; figure 3B).…”

Regional differences in the incidence of tuberculosis among patients with newly diagnosed diabetes mellitus

“…Additionally, the temperature, humidity and latent tuberculosis infection (LTBI) rate were included for adjustment. The climate, normal temperature and humidity of each region were identified from the web site of the Korea Meteorological Administration, and the LTBI rates of the regions were obtained from a national survey . When a variable attenuated the statistical significance of the regional groups for TB incidence, we planned to perform a mediation analysis to verify the variable contribution to the development of TB according to the regional differences.…”

Latent tuberculosis infection: recent progress and challenges in South Korea

“…In addition, plans for vulnerable and hard-to-reach groups (i.e., elderly individuals, foreigners residing in Korea [45], North Korean defectors [46], and the homeless) should be explored [47,48]. TB among the elderly population is becoming a major problem in TB control, which accounts for approximately 40% of new TB cases and 78% of TB-related deaths in South Korea.…”