Browse > Article

Clinical Characteristics, Diagnosis, Treatment, and Clinical Outcomes of TB Patients at a Private University Hospital in Korea  

Choi, Seong-Hoon (Departments of Family Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Sun, Woo-Sung (Departments of Family Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Kim, Mi-Na (Departments of Diagnostic Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Shim, Tae-Sun (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Publication Information
Korean Journal of Family Medicine / v.26, no.8, 2005 , pp. 481-489 More about this Journal
Abstract
Background: Even though tuberculosis (TB) is still a major public concern in Korea, there are few data on the management of TB patients and its outcome in the private sector in contrast with those of the public sector. Methods: The nine-hundred-twelve TB patients who were registered in a private university hospital from 2001 to 2002 were enrolled. The patients were divided into pulmonary (TBP), extrapulmonary (TBE), and combined (TBP+E) groups, and were also divided into initial and retreatment groups. The clinical characteristics, diagnostic methods, treatment regimens, and outcomes were analyzed and compared between the groups. Results: The mean age of 912 patients was 49.2 years and the male-to-female ratio was 56% : 44%. The number of patients of the initial and retreatment groups of TBP, and those of (TBE+TBP+E) were 449, 169, 237, 57, respectively. The bacteriological study was performed in 97.9%, and positive culture was confirmed in 54.5% and 29.6% of patients with TBP and (TBE+TBP+E), respectively (P＜0.05). The AFB smear was positive in 40.8% of TBP patients. The PCR was done in 63.6% of (TBE+TBP+E) group. The MDR was detected in 7.6% of isolates. Overall, treatment completion rate was 74.6%, default rate 13.7%, and death rate 0.5%. Conclusion: Even though the management of TB patients in a private hospital was satisfactory in terms of national guidelines, the high default rate was still a problem. Efforts to decrease the default rate is needed independently or in cooperation with the public sector.
Keywords
tuberculosis; private sector; Korea; diagnosis; treatment; treatment outcome;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Ministry of Health and Welfare, Korean National Tuberculosis Association. Report on the 7th tuberculosis prevalence survey in Korea. Seoul: Ministry of Health and Welfare, Korean National Tuberculosis Association; 1996
2 Lee EK. Situation of tuberculosis. Communicable Diseases monthly reports 2003;14:359-67
3 National Institution of Health. Guideline of the control of tuberculosis. Seoul: National Institution of Health; 2003
4 Bass JB Jr, Farer LS, Hopewell PC, O'Brien R, Jacobs RF, Ruben F, et al. Treatment of tuberculosis and tuberculosis infection in adults and children. Am J Respir Crit Care Med 1994;149:1359-74   DOI
5 Lew WJ, Kim SJ, Kim HJ, Lee EG, Kang MK, Bai JK. The treatment outcomes of 'defaulted' or 'transferred out' tuberculosis patients in Korea. Tuberculosis Surveillance Research Unit Pregress Report 2001:137-50
6 Yum H, Song Y, Jeon S, Choi S, Lee B, Kim D. The incidence of drug resistant tuberculosis in 1279 Korean patients. Korean J Intern Med 1995;10:38-42   DOI
7 Korean Academy of Tuberculosis and Respiratory Diseases. Guideline for the management of pulmonary tuberculosis, 1997. Tuberc Respir Dis 1997;44:1447-53
8 Center for Disease Control and Prevention. Update: Nucleic acid amplification tests for tuberculosis. MMWR Morb Mortal Wkly Rep 2000;49:593-4
9 Korea National Statistical Office. Annual statistics of causes of mortality 2002. Seoul: Korea National Statistical Office; 2003
10 Hong YP, Kim SJ, Lee EG, Lew WJ, Bai JY. Treatment of bacillary pulmonary tuberculosis at the chest clinics in the private sector in Korea, 1993. Int J Tuberc Lung Dis 1999;3: 695-702
11 American Thoracic Society, Center for Disease Control and Prevention. Diagnostic Standards and Classification of Tuberculosis in Adults and Children. Am J Respir Crit Care Med 2000;161:1376-95   DOI   ScienceOn
12 Koh WJ, Kwon OJ, Kim CH, Ahn YM, Lim SY, Yun JW, et al. Clinical characteristics and treatment outcomes of patients with pulmonary tuberclosis at a private general hospital. Tuberc Respir Dis 2003;55:154-64   DOI
13 Lee JH, Chang JH. Drug-resistant tuberculosis in a tertiary referral teaching hospital of Korea. Korean J Intern Med 2001;16:173-9   DOI
14 Korea Center for Disease Control and Prevention, Korean Institute of Tuberculosis. Annual report on the notified tuberculosis patients in Korea. Seoul: Korea Center for Disease Control and Prevention, Korean Institute of Tuberculosis; 2004
15 Hong YP, Kim SJ, Kwon DW, Chang SC, Lew WJ, Han YC. The sixth Nationwide Tuberculosis Prevalence Survey in Korea, 1990. Tuberc Lung Dis 1993;74:323-31   DOI   ScienceOn
16 Rhee CW, Han CH, Lim SA, Cho HJ. Compliance with anti-tuberculosis therapy of pulmonary tuberculosis patients. J Korean Acad Fam Med 2000;21(5):684-92
17 Jin BW, Jang DJ. An analysis of tuberculosis management in private sector. Tuberc Respir Dis 1990;37:399-406
18 Kim SY, Jeong SS, Kim KW, Shin KS, Park SG, Kim AK, et al. Drug-resistant pulmonary tuberculosis in a tertiary referral hospital in Korea. Korean J Intern Med 1999;14: 27-31
19 Chan ED, Laurel V, Strand MJ, Chan JF, Huynh ML, Goble M, et al. Treatment and outcome analysis of 205 patients with multidrug-resistant tuberculosis. Am J Respir Crit Care Med 2004;169:1103-9   DOI   ScienceOn
20 Hong YP, Kim SJ, Lew WJ, Lee SH, Lee EK. Cohort analyses of the treatment of smear-positive pulmonary tuberculosis patients under programme conditions in Korea, 1983-1994. Int J Tuberc Lung Dis 1998;2:365-71
21 World Health Organization. Treatment of Tuberculosis: Guidelines for national programmes. 3rd ed. Geneva, Switzerland: WHO; 2003
22 Blumberg HM, Burman WJ, Chaisson RE, Daley CL, Etkind SC, Friedman LN, et al. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 2003;167:603-62   DOI   ScienceOn
23 Lew WJ. Tuberculosis surveillance system in Korea. Tuberc Respir Dis 2000;48:298-307   DOI
24 Kim CH, Koh WJ, Kwon OJ, Ahn YM, Lim SY, An CH, et al. The accuracy of tuberculosis notification reports at a private general hospital after enforcement of new Korean Tuberculosis Surveillance System. Tuberc Respir Dis 2003; 154:178-90
25 Hong YP, Kwon DW, Kim SJ, Chang SC, Kang MK, Lee EP, et al. Survey of knowledge, attitudes and practices for tuberculosis among general practitioners. Tuberc Lung Dis 1995;76:431-5   DOI   ScienceOn