• Title/Summary/Keyword: 결핵 예방

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Factors Influencing Treatment Result in Inpatients with Tuberculosis (결핵입원환자의 치료결과에 영향을 미치는 요인)

  • Lee, Hyun-Sook;Hwang, Seul-Ki;Kim, Sang-Mi
    • The Journal of the Korea Contents Association
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    • v.16 no.10
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    • pp.196-205
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    • 2016
  • The purpose of this study is to identify factors influencing treatment result in patients with Tuberculosis by patient characteristic, admission and disease characteristic, and hospital characteristic from 2006 to 2012. Survey data was using Korean national hospital discharge in-depth survey data produced by KCDC(Korea Center for Disease Control and Prevention). Study subjects were 8,305 inpatients with TB(A15.0~A19.9) and analyzed frequency, chi-square test, and logistic regression by using SPSS 20(Statistical Package for the Science). The results of this study show that influencing factors of treatment result were ages (20-39, 40-64, and over 65 years), type of insurance(medical aid), disease code (A16, A17, A18, A19), LOS (31-90, and 91-180 days), beds of hospital (300-499, 500-999, over 1,000 beds) and hospital district (non-metropolitan). These findings implied that it is necessary to support successful prevention and management for high risk TB groups and to build middle and long-term policies as well as short -term policy.

A Descriptive Study on the Tuberculosis Mortality in a Tuberculosis-Centered Hospital (한 결핵전문병원의 입원 결핵환자 사망에 대한 기술통계학적 고찰)

  • Kim, Soo-Young;Byun, Joo-Nam;Choi, Jin-Su
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.595-601
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    • 1993
  • Background: Today, tuberculosis continues as an important cause of death in Korea despite the effective treatment and prevention. So we have studied charicteristic distribution of death by pulmonary tuberculosis through epidemiologic survey. Subjects and Method: The mortality data were obtained from 684 pulmonary tuberculosis cases who died in a tuberculosis-centered hospital in Seoul during the period of 5 years from 1986 to 1990. In order to estimate the distribution of death by tuberculosis, t-test and $x^2$-text were performed on the data. Results: 1) 19.9% of patients died among the total 3,441 hospitalized pulmonary tuberculosis cases during 5 years. 2) In distribution of sex and age, male death occupies 81% of total death. Significantly high proportions of younger female death (under 40 years-old) were also observed. 3) In terms of medical security status, medical assistance group occupies 42.3% of medical insurance group while the non-security group also occupies 11.8% of total death. 4) Treatment interruption was observed in 78% of total death. Conclusion: Special attention should be given to the identification, management and follow up of high risk group in nationwide tuberculosis control program.

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Tuberculin Skin Test and QuantiFERON-TB Gold Assay before and after Treatment for Latent Tuberculosis Infection among Health Care Workers in Local Tertiary Hospital (일개 병원의 의료인에서 투베르쿨린 검사와 QuantiFERON-TB Gold 검사를 이용한 잠복결핵의 진단과 치료 전후의 변화)

  • Lee, Seung Jun;Kim, Hyeon Sik;Ma, Jung Eun;Lee, Sang Min;Ham, HyunSeok;Cho, Yu Ji;Jeong, Yi Yeong;Kim, Ho Cheol;Lee, Jong Deok;Kim, Sun-Joo;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.270-275
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    • 2007
  • The QuantiFERON-TB Gold assay and tuberculin skin test (TST) have been useful test for diagnosing latent tuberculosis infections (LTBI). However, there are few reports on the efficacy of the QuantiFERON-TB Gold assay and TST in evaluating the response after the treatment of LTBI. This study examined the changes in the TST and QuantiFERON-TB Gold assay before and after a treatment for latent tuberculosis in health care workers (HCWs) at a local tertiary hospital. Methods: A cohort of volunteers working as nurses and doctors who underwent a TST and QuantiFERON-TB Gold assay was established. The volunteers positive for the QuantiFERON-TB Gold assay had been treated with 3 months of isoniazid (INH) and rifampin (RFP). After completing treatment, the TST and QuantiFERON-TB Gold assay were repeated. Results: Of the 48 participants (14 doctors, 34 nurses, M: F=11:37, mean $age=29.9{\pm}5.5$ years, mean employment $period=74.9{\pm}64.3$ months), 19 (39.6%) tested positive to the TST (mean induration=$19.1{\pm}9.7mm$) and 8 (16.7%) were QuantiFERON-TB Gold assay. Among them, one had active pulmonary tuberculosis. Seven volunteers were consistently positive to both the TST and QuantiFERON-TB Gold assay after being medicated with INH and RFP for 3 months. Conclusion: TST and QuantiFERON-TB Gold assay are unsuitable for evaluating the treatment response of LTBI because they were consistently positive both before and after the anti-tuberculosis medication.

Comparison of a whole blood Interferon-γ assay and A tuberculin skin test for detecting latent tuberculosis infection in children (소아 잠복 결핵 감염 진단에 있어서 투베르쿨린 피부반응 검사와 결핵 특이항원 자극 Interferon-γ 분비능 측정의 비교)

  • Chun, Jin-Kyong;Kim, Chang Ki;Kim, Hyun Sook;Jung, Ghee Young;Linton, John A.;Kim, Ki Hwan;Lee, Taek Jin;Jeon, Ji Hyun;Kim, Dong Soo
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.971-976
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    • 2008
  • Purpose : Surveillance for detecting and managing latent tuberculosis infection (LTBI) is a key component of tuberculosis control. The classic surveillance tool, the tuberculin skin test (TST), may have some limitations when used in the Bacillus Calmette-$Gu{\acute{e}}rin$ (BCG)-vaccinated population. The object was to perform a blood test $QuantiFERON^{(R)}$-TB Gold In Tube (QFT-G IT) based on the detection of interferon-$\gamma$ ($IFN-{\gamma}$) released by T cells in response to Mycobacterium tuberculosis-specific antigens, and to compare the efficacy of this new diagnostic tool for LTBI with that of TST. Methods : For six months, between October 1, 2006 and April 30, 2007, data were collected from 111 patients under 15 years of age at Severance Children's Hospital. TST and QFT-G IT tests were performed with children with or without contact histories of tuberculosis. In addition to these tests, we examined comparative data from 29 adults who had tuberculosis, to detect false negative rates in the QFT-G IT method. Results : Thirty-three children had household contact histories. In this group, 15% and 42% of cases were found to be positive using the QFT-G IT assay and TST, respectively. Agreement was low between these two tests (${\kappa}=0.39$). In the adult active tuberculosis group, the QFT-G IT false negative rate defined as a positive culture and a negative QFT-G IT result was 12.5%. Conclusion : In diagnosing LTBI in children, the usefulness of a whole-blood $IFN-{\gamma}$ assay employing TB-specific antigens will be revealed only by examining additional longitudinal clinical data; this study serves as a starting point in that process.

Detection of Specific Antibody to Mycobacterium tuberculosis in Anti-Complementary Human, Rabbit and Bovine Serum by Supplementation with Procomplementary Porcine Serum (친보체성(親補體性) 돼지혈청의 보강(補强)에 의한 항보체성(抗補體性) 사람, 토끼 및 소혈청속의 인결핵균(人結核菌)(Mycobacterium tuberculosis)에 대한 특이항체검출(特異抗體檢出))

  • Choi, Chul-Soon;Yang, Yong-Tae
    • The Journal of the Korean Society for Microbiology
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    • v.16 no.1
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    • pp.39-48
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    • 1981
  • A direct complement fixation test supplemented with procomplementary porcine serum was studied using anticomplementary human, rabbit and bovine serum against Mycobacterium tuberculosis. Procomplementary activity of porcine serum varied with porcine individual and affected by anticomplementary antiserum. The procomplementary titre of porcine serum against rabbit, human and bovine serum ranged from 1:5 to 1:40. By means of complement fixation test supplemented by porcine serum, the specific complement-fixing antibody to both tuberculopolysaccharide and/or tuberculoprotein antigen was readily differentiated from the anticomplementary antibody titre.

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우리나라 학생 신체검사의 현황, 문제점 개선방향

  • Choe, Yu-Jin
    • Journal of the Korean Society of School Health
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    • v.5 no.1
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    • pp.20-23
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    • 1992
  • 충치등의 구강질병은 예방이 가능하며 일단 발생하면 자연치유란 없고 질병의 진행만 있는 질병으로서 조기발견과 조기치료가 필요하다. 특히 학교연령층에서 폭발적으로 발생되고 있 기 때문에 학교구강보건관리가 중요하지만 선진국처럼 학교구강건강 관리실을 운영하고 전문인력을 상주 배치할 수 없는 현시점에서 예방교육과 조기발견, 조기치료를 위한 정기구강검사 제도는 필수적이다. 현행학교정기구강검사는 결핵, 간염, AIDS 등 질병의 전염문제와 검진비가 현실적이지 못하며 치과의사의 봉사강요형태로 진행되고 있는 문제 등이 있다. 그러므로 래원검진제 같은 의견도 있으나 현행 정기구강검진제를 개선하여 실시하는 것이 현실적이라고 본다. 기수소독문제는 치과의사 1인당 50개 정도의 기구가 준비되고 화학소독제로서 Glutal-dehyde(와이멕스)사용으로 해결될 수 있으며 기타 문제는 검진수가의 현실적 인상과 연계되어 근본적으로 해결될 수 있다.

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정책 제언 - 에이즈 민간단체 활동의 현황과 과제

  • Choe, Yong-Jun
    • RED RIBBON
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    • s.80
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    • pp.15-18
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    • 2008
  • 국가가 후천성면역결핍증예방법을 정한 지 이십 년이 넘었다. 주요 에이즈 민간단체의 하나인 대한에이즈예방협회도 설립된 지 만 십오 년이 되어간다. 수십 년 동안 국가와 민간단체들이 기울인 노력은 과연 소기의 성과를 거두었을까? 우리나라는 에이즈 유병률이 극히 낮은 나라지만, 이것이 효과적인 국가 정책과 민간단체 사업 때문이었는지는 확실치 않다. 그렇지만 어떤 경우든, 개선을 위한 평가는 불가피하다. 특히 평가 대상 사업이 정부 예산을 바탕으로 수행되는 경우에는 더욱 그러할 것이다. 이러한 배경에서 질병관리본부는 재작년 "국가 에이즈 관리 사업 평가 및 모니터링 연구"라는 제목의 연구 과제를 공모하여 에이즈 민간단체의 현황을 파악하고 효과적인 민간단체 사업 평가 방안을 마련하고자 하였다. 필자는 그 연구에 연구 책임자로 참여하였고, 이 글은 연구의 주요 내용을 요약한 것이다. 이 글이 언급하는 문제점이나 개선 방안 중 일부는 이미 개선되었거나 시행되고 있음을 밝혀둔다. 연구 보고서 전문이 필요한 분은 질병관리본부 에이즈 결핵관리 팀에 문의하거나 필자에게 연락하시기 바란다.

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Management of Chronic Obstructive Pulmonary Disease (만성폐쇄성 폐질환의 치료)

  • Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.6
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    • pp.587-596
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    • 1994
  • COPD의 치료에 대해 약술하였다. 예방을 위해서는 개인적으로는 금연, 국가사회적으로는 공해의 해결이 필요하며 진행된 질병에서는 진행을 막기 위한 감염의 예방 및 감염시 즉각적인 항균제 치료, 필요에 따라서 항염증제, 그리고 생활의 질을 높이기 위해서 각종 재활요법이 필요하다. 원활한 재활요법을 위해서는 필요한 기구 장비의 구입이 쉬워야 하고 치료진에서는 호흡기 전문의사, 호흡치료사, 의료기사, 병원 및 가정간호사, 사회사업가(social worker), 정신과의사, 영양사 등의 팀으로의 접근이 필요하고 제도적으로 보험적용이 되도록 해야 하겠다. 불구가 심한 예에서는 폐이식이 시도되며 기술적인 문제는 다소 해결된듯하나 장기공여자 등의 문제로 보편화되지는 않고 있다.

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Changes in Bronchoscopic Findings during Treatment-Course in Active Endobronchial Tuberculosis (활동성 기관지결핵에서 치료경과에 따른 기관지경소견의 변화)

  • Chung, Hee-Soon;Lee, Jae-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.25-34
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    • 1995
  • Background: Endobronchial tuberculosis is classified into 7 subtypes as fibrostenotic type, edematous-hyperemic type, actively caseating type, tumorous type, ulcerative type, granular type and nonspecific bronchitic type by bronchoscopic features, and we make a prospective study to follow up how bronchoscopic findings change during treatment-course in each subtype of active endobronchial tuberculosis. Methods: We planned to do follow-up bronchoscopic examination every month until there was no significant change in endobronchial lesion, then every 3 months and at the end of the treatment in each patient with biopsy proven endobronchial tuberculosis from May, 1990 to August, 1993. Results: 1) This study included 66 cases, but bronchoscopic follow-up was completed as scheduled in 47 cases. 2) In actively caseating and edematous-hyperemic type, bronchostenosis occurred within 2 or 3 months of treatment in about 2/3 of total cases. 3) In fibrostenotic type, bronchostenosis did not improve in spite of the treatment. 4) In tumorous type, the changes in bronchoscopic findings were unpredictable because new lesions occured on other sites even 4 or 6 months after treatment in 2 cases and the size of initial mass increased 6 months after treatment in 1 case (among 7 cases). 5) Granular and nonspecific bronchitic type improved without significant sequelae within 2 or 3 months of treatment. Conclusion: It may be necessary to follow up the patient with bronchoscopy repeatedly 2 or 3 months after starting treatment in active endobronchial tuberculosis, and it is better to perform bronchoscopic examination at 6 months of treatment, especially in patients with tumorous type because there is possibility that new endobronchial lesion occurs. Aggressive therapeutic modalities such as stent-insertion, laser therapy or electrocautery should be considered to prevent bronchostenosis in cases with granulation tissue, fibrostenotic and tumorous types of endobronchial tuberculosis.

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A Study on a space utilization plan for screening clinic in public health center by means of the prevention of respiratory infectious disease - Focused on a negative pressured tuberculosis exam room (호흡기 감염병 예방을 위한 보건소 상시 선별진료소 활용방안 연구 - 음압 결핵 검진실을 중심으로)

  • Yoon, Hyung Jin;Han, Su Ha
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.27 no.4
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    • pp.51-60
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    • 2021
  • Purpose: Tuberculosis(TB) care unit in public health center should be carefully considered to be re-designed as an infection safety environment for both patient and healthcare workers. So, for the enhancement, this study analyses the facility requirements for co-using the screening clinic as a TB and other respiratory disease care unit. Methods: Not only screening clinic facility guidelines from "A Study for Standard Triage Design and Construction Document" but also the guidelines of TB care and related medical facility are reviewed; KDCA, CDC, ECDC and WHO as a TB care, and FGI and NHS for facility. The facility requirements are summarized space, approach, and mechanical requirement in order. By comparing the summary and screening clinic facility guidelines, supplementations are proposed for TB care unit setting. Results: The result of this study shows that both the space program and mechanical requirement of the screening clinic and that of TB care unit are almost identical and could be share, which include direct airflow or negative air pressure in an exam room. To increase functional and economical efficiency, however, it is necessary to consider a multi-functional negative pressured room, So care process may be re-designed based on a room type; face-to-face room or glass wall inbetween. Implications: The facility guidelines for TB care unit of a public health center should be developed to build a safe environment for infection control by reflecting its medical plan and budget.