Tuberc Respir Dis.  2019 Apr;82(2):151-157. 10.4046/trd.2018.0009.

Pre-immigration Screening for Tuberculosis in South Korea: A Comparison of Smear- and Culture-Based Protocols

• Lee S
• Ryu JY
• Kim DH

• KMID: 2453985
• DOI: http://doi.org/10.4046/trd.2018.0009

Abstract

BACKGROUND
Tuberculosis (TB) is the most important disease screened for upon patient history review during preimmigration medical examinations as performed in South Korea in prospective immigrants to certain Western countries. In 2007, the U.S. Centers for Disease Control and Prevention (CDC) changed the TB screening protocol from a smear-based test to the complete Culture and Directly Observed Therapy Tuberculosis Technical Instructions (CDOT TB TI) for reducing the incidence of TB in foreign-born immigrants.
METHODS
This study evaluated the effect of the revised (as compared with the old) protocol in South Korea.
RESULTS
Of the 40,558 visa applicants, 365 exhibited chest radiographic results suggestive of active or inactive TB, and 351 underwent sputum tests (acid-fast bacilli smear and Mycobacterium tuberculosis culture). To this end, using the CDOT TB TI, 36 subjects (88.8 per 105 of the population) were found to have TB, compared with only seven using the older U.S. CDC technical instruction (TI) (p<0.001). In addition, there were six drug-resistant cases which were identified (16.7 per 105 of the population), two of whom had multidrug-resistance (5.6 per 105 of the population).
CONCLUSION
The culture-based 2007 TI identified a great deal of TB cases current to the individuals tested, as compared to older U.S. CDC TI.

Keyword

Tuberculosis; Immigrants; Screening; Republic of Korea

MeSH Terms

Centers for Disease Control and Prevention (U.S.)
Directly Observed Therapy
Emigrants and Immigrants
Humans
Incidence
Korea*
Mass Screening*
Mycobacterium tuberculosis
Prospective Studies
Radiography, Thoracic
Republic of Korea
Sputum
Tuberculosis*

Figure

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  Figure 1 The U.S. Centers for Disease Control and Prevention 1991 technical instructions for pre-immigration TB screening and treatment. Class A TB: active TB disease; Class B1 TB: chest radiographic data consistent with active TB; Class B2 TB: chest radiographic data consistent with inactive TB; TB: tuberculosis.

• 

  Figure 2 The complete Culture and Directly Observed Therapy Tuberculosis Technical Instructions of U.S. Centers for Disease Control and Prevention. Class A TB: active TB disease; Class B1 TB: chest radiographic data consistent with active TB; TB: tuberculosis; HIV: human immunodeficiency virus; DOT: directly observed therapy.

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