Latent Tuberculosis Cascade of Care Among Healthcare Workers:A Nationwide Cohort Analysis in Korea Between 2017 and 2018
10.3346/jkms.2022.37.e164
- Author:
Jinsoo MIN
1
;
Hyung Woo KIM
;
Joon Young CHOI
;
Ah Young SHIN
;
Ji Young KANG
;
Yunhee LEE
;
Jun-Pyo MYONG
;
Hyunsuk JEONG
;
Sanghyuk BAE
;
Hyeon-Kyoung KOO
;
Sung-Soon LEE
;
Jae Seuk PARK
;
Hyeon Woo YIM
;
Ju Sang KIM
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2022;37(20):e164-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:In 2017, Korea implemented nationwide latent tuberculosis infection (LTBI) project targeting healthcare workers (HCWs). We aimed to assess its performance using the cascade of care model.
Methods:We included 45,503 employees of medical institutions with positive interferongamma release assay result who participated between March 2017 and December 2018. We described percentages of LTBI participants completing each step in the cascade of care.Poisson regression model was conducted to assess individual characteristics and factors associated with not-visiting clinics for further care, not-initiating LTBI treatment, and notcompleting treatment.
Results:Proportions of visiting clinics and initiating and completing treatment in HCWs were 54.9%, 38.5%, and 32.0%, respectively. Despite of less likelihood of visiting clinics and initiating LTBI treatment, older age ≥ 65 years were more likely to complete treatment (adjusted relative risk [aRR], 0.80; 95% confidence interval [CI], 0.64–0.99), compared to young age < 35 years. Compared to nurses, doctors were less likely to visit clinic; however, were more likely to initiate treatment (aRR, 0.88; 95% CI, 0.81–0.96). Those who visited public health centers were associated with not-initiating treatment (aRR, 1.34; 95% CI, 1.29–1.40). When treated at private hospitals, 9-month isoniazid monotherapy was less likely to complete treatment, compared to 3-month isoniazid and rifampicin combination therapy (aRR, 1.33; 95% CI, 1.16–1.53).
Conclusion:Among employees of medical institutions with LTBI, only one third completed treatment. Age, occupation, treatment center, and initial regimen were significantly related to LTBI treatment performance indicators. Rifampicin-based short treatment regimens were effective under standard of care.
