Tuberculosis prevention and care in Korea: Evolution of policy and practice.
Tuberculosis prevention and care in Korea: Evolution of policy and practice.
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DOI：
10.1016/j.jctube.2018.04.006
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发表时间：
2018-05-01
影响因子：
2
通讯作者：
Lee, Jong-Koo
中科院分区：
文献类型：
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作者：
Go, Unyeong;Park, Misun;Lee, Jong-Koo
韩国的结核病(TB)仍然是一个严重的健康问题，2016年估计每10万人中就有77人患有结核病。这使韩国成为经济合作与发展组织中唯一结核病发病率较高的国家。自2011年以来，政府增加了预算，并加强了患者管理政策。在结核病控制五年计划(2013-2017)中增加了对潜在结核病的管理，加强了广泛的接触调查，并于2013年开始实施。由于这些努力，韩国在2011至2016年间实现了结核病发病率平均每年下降5.2%。为了进一步加快降低结核病负担，政府推出了额外的措施，包括对社区工作人员强制筛查潜在的结核病感染，包括儿童日托中心、幼儿园和学校的教师以及诊所和医院的医护人员，以解决2017年通过接触调查发现的问题。为活动性结核病提供高质量的免费诊断和治疗，包括对耐多药结核病进行免费诊断和治疗，并结合积极接触调查，是目前韩国方案应对工作的主要内容。然而，现有的LTBI工具的局限性带来了挑战，包括缺乏与专业人员和公众进行有效沟通的最佳机制，需要至少3个月的治疗，以及副作用的风险。开发有效的工具将有助于克服这些挑战。
Tuberculosis (TB) in Korea remains a serious health problem with an estimated 77 per 100,000 incidence rate for 2016. This makes Korea as the only OECD country with high incidence of TB. The government has increased budgets and strengthened patient management policies since 2011. The management of latent tuberculosis was added to the response with strengthened and extensive contact investigations in the five-year tuberculosis control plan (2013-2017) and implementation was established in 2013. Due to these efforts Korea has achieved an average 5.2% reduction annually in tuberculosis incidence rate between 2011 and 2016. To further expedite the reduction of the TB burden the government has introduced additional measures including mandatory screening of latent tuberculosis infection for community workers in congregate settings including daycare centers for children, kindergarten, and teachers in schools and health care workers in clinics and hospitals to solve the problems identified through contact investigations in 2017. Providing high quality free diagnosis and treatment of active TB including for multidrug resistant TB combined with active contact investigations is the mainstay of the current programmatic response in Korea. However, the limitation of existing tools for LTBI pose challenge including absence of best mechanism for effective communication with professionals and the public, the need for at least 3 months of treatment and the risk of side effects. Developing effective tools will help to overcome these challenges.