Abstract
BackgroundTuberculosis (TB) has been a major public health problem in South Korea. Although TB notification rate in Korea is gradually decreasing, still highest among the member countries of the Organization for Economic Cooperation and Development. To effectively control TB, understanding the TB epidemiology such as prevalence of latent tuberculosis infection (LTBI) and annual risk of TB infection (ARI) are important. This study aimed to identify the prevalence of LTBI and ARI among South Korean health care workers (HCWs) based on their interferon-gamma release assays (IGRA).MethodsThis was single center, cross-sectional retrospective study in a tertiary hospital in South Korea. We performed IGRA in HCWs between May 2017 and March 2018. We estimated ARI based on IGRA results. Logistic regression model was used to identify factors affecting IGRA positivity.ResultsA total of 3233 HCWs were analyzed. Median age of participants was 38.0 and female was predominant (72.6%). Overall positive rate of IGRA was 24.1% and IGRA positive rates age-group wise were 6.6%, 14.4%, 34.3%, and around 50% in the age groups 20s, 30s, 40s, and 50s and 60s, respectively. The ARIs was 0.26–1.35% between 1986 and 2005; rate of TB infection has gradually decreased in the last two decades. Multivariable analysis indicated that older age, healed TB lesion in x-ray, and male gender were risk factors for IGRA positivity, whereas working in high-risk TB departments was not.ConclusionsResults showed that ARI in South Korean HCWs gradually decreased over two decades, although LTBI remained prevalent. Our results suggest that the LTBI test result of HCWs might be greatly affected by age, rather than occupational exposure, in intermediate TB burden countries. Thus, careful interpretation considering the age structure is required.
Highlights
Tuberculosis (TB) has been a major public health problem in South Korea
We aimed to identify the prevalence of latent tuberculosis infection (LTBI) and estimate annual risk of TB infection (ARI) in health care settings based on interferon-gamma release assays (IGRA) results of health care workers (HCWs)
The working period was divided into groups ranging from less than 1 year to more than 30 years with the percentage of employees working for 10–20 years being the highest (30.1%)
Summary
Tuberculosis (TB) has been a major public health problem in South Korea. TB notification rate in Korea is gradually decreasing, still highest among the member countries of the Organization for Economic Cooperation and Development. To effectively control TB, understanding the TB epidemiology such as prevalence of latent tuberculosis infection (LTBI) and annual risk of TB infection (ARI) are important. This study aimed to identify the prevalence of LTBI and ARI among South Korean health care workers (HCWs) based on their interferon-gamma release assays (IGRA). TB is still an important public health concern in South Korea; for effective TB control, understanding its epidemiology, such as the prevalence of latent tuberculosis infection (LTBI) and annual risk of TB infection (ARI) is important. The annual risk of TB infection in South Korea was estimated using TST results in ages 5–9 years, and the ARI was 0.5–5.3% based on a 10-mm induration between 1958 and 1988 [6]. Studies on ARI using interferon-gamma release assay (IGRA) results in South Korea are lacking
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