2024-03-27 22:23:23
Prevention and treatment are difficult, and the number of patients continues to increase… Government management system introduced in 1962
Last year, domestic cases decreased to 10,000.
Korea Disease Control and Prevention Agency established the 3rd comprehensive plan last year
Strengthening customized management considering patient conditions
In April last year, Hwang Jong-il (48), who lives in Muan-gun, Jeollanam-do, coughed violently every night. He took cold medicine prescribed by a nearby hospital, but the cough did not stop. Two months later, after hearing that an acquaintance who lived with him was diagnosed with tuberculosis, Mr. Hwang wondered if it was tuberculosis and visited Mokpo National Hospital, a tuberculosis hospital. At the hospital, Mr. Hwang was diagnosed with tuberculosis and was hospitalized the next day.
Mr. Hwang is receiving treatment by leading a regular life, taking tuberculosis medication at 6 a.m. every day, eating breakfast an hour later, and then doing light exercise. Mr. Hwang said, “When I was first hospitalized, my condition was so bad that it was difficult to breathe,” and “I am recovering my health through continuous and systematic management.” Mr. Hwang will be discharged from the hospital next month.
● The number of tuberculosis patients in Korea is still around 10,000.
Many people think that tuberculosis is a ‘disease of the past.’ However, if you look at the statistics, tuberculosis patients are occurring steadily.
According to the Korea Disease Control and Prevention Agency on the 27th, the number of tuberculosis patients last year was 19,540, a 4.1% decrease from the previous year. Of these, 15,640 are new patients and the remaining 3,900 are relapse and retreatment patients. The number of tuberculosis patients has been decreasing for 12 consecutive years since reaching a peak of 50,491 in 2011.
Tuberculosis is considered a difficult disease in prevention, diagnosis, and treatment. Prevention is difficult due to the long incubation period that lasts a lifetime and the absence of a vaccine for adults, and it is not easy to diagnose tuberculosis using complex diagnostic tests. In addition, because long-term treatment of 6 to 20 months is required, there are cases where patients give up treatment midway. As of 2022, Korea ranked 2nd in tuberculosis incidence and 4th in mortality rate among 38 member countries of the Organization for Economic Co-operation and Development (OECD).
● National tuberculosis control achievements over 60 years
Despite various adverse conditions, the number of tuberculosis patients in Korea decreased to 10,000 last year thanks to the tuberculosis control project over 60 years. The government began managing tuberculosis centered on public health centers in 1962, and enacted the Tuberculosis Prevention Act in 1968 to reduce the number of patients. In 2000, a computer-based tuberculosis information surveillance system was established, and since 2007, nurses dedicated to tuberculosis management have been assigned to medical institutions that treat many tuberculosis patients to thoroughly manage treatment. In 2013, a tuberculosis epidemiology investigation team was created to prevent further spread, and in 2014, services for vulnerable patients were also provided through the tuberculosis safety belt.
Starting in 2016, out-of-pocket expenses for tuberculosis treatment were eliminated, thereby reducing the burden of medical expenses. Starting in 2018, on-site tuberculosis screening has been implemented to reduce blind spots in screening and treatment. In addition, research and development (R&D) projects such as tuberculosis diagnosis, treatment, and vaccines for adults are also being promoted. Ji Young-mi, director of the Korea Disease Control and Prevention Agency, said, “What is absolutely necessary to eradicate tuberculosis is the active participation of the people,” and added, “We recommend that people aged 65 or older receive free tuberculosis screening at public health centers once a year.”
● “By 2027, the incidence rate will be less than 20 per 100,000 people.”
In March of last year, the Korea Disease Control and Prevention Agency announced the goal of strengthening national support for prevention, diagnosis, and treatment in the ‘3rd Comprehensive Tuberculosis Control Plan’ and reducing the tuberculosis incidence rate to below 20 per 100,000 by 2027. The government is working with hospitals to strengthen customized management that takes into account patients’ conditions, such as medication consultation and confirmation.
Tuberculosis patients from vulnerable groups are separately connected to health and welfare services. If patients in financial difficulties give up treatment prematurely, tuberculosis can spread to the community, so to prevent this, various support projects are being carried out in parallel.
The Korea Disease Control and Prevention Agency plans to strengthen management of high-risk and vulnerable groups, including the elderly, and minimize ‘blind spots in tuberculosis management.’ Last year, among domestic tuberculosis patients, the number of patients under the age of 65 was 8,231, a 9.4% decrease from the previous year, but the number of patients over the age of 65 was 11,309, a 0.1% increase from the previous year. The proportion of elderly patients among all tuberculosis patients is 57.9%, and has continued to exceed 50% from 2021 to present.
We will also continue to provide on-site tuberculosis screening for vulnerable groups such as the elderly over 65 years of age and the homeless. For those who have difficulty visiting a hospital or clinic, the method is to load a mobile examination vehicle with portable X-ray equipment and visit the patient’s home directly or visit a shared facility such as a senior center. Tuberculosis patients can be quickly identified by reading chest X-ray test results remotely in real time. ‘On-site tuberculosis screening’, which started in 2018, received a total of 860,000 people as of last year, identified 751 patients, and supported treatment.
Son Ho-jun, a professor at Seoul National University’s Graduate School of Public Health, said, “Korea’s tuberculosis policy is world-class in that it systematically manages patients through cooperation between the private and public sectors.” Professor Son said, “However, there are still challenges that must be overcome, such as the high proportion of elderly people and foreigners among the patients,” adding, “There is a need to focus on on-site tuberculosis screening and latent tuberculosis infection prevention treatment, focusing on those with a high incidence rate.” said.
Reporter Cho Yu-ra jyr0101@donga.com
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2024-03-27 22:23:23