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The cascade of care for latent tuberculosis infection in congregate settings: A national cohort analysis, Korea, 2017-2018

Min, Jinsoo; Kim, Hyung Woo; Stagg, Helen R; Rangaka, Molebogeng X; Lipman, Marc; Abubakar, Ibrahim; Lee, Yunhee; ... Kim, Ju Sang; + view all (2022) The cascade of care for latent tuberculosis infection in congregate settings: A national cohort analysis, Korea, 2017-2018. Frontiers in Medicine , 9 , Article 927579. 10.3389/fmed.2022.927579. Green open access

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Abstract

BACKGROUND: In 2017, Korea implemented a nationwide project to screen and treat latent tuberculosis infection (LTBI) in high-risk for transmission public congregate settings. We aimed to assess programme success using a cascade of care framework. MATERIALS AND METHODS: We undertook a cohort study of people from three congregate settings screened between March 2017 and December 2018: (1) first-grade high school students, (2) employees of educational institutions, (3) employees of social welfare facilities. We report percentages of participants with LTBI completing each step in the cascade of care model. Poisson regression models were used to determine factors associated with not visiting clinics, not initiating treatment, and not completing treatment. RESULTS: Among the 96,439 participants who had a positive interferon-gamma release assay result, the percentage visiting clinics for further assessment, to initiate treatment, and who then completed treatment were 50.7, 34.7, and 28.9%, respectively. Compared to those aged 20–34 years, individuals aged < 20 years and aged ≥ 65 years were less likely to visit clinics, though more likely to complete treatment once initiated. Using public health centres rather than private hospitals was associated with people “not initiating treatment” (adjusted risk ratio [aRR], 3.72; 95% confidence interval [CI], 3.95–3.86). Nine-month isoniazid monotherapy therapy was associated with “not completing treatment,” compared to 3-month isoniazid and rifampin therapy (aRR, 1.28; 95% CI, 1.16–1.41). CONCLUSIONS: Among participants with LTBI from three congregate settings, less than one third completed treatment. Age, treatment centre, and initial regimen were important determinants of losses to care through the cascade.

Type: Article
Title: The cascade of care for latent tuberculosis infection in congregate settings: A national cohort analysis, Korea, 2017-2018
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fmed.2022.927579
Publisher version: https://doi.org/10.3389/fmed.2022.927579
Language: English
Additional information: © 2022 Min, Kim, Stagg, Rangaka, Lipman, Abubakar, Lee, Myong, Jeong, Bae, Shin, Kang, Lee, Park, Yim and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords: Preventive therapy, quality control, social worker, school teacher, student, latent TB infection (LTBI)
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10157148
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