J Korean Med Sci.  2007 Dec;22(6):963-967. 10.3346/jkms.2007.22.6.963.

Tuberculosis among Dislocated North Koreans Entering Republic of Korea since 1999

• Choi CM
• June JH
• Kang CI
• Park JT
• Oh SY
• Lee JB
• Lee CH
• Yim JJ
• Kim HJ

• KMID: 1785754
• DOI: http://doi.org/10.3346/jkms.2007.22.6.963

Abstract

The collapse of North Korea's public health system has increased the development of tuberculosis (TB) in its populace. This study investigated the prevalence of active and latent TB infection (LTBI) in such people who have settled in the Republic of Korea since 1999. From 1999 to August 2006, 7,722 dislocated North Koreans entered the Republic of Korea and all were screened immediately for active TB. Demographic and clinical characteristics were reviewed from the official records of the Settlement Support Office for Dislocated North Koreans, based in the Ministry of Unification. Of 7,722 participants, 87 (1.13%) were diagnosed with active TB from 1999 to August 2006. Of these, 78 (90%) had pulmonary TB. Checking for the presence of a Bacille Calmette-Guerin (BCG) scar and tuberculin skin test has been performed in all dislocated North Koreans since November 2005. Of 1,112 participants, BCG vaccination scars were found in 67.4%. The tuberculin-positive rate using two tuberculin unit doses of the purified protein derivative RT23 (> or =10 mm in diameter) was 81.5%. The prevalence of active TB and LTBI in dislocated North Koreans was high. Because this group bears a disproportionate burden of TB, we need to initiate a specific control programme and to plan for the impact of this disease in the Republic of Korea.

Keyword

Tuberculosis; Dislocated North Korean; Refugees; Latent TB infection

MeSH Terms

Adolescent
Adult
Aged
BCG Vaccine/immunology
Child
Child, Preschool
Drug Resistance, Bacterial
Female
Humans
Infant
Infant, Newborn
Korea/epidemiology
Male
Middle Aged
Prevalence
Time Factors
Tuberculosis/drug therapy/*epidemiology
Vaccination

Figure

• 

  Fig. 1 Comparison of tuberculin skin test reactivity with the presence of BCG vaccination scars among the dislocated North Koreans.

Reference

1. World Health Organization. Global tuberculosis control: surveillance, planning, financing. WHO report 2005. 2005. Geneva: World Health Organization;(WHO/HTM/TB/2005.349).

2. Frothingham R, Stout JE, Hamilton CD. Current issues in global tuberculosis control. Int J Infect Dis. 2005. 9:297–311.

3. Owen-Davies J. North Korea's public health tragedy. Lancet. 2001. 357:628–630.

4. Goe LC, Linton JA. Community-based public health interventions in North Korea: one non-governmental organization's experience with tuberculosis and hepatitis B. Public Health. 2005. 119:347–352.

5. Barnett ED. Infectious disease screening for refugees resettled in the United States. Clin Infect Dis. 2004. 39:833–841.

6. Hong YP, Kim SJ, Lew WJ, Lee EK, Han YC. The seventh nationwide tuberculosis prevalence survey in Korea, 1995. Int J Tuberc Lung Dis. 1998. 2:27–36.

7. Kim HJ, Ahn YS, Lee SG. Health development experience in North and South Korea. Asia Pac J Public Health. 2001. 13:Suppl. S51–S57.

8. Gushulak BD, MacPherson DW. Globalization of infectious diseases: the impact of migration. Clin Infect Dis. 2004. 38:1742–1748.

9. Lillebaek T, Andersen AB, Dirksen A, Smith E, Skovgaard LT, Kok-Jensen A. Persistent high incidence of tuberculosis in immigrants in a low-incidence country. Emerg Infect Dis. 2002. 8:679–684.

10. Faustini A, Hall AJ, Perucci CA. Risk factors for multidrug resistant tuberculosis in Europe: a systematic review. Thorax. 2006. 61:158–163.

11. Korea Center for Disease Control and Prevention. Anti-tuberculosis Drug Resistance in Korea. Communicable Diseases Monthly Report. 2005. 16:101–107.

12. Cohn DL, Bustreo F, Raviglione MC. Drug-resistant tuberculosis: review of the worldwide situation and the WHO/IUATLD Global Surveillance Project. International Union Against Tuberculosis and Lung Disease. Clin Infect Dis. 1997. 24:Suppl 1. S121–S130.

13. Sharma SK, Mohan A. Multidrug-resistant tuberculosis: a menace that threatens to destabilize tuberculosis control. Chest. 2006. 130:261–272.