Background: With a rapid decrease in tuberculosis (TB) incidence, the significance of latent tuberculosis infection (LTBI) has been underscored in South Korea. Although South Korea does not have a high proportion of immigrants compared to other countries, there is a growing argument that it should actively embrace immigrants as a solution to address issues of low birth rates and population aging. This study aimed to assess TB incidence among immigrants who participated a pilot LTBI screening program in South Korea.
Methods: Records of immigrants participated in a pilot LTBI screening program in South Korea between 2018 and 2019 were linked with Korean National TB Surveillance System to determine TB development. Participants underwent interferon-gamma release assay (IGRA) and chest X-rays. Standardized incidence ratios (SIRs) stratified by age, country of origin's TB burden was calculated with a reference group of general South Korean population.
Results: Of a total of 9,517 participants, 14 TB cases were identified. Participants with positive IGRA results who did not initiate LTBI treatment showed TB incidence of 312.5 per 100,000 person-years, whereas those with negative results showed TB incidence of 34.4 per 100,000 person-years, resulting in an incidence rate ratio of 9.08 (95% confidence interval [CI], 2.50-32.99). SIR of TB among total participants including those with negative IGRA results was 2.60 (95% CI, 1.54-4.38; < 0.001), whereas SIR among those with positive IGRA results was 5.86 (95% CI, 3.15-10.89; < 0.001). In the calculation of SIR among participants with positive IGRA results, those aged under 35 from high TB-burden countries or intermediate TB-burden countries showed a high SIR (18.08; 95% CI, 2.55-128.37; = 0.004), and 11.30 (95% CI, 2.82-45.16; < 0.001), respectively). Contrary to previous reports that suggest the majority of elderly population with a positive IGRA result were due to remote infection and had a lower TB risk compared to younger ages, SIR among those aged 65 or over from intermediate TB-burden countries was 6.15 (95% CI, 0.87-43.69; = 0.069), which was comparable to that in younger participants aged between 35 and 49 (SIR, 4.87; 95% CI, 1.22-19.49; = 0.025) or those aged between 50 and 64 (SIR, 4.62; 95% CI, 1.73-12.31; = 0.002).
Conclusion: Young immigrants with positive IGRA results from countries with high or intermediate TB burden showed a relatively high TB risk compared to a general South Korea population. In addition, unexpected high TB risk was observed among elderly immigrants with positive IGRA results. In establishing future policies for LTBI in immigrants in South Korea, screenings should primarily focus on younger age group (who aged under 35). Additionally, further research is needed on the high TB risk observed in elderly immigrants.
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http://dx.doi.org/10.3346/jkms.2024.39.e207 | DOI Listing |
Lancet Microbe
December 2024
Amsterdam University Medical Centres, Amsterdam, Netherlands; Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands.
Background: Tuberculosis vaccine trials using disease as the primary endpoint are large, time consuming, and expensive. An earlier immunological measure of the protection against disease would accelerate tuberculosis vaccine development. We aimed to assess whether the effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine for prevention of Mycobacterium tuberculosis infection was consistent with that for prevention of tuberculosis disease.
View Article and Find Full Text PDFBackground: In Morocco, latent tuberculosis infection (LTBI) is a public health concern affected by the country's location as transit area between sub-Saharan Africa with high TB burden to Europe. This study aimed to assess the influence of exposure intensity to Mycobacterium tuberculosis (Mtb), age, and Bacille Calmette-Guérin (BCG) vaccination on LTBI prevalence in Morocco.
Methods: A cross-sectional study of 131 participants, including 98 non-exposed healthy volunteers (NEHV) and 33 healthcare workers exposed to active TB (exposed healthcare workers [EHCW]), was conducted.
J Clin Microbiol
December 2024
Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Unlabelled: Urgent improvements in the diagnosis and management of infection are required to reach End TB goals. Conventional interferon-gamma release assays (IGRAs), such as QuantiFERON-TB Gold Plus (QFT-Plus), require substantial laboratory infrastructure and large blood volumes, limiting use in high-burden settings. The QIAreach QuantiFERON-TB (QIAreach QFT) was developed to overcome these challenges but has not previously been evaluated in field conditions in a low-income, high-burden country, or at scale in children.
View Article and Find Full Text PDFInt J Infect Dis
December 2024
Division of Clinical Services, Maricopa County Department of Public Health. Electronic address:
Background: Identifying and treating tuberculosis infection (TBI) among refugees at elevated risk for developing TB disease is crucial for TB prevention and elimination in the United States (U.S.).
View Article and Find Full Text PDFInfez Med
December 2024
Clinical Microbiology and Virology Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Latent Tuberculosis Infection (LTBI) is a state of persistent immune response to complex antigens without clinical, radiological and microbiological signs of active disease. Effective diagnosis and preventive treatment of LTBI are crucial for tuberculosis (TB) control, especially in high-risk groups. Currently, two main tests are used for LTBI diagnosis: the Tuberculin Skin Test (TST) and the Interferon-Gamma Release Assays (IGRA), including the QuantiFERON-TB Gold Plus (QFT-Plus) and the T-SPOT.
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