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Free Content Factors leading to under-reporting of tuberculosis in the private sector in Korea

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OBJECTIVE: To identify factors associated with under-reporting of tuberculosis (TB) in the private sector in Korea.

DESIGN: A cross-sectional study of 37 820 cases in whom treatment was initiated between January and December 2008 using data from the Nationwide Medical Records Survey of Patients with TB. Adjusted odds ratios (aOR) for under-reporting with respect to socio-demographic and clinical factors were estimated.

RESULTS: Among the 37 820 identified cases, 21 611 (57.1%) were reported to the Korean TB Surveillance System. Factors associated with under-reporting on univariate analysis included young children, foreign-born persons, non-multidrug-resistant TB, persons prescribed fewer than four anti-tuberculosis drugs, non-performance of or negative result on sputum smear and extra-pulmonary TB (particularly abdominal or genitourinary TB). For pulmonary TB, cases with no sputum smear results vs. smear-positive patients (aOR 2.23, P < 0.001) and those prescribed <4 drugs vs. those who were prescribed ≥4 drugs (aOR 1.60, P < 0.001) were strongly related to under-reporting on multivariate analysis.

CONCLUSION: The extent of under-reporting was greater among young children, persons who had not received sputum smear testing and those who had been prescribed fewer than four drugs. Furthermore, TB diagnostic investigations were often inadequate. Education on reporting requirements, including the importance of following guidelines on TB management, and a stricter enforcement of the existing TB Prevention Law, are needed.
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Keywords: disease notification; mandatory reporting; tuberculosis

Document Type: Research Article

Affiliations: 1: Division of HIV and TB Control, Korea Centers for Disease Control and Prevention, Seoul, Korea; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea 2: Division of HIV and TB Control, Korea Centers for Disease Control and Prevention, Seoul, Korea; Department of Biostatistics, Korea University College of Medicine, Seoul, Korea 3: Department of Biostatistics, Korea University College of Medicine, Seoul, Korea 4: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea 5: Division of HIV and TB Control, Korea Centers for Disease Control and Prevention, Seoul, Korea

Publication date: 2012-09-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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