Delays in the diagnosis and treatment of tuberculosis during the COVID-19 outbreak in the Republic of Korea in 2020

Objectives@#We investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on tuberculosis (TB) management in the Republic of Korea (ROK). @*Methods@#This retrospective cross-sectional study used nationwide ROK TB notification data (98,346 cases) from 2017 to 2020. The median time from the onset of TB symptoms to treatment initiation and the compliance rates with the required timing for notification and individual case investigations were measured and compared across periods and regions affected by the COVID-19 epidemic. @*Results@#TB diagnosis during the COVID-19 pandemic was delayed. The median time to TB treatment initiation (25 days) in 2020 increased by 3 days compared to that of the previous 3 years (22 days) (p<0.0001). In the outbreak in Seoul, Incheon, and Gyeonggi province during August, the time to TB diagnosis was 4 days longer than in the previous 3 years (p=0.0303). In the outbreak in Daegu and Gyeongbuk province from February to March 2020, the compliance rate with the required timing for individual case investigations was 2.2%p points lower than in other areas in 2020 (p=0.0148). For public health centers, the rate was 13%p lower than in other areas (80.3% vs. 93.3%, p=0.0003). @*Conclusion@#TB diagnoses during the COVID-19 pandemic in the ROK were delayed nationwide, especially for patients notified by public-private mix TB control hospitals. TB individual case investigations were delayed in regional COVID-19 outbreak areas (Daegu and Gyeongbuk province), especially in public health centers. Developing strategies to address this issue will be helpful for sustainable TB management during future outbreaks.

The Association between Esophagogastroduodenoscopic Findings and the Related Risk Factors of Obesity / 가정의학회지

BACKGROUND: The reports that obesity could be associated with upper gastrointestinal disorders such as gastritis, gastric ulcer, duodenal ulcer, reflux esophagitis have not been consistent. Therefore, we studied the association between esophagogastroduodenoscopic (EGD) findings and the related risk factors of obesity. METHODS: The study subjects include 2,210 adults who visited the Health Promotion Center of one university hospital from January 2006 to December 2006. All subjects had standard physical measurements as well as resting blood pressure, fasting blood glucose, HbA1c, serum lipids, and gastroendoscopic examination. BMI was classified into two groups (BMI > or = 23 kg/m2, normal; BMI < 23 kg/m2, overweight or obese). The study subjects were classified into four groups according to the EGD findings; normal, gastritis, gastric or duodenal ulcer, reflux esophagitis. RESULTS: Mean BMI of gastritis, gastric or duodenal ulcer, and reflux esophagitis groups were higher than normal group after adjusting age, sex, alcohol and smoking (P < 0.001). Gastritis risk (OR, 2.098; 95% CI, 1.195 to 3.682; P = 0.01), gastric or duodenal ulcer risk (OR, 2.562; 95% CI, 1.282 to 5.117; P = 0.008), and reflux esophagitis risk (OR, 2.856; 95% CI, 1.522 to 5.360; P = 0.001) were significantly higher in overweight and obesity group compare with normal weight group after adjusting age, sex, alcohol and smoking. CONCLUSION: We suggest that overweight or obesity is the risk factor of gastritis, gastric or duodenal ulcer, and reflux esophagitis.

The Association between Esophagogastroduodenoscopic Findings and the Related Risk Factors of Obesity / 가정의학회지

BACKGROUND: The reports that obesity could be associated with upper gastrointestinal disorders such as gastritis, gastric ulcer, duodenal ulcer, reflux esophagitis have not been consistent. Therefore, we studied the association between esophagogastroduodenoscopic (EGD) findings and the related risk factors of obesity. METHODS: The study subjects include 2,210 adults who visited the Health Promotion Center of one university hospital from January 2006 to December 2006. All subjects had standard physical measurements as well as resting blood pressure, fasting blood glucose, HbA1c, serum lipids, and gastroendoscopic examination. BMI was classified into two groups (BMI > or = 23 kg/m2, normal; BMI < 23 kg/m2, overweight or obese). The study subjects were classified into four groups according to the EGD findings; normal, gastritis, gastric or duodenal ulcer, reflux esophagitis. RESULTS: Mean BMI of gastritis, gastric or duodenal ulcer, and reflux esophagitis groups were higher than normal group after adjusting age, sex, alcohol and smoking (P < 0.001). Gastritis risk (OR, 2.098; 95% CI, 1.195 to 3.682; P = 0.01), gastric or duodenal ulcer risk (OR, 2.562; 95% CI, 1.282 to 5.117; P = 0.008), and reflux esophagitis risk (OR, 2.856; 95% CI, 1.522 to 5.360; P = 0.001) were significantly higher in overweight and obesity group compare with normal weight group after adjusting age, sex, alcohol and smoking. CONCLUSION: We suggest that overweight or obesity is the risk factor of gastritis, gastric or duodenal ulcer, and reflux esophagitis.