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Nationwide trends in incidence of tuberculosis among people with disabilities in South Korea: a nationwide serial cross-sectional study

박종은|민진수|SO-YOUNG KIM|Yeon-Yong Kim|Jong-Hyock Park
한국역학회 (Korean Society of Epidemiology)|2022.01|Epidemiology and Health|제44권 |pp. 1-9|DOI 10.4178/epih.e2022098

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참고문헌

키워드

RiskVulnerable populationsIntellectual disabilityMental disabilityIncidence of tuberculosisSocial determinants of health

초록

OBJECTIVES: Studies on the association between disability and tuberculosis (TB) are scarce. We aimed to assess the risk of active TB disease among people with disabilities. METHODS: We conducted a nationwide serial cross-sectional study using national registry linkage databases from 2008 to 2017. The crude and age, sex-standardized incidence rates of TB were analyzed for each year according to the presence, type, and severity of disabilities. The crude incidence rate and odds of developing TB disease were examined by a multivariable logistic regression model using data in 2017. RESULTS: The overall incidence of active TB decreased between 2008 and 2017. Age, sex-standardized incidence rates of TB disease among people with disabilities were significantly higher than among those without disabilities throughout all observed years (P< 0.001). As of 2017, the population with disabilities had a higher crude incidence rate of active TB disease than that without disability (119.9/100,000 vs. 48.5/100,000 person-years, P< 0.001), regardless of sex, income level, and place of residence. Compared to those without disability, those with disabilities had higher odds of active TB (adjusted odds ratio [aOR], 1.19; 95% confidence interval [CI], 1.15-1.24). Mental disability (aOR, 1.51; 95% CI, 1.24-1.84) had the highest odds of active TB incidence, followed by developmental disability (aOR, 1.30; 95% CI, 1.09-1.55). CONCLUSIONS: People with disabilities are at a greater risk of developing TB disease. Active screening and care for TB cases would be beneficial for people with disabilities.

Abstract

OBJECTIVES: Studies on the association between disability and tuberculosis (TB) are scarce. We aimed to assess the risk of active TB disease among people with disabilities. METHODS: We conducted a nationwide serial cross-sectional study using national registry linkage databases from 2008 to 2017. The crude and age, sex-standardized incidence rates of TB were analyzed for each year according to the presence, type, and severity of disabilities. The crude incidence rate and odds of developing TB disease were examined by a multivariable logistic regression model using data in 2017. RESULTS: The overall incidence of active TB decreased between 2008 and 2017. Age, sex-standardized incidence rates of TB disease among people with disabilities were significantly higher than among those without disabilities throughout all observed years (P< 0.001). As of 2017, the population with disabilities had a higher crude incidence rate of active TB disease than that without disability (119.9/100,000 vs. 48.5/100,000 person-years, P< 0.001), regardless of sex, income level, and place of residence. Compared to those without disability, those with disabilities had higher odds of active TB (adjusted odds ratio [aOR], 1.19; 95% confidence interval [CI], 1.15-1.24). Mental disability (aOR, 1.51; 95% CI, 1.24-1.84) had the highest odds of active TB incidence, followed by developmental disability (aOR, 1.30; 95% CI, 1.09-1.55). CONCLUSIONS: People with disabilities are at a greater risk of developing TB disease. Active screening and care for TB cases would be beneficial for people with disabilities.

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