Status of Tuberculosis in South Korea and the Need for a New Method to Diagnose Active Tuberculosis

Tuberculosis (TB) is a global health concern even in South Korea. TB incidence in South Korea is the highest among Organisation for Eoconomic Co-operation and Development (OECD) countries, and is supposed to be due to the Korean War in 1950. TB has not yet been eradicated, and is the most common infection and death among infectious diseases in South Korea. Therefore, there is a need for a method to diagnose active tuberculosis quickly and inexpensively on site, and the detection of mycobacterial proteins in sputum using a radioimmunoassay or membrane filtration method can be an alternative. In addition, the newly developed diagnostic method can contribute greatly to Africa, Southeast Asia, and North Korea, which have become major problems with tuberculosis. Abbreviations: OECD: Organisation for Eoconomic Co-operation and Development; KCDC: Korea Centers for Disease Control Jae Cheong Lim. Biomed J Sci & Tech Res Volume 5Issue 1: 2018 Biomedical Journal of Scientific & Technical Research (BJSTR) 4366 ication of TB, early diagnosis of active TB is the most important. Sputum is the most common specimen obtained for the diagnosis of active TB, and is directly tested through a microscopic examination or nucleic acid amplification tests. A direct microscopic examination is a fast and inexpensive method to identify acid-fast bacilli, but its sensitivity is poor [8]. For these reasons, WHO recommends a biomolecular test such as nucleic acid amplification. Xpert MTB/ Rif (Cepheid, Sunnyvale, CA, USA) is the most efficient and suitable tool for a nucleic acid amplification test of TB, and provides the results in < 2 h [9]. Nevertheless, a culture remains the gold standard test for the diagnosis of TB, but it requires a long waiting time (2-6 weeks) owing to the slow growth rate of mycobacteria [10]. The reason why tuberculosis has not been eradicated in South Korea is presumed to be the difficulty in diagnosing active TB of patients who are alienated, poor, or homeless. A nucleic acid amplification test is the most appropriate for an immediate inspection of active TB on site. However, expensive equipment and a skilled inspector for the test are not available in general hospitals, with the exception of university hospitals in South Korea. Therefore, new tools for the diagnosis of active TB that can be performed on site are needed. Methods for the diagnosis of active TB are continually evolving in order to achieve more rapid, less expensive, and accurate results. Although a number of molecular diagnostic tools have been developed, the detection of mycobacterial proteins in sputum is most likely to confirm active tuberculosis. For protein detection, a radioimmunoassay method can be useful because a large number of samples can be evaluated concurrently, and it does not take much time. A membrane filtration can also be useful because the concentration of sputum can amplify the sensitivity. Conclusion In South Korea, tuberculosis is prevalent in the elderly, and is the most common deadly infectious disease. This is presumably due to the difficulty in diagnosing the major infected persons with active tuberculosis. Therefore, there is a need for a method to diagnose active tuberculosis quickly and inexpensively on site, and the detection of mycobacterial proteins in sputum using a radioimmunoassay or membrane filtration method can be an alternative. In addition, the newly developed diagnostic method can contribute greatly to Africa, Southeast Asia, and North Korea, which have become major problems with tuberculosis. Acknowledgement This work was supported by a Korea Atomic Energy Research Institute major project: Development of Radioisotope Production and Application Technology (525330-18), and by the National Research Foundation of Korea (NRF), funded by the Ministry of Science and ICT (NRF-2017M2A2A6A01071321). References 1. WHO (2015) Global tuberculosis report 2015. Geneva, Switzerland. 2. WHO (2016) Global tuberculosis report 2016. Geneva, Switzerland. 3. World Bank (2015) Incidence of tuberculosis (per 100,000 people). 4. Korean National Tuberculosis Association (1998) A history of tuberculosis in Korea. The Association, Seoul, South Korea. 5. Janssens JP, Rieder HL (2008) An ecological analysis of incidence of tuberculosis and per capita gross domestic product. Eur Respir J 32(5): 1415-1416. 6. Kim JH, Yim JJ (2015) Achievements in and Challenges of Tuberculosis Control in South Korea. Emerg Infect Dis 21(11): 1913-20. 7. Wonseo P (2018) Tuberculosis notification status in Korea in 2017. Weekly Health and Disease 11(13): 401-406. 8. Marais BJ (2008) Use of light-emitting diode fluorescence microscopy to detect acid-fast bacilli in sputum. Clin Infect Dis 47(2): 203-207. 9. Ardizzoni E (2015) Implementing the Xpert (R) MTB/RIF Diagnostic Test for Tuberculosis and Rifampicin Resistance: Outcomes and Lessons Learned in 18 Countries. PLoS One 10(12): e0144656. 10. Asmar S (2015) A Novel Solid Medium for Culturing Mycobacterium tuberculosis Isolates from Clinical Specimens. J Clin Microbiol 53(8): 2566-2569. Submission Link: https://biomedres.us/submit-manuscript.php Assets of Publishing with us • Global archiving of articles • Immediate, unrestricted online access • Rigorous Peer Review Process • Authors Retain Copyrights • Unique DOI for all articles https://biomedres.us/ This work is licensed under Creative Commons Attribution 4.0 License