Incidence of pulmonary tuberculosis in Korean civil servants

Setting: Longitudinal epidemiological study based on civil servants in Korea. Objective: To estimate the incidence of pulmonary tuberculosis (PTB) for the general population from a reliable sample. Design: New active PTB developing between 1988 and 1990 in civil servants has been determined from (1) the findings of biennial medical examinations and (2) perusal of the medical records of those claiming health insurance for tuberculosis (TB). Results: A total of 790 204 subjects was available for investigation. Active PTB was diagnosed in 5107 patients over the 2 years of the study. Bacteriological examination of 3847 patients yielded 575 (14.9%) positive smears and 350 (9.1%) smear-negative positive cultures from them. Applying these rates to the 1260 whose sputum was not examined, 702 were smear-positive, and 431 were culture-positive. Overall PTB incidence was 393 per 10(5), with 84 and 53 per 10(5) smear- and culture-positives. Incidence was high in males, and in the age group 20-29 years in both sexes. Conclusion: Such high PTB incidence, particularly in the age group 20-29, clearly indicates that TB in Korea remains a serious health problem.