Achievements in and Challenges of Tuberculosis Control in South Korea

Abstract

After the Korean War (1950-1953), nearly 6.5% of South Korea's population had active tuberculosis (TB). In response, South Korea implemented the National Tuberculosis Program in 1962. From 1965 to 1995, the prevalence of bacteriologically confirmed pulmonary TB in South Korea decreased from 940 to 219 cases per 100,000 population. Astounding economic growth might have contributed to this result; however, TB incidence in South Korea remains the highest among high-income countries. The rate of decrease in TB incidence seems to have slowed over the past 15 years. A demographic shift toward an older population, many of whom have latent TB and various concurrent conditions, is challenging TB control efforts in South Korea. The increasing number of immigrants also plays a part in the prolonged battle against TB. A historical review of TB in South Korea provides an opportunity to understand national TB control efforts that are applicable to other parts of the world.

Keywords: Mycobacterium tuberculosis; South Korea; bacteria; control measures; demographics; public–private mix; tuberculosis.

Figure 1

Number of tuberculosis (TB) cases per 100,000 population in South Korea, 1926–2013. Major periods are demarcated by dotted lines. Historical tuberculosis milestones for each period are briefly described. Notable tuberculosis control efforts are summarized in the boxes. GDP, gross domestic product; PPM, public–private mix. Sources: (,–6).

Figure 2

Relationship between per capita gross domestic product (GDP) and incidence of tuberculosis (TB), 2013. Each dot represents 1 country; South Korea is indicated. The third root of the population was used to determine the size of the circles, and the figure is drawn on a logarithmic scale. The line indicates the regression on the logarithm. The figure was adapted from (19) with permission from The European Respiratory Society. Updated data was derived from (1).

Figure 3

Rate of notified tuberculosis (TB) cases by age group and year, South Korea. A) Comparison of age-specific notified TB cases per 100,000 population between 2001 and 2013. In 2013, notification rates among all age groups were lower than those in 2001. B) Comparison of notified tuberculosis cases by patient age between 2001 and 2013. In 2013, there was a marked increase in the number of cases among persons 45–54 and >65 years of age. Figure adapted from (21).