Epidemiology and Health

Cohort Profile

Cohort profile: the KDCA-Tuberculosis-NHIS cohort linking tuberculosis surveillance and health insurance data in Korea: Dawoon Jeong, Jinsun Kim, Seung Won Lee, Hongjo Choi, Hojoon Sohn, Jieun Kim, Hyewon Lee, Hyeran Jeong, Seung Eun Lee, Young-joon Park, Jaiyong Kim, Eun Mi Kim, Minji Koo, Hoyeon Jang, Young Ae Kang; Epidemiol Health. 2025;47:e2025071. Published online December 13, 2025; DOI: https://doi.org/10.4178/epih.e2025071

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Abstract Summary PDF Supplementary Material

Abstract

Despite a steady decline in incidence, tuberculosis (TB) remains a substantial public health burden in Korea, particularly among older adults. Existing national TB surveillance systems lack sufficiently comprehensive data to assess long-term outcomes and health disparities. The K-TB-N cohort integrates data from 3 national sources: the Korean Tuberculosis Surveillance System (2011-2022), the National Health Insurance Database (2010-2022), and mortality data from Statistics Korea (2010-2022). After data cleaning and linkage, the final cohort included 373,812 patients (375,440 episodes) with either drug-susceptible TB or drug- resistant TB. TB notifications declined by approximately 60% over the study period, while the median patient age continued to rise. Treatment success improved over time, accompanied by reductions in lost to follow-up. However, mortality during treatment increased, with more than half of deaths attributed to non-TB causes such as pneumonia, cancer, and cardiovascular disease. Post-treatment mortality also remained high, particularly among patients with drug-resistant TB. The K-TB-N cohort provides a comprehensive, linked dataset for advancing research on TB epidemiology, treatment outcomes, comorbidities, and health disparities. It enables evaluations of public health interventions, long-term prognosis, and strategies for post-TB care. This cohort will remain a valuable resource for shaping data-driven TB control policies in aging and high-burden settings.

Summary

Korean summary
- K-TB-N 코호트는 결핵 신고자료, 건강보험청구자료, 통계청 사망자료를 연계한 국내 최초의 전국단위 결핵 통합자료 코호트이다. - 이 코호트를 결핵 치료 성과와 치료 종료 이후 사망을 포함한 장기예후 분석이 가능하다. - 코호트에 포함된 2011-2022년 사이, 결핵 발생은 60% 감소하였고, 결핵 환자의 평균 연령은 증가하였다. 결핵 치료 중 사망율은 증가하였는데, 사망원인의 50% 이상은 비결핵성 사망이었다.

Key Message
- The K-TB-N cohort is the first national-level integrated TB cohort in South Korea that combines three distinct datasets, overcoming the limitations of single-source TB registries. - The linkage of clinical data (KTB-Surv), health insurance claims (NHID), and mortality records (Statistics Korea) allows long-term tracking of treatment outcomes and post-treatment mortality. - TB notifications declined by ~60% during the study period, while the median patient age increased. - The mortality during TB treatment rose, with over half of deaths attributed to non-TB causes.

Citations

Citations to this article as recorded by

Suicide risk in people with tuberculosis in Republic of Korea: a nationwide cohort, 2012–2021
Chiwook Chung, Seung Won Lee, Dawoon Jeong, Hongjo Choi, Hojoon Sohn, Young Ae Kang
Infectious Diseases of Poverty.2026;[Epub] CrossRef
Clinical outcomes and recurrence after treatment of asymptomatic pulmonary tuberculosis: A nationwide cohort study
Se Hyun Kwak, Hongjo Choi, Seung Won Lee, Dawoon Jeong, Hojoon Sohn, Young Ae Kang
International Journal of Infectious Diseases.2026; 169: 108805. CrossRef
Context-dependent risk stratification using a tuberculin skin test induration threshold of ≥ 15 mm in school tuberculosis screening in Hangzhou, China: a historical cohort study
Xiangjie Meng, Yin Tang, Jun Shou, Nan Jiang, Yu Zhang
Tropical Medicine and Health.2026;[Epub] CrossRef

COVID-19: Epidemiologic Investigation

COVID-19 outbreak in a military unit in Korea: Chanhee Kim, Young-Man Kim, Namwoo Heo, Eunjung Park, Sojin Choi, Sehyuk Jang, Nayoung Kim, Donghyok Kwon, Young-Joon Park, Byeongseop Choi, Beomman Ha, Kyounghwa Jung, Changbo Park, Sejin Park, Heeyoung Lee; Epidemiol Health. 2021;43:e2021065. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021065

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Abstract Summary PDF

Abstract

OBJECTIVES
This study presents the response of a military unit to an outbreak of coronavirus disease 2019 (COVID-19) in Gyeonggi Province. As soon as 2 soldiers were identified as index cases, the infectious disease investigators of the Gyeonggi Provincial Government, Korea Disease Control and Prevention Agency, and the Armed Forces Epidemiologic Investigation Center discussed the investigation and response plan for an imminent massive outbreak.

METHODS

The joint immediate response team (IRT) conducted interviews with confirmed COVID-19 patients, reviewed their medical records, performed contact tracing using global positioning system data, and undertook a field investigation. For risk assessment, the joint IRT visited all 8 sites of the military units and the army chaplain’s church to evaluate the transmission risk at each site. The evaluation items included the size of the site, the use of air conditioning, whether windows were opened, and whether masks were worn. Pooled testing was used for the low-risk population to quickly detect the spread of COVID-19 in the military base.

RESULTS

One day before the symptom onset of the index case, the lecturer and >50% of the attendees were infected with COVID-19 while attending a lecture that lasted 2 hours and 30 minutes. Attendees were not wearing masks and were in a poorly ventilated room.

CONCLUSIONS

Since COVID-19 can be spread before symptom onset, contact tracing must be performed to investigate potential exposures prior to symptom onset and to manage any exposed persons.

Summary

Korean summary
본 연구는 경기도 군부대에서 발생한 코로나19 대응 경험을 공유하는 국내 최초의 연구 결과이다. 본 연구를 통해 정리된 역학조사 과정은 군부대, 기숙사, 교정시설 등 집단 시설의 방역 대책 수립에 도움이 될 것으로 기대한다. 또한, 이번 사례는 집단 감염 발생 시 여러 유관 기관의 협조 체계가 신속한 대응과 추가 전파 예방에 중요하다는 점을 시사한다.

Key Message
This study is the first research in South Korea to share the experience of responding to COVID-19 at the military unit in Gyeonggi-do. The epidemiological investigation process organized through this study is expected to help establish response measures for group facilities such as military units, dormitories, and correctional facilities. In addition, this case suggests that the cooperative system of various related organizations in the event of a mass infection is important for rapid response and prevention of further transmission.

Citations

Citations to this article as recorded by

Evaluation of diagnostic performance of SARS-CoV-2 infection using digital droplet polymerase chain reaction in individuals with or without COVID-19 symptoms
Yoonjung Kim, Eunyoung Lee, Boyeon Kim, Jinhee Cho, Sook-Won Ryu, Kyung-A Lee
Clinica Chimica Acta.2024; 554: 117759. CrossRef
Military affected by the first wave of COVID-19 in Senegal: stress and resilience factors during care
Serigne Modou Ndiaye, Diambéré Séga Dembélé, Moustapha Lo, Adama Fané, Florentine Mbengue Diagne, Khadidiatou Konaré Dembélé, Khadim Fall, Mbayang Ndiaye Djiba, Sokhna Ndiaye, Tabara Sylla Diallo
The Pan African Medical Journal.2024;[Epub] CrossRef
Experimental assessment of low temperature plasma devices for bacterial aerosol inactivation in the air duct of HVAC systems
Yang Lv, Xiaodong Wang, Beibei Wang, Wenjie Yuan
Environmental Science: Processes & Impacts.2024; 26(10): 1836. CrossRef
Trends in Confirmed COVID-19 Cases in the Korean Military Before and After the Emergence of the Omicron Variant
Dong Hoon Shin, Haebong Jang, Sangho Lee, Byung Seop Choi, Donghoon Kim, Hong Sang Oh
Journal of Korean Medical Science.2022;[Epub] CrossRef
Characteristics of COVID-19 outbreaks and risk factors for transmission at an army training center in South Korea from June to August 2021
U Jin Cho, Seongjin Wang, Seonju Yi, Yeon Hwa Choi, Eun-Young Kim, Jin A Kim, Sanghwan Bae, Jungyeon Yu, Jangkyu Choi, Young-Joon Park
Osong Public Health and Research Perspectives.2022; 13(4): 263. CrossRef

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