As World Tuberculosis Day (March 24) approaches, experts warn that symptoms such as a persistent cough lasting over two weeks, weight loss, and fever could indicate tuberculosis. Patients with chronic conditions like diabetes or cancer require special attention, as they may experience poorer treatment outcomes and delayed diagnosis.
On Friday, Dr. Min Jin-soo, a pulmonologist at Seoul St. Mary’s Hospital, emphasized that tuberculosis is a primary airborne infectious disease caused by the tuberculosis bacterium. It spreads when people inhale bacteria released into the air by infected individuals’ coughs or sneezes. Dr. Min stressed that South Korea still has a relatively high tuberculosis incidence rate among the Organisation for Economic Co-operation and Development (OECD) countries, necessitating ongoing vigilance and management.
While coughing is the main symptom of tuberculosis, it can be difficult to distinguish from colds, asthma, or bronchitis. However, if a cough persists for more than two weeks and is accompanied by weight loss, fever, or night sweats, tuberculosis should be considered.
In South Korea, the national health screening program offers free testing for suspected pulmonary tuberculosis cases, with partial coverage of treatment costs upon diagnosis. Most tuberculosis cases can be cured with consistent use of anti-tuberculosis medications.
Recently, there has been an increase in tuberculosis patients with chronic diseases such as diabetes and chronic kidney disease, particularly among the aging population. A multicenter prospective tuberculosis cohort study involving Dr. Min revealed that diabetic patients have about 1.6 times higher risk of poor treatment outcomes compared to non-diabetic tuberculosis patients. This risk rises to 1.8 times for those with diabetes complications.
Diagnosis delays are not uncommon in tuberculosis patients with cancer. When tuberculosis and lung cancer coexist in the same area, initial tests may only identify one condition, leading to a delayed discovery of the other. Imaging tests can show similar findings for both diseases, such as nodules, masses, cavities, and lymph node involvement. Symptoms like cough, weight loss, and coughing up blood can also overlap, making differentiation challenging.
Cancer patients face a higher risk of tuberculosis infection and disease progression due to weakened immune systems. They also experience increased side effect risks during treatment. Combining chemotherapy with anti-tuberculosis drugs can lead to complications such as gastrointestinal issues or liver toxicity, requiring more careful management.
The most critical principle in tuberculosis treatment is consistent adherence to prescribed anti-tuberculosis medications without interruption. Discontinuing treatment can result in relapse or drug-resistant tuberculosis.
Recent large-scale prospective tuberculosis cohort studies in South Korea have shown that asymptomatic tuberculosis patients have better treatment outcomes than those with symptoms. Dr. Min explained that early detection and treatment during the asymptomatic stage not only improves individual treatment success rates but also plays a crucial role in reducing community transmission.
Dr. Min emphasized that strengthening early diagnosis through national health screenings and establishing a robust continuous management system will be key strategies in reducing the tuberculosis burden and accelerating its eradication in South Korea.