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Discrepancies in tuberculosis burden estimates

North Korean defectors vs. official reports

Bibliographic Data

ID22075321
AuthorsInho Jang (Korea University), Heesang Han (0000-0003-0750-5645, Korea University), Seung‐Chul Lee (0000-0002-1034-1410, Shin Ansan University, corresponding author), Seungcheol Lee, Hyeongyeong Jeong (Kyung Hee University), Rugyeom Lee, R P Lee (Ansan University), Yedham Kang (Ulsan College), In‐hwan Oh (0000-0002-5450-9887, Ulsan College, corresponding author), Seung Heon Lee (0000-0002-7180-3877, Shin Ansan University, corresponding author)
Year2025
Volume13
Pages1545628-1545628
Publication date2025-05-30
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1545628
PMID40520323
OpenAlexW4410905388
LanguageEN
Citations received1
References cited20

Objectives: North and South Korea have taken different approaches to tuberculosis (TB) epidemic control after the Korean War. This study aimed to compare TB epidemiology in North Korean defectors (NKDs) based on South Korean National Health Insurance (NHIS) data and assess its implications for understanding TB prevalence in North Korea. Methods: We used the NHIS claims data from 2007 to 2019 to evaluate TB epidemics in NKD and the age-and-sex matched South Korean control group. The number of participants was 35,620 for defectors and 107,016 for the control group. Results: The prevalence of TB among NKDs decreased from 466/100,000 persons in 2010 to 95/100,000 persons in 2019, while the North Korean TB prevalence as per the World Health Organization (WHO) report remained approximately 500/100,000 persons. The NKD TB prevalence was 3-7 times higher than that in the South Korean population. Additionally, the distribution of TB cases in NKDs showed distinct age-related patterns, with peaks in the 25-34 and 65 + age groups. The proportion of extrapulmonary TB in NKDs was 36-46%, similar to South Korean patterns. The estimated and reported multidrug-resistant TB rates in NKDs were higher than in the control group, highlighting potential underreporting in North Korean data. Conclusion: There were large gaps in TB prevalence between NKD and native North Korean residents and between the estimated and reported TB burden within North Korea. These findings underscore the need for targeted TB control strategies that address both health system disparities and the integration of NKDs into local healthcare services

Pathology · Tuberculosis · Economic Sanctions and International Relations · Korean Peninsula Historical and Political Studies · Medicine · Migration, Health and Trauma

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Unique citing works1
Citations per year1
Citation span2026 - 2026 (1)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 1

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