Tuberculosis in DPR Korea
population of nearly 24 million, the Democratic People’s Republic of Korea (DPR
Korea) has an annual incidence and prevalence of all forms of TB of,
respectively, 345 and 423 per 100,000 populations. The expected incidence was
revised upwards significantly in 2007 following a national ARTI survey. The
notification rate of all forms of TB and new smear-positive cases in 2010 were
respectively 408 and 132, showing a steady increase compared with previous
the significant gap between the estimated incidence and actual case
notifications, intensified and active case-finding in the community was adopted
as a supplementary method for case-finding. The more active case-finding
campaign and integration of previously non-DOTS sectors such as health
facilities under the ministries of the military, security and railways has led
to an increase in case notifications. The treatment success rate for the cohort
of patients registered in 2009 was 90%.
response to DR-TB has been limited due to resource constraints. A national
reference laboratory for culture and DST has been established at the Central TB
Institute in Pyongyang.
Guidelines for MDR-TB Management have been developed and Programmatic
Management of DR-TB is expected to be initiated in early 2012. There is no
reliable data on the extent of MDR-TB in the country. However, re-treatment
cases comprised 14% of all notified cases during 2010. A drug resistance survey
is planned to be initiated in early 2012. The protocol for the DRS is being
developed and support of national and international partners is being mobilised.
plan has been developed for 2008–2015, in line with the Global Plan to Stop TB
and the Regional Plan for TB Control 2008–2015. The government provides for
over half of the programmes’ funding requirements in
terms of staffing, infrastructure, drugs and surveillance. WHO continues to
provide support to the programme in terms of
technical assistance, training health staff, strengthening laboratory services,
upgrading infrastructure, and monitoring and evaluation.
supplies of anti-TB drugs have been ensured through the GDF grant mechanism
from 2003- 2009 and WHO-SEARO secured funds on an exceptional basis to provide
up to 90% of funding to cover the needs of 2010. Supplementary support is also
received through the Eugene Bell Foundation and the Christian Friends of Korea.
From 2011, the main support for adult anti-TB drugs are coming though Global
Fund Round 8 grant. UNICEF, DPR Korea is the Principal
Recipient of this Global Fund grant and WHO, Country Office is sub-recipient.
· DOTS is firmly
in place with service delivery extending to even the most peripheral level.
· A national TB reference laboratory for
culture and DST has been established.
· M&E and supervision of DOTS
implementation has been strengthened.
· Logistic management system for drug supply
and management strengthened.
estimates revised on the basis of ARTI survey.
· Health facilities in other sectors involved
in TB control and management.
· Involvement of household doctors in DOTS
· Standardized laboratory kits introduced.
· Patient-wise kits introduced.
· Global Fund-supported project initiated.
· Sustaining funding to implement basic DOTS,
shortages of laboratory reagents and first-line drugs being a consequence.
· Low level of documentation of DOTS by
· Inadequate laboratory capacity for
undertaking laboratory QA.
· Diagnosis of TB in children is not widely
· Lack of adequate information on pattern of
MDR-TB in the country and non-availability of drugs for MDR-TB.
and notification rates for 2010
24 345 000
82 000 (70000-96000)
(All forms, per 100,000
100 000(30 000~180 000)
Estimated prevalence rate
(All forms, per 100,000
NSP rate %
Estimated TB mortality rate
(All forms, per 100,000population %)
National Tuberculosis Recording and Reporting System
Global Tuberculosis control 2010, WHO