Operational Framework of the Latent Tuberculosis Infection Screening and Treatment Program Operated by the Military Manpower Administration and the Korea Disease Control and Prevention Agency (2017-2025).

Objectives: This study examines the operational framework and performance of the latent tuberculosis infection (LTBI) screening and treatment program conducted among conscription candidates in collaboration with the Military Manpower Administration and the Korea Disease Control and Prevention Agency from 2017 to 2025 and assesses its implications for national tuberculosis (TB) prevention policy. Methods: Conscription candidates who consented to screening underwent an interferon-gamma release assays. Individuals with a history of TB treatment or prior LTBI positivity were excluded through administrative data linkage. Positive cases were linked to the national TB management system through the government's administrative information-sharing platform and referred to public health centers or designated medical institutions for treatment. Descriptive methods were used to analyze screening results, treatment linkage, and treatment initiation status from 2017 to 2025. Results: Among 2,493,162 individuals screened, 41,185 tested positive, yielding an overall positivity rate of 1.7%. The positivity rate declined from 2.9% in 2017 to 0.8% in 2025. The treatment initiation rate among positive cases was 49.7%, with a median time of 28 days to initiation. Concurrently, the incidence and notification rates of TB among individuals in their twenties declined in 2024 to approximately one-sixth of the levels reported in 2015. Conclusions: This program demonstrates a systematic approach to large-scale LTBI screening and treatment linkage for young adults presenting a national TB prevention model based on interministerial collaboration. This operational experience has important implications for the development of future policies for the control of TB and other infectious diseases.