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Volume 13(6); December 2022
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Editorial
Efforts to return to a normal society
Jong-Koo Lee
Osong Public Health Res Perspect. 2022;13(6):391-393.   Published online December 30, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.13.6.01
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Review Article
SARS-CoV-2 in brief: from virus to prevention
Hassan Karami, Zeinab Karimi, Negin Karami
Osong Public Health Res Perspect. 2022;13(6):394-406.   Published online November 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0155
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AbstractAbstract PDF
The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ahighly transmissible virus with a likely animal origin, has posed major and unprecedentedchallenges to millions of lives across the affected nations of the world. This outbreak firstoccurred in China, and despite massive regional and global attempts shortly thereafter, itspread to other countries and caused millions of deaths worldwide. This review presents keyinformation about the characteristics of SARS-CoV-2 and its associated disease (namely,coronavirus disease 2019) and briefly discusses the origin of the virus. Herein, we also brieflysummarize the strategies used against viral spread and transmission.
Review Article
Carbapenem resistance in critically important human pathogens isolated from companion animals: a systematic literature review
Angie Alexandra Rincón-Real, Martha Cecilia Suárez-Alfonso
Osong Public Health Res Perspect. 2022;13(6):407-423.   Published online December 16, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0033
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AbstractAbstract PDF
This study aimed to describe the presence and geographical distribution of Gram-negativebacteria considered critical on the priority list of antibiotic-resistant pathogens publishedby the World Health Organization, including carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Acinetobacter spp., and carbapenem-resistant Pseudomonas aeruginosa.A systematic review of original studies published in 5 databases between 2010 and 2021 wasconducted, including genotypically confirmed carbapenem-resistant isolates obtained fromcanines, felines, and their settings. Fifty-one articles met the search criteria. Carbapenemresistant isolates were found in domestic canines and felines, pet food, and on veterinarymedical and household surfaces. The review found that the so-called “big five”—that is, the5 major carbapenemases identified worldwide in Enterobacterales (New Delhi metallo-βlactamase, active-on-imipenem, Verona integron-encoded metallo-β-lactamase, Klebsiellapneumoniae carbapenemase, and oxacillin [OXA]-48-like)—and the 3 most importantcarbapenemases from Acinetobacter spp. (OXA-23-like, OXA-40-like, and OXA-58-like) hadbeen detected in 8 species in the Enterobacteriaceae family and 5 species of glucose nonfermenting bacilli on 5 continents. Two publications used molecular analysis to confirmcarbapenem-resistant bacteria transmission between owners and dogs. Isolating criticallyimportant human carbapenem-resistant Gram-negative bacteria from domestic canines andfelines highlights the importance of including these animal species in surveillance programsand antimicrobial resistance containment plans as part of the One Health approach.
Original Articles
Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates
Yongmoon Kim, Bryan Inho Kim, Sangwoo Tak
Osong Public Health Res Perspect. 2022;13(6):424-434.   Published online November 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0212
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
Although it is widely used as a measure for mortality, the case fatality rate (CFR) ofcoronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons otherthan viral characteristics. To compare the CFRs of different countries in equal measure, weestimated comparable CFRs after adjusting for multiple covariates and examined the mainfactors that contributed to variability in the CFRs among 21 countries.Methods: For statistical analysis, time-series cross-sectional data were collected from OurWorld in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated bypooled generalized linear squares regression models for the panel data. Covariates includedthe predominant virus variant, reproduction rate, vaccination, national economic status,hospital beds, diabetes prevalence, and population share of individuals older than age 65. Intotal, 21 countries were eligible for analysis.Results: Adjustment for covariates reduced variation in the CFRs of COVID-19 across countriesand over time. Regression results showed that the dominant spread of the Omicron variant,reproduction rate, and vaccination were associated with lower country-level CFRs, whereasage, the extreme poverty rate, and diabetes prevalence were associated with higher countrylevel CFRs.Conclusion: A direct comparison of crude CFRs among countries may be fallacious, especiallyin a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over timefor a more proper comparison. In addition, our findings suggest that comparing CFRs amongdifferent countries without considering their context, such as the epidemic phase, medicalcapacity, surveillance strategy, and socio-demographic traits, should be avoided.
mRNA vaccine effectiveness against SARS-CoV-2 B.1.617.2 (Delta) and B.1.1.529 (Omicron) variant transmission from home care cases to household contacts in South Korea
Hanul Park, Young Joon Park, Sang Eun Lee, Min Jei Lee, Hyungtae Ahn
Osong Public Health Res Perspect. 2022;13(6):435-442.   Published online November 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0243
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
Household contacts of confirmed cases of coronavirus disease 2019 (COVID-19) areexposed to a high risk of viral transmission, and secondary incidence is an important indicatorof community transmission. This study analyzed the secondary attack rate and mRNA vaccineeffectiveness against transmission (VET) for index cases (patients treated at home) confirmedto be infected with the Delta and Omicron variants.Methods: The subjects of the study were 4,450 index cases and 10,382 household contacts.Logistic regression analysis was performed to compare the secondary attack rate byvaccination status, and adjusted relative risk and 95% confidence intervals were identified.Results: The secondary attack rate of the Delta variant was 27.3%, while the secondary attackrate of the Omicron variant was 29.8%. For the Delta variant, groups with less than 90 daysand more than 90 days after 2 doses of mRNA vaccination both showed a VET of 37%. For theOmicron variant, a 64% VET was found among those with less than 90 days after 2 doses ofmRNA vaccination.Conclusion: This study provides useful data on the secondary attack rate and VET of mRNAvaccines for household contacts of COVID-19 cases in South Korea.
Brief Reports
The effectiveness of Paxlovid treatment in long-term care facilities in South Korea during the outbreak of the Omicron variant of SARS-CoV-2
Hanul Park, Young Joon Park, Hye Young Lee, Mi Yu, Yeong-Jun Song, Sang Eun Lee, Ji-Joo Lee, Eun-Sol Lee, Yeonjung Kim
Osong Public Health Res Perspect. 2022;13(6):443-447.   Published online December 23, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0262
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
On November 5, 2021, Pfizer Inc. announced Paxlovid (nirmatrelvir +ritonavir) asa treatment method that could reduce the risk of hospitalization or death for patients withconfirmed coronavirus disease 2019 (COVID-19).Methods: From February 6, 2022 to April 2, 2022, the incidence of COVID-19 and the effectsof treatment with Paxlovid were analyzed in 2,241 patients and workers at 5 long-term carefacilities during the outbreak of the Omicron variant of severe acute respiratory syndromecoronavirus 2 in South Korea.Results: The rate of severe illness or death in the group given Paxlovid was 51% lower thanthat of the non-Paxlovid group (adjusted risk ratio [aRR], 0.49; 95% confidence interval [CI],0.24−0.98). Compared to unvaccinated patients, patients who had completed 3 doses of thevaccine had a 71% reduced rate of severe illness or death (aRR, 0.29; 95% CI, 0.13−0.64) and a65% reduced death rate (aRR, 0.35; 95% CI, 0.15−0.79).Conclusion: Patients given Paxlovid showed a lower rate of severe illness or death and alower fatality rate than those who did not receive Paxlovid. Patients who received 3 dosesof the vaccine had a lower rate of severe illness or death and a lower fatality rate than theunvaccinated group.
A low risk of nosocomial transmission of subclinical tuberculosis to neonates in a postpartum care center under COVID-19 control measures
In Kyoung Kim, So Jung Kim, Kyoung Hee Bae, Mi Young Kim, Ji Eun Oh, Mi Gyeong Lee, Young Ae Kang, Jin Su Song
Osong Public Health Res Perspect. 2022;13(6):448-452.   Published online December 16, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0235
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AbstractAbstract PDF
We report the results of investigating and managing a tuberculosis (TB) exposure in apostpartum care center. Among the contacts exposed to a nursing assistant with subclinical TB,5 of 44 neonates (11.4%) had positive tuberculin skin tests (TSTs) at 3 months of age, and all theTST-positive neonates received the Bacille Calmette-Guérin vaccination. Seven of 28 healthcareworkers (25.0%) and 1 of 3 household contacts (33.3%) were positive in the initial or repeatedinterferon-gamma release assay. None of the contacts developed TB disease during the studyperiod. Annual TB examinations of healthcare personnel at a postpartum care center under theTuberculosis Prevention Act in South Korea enabled the early detection of subclinical TB, whichreduced the risk of transmission to neonates under strict coronavirus disease 2019 preventionmeasures.

PHRP : Osong Public Health and Research Perspectives