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Volume 13(1); February 2022
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Editorial
As the incidence of Omicron increases, so will the number of deaths
Jong-Koo Lee
Osong Public Health Res Perspect. 2022;13(1):1-3.   Published online February 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.13.1.01
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PDF
Review Articles
Points to consider for COVID-19 vaccine quality control and national lot release in Republic of Korea: focus on a viral vector platform
Jung Hun Ju, Naery Lee, Sun-hee Kim, Seokkee Chang, Misook Yang, Jihyun Shin, Eunjo Lee, Sunhwa Sung, Jung-Hwan Kim, Jin Tae Hong, Ho Jung Oh
Osong Public Health Res Perspect. 2022;13(1):4-14.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0311
  • 1,596 View
  • 104 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Due to the global public health crisis caused by the coronavirus disease 2019 (COVID-19) pandemic, the importance of vaccine development has increased. In particular, a rapid supply of vaccines and prompt deployment of vaccination programs are essential to prevent and overcome the spread of COVID-19. As a part of the vaccine regulations, national lot release is regulated by the responsible authorities, and this process involves the assessment of the lot before a vaccine is marketed. A lot can be released for use when both summary protocol (SP) review and quality control testing are complete. Accelerated lot release is required to distribute COVID-19 vaccines in a timely manner. In order to expedite the process by simultaneously undertaking the verification of quality assessment and application for approval, it is necessary to prepare the test methods before marketing authorization. With the prolonged pandemic and controversies regarding the effectiveness of the COVID-19 vaccine against new variants, public interest for the development of a new vaccine are increasing. Domestic developers have raised the need to establish standard guidance on the requirements for developing COVID-19 vaccine. This paper presents considerations for quality control in the manufacturing process, test items, and SP content of viral vector vaccines.
Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis
Saber Soltani, Milad Zandi, Samireh Faramarzi, Ramin Shahbahrami, Mohebat Vali, Sara Akhavan Rezayat, Reza Pakzad, Pooneh Malekifar, Iraj Pakzad, Neda Jahandoost, Jalal Moludi
Osong Public Health Res Perspect. 2022;13(1):15-23.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0293
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AbstractAbstract PDFSupplementary Material
Microbial coinfections can increase the morbidity and mortality rates of viral respiratory diseases. Therefore, this study aimed to determine the pooled prevalence of fungal coinfections in coronavirus disease 2019 (COVID-19) patients. Web of Science, Medline, Scopus, and Embase were searched without language restrictions to identify the related research on COVID-19 patients with fungal coinfections from December 1, 2019, to December 30, 2020. A random-effects model was used for analysis. The sample size included 2,246 patients from 8 studies. The pooled prevalence of fungal coinfections was 12.60%. The frequency of fungal subtype coinfections was 3.71% for Aspergillus, 2.39% for Candida, and 0.39% for other. The World Health Organization’s Regional Office for Europe and Regional Office for Southeast Asia had the highest (23.28%) and lowest (4.53%) estimated prevalence of fungal coinfection, respectively. Our findings showed a high prevalence of fungal coinfections in COVID-19 cases, which is a likely contributor to mortality in COVID-19 patients. Early identification of fungal pathogens in the laboratory for COVID-19 patients can lead to timely treatment and prevention of further damage by this hidden infection.
Yersinia pestis antibiotic resistance: a systematic review
Chen Lei, Suresh Kumar
Osong Public Health Res Perspect. 2022;13(1):24-36.   Published online February 18, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0288
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AbstractAbstract PDF
Yersinia pestis, the cause of plague and a potential biological weapon, has always been a threatening pathogen. Some strains of Y. pestis have varying degrees of antibiotic resistance. Thus, this systematic review was conducted to alert clinicians to this pathogen’s potential antimicrobial resistance. A review of the literature was conducted for experimental reports and systematic reviews on the topics of plague, Y. pestis, and antibiotic resistance. From 1995 to 2021, 7 Y. pestis isolates with 4 antibiotic resistance mechanisms were reported. In Y. pestis 17/95, 16/95, and 2180H, resistance was mediated by transferable plasmids. Each plasmid contained resistance genes encoded within specific transposons. Strain 17/95 presented multiple drug resistance, since plasmid 1202 contained 10 resistance determinants. Strains 16/95 and 2180H showed single antibiotic resistance because both additional plasmids in these strains carried only 1 antimicrobial determinant. Strains 12/87, S19960127, 56/13, and 59/13 exhibited streptomycin resistance due to an rpsl gene mutation, a novel mechanism that was discovered recently. Y. pestis can acquire antibiotic resistance in nature not only via conjugative transfer of antimicrobial-resistant plasmids from other bacteria, but also by gene point mutations. Global surveillance should be strengthened to identify antibiotic-resistant Y. pestis strains by whole-genome sequencing and drug susceptibility testing.
Original Articles
Associations of pre-existing cardiovascular morbidity with severity and the fatality rate in COVID-19 patients: a systematic review and meta-analysis
Foad Alzoughool, Suhad Abumweis, Lo’ai Alanagreh, Manar Atoum
Osong Public Health Res Perspect. 2022;13(1):37-50.   Published online February 18, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0186
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Objectives
The aim of this study was to evaluate the association of pre-existing cardiovascular comorbidities, including hypertension and coronary heart disease, with coronavirus disease 2019 (COVID-19) severity and mortality. Methods: PubMed, ScienceDirect, and Scopus were searched between January 1, 2020, and July 18, 2020, to identify eligible studies. Random-effect models were used to estimate the pooled event rates of pre-existing cardiovascular disease comorbidities and odds ratio (OR) with 95% confidence intervals (95% CIs) of disease severity and mortality associated with the exposures of interest. Results: A total of 34 studies involving 19,156 patients with COVID-19 infection met the inclusion criteria. The prevalence of pre-existing cardiovascular disease in the included studies was 14.0%. Pre-existing cardiovascular disease in COVID-19 patients was associated with severe outcomes (OR, 4.1; 95% CI, 2.9 to 5.7) and mortality (OR, 6.1; 95% CI, 2.9 to 12.7). Hypertension and coronary heart disease increased the risk of severe outcomes by 2.6 times (OR, 2.6; 95% CI, 1.9 to 3.6) and 2.5 times (OR, 2.5; 95% CI, 1.7 to 3.8), respectively. No significant publication bias was indicated. Conclusion: COVID-19 patients with pre-existing cardiovascular comorbidities have a higher risk of severe outcomes and mortality. Awareness of pre-existing cardiovascular comorbidity is important for the early management of COVID-19.
Generalized anxiety and sleep quality among health care professionals during the COVID-19 pandemic: a cross-sectional study from a tertiary healthcare institution in Eastern India
Bijaya Nanda Naik, Sanjay Pandey, Rajath Rao, Manisha Verma, Prashant Kumar Singh
Osong Public Health Res Perspect. 2022;13(1):51-61.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0316
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AbstractAbstract PDF
Objectives
With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, healthcare professionals (HCPs) have experienced high levels of stress and anxiety because of the high risk of infection for themselves and their families. This has led to acute sleep problems for HCP. This study was designed to assess the anxiety and sleep quality of HCPs during the COVID-19 pandemic. Methods: This cross-sectional study analyzed 370 HCPs employed at All India Institute of Medical Sciences Patna over 3 months, using the standard Generalized Anxiety Disorder 7-item scale (GAD-7) for suspected GAD and the Pittsburgh Sleep Quality Index for sleep quality. Results were tabulated and multivariable binomial logistic regression analysis was done to determine the predictors of poor sleep. Significance was attributed to p<0.05. Results: Of the 370 HCPs screened, 52 (14.1%; 95% confidence interval [CI], 10.8%–18.1%) were found to have GAD and 195 (52.7%; 95% CI, 47.5%–57.9%) were found to be poor sleepers. The presence of any addictive habit (adjusted odds ratio [AOR], 1.833; 95% CI, 1.12–2.8), unprotected contact with COVID-19 cases (AOR, 1.902; 95% CI, 1.1–3.3), and the presence of GAD (AOR, 5.57; 95% CI, 2.5–12.4) were found to be predictors of poor sleep quality among HCPs. Conclusion: A significant proportion of HCPs were found to have suspected GAD and were poor sleepers. This highlights the need for measures to confront this problem.
Predictors of health-related quality of life in Koreans with cardiovascular disease
Jung-Hye Lim
Osong Public Health Res Perspect. 2022;13(1):62-70.   Published online February 22, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0286
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
This study aimed to identify the predictors of health-related quality of life (HRQoL) in Korean adults with cardiovascular disease (CVD). Methods: This was a cross-sectional study with a stratified multistage probability sampling design. Data from the 2016 to 2019 Korea National Health and Nutrition Examination Survey (n=32,379) were used. Among the participants aged 19 years or older (n=25,995), 1,081 patients with CVD were extracted after excluding those with missing data and those who had cancer. The participants’ HRQoL was measured using the three-level EuroQoL Group’s five-dimension questionnaire (EQ-5D) scale. Data were analyzed using the t-test, one-way analysis of variance, and general linear regression for complex samples. Results: The most potent predictors of HRQoL in Korean adults with CVD were limited activity (β =−0.103, p <0.001), poor perceived health (β =−0.089, p <0.001), depression (β =−0.065, p<0.01), low household income (β=−0.033, p<0.05), unemployment (β=−0.023, p<0.05), and older age (β=−0.002, p<0.01), which explained 37.2% of the variance. Conclusion: Comprehensive interventions that address both physical and mental factors and social systems that provide financial help need to be implemented to improve the HRQoL of Korean adults with CVD.
Neck circumference and incidence of cerebrovascular disease over 12 years among Korean adults
Jae-Seon Han, Yun-Hee Kim
Osong Public Health Res Perspect. 2022;13(1):71-79.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0277
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AbstractAbstract PDF
Objectives
Neck circumference is associated with a distinctive fat storage process that confers additional metabolic risk. Hence, this study aimed to investigate the correlation between baseline neck circumference and the incidence of cerebrovascular disease using a prospective community-based sample of Korean adults over 12 years of follow-up, after controlling for selected covariates. Methods: Participants with non-cerebrovascular disease were divided into 4 groups (Q1–Q4) based on their baseline neck circumference. Cox proportional hazards analysis was used to calculate hazard ratios and 95% confidence intervals (CIs) to evaluate the relationship between neck circumference and cerebrovascular disease incidence over a 12-year period. Results: Among this study’s 3,662 participants, 128 (3.50%) developed cerebrovascular disease. The incidence of cerebrovascular disease increased from 2.2% in Q1 to 4.3% in Q2, 2.5% in Q3, and 5.0% in Q4. When compared to Q1, the relative risks of cerebrovascular disease development were 0.57 (95% CI, 0.25–1.31), 0.86 (95% CI, 0.38–1.96), and 0.79 (95% CI, 0.30–2.07) in man and 1.86 (95% CI, 0.66–5.20), 3.50 (95% CI, 1.25–9.86), and 4.71 (95% CI, 1.50–14.77) in woman in Q2, Q3, and Q4, respectively, after adjusting for most risk factors related to cerebrovascular disease. Conclusion: The relationship between neck circumference and cerebrovascular disease was stronger in woman than in man, indicating potential differences between the sexes. These results are meaningful for evaluating and surveilling neck circumference as a promising tool for identifying subgroups of vulnerable and at-risk populations.
Corrigendum

PHRP : Osong Public Health and Research Perspectives