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Volume 4(1); February 2013
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Editorial
The Geographical and Economical Impact of Scrub Typus, the Fastest-growing Vector-borne Disease in Korea
Hae-Wol Cho, Chaeshin Chu
Osong Public Health Res Perspect. 2013;4(1):1-3.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.01.001
  • 1,199 View
  • 21 Download
  • 2 Citations
PDF
Original Articles
Spatial Distribution Analysis of Scrub Typhus in Korea
Hong Sung Jin, Chaeshin Chu, Dong Yeob Han
Osong Public Health Res Perspect. 2013;4(1):4-15.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2012.12.007
  • 1,375 View
  • 20 Download
  • 12 Citations
AbstractAbstract PDF
Objective: This study analyzes the spatial distribution of scrub typhus in Korea.
Methods
A spatial distribution of Orientia tsutsugamushi occurrence using a geographic information system (GIS) is presented, and analyzed by means of spatial clustering and correlations.
Results
The provinces of Gangwon-do and Gyeongsangbuk-do show a low incidence throughout the year. Some districts have almost identical environmental conditions of scrub typhus incidence. The land use change of districts does not directly affect the incidence rate.
Conclusion
GIS analysis shows the spatial characteristics of scrub typhus. This research can be used to construct a spatial-temporal model to understand the epidemic tsutsugamushi.
Willingness to Pay for Avoiding Infection of Climate Change Diseases, in Particular Tsutsugamushi Disease
Hae-Chun Rhee
Osong Public Health Res Perspect. 2013;4(1):16-20.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2012.12.003
  • 1,284 View
  • 13 Download
  • 5 Citations
AbstractAbstract PDF
Objectives
As the prevalence of tsutsugamushi disease has tripled over the past decade to affect 8307 people in October 2012, this study is conducted to estimate the willingness to pay (WTP) to avoid infection of tsutsugamushi disease in order to analyze the loss of value caused by climate change diseases.
Methods
The double-bounded dichotomous choice of contingent valuation method was used to estimate the WTP to avoid infection of tsutsugamushi disease, through surveys conducted in the patient group (n = 120) and the control group (n = 240).
Results
More young people in the family, higher level of awareness of risks caused by climate change, more male members (as opposed to female), higher income, lower suggested bid, and greater WTP, is better positioned to avoid infection of disease. The mean of the amount of WTP has been estimated to be 3689 Kwon per month.
Conclusion
As people have become increasingly aware of climate change diseases, WTP to avoid infection of tsutsugamushi disease has increased accordingly. The implicit loss of value due to climate change diseases is becoming increasingly higher. Therefore, there should be stronger and more aggressive promotional activities to prevent people from being infected with tsutsugamushi disease and to build a healthier society free from climate change diseases.
Prevalence and Risk Factors of Clonorchiasis among the Populations Served by Primary Healthcare Posts along Five Major Rivers in South Korea
Kyung Ja June, Shin Hyeong Cho, Won Ja Lee, Chunmi Kim, Kyung-Soon Park
Osong Public Health Res Perspect. 2013;4(1):21-26.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2012.12.002
  • 1,322 View
  • 13 Download
  • 14 Citations
AbstractAbstract PDF
Objectives
Clonorchiasis is an infectious disease caused by the Chinese liver fluke Clonorchis sinensis. In this study, we investigated the prevalence and risk factors of clonorchiasis among the populations served by primary healthcare posts along five major rivers in South Korea.
Methods
Forty primary healthcare posts that are located less than 5 km from one of the five rivers were selected from 26 counties. For the purpose of the survey, community health practitioners selected the nearest villages from the riversides in their own catchment area. From January to May 2009, a total of 2788 stool samples were collected and examined using the formalin–ether sedimentation technique. Village inhabitants were also interviewed by means of questionnaires in order to obtain information on potential risk factors.
Results
The prevalence rates of clonorchiasis at various river basins were as follows: Seomjin River, 21.3%; Nakdong River, 13.5%; Geum River, 9.2%; Han River, 7.6%; and Yeongsan River, 4.9%. The total number of people infected with C. sinensis was 329 (11.3%). By gender, 14.3% of males and 7.6% of females were infected. In case of both males and females, the prevalence rate was highest in those in their 40s. Consumption of raw freshwater fish was confirmed as a risk factor based on a logistic regression analysis.
Conclusion
The present findings suggest that clonorchiasis is still highly prevalent among the inhabitants of riverside areas in southern Korea, and, accordingly, it is necessary to implement a systematic control program in the endemic areas.
A Comparison of Subtyping Methods for Differentiating Salmonella enterica Serovar Enteritidis Isolates Obtained from Food and Human Sources
Ji-Yeon Hyeon, Jung-Whan Chon, Jun-Ho Park, Moo-Sang Kim, Young-Hee Oh, In-Soo Choi, Kun-Ho Seo
Osong Public Health Res Perspect. 2013;4(1):27-33.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2012.12.005
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  • 20 Citations
AbstractAbstract PDF
Purpose: To evaluate the abilities of these subtyping methods, we distinguished Salmonella Enteritidis (S. Enteritidis) isolated from food products and human clinical samples between 2009 and 2010 in Seoul using five subtyping methods.
Methods
We determined the subtypes of 20 S. Enteritidis isolates from food and human sources using phage typing, antimicrobial susceptibility, pulsed-field gel electrophoresis (PFGE), repetitive sequence-based PCR (rep-PCR), and multi-locus sequence typing (MLST).
Results
A total of 20 tested isolates were differentiated into six antimicrobial susceptibility patterns, three different phage types, four different PFGE profiles, seven rep-PCR patterns, and one MLST type. Food isolates were considerably more susceptible to antibiotics than human isolates. We were best able to discriminate among S. Enteritidis isolates using rep-PCR, and obtained the highest Simpson’s diversity index of 0.82, whereas other methods produced indices that were less than 0.71. PFGE pattern appeared to be more related to antimicrobial resistance and phage types of S. Enteritidis isolates than rep-PCR. MLST revealed identical alleles in all isolates at all seven loci examined, indicating no resolution.
Conclusion
The results of this study suggest that rep-PCR provided the best discriminatory power for phenotypically similar S. Enteritidis isolates of food and human origins, whereas the discriminatory ability of MLST may be problematic because of the high sequence conservation of the targeted genes.
Epidemiological Characteristics of Serologically Confirmed Q Fever Cases in South Korea, 2006–2011
Wooseok Kwak, Hyuk Chu, Seondo Hwang, Ji-Hyuk Park, Kyu Jam Hwang, Jin Gwack, Young-Sil Choi, Seung-Ki Youn, Mi-Yeoun Park
Osong Public Health Res Perspect. 2013;4(1):34-38.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2012.12.006
  • 1,617 View
  • 15 Download
  • 20 Citations
AbstractAbstract PDF
Objectives
Q fever has been reported worldwide; however, there was almost no official report of Q fever in Korea. In this study, we describe the current status of human Q fever occurrence in Korea.
Methods
Demographic data of Q fever patients were collected from the National Notifiable Diseases Surveillance System from 2006 to 2011. Case investigation reports from regional public health departments were used for additional information, like risk factors and clinical manifestation, of the patients since 2008.
Results
There were 65 serologically confirmed cases during the study period. The annual notification rate of Q fever was 0.22 cases per million persons. The majority of cases were men (87.7%), adults (98.5%), and urban inhabitants (67.7%). Relevant exposures to risk factors were identified in 45.7% of patients. The most common symptoms of acute Q fever were fever (89.3%), myalgia (67.9%) and asthenia (53.6%). Two cases with endocarditis were identified in chronic Q fever.
Conclusion
This study suggests that Q fever has a low endemicity in Korea. However, management and research at national level is required for prevention of a future epidemic.
Are There Spatial and Temporal Correlations in the Incidence Distribution of Scrub Typhus in Korea?
Maengseok Noh, Youngjo Lee, Chaeshin Chu, Jin Gwack, Seung-Ki Youn, Sun Huh
Osong Public Health Res Perspect. 2013;4(1):39-44.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.01.002
  • 1,602 View
  • 20 Download
  • 6 Citations
AbstractAbstract PDF
Objectives
A hierarchical generalized linear model (HGLM) was applied to estimate the transmission pattern of scrub typhus from 2001 to 2011 in the Republic of Korea, based on spatial and temporal correlation.
Methods
Based on the descriptive statistics of scrub typhus incidence from 2001 to 2011 reported to the Korean Centers for Disease Control and Prevention, the spatial and temporal correlations were estimated by HGLM. Incidences according to age, sex, and year were also estimated by the best-fit model out of nine HGLMs. A disease map was drawn to view the annual regional spread of the disease.
Results
The total number of scrub typhus cases reported from 2001 to 2011 was 51,136: male, 18,628 (36.4%); female, 32,508 (63.6%). The best-fit model selected was a combination of the spatial model (Markov random-field model) and temporal model (first order autoregressive model) of scrub typhus transmission. The peak incidence was 28.80 per 100,000 persons in early October and the peak incidence was 40.17 per 100,000 persons in those aged 63.3 years old by the best-fit HGLM. The disease map showed the spread of disease from the southern central area to a nationwide area, excepting Gangwon-do (province), Gyeongsangbuk-do (province), and Seoul.
Conclusion
In the transmission of scrub typhus in Korea, there was a correlation to the incidence of adjacent areas, as well as that of the previous year. According to the disease map, we are unlikely to see any decrease in the incidence in the near future, unless ongoing aggressive measures to prevent the exposure to the vector, chigger mites, in rural areas, are put into place.
Statistical Evaluation of Two Microbiological Diagnostic Methods of Pulmonary Tuberculosis After Implementation of a Directly Observed Treatment Short-course Program
Shakti Rath, Debasmita Dubey, Mahesh C. Sahu, Sudhanshu S. Mishra, Rabindra N. Padhy
Osong Public Health Res Perspect. 2013;4(1):45-51.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2012.12.004
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  • 2 Citations
AbstractAbstract PDF
Objectives
To evaluate the diagnostic accuracy of smear and culture tests of clinical samples of pulmonary tuberculosis after the introduction of the directly observed treatment short-course (DOTS) program.
Methods
Using sputum samples from 572 individuals as a self-selected population, both Ziehl–Neelsen staining and culturing on Lowenstein–Jensen medium were carried out as diagnostic procedures. Using Bayes’ rule, the obtained data set was analyzed.
Results
Of the 572 samples, 33 (0.05769) were true positive (results of both tests positive) cases; 22 samples (0.03846) were false positive (smear test positive and culture test negative) cases; 62 samples (0.10839) were false negative (smear test negative and culture test positive) cases; and 455 samples (0.79545) were true negative (results of both tests negative) cases. Values of test statistics, sensitivity, and specificity were used to compute several inherent other Bayesian test statistics. The a priori probability or prevalence value of tuberculosis in the targeted population was 0.166. The a posteriori probability value computed arithmetically was 0.6614 and that obtained by the graphical method was 0.62.
Conclusions
The smear test was found to be dependable for 95.4% with stable TB infections, and it was not dependable for 34.7% without stable TB infections. The culture test could be regarded as the gold standard for 96.15% as seen with the data set, which was obtained after the implementation of the DOTS program.
Autochthonous Lyme Borreliosis in Humans and Ticks in Korea
Shinje Moon, Jin Gwack, Kyu Jam Hwang, Donghyuk Kwon, Suyeon Kim, Yoontae Noh, Jongyul Roh, E-hyun Shin, Kyungjin Jeong, Wonseok Seok, Seung-Ki Youn
Osong Public Health Res Perspect. 2013;4(1):52-56.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2012.12.001
  • 1,357 View
  • 15 Download
  • 16 Citations
AbstractAbstract PDF
Objective: This study aimed at finding epidemiological and clinical features of autochthonous Lyme borreliosis in humans through epidemiological investigations and identifying its vectors and pathogens through analysis of ticks.
Method
Epidemiological investigations, including review of the retrospective medical records and patient interviews, were conducted in two cases that occurred in 2012. To identify the vectors and pathogens, ticks were collected between September 23 and October 6, 2012 from the area where the tick bite in the first patient occurred. The ticks were classified, and polymerase chain reaction (PCR) tests and cultures were performed.
Results
The first patient, a 46-year-old female, visited a forest in Gangwon province, which was 900 m above sea level, where the tick bite occurred. Two weeks after the tick bite, erythema migrans (12 × 6 cm2 in size) appeared on the site of tick bite, along with fever, chill, fatigue, myalgia, and arthralgia on shoulders, knees, and hips. The second patient, a 44-year-old male, visited a mountain in Gangwon province, which was 1200 m above sea level, where a tick bite occurred. One month after the tick bite, erythema migrans appeared at the site of the tick bite, along with fatigue, myalgia, and arthralgia on the right shoulder and temporomandibular joint. Indirect fluorescent antibody testing and Western blotting were carried out in these two cases for diagnosis, and positive findings were obtained. As a result, Lyme borreliosis could be confirmed. To estimate the pathogens and vectors, the ticks were collected. A total of 122 ticks were collected and only two species, Haemaphysalis japonica and Haemaphysalis flava, were identified. PCR and culture were performed on ticks. However, Borrelia burgdo rferi sensu lato was not isolated from any collected ticks.
Conclusions
This study is significant to confirm Lyme borreliosis officially at first by the national surveillance system, although identification of the mites and pathogens failed.
Review Article
Prion Diseases as Transmissible Zoonotic Diseases
Jeongmin Lee, Su Yeon Kim, Kyu Jam Hwang, Young Ran Ju, Hee-Jong Woo
Osong Public Health Res Perspect. 2013;4(1):57-66.   Published online February 28, 2013
DOI: https://doi.org/10.1016/j.phrp.2012.12.008
  • 1,360 View
  • 16 Download
  • 16 Citations
AbstractAbstract PDF
Prion diseases, also called transmissible spongiform encephalopathies (TSEs), lead to neurological dysfunction in animals and are fatal. Infectious prion proteins are causative agents of many mammalian TSEs, including scrapie (in sheep), chronic wasting disease (in deer and elk), bovine spongiform encephalopathy (BSE; in cattle), and Creutzfeldt–Jakob disease (CJD; in humans). BSE, better known as mad cow disease, is among the many recently discovered zoonotic diseases. BSE cases were first reported in the United Kingdom in 1986. Variant CJD (vCJD) is a disease that was first detected in 1996, which affects humans and is linked to the BSE epidemic in cattle. vCJD is presumed to be caused by consumption of contaminated meat and other food products derived from affected cattle. The BSE epidemic peaked in 1992 and decreased thereafter; this decline is continuing sharply owing to intensive surveillance and screening programs in the Western world. However, there are still new outbreaks and/or progression of prion diseases, including atypical BSE, and iatrogenic CJD and vCJD via organ transplantation and blood transfusion. This paper summarizes studies on prions, particularly on prion molecular mechanisms, BSE, vCJD, and diagnostic procedures. Risk perception and communication policies of the European Union for the prevention of prion diseases are also addressed to provide recommendations for appropriate government policies in Korea.

PHRP : Osong Public Health and Research Perspectives