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Volume 4(2); April 2013
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Editorial
Fires in the Neighborhood
Hae-Wol Cho, Chaeshin Chu
Osong Public Health Res Perspect. 2013;4(2):67-67.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.03.007
  • 1,633 View
  • 18 Download
PDF
Original Articles
Availability of Clean Tap Water and Medical Services Prevents the Incidence of Typhoid Fever
Deog-Yong Lee, Esther Lee, HyeMin Park, SeongHan Kim
Osong Public Health Res Perspect. 2013;4(2):68-71.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.03.005
  • 1,906 View
  • 19 Download
  • 2 Citations
AbstractAbstract PDF
Objective: In this study, the factors that induced a decrease in the incidence of typhoid fever were analyzed. Based on the study results, we propose a quantitative and concrete solution to reduce the incidence of typhoid fever.
Methods
We analyzed the incidence and fatality rate of typhoid fever in Korea. Tap water service rate and the number of pharmacies, which affect the incidence rate of typhoid fever, were used as environmental factors.
Results
To prevent typhoid fever in the community, it is necessary to provide clean tap water service to 35.5% of the population, with an individual requiring 173 L of clean water daily. Appropriate access to clean water (51% service coverage, 307 L) helped the population to maintain individual hygiene and food safety practices, which brought about a decrease in the incidence of typhoid fever, and subsequently a decrease in fatality rate, which was achieved twice. During the 8-year study period, the fatality rate decreased to 1% when the population has access to proper medical service.
Conclusion
The fatality rate was primarily affected by the availability of medical services as well as by the incidence of typhoid fever. However, an analysis of the study results showed that the incidence of typhoid fever was affected only by the availability of clean water through the tap water system.
Prevalence of Antimicrobial Resistance in Escherichia coli Strains Isolated from Fishery Workers
Hyun-Ho Shin, Seung-Hak Cho
Osong Public Health Res Perspect. 2013;4(2):72-75.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.03.001
  • 1,716 View
  • 15 Download
  • 6 Citations
AbstractAbstract PDF
Objectives
This study aimed to characterize the prevalence of antibiotic resistance in Escherichia coli isolates from the fecal samples of fishery workers who work in fish farms and often use antibiotics for the feeding fishes.
Methods
Seventy-three E. coli strains isolated from the fecal samples of fishery workers and 180 isolates from a control group of restaurant workers were tested for antibiotic resistance by agar disk diffusion with 16 antimicrobial agents.
Results
About 30% of isolates from each group showed antimicrobial resistance to ampicillin, and 60% of isolates from fishery workers and 41% from restaurant workers were resistant to tetracycline. The isolates showed higher resistance to cephalothin and cefoxitin than to other cephem antibiotics and to gentamicin than to other aminogycosides. Our data indicated that fecal E. coli isolates from fishery workers showed higher antibiotic resistance than those of non-fishery workers (restaurant workers), especially to cephalothin, tetracycline, and trimethoprim–sulfamethoxazole (p < 0.05). However, rates of multidrug resistance were similar among the fishery workers and restaurant workers.
Conclusion
Frequent use of antibiotics may cause increased antibiotic resistance in the human microbiome.
Susceptibility and Resistance of Field Populations of Anopheles sinensis (Diptera: Culicidae) Collected from Paju to 13 Insecticides
Kyu-Sik Chang, Dae-Hyun Yoo, E-Hyun Shin, Wook-Gyo Lee, Jong Yeol Roh, Mi Yeoun Park
Osong Public Health Res Perspect. 2013;4(2):76-80.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.02.001
  • 1,695 View
  • 19 Download
  • 10 Citations
AbstractAbstract PDF
Objectives
Over 20% of all malaria cases reported annually in the Republic of Korea (ROK) occur in Paju, Gyeonggi Province. Vector control for malaria management is essential, but the insecticide resistance of the vector, Anopheles mosquitoes, has been a major obstacle in implementing effective control. In this study, the insecticide resistance of the vector mosquitoes was evaluated and compared with that of vector mosquitoes collected from the same locality in 2001 and 2009.
Methods
The insecticide resistance of Anopheles sinensis s.s. collected from Paju, Gyeonggi Province in the ROK was evaluated under laboratory conditions with a micro-application method using 13 insecticides currently used by local public health centers and pest control operators in the ROK.
Results
Based on median lethal dose (LC50) values, An. sinensis s.s. were most susceptible to the insecticides bifenthrin, cyfluthrin, and etofenprox in that order, and least susceptible to permethrin. An. sinensis showed higher susceptibility to pyrethroids than organophosphates, except for fenthion and permethrin. In a comparative resistance test, the resistance ratios (RRs) of An. sinensis collected in 2012 (AS12) to the 13 insecticides were compared to the RRs of two strains of An. sinensis collected from the same locality in 2001 (AS01) and 2008 (AS08). With some exceptions, AS12 demonstrated higher resistance to all tested insecticides compared to AS01 and AS08, and less resistance to bifenthrin, cyfluthrin, and cypermethrin compared to AS01.
Conclusion
These results indicate that careful selection and rotation of these insecticides may result in continued satisfactory control of field populations of An. sinensis s.s. for effective malaria management in Paju.
The Effects of Religious Attendance and Obesity on Health by Race/Ethnicity
Sanggon Nam
Osong Public Health Res Perspect. 2013;4(2):81-88.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.03.002
  • 1,507 View
  • 13 Download
  • 3 Citations
AbstractAbstract PDF
Objectives
The objectives of this paper are to examine the effects of religion and obesity on health and determine how the relationship varies by racial/ethnic groups with data from the Panel Study of American Race and Ethnicity (PS-ARE).
Methods
Using ordinal logistic regression, the effects of religion and obesity on self-rated health and how the relationship varies by racial/ethnic groups are investigated. Additionally, to determine whether certain ethnic groups are more impacted by the frequency of religious attendance and obesity, whites, blacks, and Hispanics are analyzed separately with ordinal logistic regression.
Results
When obesity was added in focal relationship between religious services attendance and self-rated health strengthened this focal relationship which is a suppression effect between religious services attending and self-rated health adding obesity. For BMI is also significantly associated with decreased odds of reporting better health–normal weight (OR = 2.99; 95% CI = 2.43–3.67) and overweight (OR = 2.19; 95% CI = 1.79–2.68) compared to obese. Subjects who attend religious services 1–2 time a year (OR = 1.30; 95% CI = 1.04–1.62) and 1–3 times a month (OR = 1.28; 95% CI = 1.05–1.57) are associated with increased odds of reporting better health. In whites, attending religious services 1–2 times a year are associated with increased odds of reporting better health (OR = 1.48; 95% CI = 1.09–2.00) and 1–3 times a month are also associated with increased odds of reporting health (OR = 1.34; 95% CI = 1.02–1.78) compared to never attending religious attendance. The frequency of religious services attendance of blacks and Hispanics are not associated with self-rated health. For BMI, being white is more positively associated with increased odds of reporting better health than black and Hispanic subjects. Although white subjects are less likely to attend religious services more frequently than black and Hispanic subjects, the influence on self-rated health in white subjects is more evidenced than other racial/ethnic groups.
Conclusions
Although it was not proven that the association between participation in religious services and self-rated health is mediated by obesity, the research shows the suppression effect of obesity between participation in religious services and self-rated health.
The First Outbreak of Giardiasis with Drinking Water in Korea
Hyeng-Il Cheun, Cheon-Hyeon Kim, Shin-Hyeong Cho, Da-Won Ma, Bo-La Goo, Mun-Su Na, Seung-Ki Youn, Won-Ja Lee
Osong Public Health Res Perspect. 2013;4(2):89-92.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.03.003
  • 1,816 View
  • 17 Download
  • 21 Citations
AbstractAbstract PDF
Objectives
To identify the pathogen of the diarrhea outbreak in a village in Jeollabuk province in Korea in April 2010.
Methods
DNA extraction was performed from the 120 L of collected water, which was centrifuged at 10,000 x g for 30 min. PCR reactions were conducted in a total of 25 ul, which included PCR premix (GenDEPOT, Barker, TX, USA), 2 ul (∼100 ng) of extracted DNA, and 10 pmol of each primer.
Results
Nine people out of 25 had a symptom of abdominal pain accompanied by diarrhea after they used stored valley water in a water tank as a provisional water supply source without chlorine sterilization. Among them Giardia lamblia was detected in fecal samples of 7 people using the polymerase chain reaction method. Although G. lamblia was also detected from water provided by the provisional water supply system stored in the water tank and used as drinking water, it was not detected in the water tank itself. This water-borne outbreak is considered to have occurred when the provisional water supply tube was destroyed under a building construction and contaminated by G. lamblia, but its precise cause has not been clarified.
Conclusion
This outbreak resulting from G. lamblia is very meaningful as the first outbreak of an infection by a water-borne parasite in Korea.
Factors Related to Completed Status and Seropositivity of Hepatitis A Immunization Among Children Aged 1–3 Years and 6–8 Years in South Korea
Jee-Young Hong, Mo Ran Ki, Hye-Jung Hwang, Delacroix Sinny, Young-Joon Park, Geun-Ryang Bae, Moo-Sik Lee
Osong Public Health Res Perspect. 2013;4(2):93-98.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.02.004
  • 2,109 View
  • 11 Download
  • 1 Citations
AbstractAbstract PDF
This study was designed to identify factors associated with hepatitis A immunization status and seropositivity in Korean children. In-person interviews, reviewing their vaccination cards and testing hepatitis A antibody were conducted with 389 children aged 1–3 years and 544 children aged 6–8 years. In all age groups, earlier birth order was the only significant factor in children receiving either single or both doses of the vaccination. And completion of the second dose of vaccination was a prerequisite for increased seropositivity. Additionally, household income had a positive impact on seropositivity only in children aged 6–8 years. Our findings suggest that presence of an economic barrier is the underlying cause of the decreased hepatitis A vaccination services in Korea. Therefore, hepatitis A vaccine should be included in the essential National Immunization Program.
Peer-to-Peer JXTA Architecture for Continuing Mobile Medical Education Incorporated in Rural Public Health Centers
Rajkumar Rajasekaran, Nallani Chackravatula Sriman Narayana Iyengar
Osong Public Health Res Perspect. 2013;4(2):99-106.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.03.004
  • 1,732 View
  • 12 Download
  • 1 Citations
AbstractAbstract PDF
Objectives
Mobile technology helps to improve continuing medical education; this includes all aspects of public health care as well as keeping one’s knowledge up-to-date. The program of continuing medical and health education is intertwined with mobile health technology, which forms an imperative component of national strategies in health. Continuing mobile medical education (CMME) programs are designed to ensure that all medical and health-care professionals stay up-to-date with the knowledge required through mobile JXTA to appraise modernized strategies so as to achieve national goals of health-care information distribution.
Methods
In this study, a 20-item questionnaire was distributed to 280 health professionals practicing traditional training learning methodologies (180 nurses, 60 doctors, and 40 health inspectors) in 25 rural hospitals. Among the 83% respondents, 56% are eager to take new learning methodologies as part of their evaluation, which is considered for promotion to higher grades, increments, or as part of their work-related activities.
Results
The proposed model was executed in five public health centers in which nurses and health inspectors registered in the JXTA network were referred to the record peer group by administrators. A mobile training program on immunization was conducted through the ADVT, with the lectures delivered on their mobiles. Credits are given after taking the course and completing an evaluation test. The system is faster compared with traditional learning.
Conclusion
Medical knowledge management and mobile-streaming application support the CMME system through JXTA. The mobile system includes online lectures and practice quizzes, as well as assignments and interactions with health professionals. Evaluation and assessments are done online and credits certificates are provided based on the score the student obtains. The acceptance of mobile JXTA peer-to-peer learning has created a drastic change in learning methods among rural health professionals. The professionals undergo training and should pass an exam in order to obtain the credits. The system is controlled and monitored by the administrator peer group, which makes it more flexible and structured. Compared with traditional learning system, enhanced study improves cloud-based mobile medical education technology.
Brief Reports
A Strategic Plan for the Second Phase (2013–2015) of the Korea Biobank Project
Ok Park, Sang Yun Cho, So Youn Shin, Jae-Sun Park, Jun Woo Kim, Bok-Ghee Han
Osong Public Health Res Perspect. 2013;4(2):107-116.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.03.006
  • 1,744 View
  • 20 Download
  • 9 Citations
AbstractAbstract PDF
The Korea Biobank Project (KBP) was led by the Ministry of Health and Welfare to establish a network between the National Biobank of Korea and biobanks run by university-affiliated general hospitals (regional biobanks). The Ministry of Health and Welfare started the project to enhance medical and health technology by collecting, managing, and providing researchers with high-quality human bioresources. The National Biobank of Korea, under the leadership of the Ministry of Health and Welfare, collects specimens through various cohorts and regional biobanks within university hospitals gather specimens from patients. The project began in 2008, and the first phase ended in 2012, which meant that there needed to be a plan for the second phase that begins in 2013. Consequently, professionals from within and outside the project were gathered to develop a plan for the second phase. Under the leadership of the planning committee, six working groups were formed to formulate a practical plan. By conducting two workshops with experts in the six working groups and the planning committee and three forums in 2011 and 2012, they have developed a strategic plan for the second phase of the KBP. This document presents a brief report of the second phase of the project based on a discussion with them.During the first phase of the project (2008–2012), a network was set up between the National Biobank of Korea and 17 biobanks at university-affiliated hospitals in an effort to unify informatics and governance among the participating biobanks. The biobanks within the network manage data on their biospecimens with a unified Biobank Information Management System. Continuous efforts are being made to develop a common standard operating procedure for resource collection, management, distribution, and personal information security, and currently, management of these data is carried out in a somewhat unified manner. In addition, the KBP has trained and educated professionals to work within the biobanks, and has also carried out various publicity promotions to the public and researchers. During the first phase, biospecimens from more than 300,000 participants through various cohorts and biospecimens from more than 200,000 patients from hospitals were collected, which were distributed to approximately 600 research projects.The planning committee for the second phase evaluated that the first phase of the KBP was successful. However, the first phase of the project was meant to allow autonomy to the individual biobanks. The biobanks were able to choose the kind of specimens they were going to collect and the amount of specimen they would set as a goal, as well as being allowed to choose their own methods to manage their biobanks (autonomy). Therefore, some biobanks collected resources that were easy to collect and the resources needed by researchers were not strategically collected. In addition, there was also a low distribution rate to researchers outside of hospitals, who do not have as much access to specimens and cases as those in hospitals. There were also many cases in which researchers were not aware of the KBP, and the distribution processes were not set up to be convenient to the demands of researchers.Accordingly, the second phase of the KBP will be focused on increasing the integration and cooperation between the biobanks within the network. The KBP plans to set goals for the strategic collection of the needed human bioresources. Although the main principle of the first phase was to establish infrastructure and resource collection, the key objective of the second phase is the efficient utilization of gathered resources. In order to fully utilize the gathered resources in an efficient way, distribution systems and policies must be improved. Vitalization of distribution, securing of high-value resource and related clinical and laboratory information, international standardization of resource management systems, and establishment of a virtuous cycle between research and development (R&D) and biobanks are the four main strategies. Based on these strategies, 12 related objectives have been set and are planned to be executed.
Revision of the National Action Plan in Response to Poliovirus Importation in Korea
Young-Joon Park, Joon-Woo Kim, Yoon Hyung Kwon, Geun-Ryang Bae, Duk-Hyoung Lee
Osong Public Health Res Perspect. 2013;4(2):117-121.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.03.008
  • 1,650 View
  • 13 Download
  • 2 Citations
AbstractAbstract PDF
The polio outbreak in China in 2011 makes it necessary to revise the 2010 polio National Action Plan (NAP) in Korea. The revised plan was provided after evaluation of the 2010 NAP, literature reviews, and expert advice. It was discussed and confirmed by the Polio National Certificate Committee (NCC).The revised NAP (2012 NAP) has structured the action to take by patient phase and the role of each institution. It also provides the specified classification and management actions on the contacts. It includes a new recommendation of onetime additional immunization for the contacts regardless of the immunization history. The 2012 NAP could provide an effective countermeasure if there are imported poliomyelitis patients in Korea.

PHRP : Osong Public Health and Research Perspectives