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Volume 8(1); February 2017
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Editorial
What Matters in the Performance of a Medial Institution?
Hae-Wol Cho, Chaeshin Chu
Osong Public Health Res Perspect. 2017;8(1):1-2.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.01
  • 1,593 View
  • 20 Download
PDF
Original Articles
Estimating Tuberculin Skin Test Reactions among Children and Teenagers Who Received the Bacillus Calmette-Guerin Vaccination at Birth: A Meta-analysis
Mohammad Sadegh Rezai, Siavosh Abedi, Mahdi Afshari, Mahmood Moosazadeh
Osong Public Health Res Perspect. 2017;8(1):3-10.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.02
  • 2,025 View
  • 23 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

Tuberculin skin reaction size is one indicator of bacillus Calmette-Guérin (BCG) vaccine efficacy and a way to diagnose latent infection. Several primary studies have examined this issue. Combining the results of these studies using a meta-analysis will provide reliable evidence regarding this indicator for policymakers. This study aimed to estimate the total frequency of different tuberculin skin test reactions among Iranian children and teenagers who received the BCG vaccination at birth.

Methods

National and international databanks were searched using relevant keywords. After the search strategy was restricted and duplicates were excluded, the titles and abstracts of the remaining papers were screened. All included studies included healthy children who received the BCG vaccine without confirmed tuberculosis exposure. Heterogeneity of the results was assessed using the Cochrane test and I2 index showed the random effects model as the best model for estimating the pooled results.

Results

We combined the results of 14 primary studies including purified protein derivative reaction test measures of 26,281 Iranian children. The frequencies (95% confidence intervals) of the reactions were 8.5% (6.2–10.8) for patients with a reaction size ≥ 10 mm, 29.9% (22.3–37.4) for a reaction size of 5–9 mm, and 60% (48.9–71.1) for a reaction size < 5 mm.

Conclusion

Our study showed that large numbers of Iranian children and teens have no positive BCG vaccine reaction and a considerable number of children have been exposed to Mycobacterium tuberculosis.

Do Factors Associated Self-rated Good Health and Their Influences Differ between Males and Females across Different Age Groups in Korean and Australia?
Hyo Young Lee, Stephanie Doris Short
Osong Public Health Res Perspect. 2017;8(1):11-25.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.03
  • 2,164 View
  • 19 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

This was a comparative study between Australia and Korea that investigated whether and to what extent factors related to self-rated good health (SRGH) differ by gender among age groups.

Methods

This study was a secondary analysis of data that were collected in nationally representative, cross-sectional, and population-based surveys. We analyzed Australian and Korean participants > 20 years of age using 2011 data from the Australian National Nutritional Physical Activity Survey (n = 9,276) and the Korean National Health and Nutritional Examination Survey (n = 5,915). Analyses were based on multiple logistic regression after controlling for covariates.

Results

Factors associated with SRGH and the extent of their influence differed by gender among age groups within each nation. Australian SRGH was associated with more factors than Korean SRGH, except in participants > 65 years old. Many differences among adults aged 20–44 years were observed, particularly with regard to the influence of socioeconomic factors. Living with a spouse only influenced SRGH in men 20–44 years old in both countries, negatively for Korean men and positively for Australian men. In this same age group, SRGH was positively influenced by employment and attainment of a higher education level in Australian men but not among Korean men; among women, income, but not education, affected SRGH in Korea, whereas in Australia, women were more influenced by education than by income. Lack of chronic disease had a strong influence on SRGH in both countries and was influential in all Australians and Koreans except those ≥ 65 years old.

Conclusion

Broad features of society should be considered when discussing health and differences in associated factors and their influences. For focused public health interventions of population groups, it is also necessary to consider gender and age groups within social environments.

Knowledge Management Enablers and Process in Hospital Organizations
Hyun-Sook Lee
Osong Public Health Res Perspect. 2017;8(1):26-33.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.04
  • 2,505 View
  • 88 Download
  • 8 Citations
AbstractAbstract PDF
Objectives

This research aimed to investigate the effects of knowledge management enablers, such as organizational structure, leadership, learning, information technology systems, trust, and collaboration, on the knowledge management process of creation, storage, sharing, and application.

Methods

Using data from self-administered questionnaires in four Korean tertiary hospitals, this survey investigated the main organizational factors affecting the knowledge management process in these organizations. A total of 779 questionnaires were analyzed using SPSS 18.0 and AMOS 18.0.

Results

The results showed that organizational factors affect the knowledge management process differently in each hospital organization.

Conclusion

From a managerial perspective, the implications of these factors for developing organizational strategies that encourage and foster the knowledge management process are discussed.

Analysis of Hospital Volume and Factors Influencing Economic Outcomes in Cancer Surgery: Results from a Population-based Study in Korea
Jung-A Lee, So-Young Kim, Keeho Park, Eun-Cheol Park, Jong-Hyock Park
Osong Public Health Res Perspect. 2017;8(1):34-46.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.05
  • 2,114 View
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  • 4 Citations
AbstractAbstract PDF
Objectives

To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume.

Methods

Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy. Hospital volumes were divided into quartiles.

Results

Independent predictors of high costs and long LOS included old age, low health insurance contribution, non-metropolitan residents, emergency admission, Charlson score > 2, public hospital ownership, and teaching hospitals. After adjusting for relevant factors, there was an inverse relationship between volume and costs/LOS. The highest volume hospitals had the lowest procedure costs and LOS. However, this was not observed for cystectomy.

Conclusion

Our findings suggest an association between patient and clinical factors and greater costs and LOS per surgical oncologic procedure, with the exception of cystectomy. Yet, there were no clear associations between hospitals’ cost of care and risk-adjusted mortality.

Detection of Integrons and Staphylococcal Cassette Chromosome mec Types in Clinical Methicillin-resistant Coagulase Negative Staphylococci Strains
Fahimeh Hajiahmadi, Elham Salimi Ghale, Mohammad Yousef Alikhani, Alireza Mordadi, Mohammad Reza Arabestani
Osong Public Health Res Perspect. 2017;8(1):47-53.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.06
  • 2,108 View
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  • 1 Citations
AbstractAbstract PDF
Objectives

Integrons are thought to play an important role in the spread of antibiotic resistance. This study investigates class 1 and 2 integron-positive methicillin-resistant coagulase-negative staphylococci strains isolated in Iran and characterizes their patterns of antimicrobial resistance.

Methods

Hundred clinical isolates of coagulase-negative staphylococci were characterized for integron content and staphylococcal cassette chromosome mec (SCCmec) type.

Results

Sixteen isolates carried class 1 (intI1) integrons and four isolates carried class 2 (intI2) integrons. One resistance gene array was identified among the class 1 integrons (aadA1 cassette). The distribution of SCCmec types in 50 methicillin-resistant coagulase-negative staphylococci strains showed that SCCmec types III and V dominated among the tested strains.

Conclusion

This is the first report of methicillin-resistant coagulase-negative staphylococci strains that carry two mobile genetic elements, including class 1 and 2 integrons and SCCmec, in Iran.

The Effect of Lactobacillus acidophilus PTCC 1643 on Cultured Intestinal Epithelial Cells Infected with Salmonella enterica serovar Enteritidis
Mona Moshiri, Mohammad Mehdi Soltan Dallal, Farhad Rezaei, Masoumeh Douraghi, Laleh Sharifi, Zahra Noroozbabaei, Mehrdad Gholami, Abbas Mirshafiey
Osong Public Health Res Perspect. 2017;8(1):54-60.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.07
  • 1,951 View
  • 18 Download
  • 7 Citations
AbstractAbstract PDF
Objectives

Gastrointestinal disorders caused by Salmonella enterica serovar Enteritidis (SesE) are a significant health problem around the globe. Probiotic bacteria have been shown to have positive effects on the immune responses. Lactobacillus acidophilus was examined for its capability to influence the innate immune response of HT29 intestinal epithelial cells towards SesE. The purpose of this work was to assess the effect of L. acidophilus PTCC 1643 on cultured intestinal epithelial cells infected with SesE.

Methods

HT29 cells were cultured in Roswell Park Memorial Institute medium supplemented with 10% fetal bovine serum and 1% penicillin/streptomycin. The cells were treated with L. acidophilus PTCC 1643 after or before challenge with SesE. At 2 and 4 hours post-infection, we measured changes in the expression levels of TLR2 and TLR4 via real-time polymerase chain reaction.

Results

Treatment with L. acidophilus inhibited SesE-induced increases in TLR2 and TLR4 expression in the infected HT29 cells. Moreover, the expression of TLR2 and TLR4 in cells that were pretreated with L. acidophilus and then infected with SesE was significantly higher than that in cells infected with SesE without pretreatment. Taken together, the results indicated that L. acidophilus had an anti-inflammatory effect and modulated the innate immune response to SesE by influencing TLR2 and TLR4 expression.

Conclusion

Our findings suggested that L. acidophilus PTCC 1643 was able to suppress inflammation caused by SesE infection in HT29 cells and reduce TLR2 and TLR4 expression. Additional in vivo and in vitro studies are required to further elucidate the mechanisms underlying this anti-inflammatory effect.

Analysis of Factors Affecting Women of Childbearing Age to Screen Using Visual Inspection with Acetic Acid
Sondang Sidabutar, Santi Martini, Chatarina Umbul Wahyuni
Osong Public Health Res Perspect. 2017;8(1):61-64.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.08
  • 1,977 View
  • 32 Download
  • 2 Citations
AbstractAbstract PDF
Objectives

The purpose of this study was to evaluate patient factors such as knowledge, attitude, motivation, perception, socio-economic status and travel time to health facilities and assess how these factors affected patients’ decision to pursue cervical cancer screening with visual inspection with acetic acid (VIA).

Methods

A total of 80 women of childbearing age who visited Kenjeran and Balongsari Public Health Centers for health assessments were involved in this study. Patients who agreed to participate in the study underwent a verbal questionnaire to evaluate various factors.

Results

Bivariate analysis concluded that knowledge, attitude, motivation, perception, socioeconomic status, and travel time to health facilities were significantly different between women who received VIA screening and women who did not receive VIA screening (p < 0.05). The factors of knowledge, attitudes, motivation, perception, socio-economic status, and the travel time to health facilities accounted for 2.920-fold, 2.043-fold, 3.704-fold, 2.965-fold, 3.198-fold and 2.386-fold possibility, respectively, of patients to pursue cervical cancer screening with VIA. Multivariate analysis showed that perception, socio-economic status, and travel time to health facilities were the most important factors influencing whether or not women pursued VIA screening.

Conclusion

Knowledge, attitude, motivation, perception, socio-economic status, and travel time to health facilities appears to affect women’s’ decision to pursue cervical cancer screening with VIA, with the largest intake being the motivational factor.

A Novel PCR Assay for Detecting Brucella abortus and Brucella melitensis
Saeed Alamian, Majid Esmaelizad, Taghi Zahraei, Afshar Etemadi, Mohsen Mohammadi, Davoud Afshar, Soheila Ghaderi
Osong Public Health Res Perspect. 2017;8(1):65-70.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.09
  • 2,179 View
  • 49 Download
  • 7 Citations
AbstractAbstract PDF
Objectives

Brucellosis is a major zoonotic disease that poses a significant public health threat worldwide. The classical bacteriological detection process used to identify Brucella spp. is difficult and time-consuming. This study aimed to develop a novel molecular assay for detecting brucellosis.

Methods

All complete sequences of chromosome 1 with 2.1-Mbp lengths were compared among all available Brucella sequences. A unique repeat sequence (URS) locus on chromosome 1 could differentiate Brucella abortus from Brucella melitensis. A primer set was designed to flank the unique locus. A total of 136 lymph nodes and blood samples were evaluated and classified by the URS-polymerase chain reaction (PCR) method in 2013–2014.

Results

Biochemical tests and bacteriophage typing as the golden standard indicated that all Brucella spp. isolates were B. melitensis biovar 1 and B. abortus biovar 3. The PCR results were the same as the bacteriological method for detecting Brucella spp. The sensitivity and specificity of the URS-PCR method make it suitable for detecting B. abortus and B. melitensis.

Conclusion

Quick detection of B. abortus and B. melitensis can provide the most effective strategies for control of these bacteria. The advantage of this method over other presented methods is that both B. abortus and B. melitensis are detectable in a single test tube. Furthermore, this method covered 100% of all B. melitensis and B. abortus biotypes. The development of this URS-PCR method is the first step toward the development of a novel kit for the molecular identification of B. abortus and B. melitensis.

Surveillance of Bacillus cereus Isolates in Korea from 2012 to 2014
Su-Mi Jung, Nan-Ok Kim, Injun Cha, Hae-young Na, Gyung Tae Chung, Hyo Sun Kawk, Sahyun Hong
Osong Public Health Res Perspect. 2017;8(1):71-77.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.10
  • 1,997 View
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  • 2 Citations
AbstractAbstract PDF
Objectives

To investigate the prevalence and toxin production characteristics of non-emetic and emetic Bacillus cereus strains isolated via the laboratory surveillance system in Korea.

Methods

A total of 667 B. cereus strains were collected by the Korea National Research Institute of Health laboratory surveillance system from 2012 to 2014. The collected strains were analyzed by geographical region, season, patient age, and patient sex. Additionally, the prevalence rates of enterotoxin and emetic toxin genes were evaluated.

Results

The isolation rate of B. cereus strains increased during the summer, but the isolation rate was evenly distributed among patient age groups. Emetic toxin was produced by 20.2% of the isolated strains. The prevalence rates of five enterotoxin genes (entFM, nheA, cytK2, hblC, and bceT) were 85.0, 78.6, 44.5, 36.6, and 29.7%, respectively, among non-emetic strains and 77.8, 59.3, 17.8, 11.9 and 12.6%, respectively, among emetic strains. Thus, the prevalence rates of all five enterotoxin genes were lower in emetic B. cereus.

Conclusion

The prevalence of enterotoxin genes differed between non-emetic and emetic B. cereus strains. Among emetic B. cereus strains, the prevalence rates of two enterotoxin genes (cytK2 and hblC) were lower than those among the non-emetic strains. In both the emetic and non-emetic strains isolated in Korea, nheA and entFM were the most prevalent enterotoxin genes.

Genome Sequencing Analysis of Atypical Shigella flexneri Isolated in Korea
Nan-Ok Kim, Hae-young Na, Su-Mi Jung, Gyung Tae Chung, Hyo Sun Kawk, Sahyun Hong
Osong Public Health Res Perspect. 2017;8(1):78-85.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.11
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AbstractAbstract PDFSupplementary Material
Objectives

An atypical Shigella flexneri strain with a plural agglutination pattern [i.e., reacting not only with serum samples containing type antigen II but also with serum samples containing group antigens (3)4 and 7(8)] was selected for genome sequencing, with the aim of obtaining additional comparative information about such strains.

Methods

The genomic DNA of atypical S. flexneri strain NCCP 15744 was sequenced using an Ion Torrent PGM sequencing machine (Life Technologies, USA). The raw sequence data were preprocessed and reference-assembled in the CLC Assembly Cell software (version 4.0.6; CLC bio, USA).

Results

Ion Torrent sequencing produced 1,450,025 single reads with an average length of 144 bp, totaling ~209 Mbp. The NCCP 15744 genome is composed of one chromosome and four plasmids and contains a gtrX gene. Among the published genome sequences of S. flexneri strains, including 2457T, Sf301, and 2002017, strain NCCP 15744 showed high similarity with strain 2002017. The differences between NCCP 15744 and 2002017 are as follows: i) NCCP 15744 carries four plasmids whereas 2002017 carries five; ii) 19 genes (including CI, CII, and cro) were lost in the SHI-O genomic island of NCCP 15744 and six genes were gained as compared with strain 2002017.

Conclusion

Strain NCCP 15744 is genetically similar to 2002017, but these two strains have different multilocus sequence types and serotypes. The exact reason is unclear, but the 19 lost genes may be responsible for the atypical seroconversion of strain NCCP 15744.

Brief Report
Emergence of Norovirus GII.17-associated Outbreak and Sporadic Cases in Korea from 2014 to 2015
Sunyoung Jung, Bo-Mi Hwang, HyunJu Jung, GyungTae Chung, Cheon-Kwon Yoo, Deog-Yong Lee
Osong Public Health Res Perspect. 2017;8(1):86-90.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.12
  • 2,059 View
  • 22 Download
  • 7 Citations
AbstractAbstract PDF

Human norovirus are major causative agent of nonbacterial acute gastroenteritis. In general, genogroup (G) II.4 is the most prominent major genotype that circulate in human population and the environment. However, a shift in genotypic trends was observed in Korea in December 2014. In this study, we investigated the trend of norovirus genotype in detail using the database of Acute Diarrhea Laboratory Surveillance (K-EnterNet) in Korea. GII.17 has since become a major contributor to outbreaks of norovirus-related infections and sporadic cases in Korea, although the reason for this shift remain unknown.

Meeting Report
The First Meeting of the National Control Laboratories for Vaccines and Biologicals in the Western Pacific in 2016
Hokyung Oh, Jinho Shin, Manabu Ato, Xiao Ma, David Williams, Kiwon Han, Yang Jin Kim, Hyunggoo Kang, Kikyung Jung, Kentaro Hanada, Masaki Ochiai, Pham Van Hung, Sangmi Park, Chiyoung Ahn
Osong Public Health Res Perspect. 2017;8(1):91-103.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.13
  • 2,328 View
  • 44 Download
  • 5 Citations
AbstractAbstract PDF

The first meeting of the National Control Laboratories for Vaccines and Biologicals in the Western Pacific Region was held on September 1–2, 2016 in Seoul, the Republic of Korea. The meeting objectives were to share results of current research and to promote collaboration between the National Control Laboratories. To this end, we first discussed each country’s current status of research on quality control of biologicals. Next, we reviewed quality control of snake venom and antivenom production and the progress of a collaborative study on the Korean reference standard candidate for snake venom. We also discussed the establishment of the second regional reference standard antivenom and the characterization of the Vero cell genome landscape and its application to quality control. Moreover, we also reflected on the importance of collaboration among interested parties participating in this meeting. In conclusion, the meeting initiated networking between the national control laboratories in the Western Pacific region and paved the way to continue collaboration, which will eventually improve the region’s capacity for quality control of biologicals.


PHRP : Osong Public Health and Research Perspectives