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Volume 8(5); October 2017
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Editorial
Not One for All
Hae-Wol Cho, Chaeshin Chu
Osong Public Health Res Perspect. 2017;8(5):293-294.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.01
  • 1,983 View
  • 14 Download
PDF
Original Articles
Regional Disparity and Factors Influencing Unmet Medical Needs: A Study Based on the Sixth Korea National Health and Nutrition Examination Survey (2015)
Ji Hye Lim
Osong Public Health Res Perspect. 2017;8(5):295-301.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.02
  • 2,229 View
  • 20 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

This study aimed to determine regional differences and the factors that affect unmet medical needs.

Methods

Data from the 6th Korea National Health and Nutrition Examination Survey (2015) were used, and 4,946 health survey participants who provided responses on medical utilization and health behavior were included in the study.

Results

A statistically significant difference was observed in the incidence rate of unmet medical needs in terms of region. The independent variables that affected unmet medical needs were sex, age, education, region, household income, insurance type, smoking status, self-reported health status, and stress awareness. Gender (female), lower education level, rural residents, lowest household income, poor self-reported health status, and stress awareness increased the probability of unmet medical needs.

Conclusion

Our findings suggested that different policies and approaches should be considered for each population that is at risk to address the primary cause of the unmet medical needs. Further studies that include medical expenses and the relevant variables of an area should be conducted in the future.

Prevalence and Risk Factors of Intestinal Parasite Infection among Schoolchildren in the Peripheral Highland Regions of Huanuco, Peru
Byungjin Choi, Bongyoung Kim
Osong Public Health Res Perspect. 2017;8(5):302-307.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.03
  • 3,194 View
  • 54 Download
  • 8 Citations
AbstractAbstract PDF
Objectives

Schoolchildren in developing countries are at greater risk of intestinal parasitic infections. This study aimed to estimate the prevalence and assess the risk factors of intestinal parasite infection among schoolchildren in rural areas of Peru.

Methods

A volunteer team from the Korea International Cooperation Agency (KOICA) conducted a campaign for parasite eradication called “Chao parasitos” at five schools in the peripheral highland regions of Huanuco in October 2013. The study collected questionnaires and stool samples from children of participating schools. Entamoeba coli, Iodamoeba buschii, and Chilomastix mesnil were classified as nonpathogenic parasites.

Results

The overall prevalence of intestinal parasite infection in the students was 100% (185/185). Among them, 25.9% (48/185) were infected only with nonpathogenic parasites whereas 74.1% (137/185) were infected with at least one pathogenic parasite. Ascaris lumbricoides was the most commonly detected (37.3%, 69/185), followed by Giardia lamblia (15.1%, 28/185) and I. buschii (11.9%, 22/185). Among lifestyle practices associated with parasitic infection, the rate of washing hands before meals was significantly lower in the students with pathogenic parasites compared to those with nonpathogenic parasites (77.4%, 106/137 vs. 93.8%, 45/48, p = 0.025).

Conclusion

The prevalence of intestinal parasite was 100%. Both personal hygiene and water supply facilities are required to eradicate parasite infection in rural areas of Peru.

Different Effects of Cognitive and Non-exercise Physical Leisure Activities on Cognitive Function by Age in Elderly Korean Individuals
Mi Sook Jung, Hyunli Kim, Yeji Lee, Mijung Kim, Eunyoung Chung
Osong Public Health Res Perspect. 2017;8(5):308-317.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.04
  • 2,590 View
  • 35 Download
  • 6 Citations
AbstractAbstract PDF
Objectives

We aimed to examine the effects of various leisure activities on cognitive impairment in young-old (aged 65–74 years) and old-old (aged ≥ 75 years) adults.

Methods

In total, 10,279 elderly Korean individuals from the 2014 Korean National Survey on Older Adults’ cohort were enrolled in our study. Cognitive impairment was assessed using the standardized score of the Mini-Mental State Examination for Dementia Screening, whereas leisure activities were recorded via self-reporting of the extent and type of leisure activity the subjects involved in over the past year. Multivariate logistic regression was used to assess the effect of leisure activities on cognitive impairment, while controlling for potential covariates.

Results

The subjects were more likely to participate in cognitive activities than in non-exercise physical activities. After controlling for selected covariates, involvement in cognitive activities was found to be a significant predictor of cognitive impairment in both the groups, whereas involvement in non-exercise physical activities was not a predictor of cognitive impairment in individuals aged ≥ 75 years. Moreover, depressive symptoms, rural residence, and hearing difficulties were common predictors of cognitive impairment among elderly-Korean-individuals.

Conclusion

Leisure activity involvement may help delay cognitive impairment, which is often concomitant with aging. Hence, an early intervention service may significantly benefit both young-old and old-old individuals.

Antiviral Activity of Itraconazole against Echovirus 30 Infection In Vitro
Jae-Sug Lee, Hwa-Jung Choi, Jae-Hyoung Song, Hyun-Jeong Ko, Kyungah Yoon, Jeong-Min Seong
Osong Public Health Res Perspect. 2017;8(5):318-324.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.05
  • 2,873 View
  • 23 Download
  • 6 Citations
AbstractAbstract PDF
Objectives

Echovirus 30 is a major cause of meningitis in children and adults. The aim of this study was to investigate whether the antifungal drug itraconazole could exhibit antiviral activity against echovirus 30.

Methods

The cytopathic effect and viral RNA levels were assessed in RD cells as indicators of viral replication. The effects of itraconazole were compared to those of two known antiviral drugs, rupintrivir and pleconaril. The time course and time-of-addition assays were used to approximate the time at which itraconazole exerts its activity in the viral cycle.

Results

Itraconazole and rupintrivir demonstrated the greatest potency against echovirus 30, demonstrating concentration-dependent activity, whereas pleconaril showed no antiviral activity. Itraconazole did not directly inactivate echovirus 30 particles or impede viral uptake into RD cells, but did affect the initial stages of echovirus 30 infection through interference with viral replication.

Conclusion

Itraconazole can be considered a lead candidate for the development of antiviral drugs against echovirus 30 that may be used during the early stages of echovirus 30 replication.

Characterization of Clostridium difficile Strains Isolated from Patients with C. difficile-associated Disease in Korea
Seung-Hak Cho, Jung-Whan Chon, Kun-Ho Seo, Young Kwon Kim, Jung-Beom Kim, Young-Seok Bak, Woon-Won Jung, Cheorl-Ho Kim, Jong Tae Choi
Osong Public Health Res Perspect. 2017;8(5):325-331.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.06
  • 2,441 View
  • 24 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

Studies on Clostridium difficile are rare in Korea. We investigated the epidemiological characteristics of C. difficile isolates from patients with C. difficile-associated disease (CDAD) in Korea.

Methods

Multiplex polymerase chain reaction was performed to detect the presence of tcdA and tcdB toxin genes. Antimicrobial susceptibility test was carried out by the disk-dilution method. C. difficile strains were subtyped by automated repetitive-element palindromic PCR (rep-PCR).

Results

Among patients with CDAD, 73 (25.8%), 32 (11.3%), 32 (11.3%), and 26 (9.2%) suffered from pneumonia, cancer or neoplasm, diabetes, and colitis, respectively. Of all stool samples, 43 samples (15.2%) were positive for C. difficile strains. We observed two expression patterns of toxin genes: tcdA+/tcdB+ (86% isolates) and tcdA−/tcdB+ (14% isolates), with all isolates expressing tcdB. Furthermore, some isolates were resistant to clindamycin (65%), ampicillin (56%), and cefazolin (40%), but all were susceptible to vancomycin and metronidazole. The tested samples were classified into diverse clusters using automated rep-PCR.

Conclusion

Our findings revealed the characteristics and antibiotic resistance of C. difficile isolates from patients in Korea. The epidemiological data may provide valuable insight into development of treatment strategies for C. difficile infections in Korea.

Factors Related to Healthcare Service Quality in Long-term Care Hospitals in South Korea: A Mixed-methods Study
Minsung Sohn, Mankyu Choi
Osong Public Health Res Perspect. 2017;8(5):332-341.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.07
  • 2,433 View
  • 26 Download
  • 2 Citations
AbstractAbstract PDF
Objectives

The environment of long-term care hospitals (LTCHs) is critical to the management of the quality of their services and to patient safety, as highlighted by international studies. However, there is a lack of evidence on this topic in South Korea. This study aimed to examine the factors affecting healthcare quality in LTCHs and to explore the effectiveness of their quality management.

Methods

This study used a mixed methods approach with quantitative data collected in a national survey and qualitative data from semi-structured interviews with practice-based managers. The samples included 725 nationally representative LTCHs in South Korea for the quantitative analysis and 15 administrators for the in-depth interviews.

Results

A higher installation rate of patient-safety and hygiene-related facilities and staff with longer-tenures, especially nurses, were more likely to have better healthcare quality and education for both employees and patients.

Conclusion

The need for patient-safety- and hygiene-related facilities in LTCHs that serve older adults reflects their vulnerability to certain adverse events (e.g., infections). Consistent and skillful nursing care to improve the quality of LTCHs can be achieved by developing relevant educational programs for staff and patients, thereby strengthening the relationships between them.

Comparative Analysis of the Trends in Medical Utilization of Cancer Inpatients in Korea
Hyun-Ju Lee, Sung-Soo Kim
Osong Public Health Res Perspect. 2017;8(5):342-350.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.08
  • 2,208 View
  • 30 Download
AbstractAbstract PDF
Objectives

Cancer has attracted worldwide attention. The incidence and prevalence are increasing, and it is the main cause of death. The purpose of this study was to identify the characteristics of hospitalized cancer patients.

Methods

This study is a secondary data study using the Korean National Hospital Discharge In-depth Injury Survey Data conducted annually by the Korea Centers for Disease Control and Prevention. Using these data, we extracted inpatients who principal diagnosis is cancer for nine years from 2005 to 2013.

Results

According to the analysis, the annual trend of cancer inpatients is steadily increasing. In 2025, it is expected to increase to about 670,000 inpatients. A cancer diagnosis created a change in medical utilization depending on the characteristics of patients and hospital. Men are more at risk of cancer than women. The number of hospital beds and hospital days were inversely proportional to cancer inpatients. There was also a difference in the equity of medical utilization by region. Other cancer management policies should be based on sex.

Conclusion

Populations between the ages of 45 and 64 years should be a priority in cancer policy. Because of the long-term hospitalization of patients with death as the outcome, a terminal cancer patient care facility is needed. These conclusions can provide a basis for various health policies.

Cost of Tuberculosis Treatment: Evidence from Iran’s Health System
Vahid Bay, Payam Tabarsi, Aziz Rezapour, Sima Marzban, Ehsan Zarei
Osong Public Health Res Perspect. 2017;8(5):351-357.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.09
  • 2,863 View
  • 27 Download
  • 4 Citations
AbstractAbstract PDF
Objectives

This study aimed to estimate the cost of smear-positive drug-susceptible pulmonary tuberculosis (TB) treatment of the patients in the Azadshahr district, Golestan Province, Iran.

Methods

In this retrospective study, all new smear positive pulmonary TB patients who had been registered at the district’s health network between April, 2013 and December, 2015 and had successfully completed their treatment were entered into the study (45 patients). Treatment costs were estimated from the provider’s perspective using an activity-based costing (ABC) method.

Results

The cost of treating a new smear-positive pulmonary TB patient was US dollar (USD) 1,409.00 (Iranian Rial, 39,438,260), which can be divided into direct and indirect costs (USD 1,226.00 [87%] and USD 183.00 [13%], respectively). The highest cost (58.1%) was related to care and management of TB patients (including 46.1% human resources costs and 12% directly-observed treatment, short course implementation) and then respectively related to hospitalization (12.1%), supportive activity centers (11.4%), transportation (6.5%), medicines (5.3%), and laboratory tests and radiography (3.2%).

Conclusion

Using disease-specific cost studies can help the healthcare system management to have correct insight into the financial burden created by the disease. This can subsequently be used in prioritization, planning, operational budgeting, economic evaluation of programs, interventions, and ultimately in disease management.

A Retrospective Mid- and Long-term Follow-up Study on the Changes in Hematologic Parameters in the Highly Exposed Residents of the Hebei Spirit Oil Spill in Taean, South Korea
Young-Hyun Choi, Jee-Young Hong, Moo-Sik Lee
Osong Public Health Res Perspect. 2017;8(5):358-366.   Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.10
  • 2,477 View
  • 22 Download
  • 5 Citations
AbstractAbstract PDF
Objectives

This study aimed to analyze changes in hematologic parameters in the residents of the areas highly contaminated by the Hebei Spirit Oil Spill in 2007 and those who participated in the clean-up activities.

Methods

According to demographic characteristics, health status and behavior, and level of exposure to oil, we compared the hematologic results in 2009 and 2012 among 701 residents. The hematologic parameters were composed of white blood cell (WBC) count, and levels of hemoglobin, hematocrit (Hct), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glucose, glycosylated hemoglobin (HbA1c), blood urea nitrogen (BUN), creatinine (Cr), total cholesterol (T-chol), high-density lipoprotein (HDL), and triglyceride (TG).

Results

Paired t-test revealed that the WBC count and levels of Hct, AST, ALT, glucose, and HbA1c significantly increased, whereas the BUN, Cr, HDL, and TG levels significantly decreased. Multiple linear regression modelling showed a relationship between the level of exposure to oil and temporal changes in Hct, glucose, HbA1c, and BUN levels.

Conclusion

Our results suggest a relationship between level of exposure to oil and changes in hematologic parameters over 3 years. Further studies should be conducted to determine the impact of oil spill on health such as the occurrence of diseases.


PHRP : Osong Public Health and Research Perspectives