Osong Public Health and Research Perspectives

Most-download articles are from the articles published in 2020 during the last three month.

Review Article

COVID-19 Outbreak in Malaysia: Asita Elengoe; Osong Public Health Res Perspect. 2020;11(3):93-100. Published online June 1, 2020; DOI: https://doi.org/10.24171/j.phrp.2020.11.3.08

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Abstract PDF: In 2020 a significant threat to public health emerged. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic outbreak emerged in December 2019 from Wuhan City, Hubei Province, China and spread to the rest of the world. This disease was named COVID-19 by World Health Organization. To date (17^th April 2020) a total of 2,230,439 cases of COVID-19; 150,810 cases of deaths and 564,210 recovered cases have been reported worldwide. In this review the SARS-CoV-2 morphology, pathogenic mechanism, similarities and differences between SARS-CoV and Middle East Respiratory Syndrome and severe acute respiratory syndrome, transmission mode, diagnosis, treatment, and preventive measures were investigated. The outbreak of COVID-19 from a Malaysian perspective was explored and mental health care during the COVID-19 outbreak was explored. To date, there is no vaccine or no specific treatment for COVID-19. Therefore, preventive measures are very important to prevent and control the rapid spread of the SARS-CoV-2 virus. Preparedness should be a priority for future pandemic outbreaks.

Original Article

Changes in the pattern and disease burden of acute respiratory viral infections before and during the COVID-19 pandemic: Chungmin Park, Donghan Lee, Bryan Inho Kim, Sujin Park, Gyehee Lee, Sangwoo Tak; Osong Public Health Res Perspect. 2022;13(3):203-211. Published online June 30, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0144

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Abstract PDF: Objectives
We conducted a comparative analysis of the differences in the incidence of 8 acute respiratory viruses and the changes in their patterns before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Three sentinel surveillance systems of the Korea Disease Control and Prevention Agency and data from the Health Insurance Review and Assessment Service were analyzed. The average numbers of reported cases and the related hospital admissions and outpatient data were compared between April 2018–2019 and 2020–2021. Changes in the disease burden and medical expenditures between these 2 time periods were evaluated. Results: During the COVID-19 pandemic, the number of reported cases of all acute respiratory viral infections, except for human bocavirus, decreased significantly. Data from the Health Insurance Review and Assessment Service also showed decreases in the actual amount of medical service usage and a marked reduction in medical expenditures. Conclusion: Non-pharmacological interventions in response to COVID-19 showed preventive effects on the transmission of other respiratory viruses, as well as COVID-19. Although COVID-19 had a tremendous impact on society as a whole, with high social costs, there were also positive effects, such as a reduction in the incidence of acute respiratory viral infections.

Brief Report

Safety monitoring of COVID-19 vaccination among adolescents aged 12 to 17 years old in the Republic of Korea: Seontae Kim, Insob Hwang, Mijeong Ko, Yunhyung Kwon, Yeon-Kyeng Lee; Osong Public Health Res Perspect. 2022;13(3):230-237. Published online June 10, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0122

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Graphical Abstract Abstract PDF: Objectives
This study aimed to disseminate information on coronavirus disease 2019 (COVID-19) vaccine safety among adolescents aged 12 to 17 years in the Republic of Korea. Methods: Two databases were used to assess COVID-19 vaccine safety in adolescents aged 12 to 17 years who completed the primary Pfizer-BioNTech vaccination series. Adverse events reported to the web-based COVID-19 vaccination management system (CVMS) and collected in the text message-based system were analyzed. Results: From March 5, 2021 to February 13, 2022, 12,216 adverse events among 12- to 17-yearolds were reported to the CVMS, of which 97.1% were non-serious adverse events and 2.9% were serious adverse events, including 85 suspected cases of anaphylaxis, 74 suspected cases of myocarditis and/or pericarditis, and 2 deaths. From December 13, 2021 to January 26, 2022, 10,389 adolescents responded to a text message survey, and local/systemic adverse events were more common after dose 2 than after dose 1. The most commonly reported events following either vaccine dose were pain at the injection site, headache, fatigue/tiredness, and myalgia. Conclusion: The overall results are consistent with previous findings; the great majority of adverse events were non-serious, and serious adverse events were rare among adolescents aged 12 to 17 years following Pfizer-BioNTech COVID-19 vaccination.

Original Article

Factors influencing acceptance of the COVID-19 vaccine in Malaysia: a web-based survey: June Fei Wen Lau, Yuan Liang Woon, Chin Tho Leong, Hoon Shien Teh; Osong Public Health Res Perspect. 2021;12(6):361-373. Published online November 25, 2021; DOI: https://doi.org/10.24171/j.phrp.2021.0085

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Abstract PDF Supplementary Material: Objectives
The coronavirus disease 2019 (COVID-19) pandemic has set a precedent for the fastest-produced vaccine as a result of global collaboration and outreach. This study explored Malaysians’ acceptance of the COVID-19 vaccine and its associated factors.
Methods
A cross-sectional anonymous web-based survey was disseminated to Malaysian adults aged ≥18 years old via social media platforms between July 10, 2020 and August 31, 2020.
Results
In the analysis of 4,164 complete responses, 93.2% of participants indicated that they would accept the COVID-19 vaccine if it was offered for free by the Malaysian government. The median out-of-pocket cost that participants were willing to pay for a COVID-19 vaccine was Malaysian ringgit (MYR) 100 (interquartile range [IQR], 100) if it was readily available and MYR 150 (IQR, 200) if the supply was limited. Respondents with a low likelihood of vaccine hesitancy had 13 times higher odds of accepting the COVID-19 vaccine (95% confidence interval [CI], 8.69 to 19.13). High perceived risk and severity were also associated with willingness to be vaccinated, with adjusted odds ratios of 2.22 (95% CI, 1.44 to 3.41) and 2.76 (95% CI, 1.87 to 4.09), respectively. Age and ethnicity were the only independent demographic characteristics that predicted vaccine uptake.
Conclusion
Public health strategies targeting perceived risk, perceived susceptibility and vaccine hesitancy could be effective in enhancing vaccine uptake.

Review Article

Effect of clofibrate on reducing neonatal jaundice: a systematic review and meta-analysis: Fatemeh Eghbalian, Lotfollah Karimi, Roya Raeisi, Ayda Hasanpour Dehkordi, Hamid Bouraghi; Osong Public Health Res Perspect. 2022;13(3):174-183. Published online June 30, 2022; DOI: https://doi.org/10.24171/j.phrp.2021.0336

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Abstract PDF: In neonates, bilirubin tends to be deposited in body tissues, especially the skin and mucous membranes. Jaundice is an early symptom of bilirubin excretion disorders. Therefore, the aim of this study was to investigate the effect of clofibrate on reducing neonatal jaundice. In this systematic review, international databases, including PubMed, Scopus, Web of Science, Embase, Cochrane, and Google Scholar, were searched without time and language restrictions. The reference lists of all studies ultimately included were manually searched. In the 17 articles reviewed, with a sample size of 665 people published between 2005 and 2019, the average weight of the neonates varied from 2,186 g to 4,000 g. Furthermore, the average age of neonates varied from 2 days to 9 days. Four doses of clofibrate (25, 30, 50, 100 mg/kg of neonatal body weight) were used. The bilirubin level of neonates significantly decreased in the intervention group 24, 36, 48, and 72 hours after the start of treatment. Clofibrate administration decreased total serum bilirubin, especially from the second day onwards, and also reduced hospitalization time, hospital costs, and side effects from hospitalization.

Original Articles

Voluntary testing for COVID-19: perceptions and utilization among the inhabitants of Saudi Arabia: Ehab A. Abo-Ali, Ahmed Mousa, Rania Hussien, Shahad Mousa, Shayma Al-Rubaki, Mennatulla Omar, Badr Al-Haffashi, Abdullah Almilaibary; Osong Public Health Res Perspect. 2022;13(3):212-220. Published online June 10, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0062

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Abstract PDF: Objectives
Voluntary testing (VT) plays a crucial role in the prevention and control of infectious diseases. The present study investigated the perceptions and utilization of VT services for coronavirus disease 2019 (COVID-19) among the inhabitants of Saudi Arabia. Methods: In total, 3,510 adult participants from all provinces of Saudi Arabia were recruited via a national online survey. Results: Of the 3,510 participants, 88.9% were aware of the testing services available to them and of those, more than half (59.5%) had used the VT services and 96.1% were satisfied with the services. Contact with a positive COVID-19 case was the top reason for accessing VT, while a lack of awareness about the availability of VT services was the top perceived limiting factor. A history of chronic health conditions, anxiety and/or depression, and previous symptoms suggestive of COVID-19 were found to be predictors of the utilization of VT services (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.22−1.96; OR 1.48, 95% CI 1.16−1.88; and OR 3.31, 95% CI 2.77−3.95), respectively. Conclusion: The awareness of voluntary COVID-19 testing services was satisfactory among the Saudi Arabian population, but can be improved. Sociodemographic and health history predictors of the utilization of VT services were identified.

Seroprevalence of immunoglobulin G antibodies against SARS-CoV-2 in children and adolescents in Delhi, India, from January to October 2021: a repeated cross-sectional analysis: Pragya Sharma, Saurav Basu, Suruchi Mishra, Mongjam Meghachandra Singh; Osong Public Health Res Perspect. 2022;13(3):184-190. Published online June 10, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0014

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Graphical Abstract Abstract PDF: Objectives
The aim of this study was to assess changes in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) seroprevalence among children and adolescents in Delhi, India from January 2021 to October 2021. Methods: This was a repeated cross-sectional analysis of participants aged 5 to 17 years from 2 SARS-CoV-2 seroprevalence surveys conducted in Delhi, India during January 2021 and September to October 2021. Anti-SARS-CoV-2 IgG antibodies were detected by using the VITROS assay (90% sensitivity, 100% specificity). Results: The seroprevalence among 5- to 17-year-old school-age children and adolescents increased from 52.8% (95% confidence interval [CI], 51.3%−54.3%) in January 2021 to 81.8% (95% CI, 80.9%−82.6%) in September to October 2021. The assay-adjusted seroprevalence was 90.8% (95% CI, 89.8%−91.7%). Seropositivity positively correlated with participants’ age (p<0.001), but not sex (p=0.388). A signal to cut-off ratio ≥4.00, correlating with the presence of neutralization antibodies, was observed in 4,814 (57.9%) participants. Conclusion: The high percentage of seroconversion among children and adolescents indicates the presence of natural infection-induced immunity from past exposure to the SARS-CoV-2 virus. However, the lack of hybrid immunity and the concomitant likelihood of lower levels of neutralization antibodies than in adults due to the absence of vaccination warrants careful monitoring and surveillance of infection risk and disease severity from newer and emergent variants.

Editorial

The neglected issues of global health security that we should prepare for in our society: Jong-Koo Lee; Osong Public Health Res Perspect. 2022;13(3):171-173. Published online June 30, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0185

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Review Article

Immune-related therapeutics: an update on antiviral drugs and vaccines to tackle the COVID-19 pandemic: Iqra Mir, Sania Aamir, Syed Rizwan Hussain Shah, Muhammad Shahid, Iram Amin, Samia Afzal, Amjad Nawaz, Muhammad Umer Khan, Muhammad Idrees; Osong Public Health Res Perspect. 2022;13(2):84-100. Published online April 27, 2022; DOI: https://doi.org/10.24171/j.phrp.2022.0024

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Graphical Abstract Abstract PDF: The coronavirus disease 2019 (COVID-19) pandemic rapidly spread globally. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, is a positive-sense single-stranded RNA virus with a reported fatality rate ranging from 1% to 7%, and people with immune-compromised conditions, children, and older adults are particularly vulnerable. Respiratory failure and cytokine storm-induced multiple organ failure are the major causes of death. This article highlights the innate and adaptive immune mechanisms of host cells activated in response to SARS-CoV-2 infection and possible therapeutic approaches against COVID-19. Some potential drugs proven to be effective for other viral diseases are under clinical trials now for use against COVID-19. Examples include inhibitors of RNA-dependent RNA polymerase (remdesivir, favipiravir, ribavirin), viral protein synthesis (ivermectin, lopinavir/ ritonavir), and fusion of the viral membrane with host cells (chloroquine, hydroxychloroquine, nitazoxanide, and umifenovir). This article also presents the intellectual groundwork for the ongoing development of vaccines in preclinical and clinical trials, explaining potential candidates (live attenuated-whole virus vaccines, inactivated vaccines, subunit vaccines, DNAbased vaccines, protein-based vaccines, nanoparticle-based vaccines, virus-like particles and mRNA-based vaccines). Designing and developing an effective vaccine (both prophylactic and therapeutic) would be a long-term solution and the most effective way to eliminate the COVID-19 pandemic.

Brief Report

COVID-19 vaccine safety monitoring in Republic of Korea from February 26, 2021 to October 31, 2021: Insob Hwang, Kyeongeun Park, Tae Eun Kim, Yunhyung Kwon, Yeon-Kyeng Lee; Osong Public Health Res Perspect. 2021;12(6):396-402. Published online December 21, 2021; DOI: https://doi.org/10.24171/j.phrp.2021.0310

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Graphical Abstract Abstract PDF Supplementary Material: Objectives
This study aimed to present data on reported adverse events following coronavirus disease 2019 (COVID-19) vaccination in Republic of Korea from February 26 to October 31, 2021, and to determine whether any significant patterns emerged from an analysis of the characteristics of suspected adverse event cases for each type of vaccine.
Methods
Adverse events following COVID-19 vaccination reported by medical doctors and forensic pathologists were analyzed. Cases of suspected anaphylaxis were classified using the Brighton Collaboration definition.
Results
By October 31, 2021, a total of 353,535 (0.45%) adverse events were reported after 78,416,802 COVID-19 vaccine doses. Of the adverse events, 96.4% were non-serious and 3.6% were serious. The most frequently reported adverse events were headache, myalgia, and dizziness. Of the 835 reported deaths after COVID-19 vaccination, 2 vaccine-related deaths were confirmed. Suspected anaphylaxis was confirmed in 454 cases using the Brighton Collaboration definition.
Conclusion
The commonly reported symptoms were similar to those described in clinical trials. Most reported adverse events were non-serious, and the reporting rate of adverse events following COVID-19 vaccination was higher in women than in men (581 vs. 315 per 100,000 vaccinations). Confirmed anaphylaxis was reported in 5.8 cases per 1,000,000 vaccinations.

Original Article

Transmission parameters of coronavirus disease 2019 in South Asian countries: Mridul Sannyal, Abul Mukid Mohammad Mukaddes; Osong Public Health Res Perspect. 2022;13(3):191-202. Published online June 23, 2022; DOI: https://doi.org/10.24171/j.phrp.2021.0234

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Graphical Abstract Abstract PDF: Objectives
This study aimed to estimate the transmission parameters, effective reproduction number, epidemic peak, and future exposure of coronavirus disease 2019 (COVID-19) in South Asian countries. Methods: A susceptible-exposed-infected-recovered-death (SEIRD) model programmed with MATLAB was developed for this purpose. Data were collected (till June 28, 2021) from the official webpage of World Health Organization, along with the Center for Systems Science and Engineering at Johns Hopkins University. The model was simulated to measure the primary transmission parameters. The reproduction number was measured using the next-generating matrix method. Results: The primary transmission rate followed an exponential Gaussian process regression. India showed the highest transmission rate (0.037) and Bhutan the lowest (0.023). The simulated epidemic peaks matched the reported peaks, thereby validating the SEIRD model. The simulation was carried out up to December 31, 2020 using the reported data till June 9, 2020. Conclusion: The information gathered in this research will be helpful for authorities to prevent the transmission of COVID-19 in the subsequent wave or in the future.

Short Communication

COVID-19 outbreak and risk factors for infection in a taekwondo gym in the Republic of Korea: Seung Hwan Shin, Eonjoo Park, Sookhyun Kim, Minji Jang, Subin Park, Dong-Hwi Kim, Tae Jong Son, Ji-Hyuk Park; Osong Public Health Res Perspect. 2022;13(2):162-170. Published online March 31, 2022; DOI: https://doi.org/10.24171/j.phrp.2021.0295

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Abstract PDF: Objectives
Relatively few studies have assessed risk factors for coronavirus disease 2019 (COVID-19) in public facilities used by children and adolescents. This study presents an analysis of a COVID-19 outbreak that occurred in a taekwondo gym in Korea, predominantly among children and adolescents, with the aim of providing insights on managing COVID-19 outbreaks in similar facilities. Methods: All 108 taekwondo gym students and staff received COVID-19 tests. A survey and closed-circuit television analyses were used to identify risk factors. A univariate analysis was conducted, followed by multivariate logistic regression analysis with backward elimination for variables with a significance level <0.10 in the univariate analysis. Results: COVID-19 was confirmed in 30 of 108 subjects at the taekwondo gym (attack rate, 27.8%). The outbreak started in an adult class student. This student transmitted the virus to the staff, who consequently transmitted the virus to adolescent students. In the univariate analysis, the relative risk for younger age (≤9 years) was 2.14 (95% confidence interval [CI], 1.01–4.54; p=0.054), and that for food consumption inside the gym was 2.12 (95% CI, 1.04–4.30; p=0.048). In the multivariate logistic regression analysis, the odds ratio for younger age was 2.96 (95% CI, 1.07–8.20; p=0.036), and that for food consumption inside the gym was 3.00 (95% CI, 1.10–8.17; p=0.032). Conclusion: Food consumption inside the facility and young age were significant risk factors for COVID-19 transmission in this taekwondo gym. Food consumption should be prohibited in sports facilities, and infection prevention education for young students is also required.

Original Articles

Perceptions of the COVID-19 vaccine and willingness to receive vaccination among health workers in Nigeria: Oluseyi Ademola Adejumo, Olorunfemi Akinbode Ogundele, Cynthia Roli Madubuko, Rosena Olubanke Oluwafemi, Ogochukwu Chinedum Okoye, Kenechukwu Chukwuemeka Okonkwo, Sunday Samson Owolade, Oladimeji Adedeji Junaid, Olutoyin Morenike Lawal, Adenike Christianah Enikuomehin, Maureen Iru Ntaji, Aisha Sokunbi, Aina Omodele Timothy, Olatunji Sunday Abolarin, Emmanuel Olalekan Ali, John Oghenevwirhe Ohaju-Obodo; Osong Public Health Res Perspect. 2021;12(4):236-243. Published online July 19, 2021; DOI: https://doi.org/10.24171/j.phrp.2021.0023

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Graphical Abstract Abstract PDF: Objectives
The study aimed to examine health workers’ perceptions of the coronavirus disease 2019 (COVID-19) vaccine in Nigeria and their willingness to receive the vaccine when it becomes available.
Methods
This multi-center cross-sectional study used non-probability convenience sampling to enroll 1,470 hospital workers aged 18 and above from 4 specialized hospitals. A structured and validated self-administered questionnaire was used for data collection. Data entry and analysis were conducted using IBM SPSS ver. 22.0.
Results
The mean age of respondents was 40±6 years. Only 53.5% of the health workers had positive perceptions of the COVID-19 vaccine, and only slightly more than half (55.5%) were willing to receive vaccination. Predictors of willingness to receive the COVID-19 vaccine included having a positive perception of the vaccine (adjusted odds ratio [AOR], 4.55; 95% confidence interval [CI], 3.50−5.69), perceiving a risk of contracting COVID-19 (AOR, 1.50; 95% CI, 1.25–3.98), having received tertiary education (AOR, 3.50; 95% CI, 1.40−6.86), and being a clinical health worker (AOR, 1.25; 95% CI, 1.01−1.68).
Conclusion
Perceptions of the COVID-19 vaccine and willingness to receive the vaccine were sub-optimal among this group. Educational interventions to improve health workers' perceptions and attitudes toward the COVID-19 vaccine are needed.

Use, Awareness, Knowledge and Beliefs of Medication During Pregnancy in Malaysia: Ahmad Habeeb Hattab Dala Ali Alani, Bassam Abdul Rasool Hassan, Azyyati Mohd Suhaimi, Ali Haider Mohammed; Osong Public Health Res Perspect. 2020;11(6):373-379. Published online December 22, 2020; DOI: https://doi.org/10.24171/j.phrp.2020.11.6.05

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Abstract PDF Supplementary Material: Objectives
This study aimed to assess medication use in pregnant women in Malaysia by measuring use, knowledge, awareness, and beliefs about medications.
Methods
This was an observational, cross-sectional study involving a total of 447 pregnant women who attended the Obstetrics and Gynecology Clinic, Hospital Kuala Lumpur (HKL), Malaysia. A validated, self-administered questionnaire was used to collect participant data.
Results
Most of pregnant women had taken medication during pregnancy and more than half of them (52.8%) showed a poor level of knowledge about the medication use during pregnancy. Eighty-three percent had a poor level of awareness and 56.5% had negative beliefs. Age and education level were significantly associated with the level of knowledge regarding medication use during pregnancy. Multiparous pregnant women, and pregnant women from rural areas were observed to have a higher level of awareness compared with those who lived in urban areas. Use of medication during pregnancy was determined to be significantly associated with education level, and race.
Conclusion
Although there was prevalent use of medication among pregnant women, many had negative beliefs, and insufficient knowledge and awareness about the risks of taking medication during pregnancy. Several sociodemographic characteristics were significantly associated with the use (race and education level), level of knowledge (age and education level), awareness (parity and place of residence), and beliefs (race, education level, and occupation status) towards medication use during pregnancy.

COVID-19 outbreak response at a nursing hospital in South Korea in the post-vaccination era, including an estimation of the effectiveness of the first shot of the Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1-S): Chanhee Kim, Geon Kang, Sun Gu Kang, Heeyoung Lee; Osong Public Health Res Perspect. 2022;13(2):114-122. Published online April 26, 2022; DOI: https://doi.org/10.24171/j.phrp.2021.0262

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Abstract PDF: Objectives
We descriptively reviewed a coronavirus disease 2019 (COVID-19) outbreak at a nursing hospital in Gyeonggi Province (South Korea) and assessed the effectiveness of the first dose of the Oxford-AstraZeneca vaccine in a real-world population. Methods: The general process of the epidemiological investigation included a public health intervention. The relative risk (RR) of vaccinated and unvaccinated groups was calculated and compared to confirm the risk of severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) infection, and vaccine effectiveness was evaluated based on the calculated RR. Results: The population at risk was confined to ward E among 8 wards of Hospital X, where the outbreak occurred. This population comprised 55 people, including 39 patients, 12 nurses, and 4 caregivers, and 19 cases were identified. The RR between the vaccinated and unvaccinated groups was 0.04, resulting in a vaccine effectiveness of 95.3%. The vaccination rate of the nonpatients in ward E was the lowest in the entire hospital, whereas the overall vaccination rate of the combined patient and non-patient groups in ward E was the third lowest. Conclusion: The first dose of the Oxford-AstraZeneca vaccine (ChAdOx1-S) was effective in preventing SARS-CoV-2 infection. To prevent COVID-19 outbreaks in medical facilities, it is important to prioritize the vaccination of healthcare providers.

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