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PHRP : Osong Public Health and Research Perspectives

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"Models"

Original Articles

Optimal control strategies for dengue transmission under varying adult prevalence of Wolbachia-carrying mosquitoes: a deterministic mathematical modeling study
Fadilaturrohmah Nur, Yongkuk Kim
Received January 29, 2026  Accepted June 11, 2026  Published online August 14, 2026  
DOI: https://doi.org/10.24171/j.phrp.2026.0110    [Epub ahead of print]
Objectives
This study aimed to develop prevalence-informed post-release dengue control strategies for settings in which Wolbachia-carrying Aedes aegypti mosquitoes have become established through population replacement and to quantify how optimal supplementary intervention intensity and duration vary with adult Wolbachia prevalence, pW. Methods: A deterministic human–mosquito model was formulated that included Wolbachia-free and Wolbachia-carrying mosquitoes and incorporated cytoplasmic incompatibility, maternal transmission, and reduced vector competence. Two bounded supplementary controls were optimized over a 3-year horizon: reduction of effective human–mosquito contact and conventional adult mosquito suppression, represented by increased adult mortality. A quadratic-cost optimal-control problem was solved numerically using the Pontryagin maximum principle and a forward/backward sweep algorithm. Outcomes were compared across representative pW scenarios and prevalence scans. Results: The optimal policies applied high-intensity supplementary control early in the planning horizon and then relaxed control as infection pressure declined. Higher pW reduced the uncontrolled infection burden, decreased the incremental benefit of additional intervention, and shortened the duration of maximum control. In coarse scans with umax=0.30, the terminal dengue infection near-elimination indicator, defined as IH (T)≤10–4 at T=3 years, changed between pW=0.45 and pW=0.50 for all tested cost-weight combinations. A separate refined continuation example demonstrated non-monotonic mean control use and a sharp decrease in cumulative incidence. Conclusion: Adult Wolbachia prevalence measured through entomological surveillance may represent an actionable index for post-release dengue management. The identified transition band is a model-based planning indicator, not a universal field threshold or evidence of mosquito population elimination.
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  • 32 Download
Comparative analysis of associations between facility structure and air quality managers’ knowledge, attitudes, and practices by COVID-19 outbreak status in welfare facilities for persons with disabilities: a cross-sectional survey study in the Republic of Korea
Mi Yu, Bryan Inho Kim, Jungyeon Yu, Sanghwan Bae, Seyoung Kim, Su Jin Kang, Sangwon Lee, Sang-Eun Lee
Received December 22, 2025  Accepted June 10, 2026  Published online August 14, 2026  
DOI: https://doi.org/10.24171/j.phrp.2025.0593    [Epub ahead of print]
Objectives
This study investigated associations between building structure and managers’ knowledge, attitudes, and practices (KAP) regarding indoor air quality in welfare facilities for persons with disabilities, comparing facilities with and without coronavirus disease 2019 (COVID-19) cluster outbreaks. Methods: A web-based survey was conducted among managers of 242 welfare facilities for persons with disabilities in the Republic of Korea. Facilities were recruited from a national sampling frame of approximately 3,000 facilities, yielding a response rate of 8.1%. The 80-item questionnaire assessed building characteristics and air quality-related KAP scores. Logistic regression was used to identify factors associated with cluster outbreaks. Results: Of the 242 facilities, 50.8% had experienced cluster outbreaks. Facilities in complex/multi-use buildings had higher odds of outbreaks than those in detached buildings did (adjusted odds ratio, 2.21; 95% confidence interval, 1.25–3.91; p=0.006). For managerial factors, facilities with outbreaks tended to have lower attitude scores (p=0.02); however, this association did not remain statistically significant after Bonferroni correction (adjusted α=0.0083). No significant differences were observed in knowledge or practice scores. Conclusion: Building structure, particularly complex/multi-use configuration, was associated with COVID-19 cluster outbreaks. Managerial KAP scores were not definitively associated with outbreaks under the conservative significance threshold, but the observed trends suggest that institutional support, ventilation guidance, and practical training for facility managers may help strengthen future infection-prevention efforts.
  • 544 View
  • 11 Download
Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates
Yongmoon Kim, Bryan Inho Kim, Sangwoo Tak
Osong Public Health Res Perspect 2022;13(6):424-434.
Published online November 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0212
Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates
Objectives
Although it is widely used as a measure for mortality, the case fatality rate (CFR) ofcoronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons otherthan viral characteristics. To compare the CFRs of different countries in equal measure, weestimated comparable CFRs after adjusting for multiple covariates and examined the mainfactors that contributed to variability in the CFRs among 21 countries.Methods: For statistical analysis, time-series cross-sectional data were collected from OurWorld in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated bypooled generalized linear squares regression models for the panel data. Covariates includedthe predominant virus variant, reproduction rate, vaccination, national economic status,hospital beds, diabetes prevalence, and population share of individuals older than age 65. Intotal, 21 countries were eligible for analysis.Results: Adjustment for covariates reduced variation in the CFRs of COVID-19 across countriesand over time. Regression results showed that the dominant spread of the Omicron variant,reproduction rate, and vaccination were associated with lower country-level CFRs, whereasage, the extreme poverty rate, and diabetes prevalence were associated with higher countrylevel CFRs.Conclusion: A direct comparison of crude CFRs among countries may be fallacious, especiallyin a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over timefor a more proper comparison. In addition, our findings suggest that comparing CFRs amongdifferent countries without considering their context, such as the epidemic phase, medicalcapacity, surveillance strategy, and socio-demographic traits, should be avoided.

Citations

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  • Socioeconomic determinants of COVID-19 vaccination and mortality: a cross-national path analysis
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  • Comments on the article "Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates"
    Gaetano Perone
    Osong Public Health and Research Perspectives.2023; 14(2): 146.     CrossRef
  • 11,035 View
  • 151 Download
  • 3 Web of Science
  • Crossref

Review Article

COVID-19 prediction models: a systematic literature review
Sheikh Muzaffar Shakeel, Nithya Sathya Kumar, Pranita Pandurang Madalli, Rashmi Srinivasaiah, Devappa Renuka Swamy
Osong Public Health Res Perspect 2021;12(4):215-229.
Published online August 13, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0100
As the world grapples with the problem of the coronavirus disease 2019 (COVID-19) pandemic and its devastating effects, scientific groups are working towards solutions to mitigate the effects of the virus. This paper aimed to collate information on COVID-19 prediction models. A systematic literature review is reported, based on a manual search of 1,196 papers published from January to December 2020. Various databases such as Google Scholar, Web of Science, and Scopus were searched. The search strategy was formulated and refined in terms of subject keywords, geographical purview, and time period according to a predefined protocol. Visualizations were created to present the data trends according to different parameters. The results of this systematic literature review show that the study findings are critically relevant for both healthcare managers and prediction model developers. Healthcare managers can choose the best prediction model output for their organization or process management. Meanwhile, prediction model developers and managers can identify the lacunae in their models and improve their data-driven approaches.

Citations

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Original Articles
Factors Associated with Cesarean Section in Tehran, Iran using Multilevel Logistic Regression Model
Payam Amini, Maryam Mohammadi, Reza Omani-Samani, Amir Almasi-Hashiani, Saman Maroufizadeh
Osong Public Health Res Perspect 2018;9(2):86-92.
Published online April 30, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.2.08
<sec> <title>Objectives</title> <p>Over the past few decades, the prevalence of cesarean sections (CS) have risen dramatically worldwide, particularly in Iran. The aim of this study was to determine the prevalence of CS in Tehran, and to examine the associated risk factors.</p></sec> <sec> <title>Methods</title> <p>A cross-sectional study of 4,308 pregnant women with singleton live-births in Tehran, Iran, between July 6–21, 2015 was performed. Multilevel logistic regression analysis was performed using demographic and obstetrical variables at the first level, and hospitals as a variable at the second level.</p></sec> <sec> <title>Results</title> <p>The incidence of CS was 72.0%. Multivariate analysis showed a significant relationship between CS and the mother’s age, socioeconomic status, body mass index, parity, type of pregnancy, preeclampsia, infant height, and baby’s head circumference. The intra-class correlation using the second level variable, the hospital was 0.292, indicating approximately 29.2% of the total variation in the response variable accounted for by the hospital.</p></sec> <sec> <title>Conclusion</title> <p>The incidence of CS was substantially higher than other countries. Therefore, educational and psychological interventions are necessary to reduce CS rates amongst pregnant Iranian women.</p></sec>

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    Hamidou Niangaly, Manuella De Allegri, Laurence Touré, Dansiné Diarra, Valéry Ridde, Ama Pokuaa Fenny,
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  • Associations between maternal overweight and obesity with cesarean section delivery in Middle East and North Africa region: a systematic review, meta-analysis, and attributable risk
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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
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.

Citations

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Spatial and Temporal Distribution of Plasmodium vivax Malaria in Korea Estimated with a Hierarchical Generalized Linear Model
Maengseok Noh, Youngjo Lee, Seungyoung Oh, Chaeshin Chu, Jin Gwack, Seung-Ki Youn, Shin Hyeong Cho, Won Ja Lee, Sun Huh
Osong Public Health Res Perspect 2012;3(4):192-198.
Published online December 31, 2012
DOI: https://doi.org/10.1016/j.phrp.2012.11.003
Objectives
The spatial and temporal correlations were estimated to determine <i>Plasmodium vivax</i> malarial transmission pattern in Korea from 2001–2011 with the hierarchical generalized linear model.
Methods
Malaria cases reported to the Korea Centers for Disease Control and Prevention from 2001 to 2011 were analyzed with descriptive statistics and the incidence was estimated according to age, sex, and year by the hierarchical generalized linear model. Spatial and temporal correlation was estimated and the best model was selected from nine models. Results were presented as diseases map according to age and sex.
Results
The incidence according to age was highest in the 20–25-year-old group (244.52 infections/100,000). Mean ages of infected males and females were 31.0 years and 45.3 years with incidences 7.8 infections/100,000 and 7.1 infections/100,000 after estimation. The mean month for infection was mid-July with incidence 10.4 infections/100,000. The best-fit model showed that there was a spatial and temporal correlation in the malarial transmission. Incidence was very low or negligible in areas distant from the demilitarized zone between Republic of Korea and Democratic People’s Republic of Korea (North Korea) if the 20–29-year-old male group was omitted in the diseases map.
Conclusion
Malarial transmission in a region in Korea was influenced by the incidence in adjacent regions in recent years. Since malaria in Korea mainly originates from mosquitoes from North Korea, there will be continuous decrease if there is no further outbreak in North Korea.

Citations

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Incubation Period of Ebola Hemorrhagic Virus Subtype Zaire
Martin Eichner, Scott F. Dowell, Nina Firese
Osong Public Health Res Perspect 2011;2(1):3-7.
Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.001
Objectives
Ebola hemorrhagic fever has killed over 1300 people, mostly in equatorial Africa. There is still uncertainty about the natural reservoir of the virus and about some of the factors involved in disease transmission. Until now, a maximum incubation period of 21 days has been assumed.
Methods
We analyzed data collected during the Ebola outbreak (subtype Zaire) in Kikwit, Democratic Republic of the Congo, in 1995 using maximum likelihood inference and assuming a log-normally distributed incubation period.
Results
The mean incubation period was estimated to be 12.7 days (standard deviation 4.31 days), indicating that about 4.1% of patients may have incubation periods longer than 21 days.
Conclusion
If the risk of new cases is to be reduced to 1% then 25 days should be used when investigating the source of an outbreak, when determining the duration of surveillance for contacts, and when declaring the end of an outbreak.

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