Objectives This study assessed the economic value of 2 major initiatives within the national infectious disease response system of the Korea Disease Control and Prevention Agency (KDCA): the Training Programs for Public Health Workforce (TPPHW) and the Infectious Disease Information System (IDIS). Methods: We developed a structured estimation model to quantify the economic benefits of pandemic preparedness investments and applied it to the KDCA’s TPPHW and IDIS. The model incorporated parameters elicited from 29 senior officials into a cost-benefit analysis (CBA) framework, from which we calculated the net present value (NPV) and benefit-cost ratio (BCR) over a 10-year period, with sensitivity analyses. Results: Both initiatives yielded positive net benefits under baseline assumptions, although the margin was substantially greater for workforce training than for the information system. At the assumed discount rate of 4.5%, the CBA yielded a BCR of 2.120 and an NPV of 27.2 billion Korean won (KRW) for TPPHW. For IDIS, the corresponding values were a BCR of 1.071 and an NPV of 2.7 billion KRW. Sensitivity analysis showed that workforce training remained economically justified across all scenarios, whereas the information system remained viable only under more favorable assumptions. Conclusion: This study contributes to the literature by systematically applying CBA to infectious disease preparedness in the Republic of Korea. The findings support continued investment in skilled workforce training and integrated information infrastructure for future pandemic preparedness. The study is limited by its reliance on expert-elicited parameters and its focus on monetary benefits, excluding health outcomes such as disability-adjusted life years and quality-of-life improvements.
Objectives This study examined the social and behavioral factors influencing community leaders’ participation in community-based surveillance (CBS) of infectious diseases. We hypothesized that knowledge, attitudes, and perceptions significantly predict the behavioral likelihood of engaging in CBS activities. Methods: A cross-sectional study was conducted among 470 schoolteachers in Kelantan, Malaysia, from March to June 2024. Participants were selected using multistage sampling, with random selection of schools followed by convenience sampling of teachers. Data were collected using the validated KAP-CBS-ID questionnaire, which was based on the Theory of Reasoned Action and Health Belief Model. Structural equation modeling was used to analyze relationships among the study variables with the maximum likelihood robust estimator. Results: The final model demonstrated good fit (comparative fit index, 0.921; standardized root mean square residual, 0.071; root mean square error of approximation, 0.040 [90% confidence interval, 0.036–0.044]). Ten significant path relationships were identified, explaining 46.1% of the variance in behavioral likelihood. Knowledge of infectious diseases (β=0.419, p<0.001), subjective norms (β=0.235, p=0.038), and negative attitudes (β=–0.432, p<0.001) significantly influenced intention. Behavioral likelihood was directly predicted by intention (β =0.347, p<0.001), perceived susceptibility (β=0.310, p<0.001), perceived benefits (β=0.198, p=0.001), and perceived barriers (β=–0.132, p=0.008). Self-efficacy showed significant indirect effects through perceived benefits (β=0.785, p<0.001) and perceived susceptibility (β=0.765, p<0.001). Conclusion: Knowledge and psychosocial factors significantly inf luence community engagement in CBS of infectious diseases. Public health interventions should address these interconnected determinants to strengthen early disease detection and reporting systems.
Objectives We aimed to describe the epidemiological characteristics of carbapenemase-producing Enterobacteriaceae (CPE) outbreaks in healthcare settings in the Republic of Korea between 2017 and 2022.
Methods Under the national notifiable disease surveillance system, we obtained annual descriptive statistics regarding the isolated species, carbapenemase genotype, healthcare facility type, outbreak location and duration, and number of patients affected and recommended interventions. We used epidemiological investigation reports on CPE outbreaks reported to Korea Disease Control and Prevention Agency from June 2017 to September 2022.
Results Among the 168 reports analyzed, Klebsiella pneumoniae (85.1%) was the most frequently reported species, while K. pneumoniae carbapenemase (KPC, 82.7%) was the most common carbapenemase genotype. Both categories increased from 2017 to 2022 (p<0.01). General hospitals had the highest proportion (54.8%), while tertiary general hospitals demonstrated a decreasing trend (p<0.01). The largest proportion of outbreaks occurred exclusively in intensive care units (ICUs, 44.0%), and the frequency of concurrent outbreaks in ICUs and general wards increased over time (p<0.01). The median outbreak duration rose from 43.5 days before the coronavirus disease 2019 (COVID-19) pandemic (2017–2019) to 79.5 days during the pandemic (2020–2022) (p=0.01), and the median number of patients associated with each outbreak increased from 5.0 to 6.0 (p=0.03). Frequently recommended interventions included employee education (38.1%), and 3 or more measures were proposed for 45.2% of outbreaks.
Conclusion In the Republic of Korea, CPE outbreaks have been consistently dominated by K. pneumoniae and KPC. The size of these outbreaks increased during the COVID-19 pandemic. Our findings highlight the need for continuing efforts to control CPE outbreaks using a multimodal approach, while considering their epidemiology.
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