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Editorial
Preparedness of primary care responses to the next pandemic
Jong-Koo Lee
Osong Public Health Res Perspect. 2022;13(2):81-83.   Published online April 29, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0136
  • 181 View
  • 16 Download
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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
  • 429 View
  • 36 Download
Graphical AbstractGraphical Abstract AbstractAbstract 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.
Original Articles
Epidemiological characteristics of varicella outbreaks in the Republic of Korea, 2016–2020
Eun-Young Kim, Chungmin Park, Gyehee Lee, Suyeon Jeong, Jeongsuk Song, Dong-Han Lee
Osong Public Health Res Perspect. 2022;13(2):133-141.   Published online April 26, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0087
  • 230 View
  • 17 Download
AbstractAbstract PDF
Objectives
We described the trends and epidemiological characteristics of varicella outbreaks from 2016 to 2020 in the Republic of Korea. Methods: We investigated variables such as the outbreak setting, age of patients, vaccination status, and lesion count. The collected data were analyzed with the Cochrane-Armitage trend test and Kruskal-Wallis test. These statistical tests were performed using R ver. 4.0.3. Results: The number of varicella outbreaks increased from 2016 to 2018; however, after a slight decrease in the number of outbreaks in 2019, the number fell sharply in 2020. The median size of outbreaks decreased from 8 to 9 cases during 2016−2019 to 6 cases in 2020. The median duration of outbreaks was 18 days during 2016−2017, 28 days in 2018, 29 days in 2019, and 15 days in 2020. Varicella outbreaks occurred most frequently in elementary schools, and vaccination coverage of patients increased from 89.4% in 2016 to 97.2% in 2019. The median age of patients with outbreak-related varicella decreased from 8 years in 2016 to 6 years in 2020. Conclusion: Significant changes were observed in the age of patients with outbreak-related varicella. Ongoing monitoring of varicella outbreaks should be conducted. Further research will be needed to measure the disease burden of varicella and enable evidence-based policy decisions.
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
  • 419 View
  • 32 Download
AbstractAbstract 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.
Sex differences in factors associated with prediabetes in Korean adults
Jin Suk Ra
Osong Public Health Res Perspect. 2022;13(2):142-152.   Published online April 22, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0053
  • 207 View
  • 12 Download
AbstractAbstract PDF
Objectives
Identifying the factors associated with prediabetes is necessary for the early detection and management of high-risk individuals with prediabetes. The purpose of this study was to identify the factors associated with prediabetes according to sex in Korean adults. Methods: Using the Korean National Health and Nutrition Examination Survey from 2015 to 2019, a total of 13,595 adults (5,565 males and 8,030 females) aged ≥20 years were included in the data analysis. Logistic regression analysis was performed to identify the factors associated with prediabetes according to sex in Korean adults. Results: In both males and females, age and a family history of type 2 diabetes were associated with prediabetes. In males, current and past smoking habits were associated with increased prediabetes. In addition, low-intensity physical activity and prolonged sedentary behavior were associated with a higher prevalence of prediabetes. Females with a lower education level (less than middle school graduation) showed a higher risk of prediabetes. Conclusion: Sex-specific prevention strategies for prediabetes should be developed. In addition, older individuals and those with a family history of type 2 diabetes should be screened for prediabetes.
Phylogenetic and genome-wide mutational analysis of SARS-CoV-2 strains circulating in Nigeria: no implications for attenuated COVID-19 outcomes
Daniel B. Kolawole, Malachy I. Okeke
Osong Public Health Res Perspect. 2022;13(2):101-113.   Published online April 22, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0329
  • 343 View
  • 22 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). The COVID-19 incidence and mortality rates are low in Nigeria compared to global trends. This research mapped the evolution of SARS-CoV-2 circulating in Nigeria and globally to determine whether the Nigerian isolates are genetically distinct from strains circulating in regions of the world with a high disease burden. Methods: Bayesian phylogenetics using BEAST 2.0, genetic similarity analyses, and genomewide mutational analyses were used to characterize the strains of SARS-CoV-2 isolated in Nigeria. Results: SARS-CoV-2 strains isolated in Nigeria showed multiple lineages and possible introductions from Europe and Asia. Phylogenetic clustering and sequence similarity analyses demonstrated that Nigerian isolates were not genetically distinct from strains isolated in other parts of the globe. Mutational analysis demonstrated that the D614G mutation in the spike protein, the P323L mutation in open reading frame 1b (and more specifically in NSP12), and the R203K/ G204R mutation pair in the nucleocapsid protein were most prevalent in the Nigerian isolates. Conclusion: The SARS-CoV-2 strains in Nigeria were neither phylogenetically nor genetically distinct from virus strains circulating in other countries of the world. Thus, differences in SARS-CoV-2 genomes are not a plausible explanation for the attenuated COVID-19 outcomes in Nigeria.
The effect of an application-based educational intervention with a social cognitive theory model on pregnant women in Denpasar, Bali, Indonesia: a randomized controlled trial
Ni Wayan Ariyani, I Made Ady Wirawan, Gede Ngurah Indraguna Pinatih, Anak Agung Ngurah Jaya Kusuma
Osong Public Health Res Perspect. 2022;13(2):153-161.   Published online April 14, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0209
  • 350 View
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AbstractAbstract PDF
Objectives
The aim of this study was to elucidate the effect of application-based antenatal education based on social cognitive theory (SCT) on Health Promoting Lifestyle Profile II (HPLP II) scores, compliance with iron tablet consumption, and readiness for childbirth and complications among pregnant women in Denpasar, Bali, Indonesia. Methods: This randomized controlled trial included 71 pregnant women in the treatment group and 74 pregnant women in the control group. The treatment group application-based antenatal education based on SCT, while the control group attended a conventional pregnancy class. Iron tablet consumption was verified by counting the remaining iron tablets. Information on participants’ lifestyles was collected using the HPLP II questionnaire with the help of an assistant. The collected data were statistically analyzed using IBM SPSS ver. 24.0. Results: The antenatal education intervention effectively increased the HPLP II score by 0.32 points (2.62±0.331 before the intervention and 2.94±0.273 after). Meanwhile, the control group had a 0.13-point increase (p=0.001), from 2.67±0.336 to 2.80±0.275. There was no significant difference in iron tablet consumption (p=0.333) or readiness for delivery and complications (p=0.557) between the treatment and control groups. Conclusion: Application-based antenatal education with SCT effectively increased the HPLP II scores of pregnant women in Denpasar, Bali. Although there was no significant difference in iron tablet consumption or readiness for delivery and complications, the values increased to a greater extent in the treatment group than in the control group. This education model is more suited to urban pregnant women who employed and have good internet access.
Spatiotemporal analysis of environmental and physiographic factors related to malaria in Bareilly district, India
Shikhar Chaudhary, Biju Soman
Osong Public Health Res Perspect. 2022;13(2):123-132.   Published online March 31, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0304
  • 415 View
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
The aim of this study was to explore the spatiotemporal clustering of reported malaria cases and to study the effects of various environmental and physiographic factors on malaria incidence in Bareilly district, Uttar Pradesh, India. Methods: Malaria surveillance data were collected from the state health department and cleaned into an analyzable format. These data were analyzed along with meteorological, physiographic, and 2019 population data, which were obtained from the Indian Meteorological Department, National Aeronautics and Space Administration web portal, the Bhuvan platform of the Indian Space Research Organization, and the 2011 Census of India. Results: In total, 46,717 malaria cases were reported in Bareilly district in 2019, of which 25.99% were Plasmodium vivax cases and 74.01% were P. falciparum cases. The reported malaria cases in the district showed clustering, with significant spatial autocorrelation (Moran’s I value=0.63), and space-time clustering (p<0.01). A significant positive correlation was found between monthly malaria incidence and the monthly mean temperature (with a lag of 1−2 months) and rainfall (with a lag of 1 month). A significant negative correlation was detected between the elevation of blocks (i.e., intermediate-level administrative districts) and annual malaria reporting. Conclusion: The presence of space-time clustering of malaria cases and its correlation with meteorological and physiographic factors indicate that routine spatial analysis of the surveillance data could help control and manage malaria outbreaks in the district.
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
  • 401 View
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AbstractAbstract 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.
Editorial
As the incidence of Omicron increases, so will the number of deaths
Jong-Koo Lee
Osong Public Health Res Perspect. 2022;13(1):1-3.   Published online February 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.13.1.01
  • 799 View
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Corrigendum
Original Article
Predictors of health-related quality of life in Koreans with cardiovascular disease
Jung-Hye Lim
Osong Public Health Res Perspect. 2022;13(1):62-70.   Published online February 22, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0286
  • 755 View
  • 41 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
This study aimed to identify the predictors of health-related quality of life (HRQoL) in Korean adults with cardiovascular disease (CVD). Methods: This was a cross-sectional study with a stratified multistage probability sampling design. Data from the 2016 to 2019 Korea National Health and Nutrition Examination Survey (n=32,379) were used. Among the participants aged 19 years or older (n=25,995), 1,081 patients with CVD were extracted after excluding those with missing data and those who had cancer. The participants’ HRQoL was measured using the three-level EuroQoL Group’s five-dimension questionnaire (EQ-5D) scale. Data were analyzed using the t-test, one-way analysis of variance, and general linear regression for complex samples. Results: The most potent predictors of HRQoL in Korean adults with CVD were limited activity (β =−0.103, p <0.001), poor perceived health (β =−0.089, p <0.001), depression (β =−0.065, p<0.01), low household income (β=−0.033, p<0.05), unemployment (β=−0.023, p<0.05), and older age (β=−0.002, p<0.01), which explained 37.2% of the variance. Conclusion: Comprehensive interventions that address both physical and mental factors and social systems that provide financial help need to be implemented to improve the HRQoL of Korean adults with CVD.
Review Article
Yersinia pestis antibiotic resistance: a systematic review
Chen Lei, Suresh Kumar
Osong Public Health Res Perspect. 2022;13(1):24-36.   Published online February 18, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0288
  • 1,111 View
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AbstractAbstract PDF
Yersinia pestis, the cause of plague and a potential biological weapon, has always been a threatening pathogen. Some strains of Y. pestis have varying degrees of antibiotic resistance. Thus, this systematic review was conducted to alert clinicians to this pathogen’s potential antimicrobial resistance. A review of the literature was conducted for experimental reports and systematic reviews on the topics of plague, Y. pestis, and antibiotic resistance. From 1995 to 2021, 7 Y. pestis isolates with 4 antibiotic resistance mechanisms were reported. In Y. pestis 17/95, 16/95, and 2180H, resistance was mediated by transferable plasmids. Each plasmid contained resistance genes encoded within specific transposons. Strain 17/95 presented multiple drug resistance, since plasmid 1202 contained 10 resistance determinants. Strains 16/95 and 2180H showed single antibiotic resistance because both additional plasmids in these strains carried only 1 antimicrobial determinant. Strains 12/87, S19960127, 56/13, and 59/13 exhibited streptomycin resistance due to an rpsl gene mutation, a novel mechanism that was discovered recently. Y. pestis can acquire antibiotic resistance in nature not only via conjugative transfer of antimicrobial-resistant plasmids from other bacteria, but also by gene point mutations. Global surveillance should be strengthened to identify antibiotic-resistant Y. pestis strains by whole-genome sequencing and drug susceptibility testing.
Original Articles
Associations of pre-existing cardiovascular morbidity with severity and the fatality rate in COVID-19 patients: a systematic review and meta-analysis
Foad Alzoughool, Suhad Abumweis, Lo’ai Alanagreh, Manar Atoum
Osong Public Health Res Perspect. 2022;13(1):37-50.   Published online February 18, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0186
  • 1,003 View
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Objectives
The aim of this study was to evaluate the association of pre-existing cardiovascular comorbidities, including hypertension and coronary heart disease, with coronavirus disease 2019 (COVID-19) severity and mortality. Methods: PubMed, ScienceDirect, and Scopus were searched between January 1, 2020, and July 18, 2020, to identify eligible studies. Random-effect models were used to estimate the pooled event rates of pre-existing cardiovascular disease comorbidities and odds ratio (OR) with 95% confidence intervals (95% CIs) of disease severity and mortality associated with the exposures of interest. Results: A total of 34 studies involving 19,156 patients with COVID-19 infection met the inclusion criteria. The prevalence of pre-existing cardiovascular disease in the included studies was 14.0%. Pre-existing cardiovascular disease in COVID-19 patients was associated with severe outcomes (OR, 4.1; 95% CI, 2.9 to 5.7) and mortality (OR, 6.1; 95% CI, 2.9 to 12.7). Hypertension and coronary heart disease increased the risk of severe outcomes by 2.6 times (OR, 2.6; 95% CI, 1.9 to 3.6) and 2.5 times (OR, 2.5; 95% CI, 1.7 to 3.8), respectively. No significant publication bias was indicated. Conclusion: COVID-19 patients with pre-existing cardiovascular comorbidities have a higher risk of severe outcomes and mortality. Awareness of pre-existing cardiovascular comorbidity is important for the early management of COVID-19.
Generalized anxiety and sleep quality among health care professionals during the COVID-19 pandemic: a cross-sectional study from a tertiary healthcare institution in Eastern India
Bijaya Nanda Naik, Sanjay Pandey, Rajath Rao, Manisha Verma, Prashant Kumar Singh
Osong Public Health Res Perspect. 2022;13(1):51-61.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0316
  • 1,873 View
  • 38 Download
AbstractAbstract PDF
Objectives
With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, healthcare professionals (HCPs) have experienced high levels of stress and anxiety because of the high risk of infection for themselves and their families. This has led to acute sleep problems for HCP. This study was designed to assess the anxiety and sleep quality of HCPs during the COVID-19 pandemic. Methods: This cross-sectional study analyzed 370 HCPs employed at All India Institute of Medical Sciences Patna over 3 months, using the standard Generalized Anxiety Disorder 7-item scale (GAD-7) for suspected GAD and the Pittsburgh Sleep Quality Index for sleep quality. Results were tabulated and multivariable binomial logistic regression analysis was done to determine the predictors of poor sleep. Significance was attributed to p<0.05. Results: Of the 370 HCPs screened, 52 (14.1%; 95% confidence interval [CI], 10.8%–18.1%) were found to have GAD and 195 (52.7%; 95% CI, 47.5%–57.9%) were found to be poor sleepers. The presence of any addictive habit (adjusted odds ratio [AOR], 1.833; 95% CI, 1.12–2.8), unprotected contact with COVID-19 cases (AOR, 1.902; 95% CI, 1.1–3.3), and the presence of GAD (AOR, 5.57; 95% CI, 2.5–12.4) were found to be predictors of poor sleep quality among HCPs. Conclusion: A significant proportion of HCPs were found to have suspected GAD and were poor sleepers. This highlights the need for measures to confront this problem.

PHRP : Osong Public Health and Research Perspectives