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PHRP : Osong Public Health and Research Perspectives

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Original Articles
Neck circumference and incidence of cerebrovascular disease over 12 years among Korean adults
Jae-Seon Han, Yun-Hee Kim
Osong Public Health Res Perspect. 2022;13(1):71-79.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0277
  • 974 View
  • 35 Download
AbstractAbstract PDF
Objectives
Neck circumference is associated with a distinctive fat storage process that confers additional metabolic risk. Hence, this study aimed to investigate the correlation between baseline neck circumference and the incidence of cerebrovascular disease using a prospective community-based sample of Korean adults over 12 years of follow-up, after controlling for selected covariates. Methods: Participants with non-cerebrovascular disease were divided into 4 groups (Q1–Q4) based on their baseline neck circumference. Cox proportional hazards analysis was used to calculate hazard ratios and 95% confidence intervals (CIs) to evaluate the relationship between neck circumference and cerebrovascular disease incidence over a 12-year period. Results: Among this study’s 3,662 participants, 128 (3.50%) developed cerebrovascular disease. The incidence of cerebrovascular disease increased from 2.2% in Q1 to 4.3% in Q2, 2.5% in Q3, and 5.0% in Q4. When compared to Q1, the relative risks of cerebrovascular disease development were 0.57 (95% CI, 0.25–1.31), 0.86 (95% CI, 0.38–1.96), and 0.79 (95% CI, 0.30–2.07) in man and 1.86 (95% CI, 0.66–5.20), 3.50 (95% CI, 1.25–9.86), and 4.71 (95% CI, 1.50–14.77) in woman in Q2, Q3, and Q4, respectively, after adjusting for most risk factors related to cerebrovascular disease. Conclusion: The relationship between neck circumference and cerebrovascular disease was stronger in woman than in man, indicating potential differences between the sexes. These results are meaningful for evaluating and surveilling neck circumference as a promising tool for identifying subgroups of vulnerable and at-risk populations.
Global variation of COVID-19 mortality rates in the initial phase
Saman Hasan Siddiqui, Azza Sarfraz, Arjumand Rizvi, Fariha Shaheen, Mohammad Tahir Yousafzai, Syed Asad Ali
Osong Public Health Res Perspect. 2021;12(2):64-72.   Published online April 29, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.12.2.03
  • 3,120 View
  • 133 Download
  • 5 Citations
AbstractAbstract PDFSupplementary Material
Objectives
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused devastation in over 200 countries. Italy, Spain, and the United States (US) were most severely affected by the first wave of the pandemic. The reasons why some countries were more strongly affected than others remain unknown. We identified the most-affected and less-affected countries and states and explored environmental, host, and infrastructure risk factors that may explain differences in the SARS-CoV-2 mortality burden.
Methods
We identified the top 10 countries/US states with the highest deaths per population until May 2020. For each of these 10 case countries/states, we identified 6 control countries/states with a similar population size and at least 3 times fewer deaths per population. We extracted data for 30 risk factors from publicly available, trusted sources. We compared case and control countries/states using the non-parametric Wilcoxon rank-sum test, and conducted a secondary cluster analysis to explore the relationship between the number of cases per population and the number of deaths per population using a scalable EM (expectation–maximization) clustering algorithm.
Results
Statistically significant differences were found in 16 of 30 investigated risk factors, the most important of which were temperature, neonatal and under-5 mortality rates, the percentage of under-5 deaths due to acute respiratory infections (ARIs) and diarrhea, and tuberculosis incidence (p<0.05)
Conclusion
Countries with a higher burden of baseline pediatric mortality rates, higher pediatric mortality from preventable diseases like diarrhea and ARI, and higher tuberculosis incidence had lower rates of coronavirus disease 2019-associated mortality, supporting the hygiene hypothesis.
KCDC Risk Assessments on the Initial Phase of the COVID-19 Outbreak in Korea
Inho Kim, Jia Lee, Jihee Lee, Eensuk Shin, Chaeshin Chu, Seon Kui Lee
Osong Public Health Res Perspect. 2020;11(2):67-73.   Published online April 30, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.2.02
  • 9,782 View
  • 589 Download
  • 15 Citations
AbstractAbstract PDF
Objectives

This study aims to evaluate the risk assessments of coronavirus 2019 (COVID-19) in the Korea Centers for Disease Control and Prevention (KCDC), from the point of detection to the provision of basic information to the relevant public health authorities.

Methods

To estimate the overall risk of specific public health events, probability, and impact at the country-level were evaluated using available information. To determine the probability of particular public health events, the risk of importation and risk of transmission were taken into consideration. KCDC used 5 levels (“very low,” “low,” “moderate,” “high,” and “very high”) for each category and overall risk was eventually decided.

Results

A total of 8 risk assessments were performed on 8 separate occasions between January 8th to February 28th, 2020, depending on the detection and report of COVID-19 cases in other countries. The overall risk of the situation in each assessment increased in severity over this period: “low” (first), “moderate” (second), “high” (third), “high” (fourth), “high” (fifth), “high” (sixth), “high” (seventh), and “very high” (eighth).

Conclusion

The KCDC’s 8 risk assessments were utilized to activate national emergency response mechanisms and eventually prepare for the pandemic to ensure the containment and mitigation of COVID-19 with non-pharmaceutical public health measures.

Brief Report
Enhancing ‘Whole-of-Government’ Response to Biological Events in Korea: Able Response 2014
Sangwoo Tak, Anton Jareb, Suon Choi, Marvin Sikes, Yeon Hwa Choi, Hyeong-wook Boo
Osong Public Health Res Perspect. 2018;9(1):32-35.   Published online December 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2018.9.1.06
  • 3,110 View
  • 34 Download
  • 1 Citations
AbstractAbstract PDF

Since 2011, the Republic of Korea (ROK) and United States (U.S.) have been collaborating to conduct inter- and intra-governmental exercises to jointly respond to biological events in Korea. These exercises highlight U.S. interest in increasing its global biosurveillance capability and the ROK’s interest in improving cooperation among ministries to respond to crises. With Able Response (AR) exercises, the ROK and U.S. have improved coordination among US and ROK government and defense agencies responding to potential bio-threats and identified additional areas on which to apply refinements in policies and practices. In 2014, the AR exercise employed a Biosurveillance Portal (BSP) to facilitate more effective communication among participating agencies and countries including Australia. In the present paper, we seek to provide a comprehensive assessment of the AR 2014 (AR14) exercise and make recommendations for future improvements. Incorporating a more realistic response in future scenarios by integrating a tactical response episode in the exercise is recommended.

Original Articles
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
  • 2,630 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.

Trends and Characteristics of HIV Infection among Suspected Tuberculosis Cases in Public Health Centers in Korea: 2001–2013
Meekyung Kee, Kyoung-Ho Lee, Sae-Young Lee, Chun Kang, Chaeshin Chu
Osong Public Health Res Perspect. 2014;5(Suppl):S37-S42.   Published online December 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.11.002
  • 1,641 View
  • 16 Download
  • 1 Citations
AbstractAbstract PDF
Objectives
The Republic of Korea reports approximately 35,000 new tuberculosis (TB) patients each year, and the number of HIV-infected individuals is steadily increasing. Public health centers (PHCs) conduct TB diagnosis and treatment for risk groups in communities. This study aimed to identify possible trends and characteristics of HIV infection among suspected TB cases in PHCs.
Methods
Study subjects were suspected TB cases in PHCs who agreed to be tested for HIV from 2001 to 2013. Trends in HIV seroprevalence were assessed through a series of annual cross-sectional analyses. We analyzed suspected TB cases, and HIV-infected individuals among suspected TB cases, by gender, age, nationality, and region.
Results
The number of suspected tuberculosis cases who took an HIV test in PHCs was approximately 6,000 each year from 2001 to 2013. Among the suspected TB cases who took an HIV test, the number of those aged 20–39 is gradually decreasing, while the number of those aged 50–69 is increasing. During this period, 32 HIV-infected individuals were identified; the majority were men (94%), aged 30–49 (68%), Korean (94%), and residents in a metropolitan area (53%). HIV seroprevalence decreased from 8.2 per 10,000 persons in 2001 to 1.9 per 10,000 persons in 2013.
Conclusion
This study has identified trends and characteristics of HIV infection among suspected tuberculosis cases in PHCs. This national data provides a basis for public health policy for HIV and tuberculosis infections.
Brief Reports
Public Health Crisis Preparedness and Response in Korea
Hye-Young Lee, Mi-Na Oh, Yong-Shik Park, Chaeshin Chu, Tae-Jong Son
Osong Public Health Res Perspect. 2013;4(5):278-284.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.008
  • 1,659 View
  • 17 Download
  • 20 Citations
AbstractAbstract PDF
Since the 2006 Pandemic Influenza Preparedness and Response Plan according to the World Health Organization’s recommendation, the Republic of Korea has prepared and periodically evaluated the plan to respond to various public health crises including pandemic influenza. Korea has stockpiled 13,000,000 doses of antiviral drugs covering 26% of the Korean population and runs 519 isolated beds in 16 medical institutions. The division of public health crisis response in Korea Centers for Disease Control and Prevention are in charge of responding to public health crises caused by emerging infectious diseases including severe acute respiratory syndrome, avian influenza human infection, and pandemic influenza. Its job description includes preparing for emerging infectious diseases, securing medical resources during a crisis, activating the emergency response during the crisis, and fortification of capabilities of public health personnel. It could evolve into a comprehensive national agency to deal with public health crisis based on the experience of previous national emerging infectious diseases.
Epidemic Intelligence Service Officers and Field Epidemiology Training Program in Korea
Geun-Yong Kwon, Shinje Moon, Wooseok Kwak, Jin Gwack, Chaeshin Chu, Seung-Ki Youn
Osong Public Health Res Perspect. 2013;4(4):215-221.   Published online August 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.07.001
  • 1,717 View
  • 20 Download
  • 9 Citations
AbstractAbstract PDF
Korea has adopted Epidemic Intelligence Service (EIS) officers through the Field Epidemiology Training Program (FETP) since 1999 for systematic control of emerging and re-emerging infectious diseases. Graduates of medical schools in Korea are selected and serve as public health doctors (PHDs) for their mandatory military service. The duration of service is 3 years and PHDs comprise general practitioners and specialists. Some PHDs are selected as EIS officers with 3 weeks basic FETP training and work for central and provincial public health authorities to conduct epidemiological investigations. The total number of EIS officers is 31 as of 2012. The Korea Centers for Disease Control and Prevention (KCDC) has 12 specialists, whereas specialists and each province has one or two EIS officers to administer local epidemiological investigations in 253 public health centers. The Korean EIS officers have successfully responded and prevented infectious diseases, but there is a unique limitation: the number of PHDs in Korea is decreasing and PHDs are not allowed to stay outside Korea, which makes it difficult to cope with overseas infectious diseases. Furthermore, after 3 years service, they quit and their experiences are not accumulated. KCDC has hired full-time EIS officers since 2012 to overcome this limitation.
Original Article
The Effects of Religious Attendance and Obesity on Health by Race/Ethnicity
Sanggon Nam
Osong Public Health Res Perspect. 2013;4(2):81-88.   Published online April 30, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.03.002
  • 1,369 View
  • 13 Download
  • 3 Citations
AbstractAbstract PDF
Objectives
The objectives of this paper are to examine the effects of religion and obesity on health and determine how the relationship varies by racial/ethnic groups with data from the Panel Study of American Race and Ethnicity (PS-ARE).
Methods
Using ordinal logistic regression, the effects of religion and obesity on self-rated health and how the relationship varies by racial/ethnic groups are investigated. Additionally, to determine whether certain ethnic groups are more impacted by the frequency of religious attendance and obesity, whites, blacks, and Hispanics are analyzed separately with ordinal logistic regression.
Results
When obesity was added in focal relationship between religious services attendance and self-rated health strengthened this focal relationship which is a suppression effect between religious services attending and self-rated health adding obesity. For BMI is also significantly associated with decreased odds of reporting better health–normal weight (OR = 2.99; 95% CI = 2.43–3.67) and overweight (OR = 2.19; 95% CI = 1.79–2.68) compared to obese. Subjects who attend religious services 1–2 time a year (OR = 1.30; 95% CI = 1.04–1.62) and 1–3 times a month (OR = 1.28; 95% CI = 1.05–1.57) are associated with increased odds of reporting better health. In whites, attending religious services 1–2 times a year are associated with increased odds of reporting better health (OR = 1.48; 95% CI = 1.09–2.00) and 1–3 times a month are also associated with increased odds of reporting health (OR = 1.34; 95% CI = 1.02–1.78) compared to never attending religious attendance. The frequency of religious services attendance of blacks and Hispanics are not associated with self-rated health. For BMI, being white is more positively associated with increased odds of reporting better health than black and Hispanic subjects. Although white subjects are less likely to attend religious services more frequently than black and Hispanic subjects, the influence on self-rated health in white subjects is more evidenced than other racial/ethnic groups.
Conclusions
Although it was not proven that the association between participation in religious services and self-rated health is mediated by obesity, the research shows the suppression effect of obesity between participation in religious services and self-rated health.

PHRP : Osong Public Health and Research Perspectives