Most-read articles are from the articles published in 2021 during the last three month.
Original Articles
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A hypertension risk score for adults: a population-based cross-sectional study from the Dubai Household Survey 2019
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Ibrahim Mahmoud
, Nabil Sulaiman
, Amal Hussein
, Heba Mamdouh
, Wafa K. AL Nakhi
, Hamid Y. Hussain
, Gamal M. Ibrahim
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Epidemiol Health. 2021;43:e2021064. Published online September 8, 2021
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DOI: https://doi.org/10.4178/epih.e2021064
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Abstract
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Abstract
OBJECTIVES
The aim of this study was to develop a risk score model for predicting hypertension specific to the population of Dubai in the United Arab Emirates (UAE) to facilitate prevention and early intervention.
METHODS
A retrospective analysis of data from the Dubai Household Health Survey 2019 was conducted. Demographic and physical parameters, as well as blood glucose levels, were included in the data. The risk factors for hypertension were identified using bivariate analysis. A risk score model was developed using the enter method, where all significant predictors of hypertension in bivariate analyses were entered in a single step with the primary outcome of hypertension status (yes/no). The model was validated internally by splitting the data into Emirati and non-Emirati populations.
RESULTS
A total of 2,533 subjects were studied. The significant risk factors for hypertension identified were male sex, older age (≥40 years), education level, body mass index, diabetes mellitus, and dyslipidaemia. The model showed a high discrimination ability between individuals with and without hypertension, with an area under the curve of 0.77 (95% confidence interval [CI], 0.75 to 0.79), excellent sensitivity (81.0%; 95% CI, 71.9 to 88.2) and moderate specificity (56.0%; 95% CI, 45.7 to 65.9).
CONCLUSIONS
The model developed by this study is simple, convenient, and based on readily available demographic and medical characteristics. This risk score model could support initial hypertension screening and provide an effective tool for targeted lifestyle counselling and prevention programs.
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Summary
Korean summary
Key Message
To prevent hypertension in Dubai's adult population, primary health care physicians can use our risk score model to recommend preventative measures, with a focus on men over 40 years old, with a low educational level, who are obese, and who have other morbidities, such as diabetes mellitus and dyslipidemia.
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Trends and disparities in avoidable, treatable, and preventable mortalities in South Korea, 2001-2020: comparison of capital and non-capital areas
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Sang Jun Eun
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Epidemiol Health. 2022;44:e2022067. Published online August 16, 2022
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DOI: https://doi.org/10.4178/epih.e2022067
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4,193
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Supplementary Material
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Abstract
OBJECTIVES
This study aimed to describe the regional avoidable mortality trends in Korea and examine the trends in avoidable mortality disparities between the Seoul Capital Area and non-Seoul-Capital areas, thereby exploring the underlying reasons for the trend changes.
METHODS
Age-standardized mortality rates from avoidable causes between 2001-2020 were calculated by region. Regional disparities in avoidable mortality were quantified on both absolute and relative scales. Trends and disparities in avoidable mortality were analyzed using joinpoint regression models.
RESULTS
Avoidable, treatable, and preventable mortalities in Korea decreased at different rates over time by region. The largest decreases were in the non-Seoul-Capital non-metropolitan area for avoidable and preventable mortality rates and the non-Seoul-
Capital metropolitan area for treatable mortality rates, despite the largest decline being in the Seoul Capital Area prior to around 2009. Absolute and relative regional disparities in avoidable and preventable mortalities generally decreased. Relative disparities in treatable mortality between areas widened. Regional disparities in all types of mortalities tended to improve after around 2009, especially among males. In females, disparities in avoidable, treatable, and preventable mortalities between areas improved less or even worsened.
CONCLUSIONS
Trends and disparities in avoidable mortality across areas in Korea seem to have varied under the influence of diverse social changes. Enhancing health services to underserved areas and strengthening gender-oriented policies are needed to reduce regional disparities in avoidable mortality.
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Summary
Korean summary
2001년부터 2020년까지 회피가능, 예방가능 사망률의 수도권과 비수도권 대도시, 비수도권 비대도시 지역 간 절대적, 상대적 격차는 대체로 감소했지만, 치료가능 사망률의 상대적 격차는 커졌다. 회피가능, 치료가능, 예방가능 사망률의 지역 간 격차는 2009년경 이후에 특히 남성에서 개선됐지만, 여성의 경우 덜 개선되거나 오히려 악화되기도 했다.
Key Message
Regional disparities in avoidable, treatable, and preventable mortalities tended to improve after around 2009, especially among males, but, in females, disparities in all types of mortalities between areas improved less or even worsened.
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Citations
Citations to this article as recorded by

- Regional Health Disparities in Hypertension-Related Hospitalization of Hypertensive Patients: A Nationwide Population-Based Nested Case-Control Study
Woo-Ri Lee, Jun Hyuk Koo, Ji Yun Jeong, Min Su Kim, Ki-Bong Yoo
International Journal of Public Health.2023;[Epub] CrossRef
Methods
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Meta-analysis of diagnostic test accuracy studies with multiple thresholds for data integration
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Sung Ryul Shim
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Epidemiol Health. 2022;44:e2022083. Published online September 28, 2022
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DOI: https://doi.org/10.4178/epih.e2022083
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Summary
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Supplementary Material
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Abstract
OBJECTIVES
The objective of this study is to introduce methods to use all of the information without omission when individual studies provide multiple effect sizes according to multiple cut-off values (thresholds) during diagnostic test accuracy (DTA) for data integration. For diagnostic test meta-analysis, a general performance method for synthesizing data according to one cut value in one study and a performance method for synthesizing data according to two or more cut values in one study were compared and analyzed.
METHODS
As sample data for meta-analysis of DTA studies, 13 DTA studies on prostate cancer (34 effect sizes including total cut-offs) were collected. The summary statistics were calculated and the summary line was analyzed using the “meta”, “mada”, and “diagmeta” packagesof the R software.
RESULTS
The summary statistics of the random effect model univariate analysis of the “meta” package with a single cut-off corresponding to the highest Youden index in a single study and those of the bivariate analysis of the “mada” package were highly similar. However, in the bivariate analysis of the “diagmeta” package including all cut-off values, the sensitivity decreased and the specificity increased as the amount of data increased.
CONCLUSIONS
Considering the heterogeneity of the summary receiver op erating characteristic curve and the use of all given cut-offs, the use of the bivariate analysis model of the “diagmeta” package is recommended. This study focused on practical methods of DTA rather than theoretical concepts for use by researchers whose fields of study are non-statistics related. By performing this study, we hope that many researchers will use R software to determine the DTA more easily, and that there will be greater interest in related research.
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Summary
Korean summary
본 연구는 진단검사 메타분석시 개별 대상연구가 다수의 기준치 (cut-off value, threshold)에 따른 여러 개의 효과크기를 제공하고 있을 때, 정보의 누락없이 이를 모두 사용하는 방법과 더불어 기존의 수행방법도 비교 분석하였기에 연구에 적합한 모델 선택에 도움이 될 것이다.
Key Message
The objective of this study is to introduce methods to use all of the information without omission when indi¬vidual studies provide multiple effect sizes according to multiple cut-off values (thresholds) during diagnostic test accuracy (DTA) for data integration.
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Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions
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Kyungwon Oh
, Yoonjung Kim
, Sanghui Kweon
, Soyeon Kim
, Sungha Yun
, Suyeon Park
, Yeon-Kyeng Lee
, Youngtaek Kim
, Ok Park
, Eun Kyeong Jeong
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Epidemiol Health. 2021;43:e2021025. Published online April 19, 2021
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DOI: https://doi.org/10.4178/epih.e2021025
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12,260
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488
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29
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Abstract
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Supplementary Material
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Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.
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Summary
Korean summary
국민건강영양조사는 국민건강증진법제16조에 근거하여 1998년부터 우리 국민의 건강수준, 건강행태, 식품 및 영양소 섭취 실태에 대한 국가단위 통계를 산출하는 조사사업이다. 본 연구에서는 건강지표 생산 확대, 조사 자료 활용도 향상 등 20년간의 성과를 요약하고 사회환경과 조사여건 변화를 반영한 건강통계 생산의 발전 방안을 제시하였다.
Key Message
The Korea National Health and Nutrition Examination Survey (KNHANES) is an ongoing surveillance system that was initiated in 1998 based on Ar¬ticle 16 of the National Health Promotion Act to produce nationwide statistics regarding the health status, health behaviors, and food and nutrient consumption of the Korean population. In this study, the 20-year accomplishments of the KNHANES including vigorous production of health indicators and improvement of data utilization are summarized, and future plans are presented to improve the health statistics to reflect changes in the social and survey environments.
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Citations
Citations to this article as recorded by

- Impact of the COVID-19 Pandemic on Gender Differences in Depression Based on National Representative Data
Hyunsuk Jeong, Hyeon Woo Yim, Seung-Yup Lee, Da Young Jung
Journal of Korean Medical Science.2023;[Epub] CrossRef - Identifying the Group Vulnerable to Unmet Medical Needs Due to Food Security: According to Children in the Household
Min-Soo Kim, Hyeon-Ji Lee, Jae-Hyun Kim
Healthcare.2023; 11(3): 423. CrossRef - Food Insecurity Is Associated with Dietary Consumption during the COVID-19 Pandemic: Data from the Korea National Health and Nutrition Examination Survey 2019–2020
Jeong-Hwa Choi
Nutrients.2023; 15(3): 772. CrossRef - Metabolically unhealthy phenotype in adults with normal weight: Is cardiometabolic health worse off when compared to adults with obesity?
Myong-Won Seo, Joon Young Kim
Obesity Research & Clinical Practice.2023;[Epub] CrossRef - Sleep duration, weekend catch-up sleep, and risk of obstructive sleep apnea in relation to handgrip strength
Kayoung Lee
Archives of Gerontology and Geriatrics.2023; 110: 104987. CrossRef - Prevalence and trends in obesity and severe obesity in Korean children and adolescents, 2007–2020: A population‐based study
Hong Kyu Park, Ji‐Young Seo, Hae Woon Jung, Jung Sub Lim
Pediatrics International.2023;[Epub] CrossRef - Sex-Specific Trends in the Prevalence of Hypertension and the Number of People With Hypertension: Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 1998–2018
Eunsun Seo, Sunjae Jung, Hokyou Lee, Hyeon Chang Kim
Korean Circulation Journal.2022; 52(5): 382. CrossRef - Inverse Association of Serum Folate Level with Metabolic Syndrome and Its Components in Korean Premenopausal Women: Findings of the 2016–2018 Korean National Health Nutrition Examination Survey
Ye-Seul Koo, Yong-Jae Lee, Jae-Min Park
Nutrients.2022; 14(4): 880. CrossRef - Lower Dietary Calcium Intake is Associated with a Higher Risk of Mortality in Korean Adults
Jin Young Yoo, Hyun Jeong Cho, Jung Eun Lee
Journal of the Academy of Nutrition and Dietetics.2022; 122(11): 2072. CrossRef - Association between exposure to fine particulate matter and kidney function: Results from the Korea National Health and Nutrition Examination Survey
Jongmin Oh, Shinhee Ye, Duk-Hee Kang, Eunhee Ha
Environmental Research.2022; 212: 113080. CrossRef - Cardiovascular Implications of the 2021 KDIGO Blood Pressure Guideline for Adults With Chronic Kidney Disease
Hyeok-Hee Lee, Hokyou Lee, Raymond R. Townsend, Dong-Wook Kim, Sungha Park, Hyeon Chang Kim
Journal of the American College of Cardiology.2022; 79(17): 1675. CrossRef - The Korea National Health and Nutrition Examination Survey data linked Cause of Death data
Sungha Yun, Kyungwon Oh
Epidemiology and Health.2022; 44: e2022021. CrossRef - Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Ga Bin Lee, Yoonjung Kim, Suyeon Park, Hyeon Chang Kim, Kyungwon Oh
Epidemiology and Health.2022; 44: e2022041. CrossRef - Mental health of Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Hyunsuk Jeong, Suyeon Park, Jihee Kim, Kyungwon Oh, Hyeon Woo Yim
Epidemiology and Health.2022; 44: e2022042. CrossRef - Diabetes Fact Sheet in Korea 2021
Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won
Diabetes & Metabolism Journal.2022; 46(3): 417. CrossRef - Serum folate levels and hypertension
Yoonkyung Lee, Sangshin Park
Scientific Reports.2022;[Epub] CrossRef - The Relationship between Lipid Accumulation Product, Insulin Resistance and Obesity in Korean Adults
Hyun Yoon
Korean Journal of Clinical Laboratory Science.2022; 54(2): 149. CrossRef - Relationship between Anemia and Falls among Postmenopausal Women in Korea
Yunmi Kim, Jiyun Kim
International Journal of Environmental Research and Public Health.2022; 19(14): 8242. CrossRef - Smoking in the workplace: A study of female call center employees in South Korea
Hyunjin Oh, Sunjoo Boo, Petri Böckerman
PLOS ONE.2022; 17(7): e0267685. CrossRef - Alterations in Glomerular Filtration Rates Using Different Algorithms in the Korean Population Visiting Local Clinics and Hospitals
Rihwa Choi, Sang Gon Lee, Eun Hee Lee
Journal of Clinical Medicine.2022; 11(18): 5339. CrossRef - Prevalence Trends of Metabolic Syndrome among Korean Children and Adolescents from a Population-Based Cross-Sectional Survey
Ji Hyun Kim, Jung Sub Lim
Life.2022; 12(9): 1404. CrossRef - The Association of Mercury and ALT with Obesity in Korean Adults: Using Data from the Korea National Health and Nutrition Examination Survey for 11 Years (KNHANES 2005, 2008~2017)
Sang Shin Pyo
Korean Journal of Clinical Laboratory Science.2022; 54(3): 192. CrossRef - Low relative hand grip strength is associated with a higher risk for diabetes and impaired fasting glucose among the Korean population
Min Jin Lee, Ah Reum Khang, Dongwon Yi, Yang Ho Kang, Giacomo Pucci
PLOS ONE.2022; 17(10): e0275746. CrossRef - Menstrual and Reproductive Factors for Gastric Cancer in Postmenopausal Women: The 2007–2020 Korea National Health and Nutrition Examination Survey
Heekyoung Song, Jung Yoon Park, Ju Myung Song, Youngjae Yoon, Yong-Wook Kim
International Journal of Environmental Research and Public Health.2022; 19(21): 14468. CrossRef - Prevalence and management of hypertension in Korean adults
Hyeon Chang Kim
Journal of the Korean Medical Association.2022; 65(10): 633. CrossRef - One-year prevalence and clinical characteristics in chronic dizziness: The 2019–2020 Korean National Health and Nutrition Examination Survey
Eun Ji Kim, Hee-Jung Song, Hak In Lee, Eunjin Kwon, Seong-Hae Jeong
Frontiers in Neurology.2022;[Epub] CrossRef - Spousal concordance of ideal cardiovascular health metrics: findings from the 2014–2019 Korea National Health and Nutrition Examination Survey
Manh Thang Hoang, Hokyou Lee, Hyeon Chang Kim
Clinical Hypertension.2022;[Epub] CrossRef - The Interaction of High Sensitivity C-Reactive Protein and Uric Acid on Obesity in Koreans: Based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII, 2016∼2018)
Sang Shin Pyo
Korean Journal of Clinical Laboratory Science.2021; 53(4): 342. CrossRef - Non-cancer disease prevalence and association with occupational radiation exposure among Korean radiation workers
Soojin Park, Dal Nim Lee, Young Woo Jin, Eun Shil Cha, Won-Il Jang, Sunhoo Park, Songwon Seo
Scientific Reports.2021;[Epub] CrossRef
COVID-19: Original Article
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The impact of COVID-19 on screening for colorectal, gastric, breast, and cervical cancer in Korea
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Hyeree Park
, Seung Hee Seo
, Jong Heon Park
, Shin Hye Yoo
, Bhumsuk Keam
, Aesun Shin
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Epidemiol Health. 2022;44:e2022053. Published online June 21, 2022
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DOI: https://doi.org/10.4178/epih.e2022053
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Abstract
Summary
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Supplementary Material
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Abstract
OBJECTIVES
The coronavirus disease 2019 (COVID-19) pandemic has affected the utilization of healthcare services, including participation in cancer screening programs. We compared cancer screening participation rates for colorectal, gastric, breast, and cervical cancers among participants in the National Cancer Screening Program (NCSP) in 2019 and 2020 to address the potential distraction effect of COVID-19 on cancer screening.
METHODS
Data from the NCSP for 4 cancer types (stomach, colorectal, breast, and cervical) in 2019 and 2020 were used to calculate cancer screening participation rates by calendar month, gender, age group, and geographical region. Monthly participation rates were analyzed per 1,000 eligible individuals.
RESULTS
The screening participation rate decreased in 2020 compared to 2019 for all 4 cancers: colorectal (40.5 vs. 35.3%), gastric (61.9 vs. 54.6%), breast (63.8 vs. 55.8%), and cervical (57.8 vs. 52.2%) cancers. Following 2 major COVID-19 waves in March and December 2020, the participation rates in the 4 types of cancer screening dropped compared with those in 2019. The highest decline was observed in the elderly population aged 80 years and older (percentage change: -21% for colorectal cancer; -20% for gastric cancer; -26% for breast cancer; -20% for cervical cancer).
CONCLUSIONS
After the 2 major COVID-19 waves, the screening participation rate for 4 types of cancer declined compared with 2019. Further studies are needed to identify the indirect effects of the COVID-19 pandemic on cancer patients, such as delayed diagnoses of cancer or excess cancer deaths.
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Summary
Korean summary
본 연구는 코로나 대유행 기간 전과 후 대장암, 위암, 유방암, 자궁경부암 검진 수검률 차이를 비교하고자 하였다. 첫 코로나 확진자가 발생한 2020년을 코로나 대유행 기간, 전년도 기간인 2019년을 코로나 대유행 전 기간으로 설정하며 국민건강보험공단에서 집계된 전수자료를 이용하여 암 검진 대상자 수와 수검자 수를 비교 분석하였다. 4개 암종 모두에서 2019년도와 비교하여 2020년도에 전국적으로 수검률이 감소하는 경향이 있었으며, 1차 대유행이 있었던 3월과 3차 대유행 시기인 12월에 2019년도 동기간과 비교하여 수검률이 크게 감소하였고, 80대 이상 노인 인구에서 감소폭이 다른 연령대와 비교하여 크게 나타났다.
Key Message
We found decline of the colorectal, gastric, breast and cervical cancer screening participation rates in 2020 following the two major COVID-19 waves, compared with those of 2019, and the highest decline was observed in the elderly population aged 80 years and older.
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Citations
Citations to this article as recorded by

- Analysis of the current situation and related influencing factors of cervical precancer screening under the COVID-19
Xiaohong Song, Yongbin Yang
Biotechnology and Genetic Engineering Reviews.2023; : 1. CrossRef - Willingness to Undergo Gastroscopy for Early Gastric Cancer Screening and Its Associated Factors During the COVID-19 Pandemic – A Nationwide Cross-Sectional Study in China
Kejia Ma, Xuejie Chen, Xin Xiang, Xueyi Mao, Ningxin Zhu, Tianyu Wang, Shuyu Ye, Xiaoyan Wang, Minzi Deng
Patient Preference and Adherence.2023; Volume 17: 505. CrossRef - Impact of the COVID-19 Pandemic on Gastric Cancer Screening in South Korea: Results From the Korean National Cancer Screening Survey (2017–2021)
Kyeongmin Lee, Mina Suh, Jae Kwan Jun, Kui Son Choi
Journal of Gastric Cancer.2022; 22(4): 297. CrossRef - Impact of frailty on survival and readmission in patients with gastric cancer undergoing gastrectomy: A meta-analysis
Xiaoyan Wang, Yimeng Sun, Pei Wang, Yu Jie, Guodong Liu, Dandan Gong, Yu Fan
Frontiers in Oncology.2022;[Epub] CrossRef
Review
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Epidemiology of myocardial infarction in Korea: hospitalization incidence, prevalence, and mortality
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Rock Bum Kim
, Jang-Rak Kim
, Jin Yong Hwang
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Epidemiol Health. 2022;44:e2022057. Published online July 12, 2022
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DOI: https://doi.org/10.4178/epih.e2022057
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Abstract
Few studies have comprehensively presented epidemiological indicators of myocardial infarction in Korea. However, multiple published articles and open-source secondary data on the epidemiology of myocardial infarction are now available. This review summarized the hospitalization incidence, prevalence, and mortality rate of myocardial infarction in Korea using articles and open-source data from the Health Insurance Service and the Department of Statistics, surveys of sample populations, registries of patients, and other sources. The epidemiological indicators of myocardial infarction were compared between Korea and other high-income countries. The incidence of hospitalization due to myocardial infarction in Korea was 43.2 cases per 100,000 population in 2016 and has consistently increased since 2011. It was 2.4 times higher among men than among women. The estimated prevalence among adults over 30 years of age ranged from 0.34% to 0.70% in 2020; it was higher among men and increased with age. The mortality in 2020, which was 19.3 per 100,000 population in 2020, remained relatively stable in recent years. Mortality was higher among men than among women. Based on representative inpatient registry data, the proportion of ST-elevated myocardial infarction decreased until recently, and the median time from symptom onset to hospital arrival was approximately 2 hours and 30 minutes. The hospitalization incidence, prevalence, and mortality rate of myocardial infarction were lower in Korea than in other countries, although there was an increasing trend. Comprehensive national-level support and surveillance systems are needed to routinely collect accurate epidemiological indicators.
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Summary
Korean summary
○우리나라의 심근경색증 발생률은 2016년 기준 인구 10만명 당 43.2명으로 추정되며 2011년 이후 증가하고 있음.
○ 30세 이상 인구에서 심근경색증 유병률은 0.34% (건강보험청구데이터) 또는 1.0% (국민건강영양조사)로 추정됨.
○ 전체인구에서 심근경색증으로 인한 사망률은 2019년 인구 10만명 당 18.8명으로 최근 큰 변화가 없거나 약간 감소하는 추세임.
Key Message
This review article showed the hospitalized incidence, prevalence, mortality, and features on patient registry of myocardial infarction in Korea from published articles and opened data sources.
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Citations
Citations to this article as recorded by

- Systematic review and meta-analysis of the intervention effect of curcumin on rodent models of myocardial infarction
Bing-Yao Pang, Ya-Hong Wang, Xing-Wang Ji, Yan Leng, Hou-Bo Deng, Li-Hong Jiang
Frontiers in Pharmacology.2022;[Epub] CrossRef
COVID-19: Original Article
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The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies
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Mehmet Onur Kaya
, Esra Pamukçu
, Burkay Yakar
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Epidemiol Health. 2021;43:e2021074. Published online September 23, 2021
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DOI: https://doi.org/10.4178/epih.e2021074
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9,987
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
Although vaccination has started, coronavirus disease 2019 (COVID-19) poses a continuing threat to public health. Therefore, in addition to vaccination, the use of supplements to support the immune system may be important. The purpose of this study was to synthesize evidence on the possible effect of low serum vitamin D levels (25[OH]D<20 ng/mL or 50 nmol/L) on COVID-19 infection and outcomes.
METHODS
We searched Google Scholar, PubMed, Scopus, Web of Science, and ScienceDirect without any language restrictions for articles published between January 1 and December 15, 2020. We performed 3 meta-analyses (called vitamin D and COVID-19 infection meta-analysis [D-CIMA], vitamin D and COVID-19 severity meta-analysis [D-CSMA], and vitamin D and COV ID-19 mortality meta-analysis [D-CMMA] for COVID-19 infection, severity, and mortality, respectively) to combine odds ratio values according to laboratory measurement units for vitamin D and the measured serum 25(OH)D level.
RESULTS
Twenty-one eligible studies were found to be relevant to the relationship between vitamin D and COVID-19 infection/outcomes (n=205,869). The D-CIMA meta-analysis showed that individuals with low serum vitamin D levels were 1.64 times (95% confidence interval [CI], 1.32 to 2.04; p<0.001) more likely to contract COVID-19. The D-CSMA meta-analysis showed that people with serum 25(OH)D levels below 20 ng/mL or 50 nmol/L were 2.42 times (95% CI, 1.13 to 5.18; p=0.022) more likely to have severe COVID-19. The D-CMMA meta-analysis showed that low vitamin D levels had no effect on COVID-19 mortality (OR, 1.64; 95% CI, 0.53 to 5.06, p=0.390).
CONCLUSIONS
According to our results, vitamin D deficiency may increase the risk of COVID-19 infection and the likelihood of severe disease. Therefore, we recommend vitamin D supplementation to prevent COVID-19 and its negative outcomes.
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Summary
Korean summary
Key Message
Although vaccination has started, it seems that Covid-19 will continue to threaten public health for a long time. In addition to the vaccine, the use of supplements to support the immune system may also be important. The purpose of this study is to indicate the possible effect of low serum vitamin D (25(OH)D<20 ng/mL or 50nmol/L) on the Covid-19 infection and outcomes. According to our remarkable results, vitamin D deficiency increases the risk of Covid-19 infection and the potential for the severity of the disease. Therefore, vitamin D supplements should be added to prevention and treatment protocols for Covid-19 disease.
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Citations
Citations to this article as recorded by

- 100 years of vitamin D. The impact of vitamin D level in the time of COVID-19 pandemic
K. A. Golovatyuk, A. A. Mikhailova, D. I. Lagutina, A. T. Chernikova, T. L. Karonova
Russian Journal for Personalized Medicine.2023; 2(6): 33. CrossRef - Vitamin D3 and COVID-19 Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses
Fausto Petrelli, Simone Oldani, Karen Borgonovo, Mary Cabiddu, Giuseppina Dognini, Mara Ghilardi, Maria Chiara Parati, Daniela Petro’, Lorenzo Dottorini, Carmen Rea, Veronica Lonati, Andrea Luciani, Antonio Ghidini
Antioxidants.2023; 12(2): 247. CrossRef - Genetic Variations of the Vitamin D Metabolic Pathway and COVID-19 Susceptibility and Severity: Current Understanding and Existing Evidence
Nipith Charoenngam, Aunchalee Jaroenlapnopparat, Sofia K. Mettler, Ashna Grover
Biomedicines.2023; 11(2): 400. CrossRef - MC-Au/MSS-Z8 porous network assisted advanced electrochemical immunosensing of 25-hydroxyvitamin D3
Amandeep Kaur, Lavisha, Ganga Ram Chaudhary, Nirmal Prabhakar
Talanta.2023; 257: 124376. CrossRef - Nutritional deficiencies that may predispose to long COVID
John V. Schloss
Inflammopharmacology.2023;[Epub] CrossRef - Effects of environmental parameters and their interactions on the spreading of SARS-CoV-2 in North Italy under different social restrictions. A new approach based on multivariate analysis
Fabio Tateo, Sirio Fiorino, Luca Peruzzo, Maddalena Zippi, Dario De Biase, Federico Lari, Dora Melucci
Environmental Research.2022; 210: 112921. CrossRef - The Relation between Vitamin D Level and Lung Clearance Index in Cystic Fibrosis—A Pilot Study
Mihaela Dediu, Ioana Mihaiela Ciuca, Liviu Laurentiu Pop, Daniela Iacob
Children.2022; 9(3): 329. CrossRef - Effect of Cholecalciferol Supplementation on the Clinical Features and Inflammatory Markers in Hospitalized COVID-19 Patients: A Randomized, Open-Label, Single-Center Study
Tatiana L. Karonova, Ksenia A. Golovatyuk, Igor V. Kudryavtsev, Alena T. Chernikova, Arina A. Mikhaylova, Arthur D. Aquino, Daria I. Lagutina, Ekaterina K. Zaikova, Olga V. Kalinina, Alexey S. Golovkin, William B. Grant, Evgeny V. Shlyakhto
Nutrients.2022; 14(13): 2602. CrossRef - Vitamin D Endocrine System and COVID-19: Treatment with Calcifediol
Jose Manuel Quesada-Gomez, José Lopez-Miranda, Marta Entrenas-Castillo, Antonio Casado-Díaz, Xavier Nogues y Solans, José Luis Mansur, Roger Bouillon
Nutrients.2022; 14(13): 2716. CrossRef - Impaired Vitamin D Metabolism in Hospitalized COVID-19 Patients
Alexandra Povaliaeva, Viktor Bogdanov, Ekaterina Pigarova, Larisa Dzeranova, Nino Katamadze, Natalya Malysheva, Vitaliy Ioutsi, Larisa Nikankina, Liudmila Rozhinskaya, Natalia Mokrysheva
Pharmaceuticals.2022; 15(8): 906. CrossRef - Vitamin D and COVID-19. Two years of research
Andrey P. Fisenko, Svetlana G. Makarova, Dmitry S. Yasakov, Irina Yu. Pronina, Oksana A. Ereshko, Irina G. Gordeeva, Albina A. Galimova, Tamara R. Chumbadze, Evgeny Е. Emelyashenkov, Ayina M. Lebedeva
Russian Pediatric Journal.2022; 25(3): 199. CrossRef - Vitamin D as the essential immunonutrient – the evidence base update: A review
Svetlana G. Makarova, Evgeny E. Emelyashenkov, Dmitry S. Yasakov, Irina Yu. Pronina, Oksana A. Ereshko, Irina G. Gordeeva, Albina A. Galimova, Tamara R. Chumbadze, Ayina M. Lebedeva
Pediatrics. Consilium Medicum.2022; (2): 133. CrossRef - COVID-19 Severity and Mortality in Two Pandemic Waves in Poland and Predictors of Poor Outcomes of SARS-CoV-2 Infection in Hospitalized Young Adults
Laura Ziuzia-Januszewska, Marcin Januszewski, Joanna Sosnowska-Nowak, Mariusz Janiszewski, Paweł Dobrzyński, Alicja A. Jakimiuk, Artur J. Jakimiuk
Viruses.2022; 14(8): 1700. CrossRef - Serum vitamin D levels and COVID-19 during pregnancy: A systematic review and meta-analysis
Sadegh Mazaheri-Tehrani, Mohammad Hossein Mirzapour, Maryam Yazdi, Mohammad Fakhrolmobasheri, Amir Parsa Abhari
Clinical Nutrition ESPEN.2022; 51: 120. CrossRef - Administration of vitamin D and its metabolites in critically ill adult patients: an updated systematic review with meta-analysis of randomized controlled trials
Johannes Menger, Zheng-Yii Lee, Quirin Notz, Julia Wallqvist, M. Shahnaz Hasan, Gunnar Elke, Martin Dworschak, Patrick Meybohm, Daren K. Heyland, Christian Stoppe
Critical Care.2022;[Epub] CrossRef - Prevention of covid-19 and other acute respiratory infections with cod liver oil supplementation, a low dose vitamin D supplement: quadruple blinded, randomised placebo controlled trial
Sonja H Brunvoll, Anders B Nygaard, Merete Ellingjord-Dale, Petter Holland, Mette Stausland Istre, Karl Trygve Kalleberg, Camilla L Søraas, Kirsten B Holven, Stine M Ulven, Anette Hjartåker, Trond Haider, Fridtjof Lund-Johansen, John Arne Dahl, Haakon E M
BMJ.2022; : e071245. CrossRef - Adipokines, and not vitamin D, associate with antibody immune responses following dual BNT162b2 vaccination within individuals younger than 60 years
Mariana Pavel-Tanasa, Daniela Constantinescu, Corina Maria Cianga, Ecaterina Anisie, Ana Irina Mereuta, Cristina Gabriela Tuchilus, Petru Cianga
Frontiers in Immunology.2022;[Epub] CrossRef - Vitamin D intoxication induced severe hypercalcemia from self-medication for COVID-19 infection: a public health problem?
Stefano PINI, Giuseppe SCAPARROTTA, Valentina DI VICO, Antonio FRAGASSO, Lucia F. STEFANELLI, Federico NALESSO, Lorenzo A. CALÒ
Minerva Endocrinology.2022;[Epub] CrossRef - Novel CYP11A1-Derived Vitamin D and Lumisterol Biometabolites for the Management of COVID-19
Shariq Qayyum, Radomir M. Slominski, Chander Raman, Andrzej T. Slominski
Nutrients.2022; 14(22): 4779. CrossRef - COVID-19 Prevention: Vitamin D Is Still a Valid Remedy
Rachel Nicoll, Michael Y. Henein
Journal of Clinical Medicine.2022; 11(22): 6818. CrossRef - Integrated bioinformatics and in silico approaches reveal the biological targets and molecular mechanisms of 1,25-dihydroxyvitamin D against COVID-19 and diabetes mellitus
Fanqiang Zeng, Yongli Xu, Chaoling Tang, Zhigang Yan, Chaohe Wei
Frontiers in Nutrition.2022;[Epub] CrossRef - Vitamin D in the prevention or treatment of COVID-19
Adrian R. Martineau
Proceedings of the Nutrition Society.2022; : 1. CrossRef - Can vitamin D status influence seroconversion to SARS-COV2 vaccines?
Endrit Shahini, Francesco Pesce, Antonella Argentiero, Antonio Giovanni Solimando
Frontiers in Immunology.2022;[Epub] CrossRef - Cholecalciferol as part of complex therapy for acute COVID-19
K.A. Golovatyuk, T.L. Karonova, A.A. Mikhailova, D.I. Lagutina, A.T. Chernikova, E.Yu. Vasilieva, E.V. Shlyakhto
Profilakticheskaya meditsina.2022; 25(12): 106. CrossRef - Vitamin D Metabolism Gene Polymorphisms and Their Associated Disorders: A
Literature Review
Mohamed Abouzid, Franciszek Główka, Leonid Kagan, Marta Karaźniewicz-Łada
Current Drug Metabolism.2022; 23(8): 630. CrossRef - Nutraceuticals in prevention and management of COVID-19
Ivana Đuričić, Milica Zrnić-Ćirić, Bojana Vidović, Vanja Todorović, Nevena Dabetić, Nevena Ivanović
Hrana i ishrana.2021; 62(2): 7. CrossRef
Original Articles
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The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data
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Reza Ebrahimoghli, Hassan Ghobadi, Davoud Adham, Parviz Jangi, Abbas Abbasi-Ghahramanloo, Eslam Moradi-Asl
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Epidemiol Health. 2022;44:e2022060. Published online July 18, 2022
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DOI: https://doi.org/10.4178/epih.e2022060
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Abstract
PDF
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Abstract
OBJECTIVES
Early diagnosis is essential for effective tuberculosis (TB) control programs. Therefore, this study examined the risk of delays in TB diagnosis and associated factors in Ardabil Province in northwest Iran from 2005 to 2016.
METHODS
This longitudinal retrospective cohort study was conducted using data obtained from the Iranian National Tuberculosis Control Program at the provincial level between 2005 and 2016. The total delay in diagnosis was defined as the time interval (days) between the onset of symptoms and TB diagnosis. Survival analysis was conducted to analyze the delay in diagnosis. Associated factors were identified using a Cox proportional hazards model.
RESULTS
A total of 1,367 new TB cases were identified. The 12-year median diagnostic delay was 45 days (interquartile range [IQR], 30-87). The annual median diagnostic delay decreased from 68 days (IQR, 33-131) in 2005 to 31 days (IQR, 30-62) in 2016. The probability of a delay in TB diagnosis decreased by 5.0% each year (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.04 to 1.07). Residence in a non-capital county (HR, 0.83; 95% CI, 0.74 to 0.92) and referral from the private health system (HR, 0.74%; 95% CI, 0.65 to 0.84) were significantly associated with an increased risk of delay in TB diagnosis over the 12-year study period.
CONCLUSIONS
The median delay decreased during the study period. We identified factors associated with a longer delay in TB diagnosis. These findings may be useful for further TB control plans and policies in Iran.
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Summary
Korean summary
Key Message
A longitudinal analysis of tuberculosis surveillance data from northwest Iran showed that during the 12-year period from 2005 to 2016, a total of 1,367 tuberculosis cases were registered, of whom 942 patients had a prolonged diagnostic delay (>30 days) and the probability of a delay in tuberculosis diagnosis decreased by 5.0% each year.
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Increasing trends in mortality and costs of infectious diseases in Korea: trends in mortality and costs of infectious diseases
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Dahye Baik
, Byung-Woo Kim
, Moran Ki
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Epidemiol Health. 2022;44:e2022010. Published online January 3, 2022
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DOI: https://doi.org/10.4178/epih.e2022010
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7,030
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448
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1
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Abstract
Summary
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Supplementary Material
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Abstract
OBJECTIVES
In an era when the average life expectancy and overall mortality rate have improved, Korea remains at risk for infectious disease outbreaks that place substantial burdens on the healthcare system. This study investigated trends in mortality and the economic burden of infectious diseases.
METHODS
Healthcare data from the Health Insurance Review and Assessment Service (2009-2019) and the Korean Statistics Information Service (1997-2019) were used. We selected 10 infectious disease groups (intestinal infections, tuberculosis, vaccine- preventable diseases, sepsis, viral hepatitis, HIV-related diseases, central nervous system infections, rheumatic heart diseases, respiratory tract infections, and arthropod-borne viral diseases).
RESULTS
The age-standardized mortality rate for infectious diseases increased from 27.2 per 100,000 population in 1997 to 37.1 per 100,000 population in 2019 and has had an upward trend since 2004. During this same period, significant increases were seen in respiratory tract infections and among elderly persons, especially those aged ≥85 years. The costs for infectious diseases increased from 4.126 billion US dollar (USD) in 2009 to 6.612 billion USD in 2019, with respiratory tract infections accounting for 3.699 billion USD (69%). The annual cost per patient for visits for medical care due to infectious diseases increased from 131 USD in 2009 to 204 USD in 2019.
CONCLUSIONS
Mortality among elderly persons and those with respiratory tract infections increased during the study period. The economic burden of infectious diseases has consistently increased, especially for respiratory tract infections. It is therefore essential to establish effective management policies that considers specific infectious diseases and patient groups.
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Summary
Korean summary
우리나라의 감염병으로 인한 사망률과 의료비용은 증가하고 있다. 특히 고령층에서의 높은 사망률과 과다한 의료비용 지출을 고려하면, 호흡기 감염 관리에 집중하는 것이 중요하며 각 감염병 그룹별로 효과적인 정책과 효율적인 관리가 필요하다. 본 연구는 COVID-19 발생 이전의 우리나라 감염병의 사망률과 발생, 의료비 부담의 장기적인 추세를 분석한 중요한 레퍼런스가 될 것이다.
Key Message
In Republic of Korea, the mortality trends (1997-2019) and costs (2009-2019) of infectious disease have increased and this study is particularly important reference for identifying the long-term trends including mortality, outbreak, financial burden of infectious disease in Korea before COVID-19 outbreak.
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Citations
Citations to this article as recorded by

- Determination of Volatile Compounds of Mentha piperita and Lavandula multifida and Investigation of Their Antibacterial, Antioxidant, and Antidiabetic Properties
Samiah Hamad Al-Mijalli, Eman R. ELsharkawy, Emad M. Abdallah, Munerah Hamed, Nasreddine El Omari, Shafi Mahmud, Mohammed Merae Alshahrani, Hanae Naceiri Mrabti, Abdelhakim Bouyahya, Fernanda Tonelli
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
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Model-based cost-effectiveness analysis of oral antivirals against SARS-CoV-2 in Korea
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Youngji Jo
, Sun Bean Kim
, Munkhzul Radnaabaatar
, Kyungmin Huh
, Jin-Hong Yoo
, Kyong Ran Peck
, Hojun Park
, Jaehun Jung
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Epidemiol Health. 2022;44:e2022034. Published online March 12, 2022
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DOI: https://doi.org/10.4178/epih.e2022034
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6,883
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565
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8
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Abstract
Summary
PDF
Supplementary Material
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Abstract
OBJECTIVES
Many countries have authorized the emergency use of oral antiviral agents for patients with mild-to-moderate cases of coronavirus disease 2019 (COVID-19). We assessed the cost-effectiveness of these agents for reducing the number of severe COVID-19 cases and the burden on Korea’s medical system.
METHODS
Using an existing model, we estimated the number of people who would require hospital/intensive care unit (ICU) admission in Korea in 2022. The treatment scenarios included (1) all adult patients, (2) elderly patients only, and (3) adult patients with underlying diseases only, compared to standard care. Based on the current health system capacity, we calculated the incremental costs per severe case averted and hospital admission for each scenario.
RESULTS
We estimated that 236,510 COVID-19 patients would require hospital/ICU admission in 2022 with standard care only. Nirmatrelvir/ritonavir (87% efficacy) was predicted to reduce this number by 80%, 24%, and 17% when targeting all adults, adults with underlying diseases, and elderly patients (25, 8, and 4%, respectively, for molnupiravir, with 30% efficacy). Nirmatrelvir/ritonavir use is likely to be cost-effective, with predicted costs of US$8,878, US$8,964, and US$1,454, per severe patient averted for the target groups listed above, respectively, while molnupiravir is likely to be less cost-effective, with costs of US$28,492, US$29,575, and US$7,915, respectively.
CONCLUSIONS
In Korea, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients targeting elderly patients would be highly cost-effective and would substantially reduce the demand for hospital admission to below the capacity of the health system if targeted to all adult patients instead of standard care.
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Summary
Korean summary
본 연구는 감염병 수리모형을 바탕으로 두가지 항바이러스제의 (nirmatrelvir/ritonavir와 molnupiravir) 비용 효익을 평가하였다. 본 모델에 따르면, 2022년 한국에서, 현재 의료시스템의 수용한계를 넘는 코로나 19 대유행이 발생할 때, nirmatrelvir/ritonavir 를 코로나 감염 및 증상 있는 고령층 환자들을 대상으로 투여할 경우 높은 비용 효익이 기대되고 (중증환자 1명 감소효과에$1,454 비용소요), 성인 환자 대상으로 투여할 경우, (molnupiravir이나 nirmatrelvir/ritonavir를 투여하지 않는) 일반 치료에 비해서 전체 입원 수요를 80% 줄일 것으로 기대된다.
Key Message
Given an expected high epidemic resurgence in 2022 that could exceed South Korea’s current health system capacity, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients may be a highly cost-effective solution if targeted to elderly patients ($1,454 per severe case averted) and substantially reduce the demand for hospital admission (80%, 188,478 patients) below the capacity of the health system if targeted to all adult patients compared to standard care.
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Citations
Citations to this article as recorded by

- Impact of the Use of Oral Antiviral Agents on the Risk of Hospitalization in Community Coronavirus Disease 2019 Patients (COVID-19)
Terry Cheuk-Fung Yip, Grace Chung-Yan Lui, Mandy Sze-Man Lai, Vincent Wai-Sun Wong, Yee-Kit Tse, Bosco Hon-Ming Ma, Elsie Hui, Maria K W Leung, Henry Lik-Yuen Chan, David Shu-Cheong Hui, Grace Lai-Hung Wong
Clinical Infectious Diseases.2023; 76(3): e26. CrossRef - Nirmatrelvir plus ritonavir in COVID-19: a profile of its use
Hannah A. Blair
Drugs & Therapy Perspectives.2023; 39(2): 41. CrossRef - Multi-Faceted Analysis of COVID-19 Epidemic in Korea Considering Omicron Variant: Mathematical Modeling-Based Study
Youngsuk Ko, Victoria May Mendoza, Renier Mendoza, Yubin Seo, Jacob Lee, Jonggul Lee, Donghyok Kwon, Eunok Jung
Journal of Korean Medical Science.2022;[Epub] CrossRef - Adjusting non-pharmaceutical interventions based on hospital bed capacity using a multi-operator differential evolution
Victoria May P. Mendoza, Renier Mendoza, Jongmin Lee, Eunok Jung
AIMS Mathematics.2022; 7(11): 19922. CrossRef - The Possible Impact of Nationwide Vaccination on Outcomes of the COVID-19 Epidemic in North Korea: A Modelling Study
Sung-mok Jung, Jaehun Jung
Journal of Korean Medical Science.2022;[Epub] CrossRef -
Medications for early treatment of
COVID
‐19 in Australia
Adam Polkinghorne, James M Branley
Medical Journal of Australia.2022;[Epub] CrossRef - Comparative effectiveness of sotrovimab and molnupiravir for prevention of severe covid-19 outcomes in patients in the community: observational cohort study with the OpenSAFELY platform
Bang Zheng, Amelia C A Green, John Tazare, Helen J Curtis, Louis Fisher, Linda Nab, Anna Schultze, Viyaasan Mahalingasivam, Edward P K Parker, William J Hulme, Sebastian C J Bacon, Nicholas J DeVito, Christopher Bates, David Evans, Peter Inglesby, Henry D
BMJ.2022; : e071932. CrossRef - Treatment Options for Patients With Mild-to-Moderate Coronavirus Disease 2019 in Korea
Jaehyun Jeon, BumSik Chin
Journal of Korean Medical Science.2022;[Epub] CrossRef
Data Profiles
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The Korea National Health and Nutrition Examination Survey data linked Cause of Death data
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Sungha Yun
, Kyungwon Oh
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Epidemiol Health. 2022;44:e2022021. Published online February 9, 2022
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DOI: https://doi.org/10.4178/epih.e2022021
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6,490
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456
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4
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Abstract
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Supplementary Material
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Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey that is conducted annually to assess the health and and health-related behaviors of Korean population. To utilize KNHANES data to studies of mortality risk factors, the Korea Disease Control and Prevention Agency (KDCA) constructed a database linking KNHANES data to cause-of-death statistics in Statistics Korea, made available to researchers since 2020. The KNHANES data were linked to the Cause of Death Statistics based on resident registration numbers for subjects aged 19 years or older who agreed to link the data. The linkage rate between 2007-2015 National Health and Nutrition Examination Survey and 2007-2019 Cause of Death Statistics was 97.1%. In the linked dataset, the total death rate was 6.6%, of which neoplasms accounted for the highest death rate (32.1%), followed by circulatory system disease (22.7%) and respiratory system disease (11.5%). The linked dataset was made available through the Research Data Center of the KDCA after a review of the research proposal, and will be made available after periodical updates.
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Summary
Korean summary
1. 국민건강영양조사 자료가 사망 위험요인 규명 연구에 활용되도록 통계청의 사망원인통계와 연계자료 구축함
2. 2007~2015년 국민건강영양조사와 2007~2019년 사망원인통계의 연계율은 97.1%이었음
3. 국민건강영양조사-사망원인통계 연계자료는 2020년부터 연구자에게 질병관리청 내 학술연구자료처리실를 통해 제공되고 있음
Key Message
1. To utilize the Korea National Health and Nutrition Examination Survey (KNHANES) data to studies of mortality risk factors, the data were linked to the Cause of Death Statistics in the Statistics Korea.
2. The linkage rate between the 2007-2015 KNHANES and the 2007-2019 Cause of Death Statistics was 97.1%.
3. The Korea National Health and Nutrition Examination Survey data linked Cause of Death data have been provided to researchers through the Research Data Center in the Korea Disease Control and Prevention Agency (KDCA) since 2020.
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Citations
Citations to this article as recorded by

- Computational method of the cardiovascular diseases classification based on a generalized nonlinear canonical decomposition of random sequences
Igor Atamanyuk, Yuriy Kondratenko, Valerii Havrysh, Yuriy Volosyuk
Scientific Reports.2023;[Epub] CrossRef - The Association between Advanced Liver Fibrosis and Mortality Is Modified by Dietary Quality among Korean Adults: Results from the Korea National Health and Nutrition Examination Survey with Mortality Data
Juhee Lee, Garam Jo, Dahyun Park, Hee Ju Jun, Jae Hyun Bae, Min-Jeong Shin
Nutrients.2023; 15(6): 1501. CrossRef - The Korea Cohort Consortium: The Future of Pooling Cohort Studies
Sangjun Lee, Kwang-Pil Ko, Jung Eun Lee, Inah Kim, Sun Ha Jee, Aesun Shin, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Daehee Kang, Keun-Young Yoo, Sue K. Park
Journal of Preventive Medicine and Public Health.2022; 55(5): 464. CrossRef - Self-perceived Weight and Mortality in Korean Adults Based on the Korea National Health and Nutrition Examination Survey Data Linked to Cause of Death Statistics
Kayoung Lee
Journal of Obesity & Metabolic Syndrome.2022; 31(4): 313. CrossRef
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Integrated dataset of the Korean Genome and Epidemiology Study cohort with estimated air pollution data
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Hae Dong Woo, Dae Sub Song, Sun Ho Choi, Jae Kyung Park, Kyoungho Lee, Hui-Young Yun, Dae-Ryun Choi, Youn-Seo Koo, Hyun-Young Park
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Epidemiol Health. 2022;44:e2022071. Published online September 7, 2022
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DOI: https://doi.org/10.4178/epih.e2022071
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Abstract
Summary
PDF
Supplementary Material
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Abstract
Public concern about the adverse health effects of air pollution has grown rapidly in Korea, and there has been increasing demand for research on ways to minimize the health effects of air pollution. Integrating large epidemiological data and air pollution exposure levels can provide a data infrastructure for studying ambient air pollution and its health effects. The Korean Genome and Epidemiology Study (KoGES), a large population-based study, has been used in many epidemiological studies of chronic diseases. Therefore, KoGES cohort data were linked to air pollution data as a national resource for air pollution studies. Air pollution data were produced using community multiscale air quality modeling with additional adjustment of monitoring data, satellite-derived aerosol optical depth, normalized difference vegetation index, and meteorological data to increase the accuracy and spatial resolution. The modeled air pollution data were linked to the KoGES cohort based on participants’ geocoded residential addresses in grids of 1 km (particulate matter) or 9 km (gaseous air pollutants and meteorological variables). As the integrated data become available to all researchers, this resource is expected to serve as a useful infrastructure for research on the health effects of air pollution.
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Summary
Korean summary
대기오염이 건강에 미치는 정도를 파악하고 이를 최소화하는 과학적 근거 생산 마련을 위하여 한국인유전체역학조사사업(KoGES) 자료와 대기오염 및 기상 자료를 연계하여 연구 기반을 마련하고자 하였다.
배출량, 기상자료 및 공기의 확산 등을 고려하는 화학수송모델(CMAQ)을 통하여 2005년에서 2017년 사이의 대기오염 및 기상자료를 예측하였으며, 이후 관측소 자료 및 인공위성자료인 에어로졸 광화학두께(AOD)를 추가 적용하여 최종 생산하였다. 미세먼지 자료는 1 km 격자로 기체상 오염물질 및 기상 자료는 9 km 격자 단위로 구성되었다.
생산된 자료는 KoGES 참여자의 주소를 기반으로 연계하여 최종 KoGES-대기오염 연계DB를 구축하였으며, 구축된 자료를 이용하여 KoGES 참여자의 대기오염 노출 수준을 공간적 시간적 분포로 살펴보았다.
구축된 자료는 내외부 연구자에게 공개가 되고 있어 대기오염에 의한 건강영향평가 및 피해를 최소화하는 방안 마련 연구를 위한 좋은 기반 자료가 될 것으로 기대된다.
Key Message
The Korean Genome and Epidemiology Study (KoGES) cohort were linked to air pollution data as a national resource for studying air pollution and its health effect. Air pollution data (2005~2017) were produced using community multiscale air quality modeling with additional adjustment of monitoring data, satellite-derived aerosol optical depth, normalized difference vegetation index, and meteorological data to increase the accuracy and spatial resolution. The modelled air pollution data were linked to the cohort based on participants’ geocoded residential addresses in grids of 1 km (particulate matter) or 9 km (gaseous air pollutants and meteorological variables).
Original Articles
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Non-linear association between serum folate concentrations and dyslipidemia: Korea National Health and Nutrition Examination Survey 2016-2018
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Taiyue Jin
, Eun Young Park
, Byungmi Kim
, Jin-Kyoung Oh
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Epidemiol Health. 2022;44:e2022046. Published online May 15, 2022
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DOI: https://doi.org/10.4178/epih.e2022046
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Abstract
Summary
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Supplementary Material
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Abstract
OBJECTIVES
We aimed to evaluate the association between serum folate concentrations and the prevalence of dyslipidemia.
METHODS
A total of 4,477 adults (2,019 male and 2,458 female) enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 were included. Serum samples were used to assess folate concentrations and total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol levels. Multivariate logistic regression with sampling weights was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
Elevated TC, TG, LDL-cholesterol and HDL-cholesterol levels were observed in 506 (11.3%), 646 (14.4%), 434 (9.7%), and 767 (17.1%) participants, respectively. We found non-linear trends between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia from the restricted cubic smoothing spline. A higher prevalence of hypercholesterolemia was observed among participants in the first tertile of serum folate concentrations (OR,1.38; 95% CI, 1.05 to 1.79) than among those in the second tertile. However, a higher prevalence of hyper-LDL cholesterolemia was identified for both the first and third serum folate concentration tertiles (OR, 1.49; 95% CI, 1.08 to 2.05 and OR, 1.63; 95% CI, 1.20 to 2.20, respectively); furthermore, in these tertiles, the prevalence of hyper-LDL cholesterolemia was more pronounced among obese participants.
CONCLUSIONS
Non-linear associations may exist between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia in adults. The findings suggest that more accurate recommendations about folate intake and folic acid fortification and supplementation should be provided.
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Summary
Korean summary
본 연구는 국민건강영양조사 자료를 활용하여 한국 성인에서 혈청 엽산 농도와 고콜레스테롤혈증 및 저밀도지단백 (LDL) 콜레스테롤혈증 유병률 간의 비선형 연관성을 확인하였다. 이 결과는 적정 혈청 엽산 농도와 정확한 엽산 권장섭취량을 추정하는데 근거로 활용될수 있을 것이다.
Key Message
1. The prevalence of hypercholesterolemia and hyper-LDL cholesterolemia were non-linearly associated with serum concentrations of folate in the Korean population.
2. An inverse association with a significant linear trend between serum folate concentrations and prevalence of hypo-HDL cholesterolemia was observed.
3. In relation to folate intake and folic acid fortification and supplementation, more accurate recommendations should be provided.
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Inequitable distribution of excess mortality during the COVID-19 pandemic in Korea, 2020
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Jin-Hwan Kim
, Saerom Kim
, Eunhye Park
, Chang-yup Kim
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Epidemiol Health. 2022;44:e2022081. Published online September 26, 2022
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DOI: https://doi.org/10.4178/epih.e2022081
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
This study analyzed inequities in excess mortality according to region and socioeconomic position to explain the distribution of excess mortality in Korea in 2020.
METHODS
We acquired weekly all-cause mortality data from January 2015 to December 2020 from (1) the National Health Insurance Database and (2) Vital Statistics. Excess mortality for 2020 was calculated by comparing the weekly observed and expected deaths from the same period (2015-2019) using quasi-Poisson regression.
RESULTS
An inequitable distribution of excess mortality was identified. The estimated excess mortality in Korea was -29,112 (95% confidence interval, -29,832 to -28,391), corresponding to -55 per 100,000, and the ratio of observed deaths to expected deaths was 0.91. Negative excess mortality was observed except for females in the 0-14 age group. Male Medical Aid beneficiaries showed positive excess mortality, while non-disabled and disabled groups showed similar negative values. When the standardized mortality ratio was calculated for the top 10 causes of death, deaths from Alzheimer’s disease and septicemia increased, whereas those from diabetes mellitus and cerebrovascular disease decreased. The decrease in mortality was primarily concentrated in older adults, while the mortality of young females increased due to increased intentional self-harm.
CONCLUSIONS
This study adds essential evidence regarding the overall performance of Korea. The observed inequalities according to various socioeconomic variables indicate that the results of strict measures to control coronavirus disease 2019 were not distributed equitably. Efforts should be made to properly evaluate the current and future problems related to the pandemic.
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Summary
Korean summary
Key Message
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Predictors of COVID-19 booster vaccine hesitancy among fully vaccinated adults in Korea: a nationwide cross-sectional survey
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Yunha Noh, Ju Hwan Kim, Dongwon Yoon, Young June Choe, Seung-Ah Choe, Jaehun Jung, Sang-Won Lee, Ju-Young Shin
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Epidemiol Health. 2022;44:e2022061. Published online July 22, 2022
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DOI: https://doi.org/10.4178/epih.e2022061
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Citations
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Abstract
Summary
PDF
Supplementary Material
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Abstract
OBJECTIVES
This study explored predictors of coronavirus disease 2019 (COVID-19) booster hesitancy among fully vaccinated young adults and parental COVID-19 vaccine hesitancy for their children.
METHODS
This cross-sectional study administered an online survey from December 2 to December 20, 2021. We enrolled participants aged 18-49 years, for whom ≥2 weeks had passed after their initial COVID-19 vaccination. We estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multivariate logistic regression to evaluate factors associated with booster/vaccine hesitancy.
RESULTS
Among the 2,993 participants, 48.8% showed hesitancy (wait and see: 40.2%; definitely not: 8.7%). Booster hesitancy was more common among women (OR, 1.25; 95% CI, 1.05 to 1.50), younger people (OR, 1.44; 95% CI, 1.17 to 1.77), those with a lower education level (OR, 2.05; 95% CI, 1.10 to 3.82), those who received the mRNA-1273 vaccine type (OR, 2.01; 95% CI, 1.65 to 2.45), and those who experienced serious adverse events following previous COVID-19 vaccination (OR, 2.03; 95% CI, 1.47 to 2.80). The main reasons for booster hesitancy were concerns about safety (54.1%) and doubts about efficacy (29.8%). Among the 1,020 respondents with children aged <18 years, 65.8% were hesitant to vaccinate their children against COVID-19; hesitancy was associated with younger parental age, education level, the type of vaccine the parent received, and a history of COVID-19 infection.
CONCLUSIONS
Concerns about the efficacy and safety of COVID-19 vaccines were the major barrier to booster acceptance. The initial COVID-19 vaccine type (mRNA-1273), young age, gender (women), a low education level, and adverse events after the first COVID-19 vaccine were key predictors of booster hesitancy.
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Summary
Korean summary
본 연구는 국내 19-49세 성인을 대상으로, 코로나19 3차접종 의향과 그들의 18세 미만 자녀에 대한 코로나19 기초접종 의향을 조사하고, 코로나19 백신접종 기피와 관련된 요인을 파악하고자 하였다. 2021년 12월 2일부터 20일까지 온라인 설문조사를 통하여 자료를 수집하였으며, 연구대상자는 코로나19 기초접종을 완료한 후 2주 경과한 19-49세 성인으로, 전국 대표성을 확보하기 위해 성별, 연령, 지역별로 층화하여 모집하였다. 코로나19 3차접종 기피율은 약 48.8%로 나타났으며, 접종 기피 관련 영향요인으로는 젊은 연령층, 여성, 낮은 교육수준, 기초접종 백신 종류, 기초접종 후 중증 이상반응 경험이 포함되었으며, 18세 미만 자녀에 대한 코로나19 기초접종 기피율은 65.8%로, 관련 영향요인으로는 젊은 부모 연령, 교육수준, 부모의 기초접종 백신 종류, 코로나19 감염 과거력이 포함되었다.
Key Message
Concerns about the safety and efficacy of COVID-19 vaccines were the major barrier to booster acceptance; the initial COVID-19 vaccine type (mRNA-1273), younger age, gender (women), a low education level, and adverse events after the first COVID-19 vaccine were key predictors of booster hesitancy.
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Citations
Citations to this article as recorded by

- Why Some People Are Hesitant to Receive COVID-19 Boosters: A Systematic Review
Yam B. Limbu, Bruce A. Huhmann
Tropical Medicine and Infectious Disease.2023; 8(3): 159. CrossRef - COVID-19 Vaccine Booster Hesitancy in Malaysia: A Web-Based Cross-Sectional Study
Kai Wei Lee, Sook Fan Yap, Hooi Tin Ong, Myo Oo, Kye Mon Min Swe
Vaccines.2023; 11(3): 638. CrossRef