Epidemiology and Health

Perspective

Misattribution of Korea’s malaria elimination status in 1979: Roma Seol, Youngtaek Kim; Epidemiol Health. 2025;47:e2025070. Published online December 10, 2025; DOI: https://doi.org/10.4178/epih.e2025070

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This study aimed to trace the origin and propagation of the common but incorrect belief that the World Health Organization (WHO) declared Republic of Korea (ROK) malaria-free in 1979. We conducted a source-based historical review of WHO Weekly Epidemiological Record (WER), regional reports from WHO’s Western Pacific Regional Office (WPRO), United States Department of Defense (DoD) health reports, and scholarly and web-based citations. WHO WER 1981 identified the Democratic People’s Republic of Korea (DPRK) as one of the countries that had eliminated malaria by 1979. WHO/WPRO, to which ROK belongs, reported that malaria had not been eliminated in ROK as of 1980. Misinterpretations within United States DoD documents incorrectly attributed this certification to ROK, resulting in widespread citation errors across academic literature and online sources. The misattribution of DPRK’s elimination status to ROK derives from a misreading of WHO records and has persisted for decades through repeated, unverified citations. Strengthening source accuracy and citation practices is essential for ensuring reliability in global health reporting.; Summary

Korean summary
- WHO는 1979년에 대한민국을 말라리아 퇴치국으로 인증한 바 없으며, 해당 인증은 북한에만 적용되었다. - 이 잘못된 통념은 WHO 문헌의 오해석과 미국 국방부 문헌을 통한 반복 인용으로 학술 문헌과 온라인 자료 전반에 확산되었다.

Key Message
-The World Health Organization did not certify the Republic of Korea as malaria-free in 1979; this status applied exclusively to the Democratic People’s Republic of Korea. -This persistent misconception originated from misinterpretation of WHO records and was amplified through U.S. Department of Defense publications and repeated citations.

Original Article

Risk factors for Q fever incidence in Korea: a comparative analysis using frequentist and Bayesian methods: Ji-Hyun Son, Sung-Dae Park; Epidemiol Health. 2025;47:e2025046. Published online August 20, 2025; DOI: https://doi.org/10.4178/epih.e2025046

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OBJECTIVES
This study investigated the principal determinants of human Q fever incidence and explored regional variation between metropolitan cities and provinces in Korea.
METHODS
Panel data on human Q fever incidence, livestock populations, and facility metrics were collected across 17 metropolitan cities and provinces from 2017 to 2024. Analytical approaches included frequentist models (ordinary least squares [OLS], random effects [RE], fixed effects [FE]) and Bayesian models.
RESULTS
Frequentist panel analysis indicated that slaughterhouse count was positively associated with Q fever incidence in both pooled OLS (β=1.20, p<0.001) and RE models (β=1.03, p<0.001), but not in the FE model (β=0.14, p=0.65). After correcting for serial correlation using Driscoll-Kraay standard errors, livestock population (β=0.55, p<0.01), livestock market count (β=-2.01, p<0.05), and livestock Q fever cases (β=-0.11, p<0.01) were significantly associated with human incidence. A Bayesian FE model confirmed a significant relationship between slaughterhouses and human Q fever incidence (posterior mean: 0.87; 95% credible interval [CrI], 0.21 to 1.42), providing more stable inference with limited samples and allowing probabilistic uncertainty estimation. A Bayesian hierarchical model revealed a stronger association in metropolitan cities (posterior mean, 1.46; 95% CrI, 0.34 to 2.57) than in provinces (1.22), while livestock population remained significant in provinces (0.94; 95% CrI, 0.15 to 1.74).
CONCLUSIONS
In Korea, slaughterhouse density was the main determinant of Q fever in metropolitan cities and livestock density was the primary risk factor in provinces. These findings underscore the need for region-specific preventive strategies and reinforce the value of a One Health approach.; Summary

Korean summary
본 연구는 대한민국 내 큐열(Q fever) 발생의 주요 위험 요인이 지역별로 다르다는 것을 규명하였다. 광역시(metropolitan cities)에서는 도축장 밀도가, 도(provinces)에서는 가축 사육 밀도가 사람에서 큐열 발생의 주된 위험 요인으로 확인되었다. 이러한 결과는 사람, 동물, 환경의 건강을 통합적으로 고려하는 원헬스(One Health) 접근법에 기반하여 각 지역 특성에 맞는 예방 전략이 필요함을 강조한다.

Key Message
This study identified that the primary risk factors for Q fever in Korea vary by region. Slaughterhouse density was the main determinant of human Q fever incidence in metropolitan cities, whereas livestock density was the primary risk factor in provinces. These findings underscore the need for region-specific preventive strategies based on a One Health approach, which integrally considers human, animal, and environmental health.

Cohort Profile

Cohort profile update: the Korean Cancer Prevention Study-II (KCPS-II) biobank: Heejin Kimm, Keum Ji Jung, Wes Spiller, Yeun Soo Yang, So Young Kim, Min Young Park, Sun Mi Lee, Sun Ha Jee; Epidemiol Health. 2025;47:e2025040. Published online July 29, 2025; DOI: https://doi.org/10.4178/epih.e2025040

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Chronic diseases such as cancer and cardiovascular disease have a substantial impact on mortality and global disease burden. The Korean Cancer Prevention Study-II (KCPS-II) biobank was established to investigate these chronic diseases, with a particular focus on metabolic risk factors. Recently, genetic information reflecting diverse ancestries has been incorporated to support a precision medicine approach. These data can be leveraged to identify variation in causal effects among different ancestral groups, thereby informing the development of more effective, ancestry-specific treatments. From 2004 to 2013, baseline data were collected from 156,701 individuals aged 20-85 years, recruited from 18 health promotion centers across Korea. Outcome data are routinely obtained from Statistics Korea (mortality data), the National Cancer Center (cancer registry data), and the National Health Insurance Service (morbidity data). Additionally, new participants have been enrolled since 2022 as part of an ongoing expansion. This population-based cohort, enriched with genetic data, provides a robust foundation for research aimed at elucidating causal relationships in chronic disease.; Summary

Korean summary
· 한국 암 예방 연구 II 바이오 뱅크에는 한국 전역의 18개 건강 검진 센터에서 모집한 20~85세의 156,701명의 참여자가 포함되어 있다. · 모집 시 기준 측정에는 사회 경제적, 병력, 행동적, 생리적 및 혈액 샘플 데이터가 포함되어 있으며, 이들의 유전 분석이 완료되었다. · 한국 암 예방 연구 II는 현재 참여자를 모집하고 있는 진행 중인 코호트이며, 사망률 외에도 심혈관 및 암 이환율을 포함한 2차 자료 연계를 통해 후속 데이터를 사용할 수 있다. · 본 코호트를 통해 한국인의 역학 자료와 유전 자료를 이용하여 질병에 대한 매커니즘을 확인하고 질병 예방 및 극복에 대한 과학적 근거를 창출할 것으로 기대한다.

Key Message
· The Korean Cancer Prevention Study II (KCPS-II) Biobank comprises 156,701 adults aged 20–85 years, recruited from 18 health examination centers nationwide. · Baseline data include socioeconomic, medical history, behavioral, physiological, and blood sample information, with completed genetic analyses. · KCPS-II is an ongoing cohort with follow-up through linkage to secondary data on mortality, cardiovascular events, and cancer incidence. · This resource enables the integration of epidemiological and genetic data to investigate disease mechanisms and provide scientific evidence for prevention and control in the Korean population.

Original Articles

Spatial patterns of laboratory-confirmed leptospirosis in north-eastern Peninsular Malaysia, 2016-2023: Hazlienor Mohd Hatta, Kamarul Imran Musa, Nik Mohd Hafiz Mohd Fuzi, Paula Moraga; Epidemiol Health. 2025;47:e2025030. Published online May 29, 2025; DOI: https://doi.org/10.4178/epih.e2025030

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OBJECTIVES
Leptospirosis presents significant public health challenges in endemic regions such as north-eastern Peninsular Malaysia. Spatial analysis is essential for visualising disease incidence and distribution, assessing vulnerability based on geographical and socioeconomic factors, and ultimately informing targeted interventions, optimising resource allocation, and enhancing surveillance strategies. This study aimed to determine the incidence and characterise the spatial distribution of leptospirosis in Kelantan, Malaysia.
METHODS
All laboratory-confirmed leptospirosis cases reported in Kelantan between 2016 and 2023 were extracted from the Communicable Disease Control Information System e-Notifikasi online database. Spatial analyses were performed using the spatstat, spdep, and ggplot2 packages within the RStudio integrated development environment.
RESULTS
The analysis encompassed 1,534 laboratory-confirmed leptospirosis cases. The average crude annual incidence of leptospirosis cases per 1,000 population from 2016 to 2023 was 0.101 (95% confidence interval, 0.038 to 0.164). Incidence varied considerably across districts and subdistricts, initially higher in the north but declining over time, while consistently high and increasing incidence was observed in the southern region. Significant clustering of leptospirosis cases occurred throughout the studied years, except during the coronavirus disease 2019 pandemic. Hotspots were initially prevalent in northern areas but later emerged in south-eastern and southern regions. Significant spatial autocorrelation evolved from high-low to high-high clusters, particularly evident in central and southern regions.
CONCLUSIONS
This study provides valuable local epidemiological and spatial insights into the endemicity of leptospirosis. The findings highlight the need for targeted interventions and continued surveillance to effectively mitigate the leptospirosis burden in endemic areas.; Summary

Key Message
• This study examined leptospirosis patterns in Kelantan, Malaysia, from 2016 to 2023, highlighting distinct regional varia- tions in disease incidence. • Case densities were high in the northern region, whereas incidence demonstrated higher risk in the central and southern regions. • The study underscores the importance of considering both geographic location and population dynamics when planning interventions and allocating resources for disease control. • The evident spatial clustering highlights the need for targeted public health interventions.

Geospatial analysis of neonatal mortality in north-eastern India: a multilevel Bayesian approach: Vidhi Jain, Kh. Jitenkumar Singh, Deboshree Das, Shefali Gupta, Gunjan Singh; Epidemiol Health. 2025;47:e2025021. Published online April 27, 2025; DOI: https://doi.org/10.4178/epih.e2025021

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Abstract PDF: Abstract
OBJECTIVES
Neonatal mortality remains a significant public health issue in India. This study investigates spatial patterns and contributing factors to neonatal mortality in the north-eastern states, identifying hotspot regions and spatial variations.
METHODS
A sample of 34,222 mothers from India’s National Family Health Survey (NFHS-5, 2019-21) in the north-eastern states was analysed. Descriptive and bivariate analyses were conducted alongside Bayesian multilevel logistic regression using integrated nested Laplace approximation to model neonatal mortality. Spatial hotspot analysis using Getis-Ord Gi* statistics identified clusters of high neonatal mortality, while geographically weighted regression (GWR) was used to examine spatial variations in the relationships between neonatal mortality and contributing factors.
RESULTS
The neonatal mortality rate in the north-eastern states declined from 45 to 21 per 1,000 live births (NFHS-1 to NFHS-5) but remains higher than the national average. Assam reported the highest mortality (42.16%), whereas Sikkim had the lowest (0.87%). Higher mortality was observed among male infants, mothers with advanced age, low maternal education, and mothers who attended less than 5 antenatal care (ANC) visits. Spatial analysis identified hotspots in Assam, Meghalaya, and Tripura. GWR indicated that areas with less than 5 ANC visits had the strongest association with neonatal mortality. Bayesian multilevel analysis highlighted spatial variations of up to 51% across districts in northeast India.
CONCLUSIONS
This study underscores spatial disparities in neonatal mortality across north-eastern India. Addressing childcare practices and healthcare access in hotspot regions is essential for improving new-born health outcomes. The findings provide critical insights for policymakers to develop targeted interventions aimed at reducing neonatal mortality in these underserved areas.; Summary

Epidemiologic Investigation

Spatiotemporal trends in severe complicated influenza among the local population in Taiwan region, 2003-2023: Kangjun Wu, Yujian Lu; Epidemiol Health. 2025;47:e2025016. Published online April 2, 2025; DOI: https://doi.org/10.4178/epih.e2025016

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OBJECTIVES
Severe influenza has raised considerable concern worldwide, and its incidence appears to have shifted in the context of globalization. This study aimed to examine the temporal, spatial, and demographic distributions of local severe influenza cases in Taiwan region from January 2003 to June 2023.
METHODS
We aggregated severe complicated influenza cases by month, area (city/county), age, and sex. The age-standardized incidence rate (ASIR) was calculated to compare differences across regions and populations. Yearly incidence rate ratios comparing males to females were also computed to assess sex differences.
RESULTS
A total of 16,459 cases were included from 2003 to 2023. Crude incidence rates per 100,000 population were 0.07-0.14 for 2003-2008, 3.64-9.81 for 2009-2019, and 0.00-1.87 for 2020-2023. Higher incidence rates were observed in Hualien and Taitung Counties, with average ASIRs exceeding 10.00 per 100,000 population, compared to other cities. Except for 2005 and 2007, the incidence among males exceeded that among females, with ASIR ratios ranging from 1.10 to 2.20. The highest incidence was observed among populations aged 0-4 and those aged ≥55.
CONCLUSIONS
The incidence of severe complicated influenza exhibited clear regional and demographic variations in Taiwan region. The observed rebound in incidence calls for increased vigilance to protect vulnerable populations from severe illness.; Summary

Key Message
In Taiwan Region, the incidence rate of severe complicated influenza was significantly higher between 2009 and 2019 compared to the periods both preceding and following this decade, with a notable resurgence trend emerging in 2023. Severe complicated influenza cases exhibited distinct spatial clustering patterns, particularly concentrated in Taichung and Hualien. Males faced elevated morbidity risks, while both young children and the elderly showed heightened vulnerability—though the elderly population drove the majority of cases.

Original Articles

Preventable cancer cases and deaths attributable to alcohol consumption in Korea from 2015 to 2030: Soseul Sung, Jihye An, Jeehi Jung, Hyeon Sook Lee, Sungji Moon, Inah Kim, Jung Eun Lee, Aesun Shin, Sun Ha Jee, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Sohee Park, Jeong-Soo Im, Hong Gwan Seo, Kwang-Pil Ko, Sue K. Park; Epidemiol Health. 2025;47:e2025009. Published online February 27, 2025; DOI: https://doi.org/10.4178/epih.e2025009

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OBJECTIVES
Alcohol consumption is causally linked to several cancers, and major health organizations classify it as a carcinogen. This study assessed the impact of alcohol consumption on cancer incidence and mortality in Korea in 2015 and 2020, projected trends up to 2030, and compared results based on different criteria.
METHODS
The relative risk of cancer associated with alcohol consumption in Korea was determined through a meta-analysis of alcohol-related relative risks for specific cancers, using primary data from the Korean Cohort Study within the Korean Cohort Consortium. The population-attributable fraction (PAF) was calculated using Levin’s formula, incorporating drinking prevalence and the number of cancer cases and deaths, with a 15-year latency period assumed.
RESULTS
In Korea, the PAF for alcohol consumption, based on ever/never drinking criteria, was higher than that calculated using other criteria, except for the PAF based on past and current/never drinking criteria. Alcohol consumption contributed to 3.58% of all cancer cases and 3.28% of cancer deaths in 2015. It accounted for 4.58% of new cancer cases in male and 2.08% in female, with a higher contribution to incidence than mortality (4.00 and 2.25% of cancer deaths in male and female, respectively). Projections indicate that alcohol-related cancer PAF will decrease by 17.2% in male but increase by 70.2% in female by 2030.
CONCLUSIONS
This study highlights the impact of alcohol consumption on cancer in Korea, emphasizing the need for sex-specific regulations to address sex differences.; Summary

Korean summary
2015년 알콜 섭취는 한국에서 전체 암 발생의 3.58%, 암 사망의 3.28%를 차지했으며, 남성(4.58%)이 여성(2.08%)보다 더 큰 영향을 받았음. 2030년까지 남성의 알콜 관련 암 발생률은 감소할 것으로 예상되지만, 여성에서는 급증할 것으로 보임. 이러한 결과는 특히 여성에서 증가하는 추세를 반영하여 성별 맞춤형 공공 보건 정책의 필요성을 시사함.

Key Message
In 2015, alcohol consumption was responsible for 3.58% of all cancer cases and 3.28% of cancer deaths in Korea, with a more significant impact on males (4.58% of new cases) than females (2.08%). Projections indicate a decrease in alcohol-related cancer cases among males but a sharp increase in females by 2030. These findings highlight the need for sex-specific public health measures to address the growing impact of alcohol on cancer, particularly the increasing trend in female cases.

Preventable cancer cases and deaths attributable to tobacco smoking in Korea from 2015 to 2030: Soseul Sung, Jihye An, Jeehi Jung, Hyeon Sook Lee, Sungji Moon, Inah Kim, Jung Eun Lee, Aesun Shin, Sun Ha Jee, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Daehee Kang, Keun-Young Yoo, Sohee Park, Jeong-Soo Im, Hong Gwan Seo, Hai-Rim Shin, Kwang-Pil Ko, Sue K. Park; Epidemiol Health. 2025;47:e2025008. Published online February 27, 2025; DOI: https://doi.org/10.4178/epih.e2025008

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OBJECTIVES
Tobacco smoking is a major public health concern worldwide. This study aimed to assess its impact on cancer incidence and mortality by estimating the population attributable fraction (PAF) in the Korean population for 2015 and 2020 and by projecting future trends until 2030.
METHODS
The Korean relative risk (RR) was calculated via a meta–analysis of RRs for individual cancers attributed to tobacco smoking, based on primary data analysis from the Korean Cohort Consortium. The PAF was estimated using the Levin formula with past and current prevalence rates and the number of cancer cases and deaths, assuming a 15-year latency period.
RESULTS
The proportions of cancer cases and deaths in Korea attributable to tobacco smoking were similar to those calculated using Asian and global RRs for both male and female. In 2015 and 2020, tobacco smoking contributed to 14.32% and 13.17% of cancer cases and 21.70% and 20.69% of cancer deaths in adults, respectively. Among Koreans, smoking was responsible for 25.83% of new cancer cases in male in 2015, 23.49% in male in 2020, 1.46% in female in 2015, and 1.68% in female in 2020. In both years, smoking impacted mortality more strongly than incidence in Korean male and female (incidence in male: 25.83% and 23.49%; mortality in male: 32.09% and 30.41%; incidence in female: 1.46% and 1.68%; and mortality in female: 4.70% and 4.96%, respectively).
CONCLUSIONS
Tobacco smoking causes cancers and deaths in Korea, however, it is preventable. Effective control policies that consider trends and vulnerabilities among female are required.; Summary

Korean summary
한국에서 흡연으로 인한 암 부담은 2015년 발생 14.32%, 사망 21.70%였고 2020년에는 발생 13.17%, 사망 20.69%로 나타남. 두 해 모두 남성에서 부담이 훨씬 컸음(남성: 발생 2015년 25.83%, 2020년 23.49%; 사망 2015년 32.09%, 2020년 30.41% / 여성: 발생 2015년 1.46%, 2020년 1.68%; 사망 2015년 4.70%, 2020년 4.96%). 흡연은 예방 가능한 주요 원인이므로, 여성의 취약성과 추세를 고려한 보다 강력한 금연·규제 정책 강화가 필요함.

Key Message
In Korea, tobacco smoking accounted for 14.32% of incident cancers and 21.70% of cancer deaths in 2015, and 13.17% of incidence and 20.69% of mortality in 2020. The burden was much greater in men than in women in both years (men: incidence 25.83% in 2015 and 23.49% in 2020; mortality 32.09% in 2015 and 30.41% in 2020; women: incidence 1.46% in 2015 and 1.68% in 2020; mortality 4.70% in 2015 and 4.96% in 2020). Smoking remains a preventable driver of substantial cancer incidence and mortality, calling for stronger control policies that also address emerging vulnerabilities among women.

Preventable cancer cases and deaths attributable to deficit of physical activity in Korea from 2015 to 2030: Soseul Sung, Sungji Moon, Jihye An, Jeehi Jung, Hyeon Sook Lee, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Inah Kim, Jung Eun Lee, Sun Ha Jee, Aesun Shin, Ji-Yeob Choi, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Jeong-Soo Im, Hong Gwan Seo, Sohee Park, Kwang-Pil Ko, Sue K. Park; Epidemiol Health. 2025;47:e2025010. Published online January 27, 2025; DOI: https://doi.org/10.4178/epih.e2025010

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study aimed to determine the population-attributable fractions (PAFs) of cancers using various calculation methods and to estimate the PAFs of cancer incidence and mortality resulting from deficit in physical activity (DPA) from 2015 to 2030, based on data on prevalence rates.
METHODS
The PAF of cancer was estimated using a cohort study-based meta-analysis of relative risk (RR), national prevalence rates of DPA from 2000 to 2015, and national cancer statistics from 2015 to 2030, with a latency of 15 years.
RESULTS
In 2015, DPA contributed to 909 cancer cases and 548 deaths, accounting for 0.42% and 0.68% of new cancer cases and deaths, respectively. By 2030, the PAF values are expected to increase to 1.31% of incidence and 1.80% of mortality, with a continual increase from 2015 to 2030. When the low metabolic equivalent of task (MET) criteria were selected, the PAF values decreased for both incidence and mortality. The PAF calculated with <900 MET-min/wk for the sex-specific MET criterion was higher than that calculated with <900 MET-min/wk for both incidence and mortality.
CONCLUSIONS
The risk of cancer associated with DPA is expected to rise in both male and female. Future research and strategies should emphasize the promotion of physical activity for cancer prevention, considering its significant implications for public health.; Summary

Korean summary
2015년 신체활동 부족(deficit in physical activity, DPA)에 의한 인구집단기여분율(population-attributable fraction, PAF)은 암 발생 0.42%(909건), 암 사망 0.68%(548건)였으며 2030년에는 각각 1.31%, 1.80%로 증가할 것으로 예측됨. 남녀 모두에서 DPA로 인한 암 부담이 증가하고 있으므로, 암 예방을 위한 신체활동 증진 전략을 강화할 필요가 있음.

Key Message
In 2015, deficit in physical activity (DPA) accounted for 0.42% of incident cancers (909 cases) and 0.68% of cancer deaths (548 deaths), with population-attributable fraction (PAF) values projected to rise to 1.31% for incidence and 1.80% for mortality by 2030. The cancer burden attributable to DPA is increasing in both sexes, underscoring the need to strengthen population-level physical-activity promotion for prevention.

Temporal trends in the prevalence, incidence, and mortality of cardiac amyloidosis in Korea over 12 years: You-Jung Choi, Yun Jin Choi, Jieun Lee, Jah Yeon Choi, Geum Joon Cho, Jin Oh Na; Epidemiol Health. 2024;46:e2024078. Published online September 15, 2024; DOI: https://doi.org/10.4178/epih.e2024078

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated the prevalence, incidence, and prognosis of cardiac amyloidosis (CA) in Korea.

METHODS

This retrospective nationwide population-based study used the Health Insurance Review and Assessment Service databases between 2008 and 2020. All patients diagnosed with amyloidosis were included, and those with a diagnosis of heart failure or cardiomyopathy were classified as having CA. Both the special code for amyloidosis (V121), which enables coverage of medical expenses, and the corresponding International Classification of Diseases, 10th revision codes for amyloidosis (E850- E854, E858, E859) were used to improve the reliability of amyloidosis diagnosis.

RESULTS

Among 2,239 patients with amyloidosis, 758 met the criteria for CA (mean age, 64.4±11.9 years; 59.1% male). The mean age of patients with CA increased from 59.5±14.7 years in 2009 to 68.1±13.9 years in 2020. The incidence and prevalence increased from 0.09 (95% confidence interval [CI], 0.06 to 0.12) to 0.22 (95% CI, 0.18 to 0.27) per 100,000 person-years and 0.20 (95% CI, 0.16 to 0.25) to 1.30 (95% CI, 0.12 to 0.42) per 100,000 persons, respectively (all p<0.001). Patients with light-chain CA showed similar trends. In-hospital mortality decreased from 17.3% (95% CI, 9.23 to 29.6) to 6.10% (95% CI, 4.21 to 8.48) between 2009 and 2020. While age-specific in-hospital mortality was significantly higher in patients aged ≥70 years (p=0.004), no significant age-specific difference in in-hospital mortality was observed in patients with CA aged <70 years (p=0.981).

CONCLUSIONS

The prevalence and incidence of CA have increased in Korea, predominantly affecting older individuals, particularly males. Notably, in-hospital mortality decreased significantly.

Summary

Korean summary
본 연구는 2009년부터 2020년까지 한국에서의 심장 아밀로이드증의 역학을 조사했으며, 유병률과 발생률이 시간이 지남에 따라 유의미하게 증가하고, 환자의 평균 연령도 높아지는 추세를 보였습니다. 특히, 전체 환자에서 입원 중 사망률이 크게 감소하며 치료와 관리가 개선되었음을 보여주었으나, 70세 이하에서는 심장 아밀로이드증으로 인한 사망이 나이에 따른 차이를 보이지 않아 조기 발견 및 적극적인 치료의 중요성이 강조되었습니다.

Key Message
This study investigated the epidemiology of cardiac amyloidosis in South Korea from 2009 to 2020, revealing a significant increase in prevalence and incidence over time, along with a rise in the median age of patients. Notably, in-hospital mortality decreased substantially across all patients, reflecting improvements in treatment and management. However, among patients under 70 years of age, mortality due to cardiac amyloidosis showed no significant age-related differences, underscoring the importance of early detection and proactive treatment.

Citations

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Epidemiological perspectives of amyloidosis in Argentina: a cohort study analysing incidence and mortality patterns among a population affiliated to a medical care programme
María Lourdes Posadas-Martínez, Delfina Cirelli, Florencia De Florio, María Adela Aguirre, Elsa Mercedes Nucifora, Patricia Beatriz Sorroche, María Soledad Sáez, Valeria Inés Aliperti, Jimena Vicens, Marcelina Carretero
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The associations of cardiovascular and lifestyle factors with mortality from chronic kidney disease as the underlying cause: the JACC study: Shuai Guo, Tomoko Sankai, Kazumasa Yamagishi, Tomomi Kihara, Akiko Tamakoshi, Hiroyasu Iso, for the JACC Study Group; Epidemiol Health. 2024;46:e2024077. Published online September 13, 2024; DOI: https://doi.org/10.4178/epih.e2024077

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Abstract PDF: Abstract
OBJECTIVES
This study investigated conventional cardiovascular and lifestyle risk factors affecting mortality from chronic kidney disease as the underlying cause in the general Japanese population.
METHODS
We conducted an 18.8-year follow-up study of 44,792 men and 61,522 women aged 40-79 from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk between 1986 and 1990. Cox proportional hazard models were used to analyze the association between risk factors and mortality from chronic kidney disease.
RESULTS
During the follow-up period, 373 participants (185 men and 188 women) died from chronic kidney disease. A body mass index of ≥27.0 kg/m2 (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.19 to 3.36 for men and HR, 1.91; 95% CI, 1.19 to 3.07 for women, compared with 23.0-24.9 kg/m2), a history of hypertension (HR, 2.32; 95% CI, 1.67 to 3.22 for men and HR, 2.01; 95% CI, 1.44 to 2.81 for women) and a history of diabetes mellitus (HR, 5.21; 95% CI, 3.68 to 7.37 for men and HR, 7.10; 95% CI, 4.93 to 10.24 for women) were associated with an increased risk of mortality from chronic kidney disease in both genders. In men, smoking was also associated with an increased risk (HR, 1.91; 95% CI, 1.25 to 2.90), while current drinking (HR, 0.58; 95% CI, 0.34 to 0.98 for <23 g/day; HR, 0.48; 95% CI, 0.29 to 0.80 for 23-45 g/day and HR, 0.53; 95% CI, 0.32 to 0.86 for ≥46 g/day) and exercising ≥5 hr/wk (HR, 0.42; 95% CI, 0.18 to 0.96) were associated with a lower risk. Similar but non-significant associations for smoking and drinking were observed in women.
CONCLUSIONS
In addition to a history of hypertension and a history of diabetes mellitus, body mass index, smoking status, drinking status, and exercise habits were associated with the risk of mortality from chronic kidney disease.; Summary

COVID-19 infection and severe clinical outcomes in patients with kidney disease by vaccination status: a nationwide cohort study in Korea: Jieun Woo, Ahhyung Choi, Jaehun Jung, Ju-Young Shin; Epidemiol Health. 2024;46:e2024065. Published online July 17, 2024; DOI: https://doi.org/10.4178/epih.e2024065

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Patients with kidney disease have been prioritized for coronavirus disease 2019 (COVID-19) vaccination due to their susceptibility to COVID-19 infection. However, little evidence exists regarding these patients’ vulnerability to COVID-19 post-vaccination. Thus, we evaluated the risk of COVID-19 in patients with kidney disease compared to individuals without kidney disease according to vaccination status.

METHODS

A retrospective cohort study was conducted using the Korean nationwide COVID-19 registry linked with National Health Insurance Service claims data (2018-2021). Among individuals aged 12 years or older, 2 separate cohorts were constructed: a COVID-19-vaccinated cohort and an unvaccinated cohort. Within each cohort, the risk of COVID-19 infection and all-cause mortality, hospitalization, and emergency room visits within 30 days of COVID-19 infection were compared between patients with and without kidney disease. To adjust for potential confounding, we used propensity score matching. Hazard ratios (HRs) for each outcome were estimated using a Cox proportional hazard model.

RESULTS

We identified 785,390 and 836,490 individuals in the vaccinated and unvaccinated cohorts, respectively. Compared to patients without kidney disease, patients with kidney disease were at a higher risk of COVID-19 infection in both the vaccinated cohort (HR, 1.08; 95% confidence interval [CI], 1.02 to 1.16) and the unvaccinated cohort (HR, 1.09; 95% CI, 0.99 to 1.20). Likewise, patients with kidney disease generally were at higher risk for severe clinical outcomes within 30 days of COVID-19 infection. Subgroup and sensitivity analyses showed generally consistent results.

CONCLUSIONS

Our study observed excess risk of COVID-19 in patients with kidney disease, highlighting the importance of ongoing attention to these patients even post-vaccination.

Summary

Korean summary
본 연구는 신장 질환이 없는 사람과 비교하여 신장 질환이 있는 환자의 COVID-19 위험을 백신 접종 여부에 따라 평가하였습니다. 백신 접종 여부와 상관없이 신장 질환이 있는 환자는 신장 질환이 없는 환자에 비해 코로나19 감염 및 코로나19 감염 이후 사망, 입원, 응급실 방문의 위험이 더 높았습니다. 즉, 이러한 연구 결과는 백신 접종 후에도 신장 질환이 있는 환자에 대한 코로나19에 대한 지속적인 주의가 필요함을 시사합니다.

Key Message
This study evaluated the risk of COVID-19 in patients with kidney disease compared to patients without kidney disease according to vaccination status. Compared to patients without kidney disease, patients with kidney disease were at a higher risk of COVID-19 infection and severe clinical outcomes after COVID-19 infection in both the vaccinated cohort and the unvaccinated cohort. These findings highlighted the importance of ongoing attention to these patients even post-vaccination.

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Kyoung-Hoon Kim
Journal of Korean Medical Science.2025;[Epub] CrossRef

Special Article

Nutrition survey methods and food composition database update of the Korean Genome and Epidemiology Study: Seon-Joo Park, Jieun Lyu, Kyoungho Lee, Hae-Jeung Lee, Hyun-Young Park; Epidemiol Health. 2024;46:e2024042. Published online April 2, 2024; DOI: https://doi.org/10.4178/epih.e2024042

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Abstract Summary PDF Supplementary Material

Abstract

This study presents the nutrition survey methods and the updated food composition database for the Korean Genome and Epidemiology Study (KoGES). The KoGES, which is the largest and longest cohort study in Korea, aims to identify genetic and environmental factors associated with chronic diseases. This study has collected dietary data using a validated semi-quantitative food frequency questionnaire and/or the 24-hour recall method. However, these dietary survey methods use different food composition databases, and their nutritional values are out of date. Therefore, it became necessary to update the food composition database by revising nutrient analysis values to reflect improvements in the performance of food ingredient analysis equipment, revising international values to analysis values of Korean agricultural products, adjusting nutrient units, and adding newly reported nutrients related to chronic diseases. For this purpose, we integrated the different food composition databases used in each nutrition survey, updated 23 nutrients, and expanded 48 new nutrients for 3,648 food items using the latest reliable food composition databases published by national and international institutions. This revised food composition database may help to clarify the relationship between various nutrients and chronic diseases. It could serve as a valuable resource for nutritional, epidemiological, and genomic research and provide a basis for determining public health policies.

Summary

Korean summary
한국인유전체역학조사사업은 우리나라에서 가장 크고 오래된 코호트로 만성질환과 영양과의 관련성을 밝히기 위하여 사용되고 있다. 이 논문에서는 영양조사에 대한 자세한 방법론과 현재 공개하고 있는 23개 영양소의 업데이트 및 48개 새로운 영양소의 확대에 대한 내용을 소개하였다. 이러한 개선을 통해 KoGES 영양 데이터의 활용도가 더욱 높아질 것으로 기대된다.

Key Message
The Korean Genome and Epidemiology Study (KoGES) is the largest and longest-running cohort study in South Korea aimed at identifying the relationship between chronic diseases and nutrient intake. This paper provides a detailed methods of the nutritional surveys and introduces updates to the existing 23 nutrients and the addition of 48 new nutrients. These enhancements are expected to significantly increase the utility of the KoGES nutritional data.

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COVID-19: Original Article

Public holidays increased the transmission of COVID-19 in Japan, 2020-2021: a mathematical modelling study: Jiaying Qiao, Hiroshi Nishiura; Epidemiol Health. 2024;46:e2024025. Published online January 22, 2024; DOI: https://doi.org/10.4178/epih.e2024025

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Although the role of specific holidays in modifying transmission dynamics of infectious diseases has received some research attention, the epidemiological impact of public holidays on the transmission of coronavirus disease 2019 (COVID-19) remains unclear.

METHODS

To assess the extent of increased transmission frequency during public holidays, we collected COVID-19 incidence and mobility data in Hokkaido, Tokyo, Aichi, and Osaka from February 15, 2020 to September 30, 2021. Models linking the estimated effective reproduction number (Rt) with raw or adjusted mobility, public holidays, and the state of emergency declaration were developed. The best-fit model included public holidays as an essential input variable, and was used to calculate counterfactuals of Rt in the absence of holidays.

RESULTS

During public holidays, on average, Rt increased by 5.71%, 3.19%, 4.84%, and 24.82% in Hokkaido, Tokyo, Aichi, and Osaka, respectively, resulting in a total increase of 580 (95% confidence interval [CI], 213 to 954), 2,209 (95% CI, 1,230 to 3,201), 1,086 (95% CI, 478 to 1,686), and 5,211 (95% CI, 4,554 to 5,867) cases that were attributable to the impact of public holidays.

CONCLUSIONS

Public holidays intensified the transmission of COVID-19, highlighting the importance of considering public holidays in designing appropriate public health and social measures in the future.

Summary

Key Message
• The number of COVID-19 cases increased during public holidays in Japan.
• The increase may have occurred because of elevated mobility rate and altered contact behaviours.
• The effect of holidays varied by prefecture in Japan.

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Soraya Abegail de Lima, Eduarda Pereira, Auriane Silva Lima Grígolo, Elis Carolina Pacheco, Camila Marinelli Martins, Erildo Vicente Muller, Eliseu Alves Waldman, Pollyanna Kássia de Oliveira Borges
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Special Article

Identification of acute myocardial infarction and stroke events using the National Health Insurance Service database in Korea: Minsung Cho, Hyeok-Hee Lee, Jang-Hyun Baek, Kyu Sun Yum, Min Kim, Jang-Whan Bae, Seung-Jun Lee, Byeong-Keuk Kim, Young Ah Kim, JiHyun Yang, Dong Wook Kim, Young Dae Kim, Haeyong Pak, Kyung Won Kim, Sohee Park, Seng Chan You, Hokyou Lee, Hyeon Chang Kim; Epidemiol Health. 2024;46:e2024001. Published online December 26, 2023; DOI: https://doi.org/10.4178/epih.e2024001

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Abstract Summary PDF

Abstract

OBJECTIVES
The escalating burden of cardiovascular disease (CVD) is a critical public health issue worldwide. CVD, especially acute myocardial infarction (AMI) and stroke, is the leading contributor to morbidity and mortality in Korea. We aimed to develop algorithms for identifying AMI and stroke events from the National Health Insurance Service (NHIS) database and validate these algorithms through medical record review.

METHODS

We first established a concept and definition of “hospitalization episode,” taking into account the unique features of health claims-based NHIS database. We then developed first and recurrent event identification algorithms, separately for AMI and stroke, to determine whether each hospitalization episode represents a true incident case of AMI or stroke. Finally, we assessed our algorithms’ accuracy by calculating their positive predictive values (PPVs) based on medical records of algorithm-identified events.

RESULTS

We developed identification algorithms for both AMI and stroke. To validate them, we conducted retrospective review of medical records for 3,140 algorithm-identified events (1,399 AMI and 1,741 stroke events) across 24 hospitals throughout Korea. The overall PPVs for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.

CONCLUSIONS

We successfully developed algorithms for identifying AMI and stroke events. The algorithms demonstrated high accuracy, with PPVs of approximately 90% for first events and 80% for recurrent events. These findings indicate that our algorithms hold promise as an instrumental tool for the consistent and reliable production of national CVD statistics in Korea.

Summary

Key Message
In this study, we developed algorithms to identify acute myocardial infarction (AMI) and stroke events from the Korean National Health insurance Service database. To validate them, we conducted retrospective review of medical records across 24 hospitals throughout Korea. The overall positive predictive values for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.

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Cardiovascular Risk Among Stroke Survivors With Combustible and Electronic Cigarettes: A Nationwide Study in Korean Men
Joonsang Yoo, Jimin Jeon, Minyoul Baik, Yun Young Choi, Jinkwon Kim
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Blood pressure status and risk of cardiovascular disease in older adults aged 75+ without prior cardiovascular events: a nationwide cohort study
Sangwon Choi, Kyung-Do Han, Kyung-Ho Yu, Byung-Chul Lee, Mi Sun Oh, Dae Young Cheon, Minwoo Lee
European Journal of Preventive Cardiology.2026;[Epub] CrossRef
Constipation and risk of death and cardiovascular events in patients on hemodialysis
Sang Cheol Park, Juyoung Jung, Young Eun Kwon, Song In Baeg, Dong-Jin Oh, Do Hyoung Kim, Young-Ki Lee, Hye Min Choi
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Incidence and case fatality of stroke in Korea, 2011-2020
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Epidemiology and Health.2023; 46: e2024003. CrossRef

COVID-19: Cohort Profile

Cohort profile: investigating SARS-CoV-2 infection and the health and psychosocial impact of the COVID-19 pandemic in the Canadian CHILD Cohort: Rilwan Azeez, Larisa Lotoski, Aimée Dubeau, Natalie Rodriguez, Myrtha E. Reyna, Tyler Freitas, Stephanie Goguen, Maria Medeleanu, Geoffrey L. Winsor, Fiona S. L. Brinkman, Emily E. Cameron, Leslie Roos, Elinor Simons, Theo J. Moraes, Piush J. Mandhane, Stuart E. Turvey, Shelly Bolotin, Kim Wright, Deborah McNeil, David M. Patrick, Jared Bullard, Marc-André Langlois, Corey R. Arnold, Yannick Galipeau, Martin Pelchat, Natasha Doucas, Padmaja Subbarao, Meghan B. Azad; Epidemiol Health. 2023;45:e2023091. Published online October 13, 2023; DOI: https://doi.org/10.4178/epih.e2023091

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Abstract

The coronavirus disease 2019 (COVID-19) pandemic has affected all Canadian families, with some impacted differently than others. Our study aims to: (1) determine the prevalence and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among Canadian families, (2) identify predictors of infection susceptibility and severity of SARS-CoV-2, and (3) identify health and psychosocial impacts of the COVID-19 pandemic. This study builds upon the CHILD Cohort Study, an ongoing multi-ethnic general population prospective cohort consisting of 3,454 Canadian families with children born in Vancouver, Edmonton, Manitoba, and Toronto between 2009 and 2012. During the pandemic, CHILD households were invited to participate in the CHILD COVID-19 Add-On Study involving: (1) brief biweekly surveys about COVID-19 symptoms and testing; (2) quarterly questionnaires assessing COVID-19 exposure and testing, vaccination status, physical and mental health, and pandemic-driven life changes; and (3) in-home biological sampling kits to collect blood and stool. In total, 1,462 households (5,378 participants) consented to the CHILD COVID-19 Add-On Study: 2,803 children (mean±standard deviation [SD], 9.0±2.7 years; range, 0-17 years) and 2,576 adults (mean±SD, 43.0±6.5 years; range, 18-85 years). We will leverage the wealth of pre-pandemic CHILD data to identify risk and resilience factors for susceptibility and severity to the direct and indirect pandemic effects. Our short-term findings will inform key stakeholders and knowledge users to shape current and future pandemic responses. Additionally, this study provides a unique resource to study the long-term impacts of the pandemic as the CHILD Cohort Study continues.

Summary

Key Message
· This study of 1,462 Canadian families (5,378 individuals) leverages a decade of extensive pre-pandemic CHILD Cohort Study data to identify risk and resilience factors for susceptibility to the direct and indirect effects of the COVID-19 pandemic. · Our short-term findings will inform key stakeholders and knowledge users to shape current and future pandemic responses. · This study provides a unique resource to study the long-term impacts of the pandemic as the CHILD Cohort Study continues.

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From fetus to 8: the CHILD Cohort Study
Kozeta Miliku, Myrtha E Reyna, Maria Medeleanu, Ruixue Dai, Aimee Dubeau, Diana L Lefebvre, Kim Wright, Bassel Dawod, Marshall Beck, Elissa Brooks, Michael Kobor, Qingling Duan, Jeffrey R Brook, Wendy Lou, Fiona S L Brinkman, Geoffrey L Winsor, Justin Coo
American Journal of Epidemiology.2025; 194(7): 1984. CrossRef

Original Article

Regional disparities in major cancer incidence in Korea, 1999-2018: Eun Hye Park, Mee Joo Kang, Kyu-Won Jung, Eun Hye Park, E Hwa Yun, Hye-Jin Kim, Hyun-Joo Kong, Chang Kyun Choi, Jeong-Soo Im, Hong Gwan Seo, The Community of Population-Based Regional Cancer Registries; Epidemiol Health. 2023;45:e2023089. Published online October 12, 2023; DOI: https://doi.org/10.4178/epih.e2023089

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Abstract

OBJECTIVES
This study investigated regional disparities in the incidence of 8 major cancers at the municipal level in Korea during 1999-2018 and evaluated the presence or absence of hot spots of cancer clusters during 2014-2018.

METHODS

The Korea National Cancer Incidence Database was used. Age-standardized incidence rates were calculated by gender and region at the municipal level for 4 periods of 5 years and 8 cancer types. Regional disparities were calculated as both absolute and relative measures. The possibility of clusters was examined using global Moran’s I with a spatial weight matrix based on adjacency or distance.

RESULTS

Regional disparities varied depending on cancer type and gender during the 20-year study period. For men, the regional disparities of stomach, colon and rectum, lung, and liver cancer declined, and those of thyroid and prostate cancer recently decreased, despite an overall increasing incidence. For women, regional disparities in stomach, colon and rectum, lung, liver, and cervical cancer declined, that of thyroid cancer recently decreased, despite an overall increasing incidence, and that of breast cancer steadily increased. In 2014-2018, breast cancer (I, 0.61; 95% confidence interval [CI], 0.53 to 0.70) showed a high probability of cancer clusters in women, and liver cancer (I, 0.48; 95% CI, 0.40 to 0.56) showed a high probability of cancer clusters in men.

CONCLUSIONS

Disparities in cancer incidence that were not seen at the national level were discovered at the municipal level. These results could provide important directions for planning and implementing local cancer policies.

Summary

Korean summary
이 연구는 한국 시군구 단위에서 지난 20년(1999-2018)간 주요 8개 암 발생률의 지역 간 격차를 조사하고, 최근 5년(2014-2018)의 암 발생 군집 가능성을 평가했습니다. 지역 간 격차는 여성에서 갑상선암, 남성에서는 폐암이 가장 큰 격차를 보였습니다. 군집 가능성은 여성의 경우 유방암, 남성의 경우 간암에서 가장 높았습니다. 전국 단위에서는 볼 수 없었던 지역 간 격차 및 군집 발생 가능성이 시군구 단위에서 발견되었고, 이러한 결과는 지역에 맞는 암 정책을 기획하고 실행하는 데 중요한 방향을 제시할 수 있을 것입니다.

Key Message
This study investigated regional disparities in the incidence of eight major cancers in Korea at the municipal level during 1999-2018 and assessed the possibility of cancer clusters during 2014-2018. Thyroid cancer in women and lung cancer in men showed the most significant regional disparities. Breast cancer in women and liver cancer in men displayed the highest possibility of clustering. Regional disparities and cancer clusters were identified locally, which were not detected nationally. These findings could provide valuable guidance for developing and implementing cancer policies that are tailored to local needs.

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Cohort Profile

Epidemiologic Questionnaire (EPI-Q) – a scalable, app-based health survey linked to electronic health record and genotype data: Maxwell Salvatore, Dylan Clark-Boucher, Lars G. Fritsche, Jacob Ortlieb, Janet Houghtby, Anisa Driscoll, Bryanne Caldwell-Larkins, Jennifer A. Smith, Chad M. Brummett, Sachin Kheterpal, Lynda Lisabeth, Bhramar Mukherjee; Epidemiol Health. 2023;45:e2023074. Published online August 8, 2023; DOI: https://doi.org/10.4178/epih.e2023074

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Abstract Summary PDF Supplementary Material: Abstract
The Epidemiologic Questionnaire (EPI-Q) was established to collect broad, uniform, self-reported health data to supplement electronic health record (EHR) and genotype information from participants in the University of Michigan (UM) Precision Health cohorts. Recruitment of EPI-Q participants, who were already enrolled in 1 of 3 ongoing UM Precision Health cohorts—the Michigan Genomics Initiative, Mental Health Biobank, and Metabolism, Endocrinology, and Diabetes cohorts—began in March 2020. Of 54,043 retrospective invitations, 5,577 individuals enrolled, representing a 10.3% response rate. Of these, 3,502 (63.7%) were female, and the average age was 56.1 years (standard deviation, 15.4). The baseline survey comprises 11 modules on topics including personal and family health history, lifestyle, and cancer screening and history. Additionally, 11 optional modules cover topics including financial toxicity, occupational exposure, and life meaning. The questions are based on standardized and validated instruments used in other cohorts, and we share resources to expedite development of similar surveys. Data are collected via the MyDataHelps platform, which enables current and future participants to share non-Michigan Medicine EHR data. Recruitment is ongoing. Cohort data are available to those with institutional review board approval; for details, contact the Data Office for Clinical and Translational Research (DataOffice@umich.edu).; Summary

Key Message
The Epidemiologic Questionnaire (EPI-Q) is an app-based, scalable health survey that collects broad, self-reported data to augment an electronic health record-linked biobank – the Michigan Genomics Initiative. Of an initial 54,043 invitations (recruitment is ongoing), 5,577 participants enrolled (10.3% response rate) and were invited to complete 11 baseline modules (including personal and family health history, lifestyle, and cancer screening and history) and 11 optional modules (including financial toxicity, occupational exposure, and life meaning). Questions are based on standardized and validated instruments used in other cohort studies and documentation is shared publicly to accelerate development of similar surveys.

Special Article

The Korea National Disability Registration System: Miso Kim, Wonyoung Jung, So Young Kim, Jong Hyock Park, Dong Wook Shin; Epidemiol Health. 2023;45:e2023053. Published online May 11, 2023; DOI: https://doi.org/10.4178/epih.e2023053

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Abstract Summary PDF Supplementary Material

Abstract

The Korea National Disability Registration System (KNDRS) was established in 1989 to provide social welfare benefits based on predefined criteria for disability registration and an objective medical assessment using a disability grading system. Disability registration requires (1) a medical examination by a qualified specialist physician and (2) a medical advisory meeting to review the degree of disability. Medical institutions and specialists for the diagnosis of disabilities are legally stipulated, and medical records for a specified period are required to support the diagnosis. The number of disability types has gradually expanded, and 15 disability types have been legally defined. As of 2021, 2.645 million people were registered as disabled, accounting for approximately 5.1% of the total population. Among the 15 disability types, disabilities of the extremities account for the largest proportion (45.1%). Previous studies have investigated the epidemiology of disabilities using data from the KNDRS, combined predominantly with data from the National Health Insurance Research Database (NHIRD). Korea has a mandatory public health insurance system that covers the entire Korean population, and the National Health Insurance Services manages all eligibility information, including disability types and severity ratings. In short, the KNDRS-NHIRD is a significant data resource for research on the epidemiology of disabilities.

Summary

Korean summary
한국에서는 장애의 유형과 장애 유형별 장애정도를 장애인 복지법에서 규정하고 있다. 우리는 한국의 장애등록제도의 역사와 장애등록절차 그리고 장애유형별 통계 현황에 대해서 다루고자 한다.

Key Message
In Korea, the types and severity levels of disabilities are legally defined by the Korea National Disability Registration System (KNDRS). We address the history of the KNDRS, disability registration procedures, and current statistics.

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Original Articles

Chronic obstructive pulmonary disease mortality trends in Spain, 1980-2020: Lucia Cayuela, José Luis López-Campos, Anna Michela Gaeta, Rocio Reinoso-Arija, Aurelio Cayuela; Epidemiol Health. 2023;45:e2023036. Published online March 18, 2023; DOI: https://doi.org/10.4178/epih.e2023036

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140 Download
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Abstract Summary PDF

Abstract

OBJECTIVES
In Spain, there has been a recent increase in the mortality rate for chronic obstructive pulmonary disease (COPD) in younger women. This study aimed to analyze trends in the COPD mortality rate in Spain from 1980 to 2020, evaluating any differences between genders and age groups.

METHODS

Death certificates and mid-year population data were obtained from the Spanish National Institute of Statistics. For both genders, age group-specific and standardized (overall and truncated) rates were calculated by the direct method using the world standard population. The data were analyzed using the joinpoint regression method.

RESULTS

In both men and women, the number of COPD deaths increased from 1980 to 1999 (average annual increase of 7% in men and 4% in women), while from 1999 onwards, deaths decreased by -1.0% per year in both genders. In women, there was a significant final period of increase in the 55-59 to 70-74 age groups and a slowing of the decline in the over 75 age group. Additionally, an increase in mortality for the truncated rates was observed for women between 2006 and 2020. In men under 70 years of age, there was an initial period in which death rates remained stable or significantly increased, followed by a period in which they decreased significantly.

CONCLUSIONS

Our study shows age and gender differences in COPD mortality trends in Spain. Although the data show a downward trend, we have identified a worrying increase in the truncated rates in women for the last few years.

Summary

Key Message
Currently, mortality trends for COPD in Spain shows age and gender differences. Although the data show an overall downward trend, we have identified a worrying increase in the truncated rates in women for the last few years. This could be representing the beginning of an epidemic increase in mortality from COPD in women. Consequently, strategies should be strengthened and promoted to prevent smoking in all its forms in the general population, as well as encourage proper cessation treatments.

Citations

Citations to this article as recorded by

Impact of Increased Single-Inhaler Triple Therapy Use in Appropriate Patients on Chronic Obstructive Pulmonary Disease Exacerbations, Mortality, and Medical Costs: PROMETHEUS Spain
Marta Marín-Oto, Jorge Mestre-Ferrándiz, Joaquín Sánchez-Covisa, Carmen Corregidor García, Néstor Martínez-Martínez, John Bell, Melissa Caplen, Prachi D. Bhatt, Jennifer Carioto, Bruce Pyenson
Respiration.2025; : 1. CrossRef

Perceived usefulness of COVID-19 tools for contact tracing among contact tracers in Korea: Seonyeong Gong, Jong Youn Moon, Jaehun Jung; Epidemiol Health. 2022;44:e2022106. Published online November 15, 2022; DOI: https://doi.org/10.4178/epih.e2022106

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
In Korea, contact tracing for coronavirus disease 2019 is conducted using information from credit card records, handwritten visitor logs, KI-Pass (QR code), and the Safe Call system after an interview. We investigated the usefulness of these tools for contact tracing.

METHODS

An anonymous survey was conducted for 2 months (July to September 2021) among contact tracers throughout Korea. The questionnaire consisted of 4 parts: (1) demographic characteristics; (2) the usefulness of each tool for contact tracing; (3) the order in which information was checked during contact tracing; and (4) the match rate between tools for contact tracing, screening test rate, response rate, and helpfulness (rated on a Likert scale).

RESULTS

In total, 190 individuals completed the survey. When asked to rate the usefulness of each tool for contact tracing on a Likert scale, most respondents (86.3%) provided positive responses for credit card records, while the most common responses for handwritten visitor logs were negative. The highest percentage of positive responses for helpfulness was found for KI-Pass (91.1%), followed in descending order by credit card records (82.6%), Safe Call (78.2%), and handwritten visitor logs (22.1%).

CONCLUSIONS

Over 80% of participants provided positive responses for credit card records, KI-Pass, and Safe Call data, while approximately 50% provided negative responses regarding the usefulness of handwritten visitor logs. Our findings highlight the need to unify systems for post-interview contact tracing to increase their convenience for contact tracers, as well as the need to improve tools utilizing handwritten visitor logs for digitally vulnerable groups.

Summary

Korean summary
본 연구는 국내 역학조사 담당자들을 대상으로 시행한 설문조사를 중심으로 면담조사 후 추가적으로 실시하는 다양한 접촉자 추적 방법의 유용성에 대한 분석을 목표로 한다. 응답자 중 약 80% 이상이 카드결제기록, KI-Pass, GPS 및 CCTV 정보의 유용성에 대해 긍정적으로 응답하였다. 반면 약 50%는 수기명부의 유용성에 대해 부정적으로 응답하였다. 본 연구의 결과는 역학조사관과 사용자 모두의 편의를 위해 역학조사 방법의 일원화가 필요할 뿐만 아니라 디지털 취약 계층을 위해 수기명부를 대체할 수 있는 시스템의 필요성을 시사한다.

Key Message
We conducted an anonymous online survey to assess the usefulness of tools for contact tracing for COVID-19 in Korea. Over 80% of participants provided positive responses regarding the usefulness of credit card records, KI-Pass, and Safe Call data, while approximately 50% provided negative responses regarding the usefulness of handwritten visitor logs. Our findings highlight the need to unify contact tracing systems to increase their convenience for contact tracers.

Citations

Citations to this article as recorded by

Post-COVID, Digital Societies: Opportunities and Policy Challenges for Human Security in the United Kingdom and South Korea
Minjun Hong, Matthew Lariviere, Kilkon Ko
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Danielle Guy, Petya Kodjamanova, Lena Woldmann, Jyoti Sahota, Melanie Bannister-Tyrrell, Yajna Elouard, Marie-Amélie Degail, Bashar Haruna Gulumbe
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COVID-19: Epidemiologic Investigation

Analysis of the on-ship transmission of the COVID-19 mass outbreak on the Republic of Korea Navy amphibious warfare ship: Soo Hyeon Cho, Young-Man Kim, Gyeongyong Seong, Sunkyun Park, Seoncheol Park, Sang-Eun Lee, Young Joon Park; Epidemiol Health. 2022;44:e2022065. Published online August 11, 2022; DOI: https://doi.org/10.4178/epih.e2022065

17,923 View
447 Download
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1 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This investigation was conducted to determine the size and pattern, source, and transmission route of the coronavirus disease 2019 (COVID-19) outbreak on the Republic of Korea Navy (ROKN) amphibious warfare ship.

METHODS

We investigated the characteristics of all crew members and tracked the medical records of the confirmed cases. Fourteen essential ship operation personnel were interviewed. The study design was a retrospective cohort study, and the incidence rate ratio was through a statistical program.

RESULTS

The COVID-19 incidence on the ROKN amphibious warfare ship was 44.7% (38/85). It was estimated that the main propagation route started from the 1st floor worker, which spread to the same floor, and then to other floors. In the case of the working area, the incidence rate of crew members below the 1st floor without ventilation was higher than those on the 2nd or higher floors with natural ventilation.

CONCLUSIONS

This case is the first case of a COVID-19 outbreak on the ROKN amphibious warfare ship, and it is estimated that the incidence rate is high because of the closed and dense environment. To prevent the spread of various respiratory diseases including COVID-19, unified mitigation such as vaccination, observing personal quarantine rules, periodic ventilation, preemptive testing, and blocking transmission through prompt contact management is necessary.

Summary

Korean summary
본 조사는 국내 첫 해군 상륙함 내 코로나19 집단발생의 규모 및 양상, 감염원과 전파경로를 규명하기 위해 수행되었다. 해군 상륙함에서의 발생률은 44.7%였으며 자연 환기가 가능한 2층 이상 근무자에 비해 환기가 불가능한 1층 이하 근무자의 발생률이 높았고 이는 통계적으로 유의했다. 밀폐된 환경에서 밀접한 생활을 하는 해군 상륙함의 특성을 고려하여 개인방역수칙 준수, 주기적 환기, 선제적 검사, 신속한 접촉자 관리 등을 통한 전파 차단이 필요할 것으로 판단된다.

Key Message
This investigation was conducted to determine the size and pattern of the outbreak of the COVID-19 infection, the source of infection and the transmission route on the ROK Navy Amphibious Warfare ship. The incidence on ROKN Amphibious Warfare ship was 44.7% (38/85) and the incidence rate of crew members below the first floor without ventilation was higher than those on the second floor or higher with natural ventilation. To prevent various respiratory diseases including COVID-19, unified mitigation such as vaccination, observing personal quarantine rules, periodic ventilation, preemptive testing, and blocking transmission through prompt contact management is necessary.

Citations

Citations to this article as recorded by

Indoor Air Quality and COVID-19: A Scoping Review
Axelle Braggion, Adeline Dugerdil, Olwen Wilson, Francesca Hovagemyan, Antoine Flahault
Public Health Reviews.2024;[Epub] CrossRef

Review

Epidemiology of myocardial infarction in Korea: hospitalization incidence, prevalence, and mortality: Rock Bum Kim, Jang-Rak Kim, Jin Yong Hwang; Epidemiol Health. 2022;44:e2022057. Published online July 12, 2022; DOI: https://doi.org/10.4178/epih.e2022057

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Abstract Summary PDF

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.

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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Original Articles

Effect modification of consecutive high concentration days on the association between fine particulate matter and mortality: a multi-city study in Korea: Hyungryul Lim, Sanghyuk Bae, Jonghyuk Choi, Kyung-Hwa Choi, Hyun-Joo Bae, Soontae Kim, Mina Ha, Ho-Jang Kwon; Epidemiol Health. 2022;44:e2022052. Published online June 9, 2022; DOI: https://doi.org/10.4178/epih.e2022052

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Although there is substantial evidence for the short-term effect of fine particulate matter (PM2.5) on daily mortality, few epidemiological studies have explored the effect of prolonged continuous exposure to high concentrations of PM2.5. This study investigated how the magnitude of the mortality effect of PM2.5 exposure is modified by persistent exposure to high PM2.5 concentrations.

METHODS

We analyzed data on the daily mortality count, simulated daily PM2.5 level, mean daily temperature, and relative humidity level from 7 metropolitan cities from 2006 to 2019. Generalized additive models (GAMs) with quasi-Poisson distribution and random-effects meta-analyses were used to pool city-specific effects. To investigate the effect modification of continuous exposure to prolonged high concentrations, we applied categorical consecutive-day variables to the GAMs as effect modification terms for PM2.5.

RESULTS

The mortality risk increased by 0.33% (95% confidence interval [CI], 0.16 to 0.50), 0.47% (95% CI, -0.09 to 1.04), and 0.26% (95% CI, -0.08 to 0.60) for all-cause, respiratory, and cardiovascular diseases, respectively, with a 10 μg/m3 increase in PM2.5 concentration. The risk of all-cause mortality per 10 μg/m3 increase in PM2.5 on the first and fourth consecutive days significantly increased by 0.63% (95% CI, 0.20 to 1.06) and 0.36% (95% CI, 0.01 to 0.70), respectively.

CONCLUSIONS

We found increased risks of all-cause, respiratory, and cardiovascular mortality related to daily PM2.5 exposure on the day when exposure to high PM2.5 concentrations began and when exposure persisted for more than 4 days with concentrations of ≥35 μg/m3. Persistently high PM2.5 exposure had a stronger effect on seniors.

Summary

Korean summary
한국의 7개 대도시를 배경으로 수행한 본 시계열 연구를 통하여 2006년부터 2019년까지의 기간 동안에 초미세먼지의 단기 노출이 일별 사망률을 증가시키며, 교호작용모형을 통해 일평균 35 μg/m3 이상의 고농도 지속기간이 처음 시작되는 날과 넷째 지속일에 이러한 사망효과가 커짐을 보고하였다. 이러한 고농도 지속기간의 교호작용은 65세 이상 연령군에서 더욱 두드러졌다.

Key Message
With our Korean multi-city study design from 2006 to 2019, the short-term effects of PM2.5 on mortality were greater when the high PM2.5 concentration duration began during the day and lasted for approximately 4 days, and the elderly may be more affected by persistently high PM2.5.

Citations

Citations to this article as recorded by

Estimating Health and Economic Benefits from PM2.5 Reduction in Fishery-Based Communities: A Sector-Specific Approach to Sustainable Air Quality Management in the Philippines
James Roy Lesidan, Nadine Grace Caido, Oliver Semblante, Floro Junior Roque, Jejomar Bulan, Jumar Cadondon, Maria Cecilia Galvez, Edgar Vallar
Sustainability.2025; 17(3): 1316. CrossRef

Gender differences in under-reporting hiring discrimination in Korea: a machine learning approach: Jaehong Yoon, Ji-Hwan Kim, Yeonseung Chung, Jinsu Park, Glorian Sorensen, Seung-Sup Kim; Epidemiol Health. 2021;43:e2021099. Published online November 17, 2021; DOI: https://doi.org/10.4178/epih.e2021099

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study was conducted to examine gender differences in under-reporting hiring discrimination by building a prediction model for workers who responded “not applicable (NA)” to a question about hiring discrimination despite being eligible to answer.

METHODS

Using data from 3,576 wage workers in the seventh wave (2004) of the Korea Labor and Income Panel Study, we trained and tested 9 machine learning algorithms using “yes” or “no” responses regarding the lifetime experience of hiring discrimination. We then applied the best-performing model to estimate the prevalence of experiencing hiring discrimination among those who answered “NA.” Under-reporting of hiring discrimination was calculated by comparing the prevalence of hiring discrimination between the “yes” or “no” group and the “NA” group.

RESULTS

Based on the predictions from the random forest model, we found that 58.8% of the “NA” group were predicted to have experienced hiring discrimination, while 19.7% of the “yes” or “no” group reported hiring discrimination. Among the “NA” group, the predicted prevalence of hiring discrimination for men and women was 45.3% and 84.8%, respectively.

CONCLUSIONS

This study introduces a methodological strategy for epidemiologic studies to address the under-reporting of discrimination by applying machine learning algorithms.

Summary

Korean summary
본 연구는 한국노동패널조사(7차년도)에 포함된 3576명의 임금근로자의 자료를 이용해 성별에 따른 구직 과정 경험한 차별에 대한 과소보고의 규모를 확인하고자 하였다. 질문에 “예” 또는 “아니요”라고 응답한 임금근로자 3479명 데이터를 이용하여 고용 시 차별경험을 예측하는 머신러닝 모형을 구축하였고, 이를 활용해 이미 직장에서 일하고 있는 상태임에도 “해당사항 없음”이라고 응답한 임금근로자 97명이 차별을 경험했는지 여부를 예측하였다. 분석결과, “해당사항 없음”이라고 답한남성 근로자 64명 중 29명(45.3%), 여성 근로자 33명 중 28명(84.8%)가 실제로 차별을 경험한 것으로 추정되었다.

Key Message
We examined gender differences in under-reporting hiring discrimination for wage workers who responded “not applicable(NA)” to a question about hiring discrimination despite being eligible to answer “yes” or “no.” Using data from 3,576 wage workers of the Korea Labor and Income Panel Study, we estimated the prevalence of hiring discrimination among those who answered “NA,” based on the best-performing machine learning prediction model for “yes” or “no” group. Among the “NA” group, the predicted prevalence of hiring discrimination for men and women was 45.3% and 84.8%, respectively.

Citations

Citations to this article as recorded by

Perceived gender discrimination in the workplace and onset of depressive symptoms in women: A population-based longitudinal analysis in South Korea
Seong-Uk Baek, Jin-Ha Yoon
Journal of Psychiatric Research.2025; 181: 689. CrossRef
The unmet need for mental health support among persons with disabilities in Somalia: Principal correlates and barriers to access
Charles Zemp, Frédérique Vallières, Mohamed Abdul Jama, Abdifatah Hassan Ali, Kirsten Young, Caroline Jagoe
Cambridge Prisms: Global Mental Health.2024;[Epub] CrossRef

Joint association of aerobic physical activity and muscle-strengthening activities with metabolic syndrome : the Korean National Health and Nutrition Examination Survey 2014-2015: Jungjun Lim, Soyoung Park, Joon-Sik Kim; Epidemiol Health. 2021;43:e2021096. Published online November 6, 2021; DOI: https://doi.org/10.4178/epih.e2021096

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Abstract Summary PDF

Abstract

OBJECTIVES
The study aimed to examine whether simultaneously meeting the combined guidelines of accelerometer-assessed moderate to vigorous physical activity (MVPA) and self-reported muscle-strengthening activity (MSA) was associated with lower odds of metabolic syndrome (MetS) than meeting neither or 1 of the guidelines among the Koreans.

METHODS

This cross-sectional analysis included 1,355 participants from the Korea National Health and Nutrition Examination Survey (2014-2015). Logistic regression was used to analyze the associations across groups of MVPA-MSA guideline adherence (meeting neither [reference]; meeting MVPA only; meeting MSA only; meeting both MVPS and MSA) with MetS components (abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol [HDL-C], hypertension, and hyperglycemia). The odds ratios (ORs) were adjusted for covariates (e.g., sex, age, body mass index, and accelerometer wearing time).

RESULTS

MSA only significantly reduced the OR for abdominal obesity (OR, 0.34; 95% confidence interval [CI], 0.13 to 0.91). Meeting both MVPA and MSA reduced the OR for hypertriglyceridemia (OR, 0.59; 95% CI, 0.39 to 0.88) and low HDL-C (OR, 0.46; 95% CI, 0.31 to 0.68). Compared to meeting neither, MVPA only (OR, 0.63; 95% CI, 0.44 to 0.89) and both MVPA and MSA (OR, 0.46; 95% CI, 0.28 to 0.76) significantly reduced the OR for MetS.

CONCLUSIONS

Combined MVPA-MSA was more beneficially associated with MetS prevalence than MVPA only and MSA only. Considering that more than 85% of Korean adults do not meet both the MVPA and MSA guidelines, public health actions to promote adherence should be supported.

Summary

Korean summary
본 연구는 2014-2015 국민건강영양조사 자료의 가속도계 자료와 신체활동 설문지를 활용하여 한국 성인의 유산소 신체활동과 근력강화운동 지침 충족 여부에 따른 대사증후군의 오즈비를 확인하였다. 그 결과, 유산소 신체활동과 근력강화운동 지침을 모두 충족한 한국 성인은 둘 중 하나의 지침만을 충족하거나, 모두 충족하지 않는 성인에 비해 더 낮은 오즈비를 나타내었다.

Key Message
In this study, the 2014-2015 Korean National Health and Nutrition Examination Survey data, the odds ratio of metabolic syndrome was confirmed according to the guidelines for aerobic physical activities and muscle-strengthening activities were met in Korean adults. As a result, Korean adults who met both the guidelines for aerobic physical activity and muscle-strengthening activities showed a lower odds ratio than adults who met only one of the guidelines or did not meet both guidelines.

Citations

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Does Physical Activity or Sedentary Behavior Moderate the Association of Smoking Consumption With All-Cause and Cardiovascular Disease Mortality?
Yang Hei, Younghwan Choi, Yeon Soo Kim
Journal of Physical Activity and Health.2025; : 1. CrossRef
Association Between Frequency of Muscle-Strengthening Exercise and Depression Symptoms Among Middle and High School Students: Cross-Sectional Survey Study
Hao Wang, Huaidong Du, Yunqi Guan, Jieming Zhong, Na Li, Jin Pan, Min Yu
JMIR Public Health and Surveillance.2024; 10: e50996. CrossRef
The effect of Tabata-style functional high-intensity interval training on cardiometabolic health and physical activity in female university students
Yining Lu, Huw D. Wiltshire, Julien Steven Baker, Qiaojun Wang, Shanshan Ying
Frontiers in Physiology.2023;[Epub] CrossRef
Association of Aerobic and Muscle-strengthening Activities with AIP in Korean Adults: Korea National Health and Nutrition Examination Survey 2014-2019
Jungjun Lim, Yang Hei, Yeonsoo Kim
Journal of Korean Association of Physical Education and Sport for Girls and Women.2022; 36(3): 245. CrossRef
Current status of health promotion in Korea
Soo Young Kim
Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef
Aerobic or Muscle-Strengthening Physical Activity: Which Is Better for Health?
Angelique G. Brellenthin, Jason A. Bennie, Duck-chul Lee
Current Sports Medicine Reports.2022; 21(8): 272. CrossRef

Epidemiology and treatment status of hepatitis C virus infection among people who have ever injected drugs in Korea: a prospective multicenter cohort study from 2007 to 2019 in comparison with non-PWID: Kyung-Ah Kim, Gwang Hyun Choi, Eun Sun Jang, Young Seok Kim, Youn Jae Lee, In Hee Kim, Sung Bum Cho, Moran Ki, Hwa Young Choi, Dahye Paik, Sook-Hyang Jeong; Epidemiol Health. 2021;43:e2021077. Published online October 6, 2021; DOI: https://doi.org/10.4178/epih.e2021077

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Abstract Summary PDF

Abstract

OBJECTIVES
Injection drug use is a major risk factor for hepatitis C virus (HCV) infection; however, limited data on this topic are available in Korea. Thus, this study aimed to investigate the epidemiological and clinical characteristics, treatment uptake, and outcomes of HCV infection among people who inject drugs (PWID).

METHODS

We used the data from the Korea HCV cohort, which prospectively enrolled patients with HCV infection between 2007 and 2019. Clinical data and results of a questionnaire survey on lifetime risk factors for HCV infection were analyzed according to a self-reported history of injection drug use (PWID vs. non-PWID group).

RESULTS

Among the 2,468 patients, 166 (6.7%) were in the PWID group, which contained younger patients (50.6±8.2 vs. 58.2±13.1 years) and a higher proportion of male (81.9 vs. 48.8%) than the non-PWID group. The distribution of PWID showed significant regional variations. Exposure to other risk factors for HCV infection was different between the groups. The proportion of patients with genotype non-2 infection was higher in the PWID group. Treatment uptake was higher in the PWID group in the interferon era; however, it was comparable between the groups in the direct-acting antiviral era. The rate of sustained virological response did not significantly differ between the groups.

CONCLUSIONS

As of 2019, PWID constituted a minority of HCV-infected people in Korea. The epidemiological characteristics, but not treatment uptake and outcomes, were different between the PWID and non-PWID groups. Therefore, active HCV screening and treatment should be offered to PWID in Korea.

Summary

Korean summary
1. 국내 C형간염 환자 중 정맥주사 사용자의 비율은 6.7%로 서구에 비하면 낮은 편이며, 지역별로 차이가 있다. 2. C형간염 환자 중 정맥주사 사용자는 비사용자에 비하여 연령, 성별 및 C형간염 위험 요인 노출 등에서 상이한 역학적 특성을 보인다. 3. 정맥주사 사용자의 C형간염 치료 수용률이나 치료 성공률은 비사용자와 비슷하다.

Key Message
As of 2019, PWID comprised a minority (6.7%) of all HCV-infected people in South Korea. The epidemiological features of the PWID group were different from those of the non-PWID group in terms of age, sex and exposure to risk factors of HCV infection. However, the treatment uptake and outcomes were not significantly different between these 2 groups in DAA era. Therefore, considering the global and national increase in the number of PWID and the contribution of PWID to new cases of HCV infection, active screening and treatment should be offered to PWID in Korea.

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2025 KASL clinical practice guidelines for management of hepatitis C
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Clinical and Molecular Hepatology.2026; 32(1): 1. CrossRef
Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
Hwa Young Choi, Kyung-Ah Kim, Bo Young Park, Bo Youl Choi, Moran Ki
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한국 마약류 사용자의 C형 간염 현황
광현 최, 영훈 천, 도훈 권, 성남 조, 옥진 장, 다혜 백, 은선 장, 민경 박, 외욱 정, 민진 고, 정연 김, 숙향 정
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Scientific Reports.2023;[Epub] CrossRef
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Words are not just words: how the use of media language in the COVID-19 era affects public health: Georgios P. Georgiou; Epidemiol Health. 2021;43:e2021072. Published online September 23, 2021; DOI: https://doi.org/10.4178/epih.e2021072

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Abstract Summary PDF

Abstract

OBJECTIVES
Language can shape the way we perceive the world. In this paper, we investigated how exposure to media texts containing alarming and militaristic language affects peoples’ notions regarding coronavirus disease 2019 (COVID-19) and the consequences of this effect for public health.

METHODS

After reading a passage including either alarming and militaristic or neutral terminology on COVID-19, participants completed a questionnaire in which they answered 4 questions on a 7-point Likert scale. The questions assessed participants’ notions on the end of the pandemic, vaccine effectiveness, and the consequences of COVID-19 for economies and mental health. Ordinal regression models in R were used for the analysis.

RESULTS

Individuals who were exposed to alarming and militaristic language expressed more pessimistic notions regarding COVID-19 than those who were exposed to more neutral language. However, both groups of individuals had similar notions regarding vaccine effectiveness.

CONCLUSIONS

The media should redefine the language they use for the description of the pandemic, considering that the extensive use of alarming and militaristic terminology may have a negative impact on public health.

Summary

Key Message
This study shows that exposure to alarming and militaristic terminology creates pessimistic notions about COVID-19. The media should avoid the extensive use of such terminology for the description of the pandemic, as this can negatively affect public health.

Citations

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Examining the association between the COVID-19 pandemic and self-harm death counts in four Canadian provinces
Shelly Isnar, Mark Oremus
Psychiatry Research.2022; 310: 114433. CrossRef
How Has COVID-19 Impacted Our Language Use?
Francesca Pisano, Alessio Manfredini, Daniela Brachi, Luana Landi, Lucia Sorrentino, Marianna Bottone, Chiara Incoccia, Paola Marangolo
International Journal of Environmental Research and Public Health.2022; 19(21): 13836. CrossRef

Data Profile

Data resource profile: the Korea National Hospital Discharge In-depth Injury Survey: Yeon-Kyeng Lee, Sung Ok Hong, Soo-Jung Park, Mijin Park, Kyunghae Wang, Mini Jo, Jeongah Oh, Sin Ae Lee, Hyeon Ju Lee, Jungeun Oh, Dosang Lim, Sanghui Kweon, Youngtaek Kim; Epidemiol Health. 2021;43:e2021052. Published online August 17, 2021; DOI: https://doi.org/10.4178/epih.e2021052

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Abstract

The Korea National Hospital Discharge In-depth Injury Survey (KNHDIS), which was started in 2005, is a national probability survey of general hospitals in Korea with 100 or more beds conducted by the Korea Disease Control and Prevention Agency (KDCA). The KNHDIS captures approximately 9% of discharged cases from sampled hospitals using a 2-stage stratified cluster sampling scheme, among which 13% are injury related cases, defined as S00-T98 (injury, poisoning, and certain other consequences of external causes) using International Classification of Diseases, 10th revision codes. The KNHDIS collects information on characteristics of injury-related discharges in order to understand the scale of injuries, identify risk factors, and provide data supporting prevention policies and intervention strategies. The types of data captured include the hospitals’ information, detailed clinical information, and injury-related codes such as the mechanism, activities undertaken when injured (sports, leisure activities, work, treatment, and education), external causes of the injury, and location of the occurrence of the injury based on the International Classification of External Causes of Injuries. Furthermore, the means of transportation, risk factors for suicide, and toxic substances are recoreded. Annual reports of the KNHDIS are publicly accessible to browse via the KDCA website (http://www.kdca.go.kr) and microdata are available free of charge upon request via email (kcdcinjury@korea.kr).

Summary

Korean summary
퇴원손상심층조사는 손상발생 규모 및 손상 퇴원환자의 발생 추이를 파악하고자 2005년 도입된국가 단위 통계를 산출하는 표본 조사 사업이다. 본 연구는 퇴원손상심층조사의 표본설계, 조사방법, 조사항목과 함께 그간의 조사결과의 활용도 등 성과에 대해 살펴보았다. 조사결과는 국가 손상예방관리를 위한 기초자료로 활용되고 있으며, 조사 원자료는 공개하고 있다.

Key Message
The Korea National Hospital Discharge In-depth Injury Survey (KNHDIS), started in 2005, is a national probability survey of general hospitals in Korea with 100 or more beds conducted by the Korea Disease Control and Prevention Agency. The KNHDIS collects information on characteristics of injury-related discharges to understand the scale of injuries, identify risk factors, and provide data supporting prevention policies. The data captured including the hospitals’ information, and injury-related codes based on the International Classification of External Causes of Injuries. Annual reports of the KNHDIS are publicly accessible from KDCA website and microdata are available upon request via email.

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The Gender Distribution and Association between Sociodemographic Factors and Hospital-Presenting Self-Injury: Analysis from the Korea National Hospital Discharge In-Depth Injury Survey
Meekang Sung, S. V. Subramanian, Rockli Kim
Archives of Suicide Research.2025; : 1. CrossRef
Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data
Hyun-Ju Seo, Soon-Ki Ahn, Min-Jung Choi
BMJ Open.2024; 14(4): e081549. CrossRef
Assessing Trends in Hospitalizations for Breast Cancer among Women in Korea: A Utilization of the Korea National Hospital Discharge In-depth Injury Survey (2006–2020)
Jieun Hwang, Jeong-Hoon Jang
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Mortality and Discharge Outcome in Acute Myocardial Infarction Patients: A Study Based on Korean National Hospital Discharge In-Depth Injury Survey Data
Jieun Hwang, Kyunghee Lee
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Injury.2023; 54(3): 896. CrossRef
Area-Level Socioeconomic Inequalities in Intracranial Injury-Related Hospitalization in Korea: A Retrospective Analysis of Data From Korea National Hospital Discharge Survey 2008–2015
Hang A Park, Federico E. Vaca, Kyunghee Jung-Choi, Hyesook Park, Ju Ok Park
Journal of Korean Medical Science.2023;[Epub] CrossRef
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Estimated trends in hospitalizations due to occupational injuries in Korea based on the Korean National Hospital Discharge In-depth Injury Survey (2006-2019)
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Original Articles

Epidemiological distribution of primary central nervous system tumors in the Western Province of Saudi Arabia: a local registry from neuroscience-affiliated centers: Maher Kurdi, Nadeem Shafique Butt, Saleh Baeesa, Badrah Alghamdi, Yazid Maghrabi, Anas Bardeesi, Rothaina Saeedi, Ahmed I. Lary; Epidemiol Health. 2021;43:e2021037. Published online May 23, 2021; DOI: https://doi.org/10.4178/epih.e2021037

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368 Download
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Abstract Summary PDF

Abstract

OBJECTIVES
Central nervous system (CNS) tumors are a major and growing global healthcare challenge. Western Saudi Arabia has an inconsistent data registry; therefore, the epidemiology of CNS tumors is unclear across the country. This study is aimed to assemble the epidemiological matrix of CNS tumors in the Western Province of Saudi Arabia.

METHODS

A retrospective analysis was performed using clinical data obtained from 3 neuroscience centers in Western Saudi Arabia in the period 2014-2019. The sample size included 663 adult and pediatric cases from the local and expatriate populations diagnosed with CNS tumors. The distributions of age, sex, clinical presentation, tumor location, type of surgery, histological subtype, genetic characteristics, and recurrence rate were explored.

RESULTS

The analysis included 500 adult cases and 163 pediatric cases up to 18 years of age with a male-to-female ratio of 1.16. The mean age at diagnosis was 38.0±22.6 years. The supratentorium was the most common location (n=515, 77.7%). Most patients presented with headache (n=298, 44.9%), followed by a focal neurological deficit (19.9%). The most common primary CNS tumor was glioblastoma (n=234, 35.3%), followed by meningioma (n=100, 15.1%). The recurrence rate after surgery was estimated to be 40.9% among all CNS tumors.

CONCLUSIONS

This is the first tumor registry of Western Province of Saudi Arabia that describes the distribution of primary CNS tumors and highlights their epidemiological matrix. Several incidence trends in terms of histological type, age group, sex, location, and recurrence were determined, and some genetic characteristics were recognized.

Summary

Key Message
Incidence, prevalence and the recurrence of CNS tumors vary according to histological type, age at diagnosis, sex, and available treatments. Further research should be performed to identify potential risk factors for CNS tumors in Saudi Arabia. Genome technology provides an opportunity to relate incidence rates with risk factors.

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Clinical Oncology.2025; 38: 103741. CrossRef
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Maysa Al-Hussaini, Abdallah Al-Ani, Justin Z. Amarin, Sarah Al Sharie, Mouness Obeidat, Awni Musharbash, Amer A. Al Shurbaji, Ahmad Kh. Ibrahimi, Abdellatif Al-Mousa, Nasim Sarhan, Nisreen Amayiri, Rula Amarin, Tala Alawabdeh, Qasem Alzoubi, Dima Abu Laba
Cancers.2025; 17(4): 590. CrossRef
Epidemiology and Anatomical Distribution of Primary Brain Tumors Among Children in Palestine: A 6-Year National Referral Institution Study
Ahmad Rjoub, Wafaa Abu Zahra, Noor Issa, Yazan Dumaidi, Mohammad Abuawad, Ahmed Daqour, Abdulsalam Alkaiyat, Shahed Nasser
World Neurosurgery.2024; 186: e470. CrossRef
Epidemiology of primary brain tumor among adolescents and adults in Palestine: a retrospective study from 2018 to 2023
Mohammad Abuawad, Ahmed Daqour, Abdulsalam Alkaiyat, Ahmad Rjoub, Wafaa Abu Zahra, Noor Issa, Yazan Dumaidi, Shahed Nasser
BMC Neurology.2024;[Epub] CrossRef
Nuclear Factor-Kappa B in Gliomas as a Predictive Factor for Tumor Recurrence – A Clinicopathological Study
Basant H. Sayed, Samia M. Gabal, Ahmed M. Abdalaziz, Dalia Abd El-Kareem
Open Access Macedonian Journal of Medical Sciences.2023; 11(A): 221. CrossRef
Epidemiological Trends in Childhood Cancer in Saudi Arabia
Nazim Faisal Hamid, Fayez Muawwadh Albalawi, Abdulrahman Abdullah Aloufi, Rawapy Ali Hamas, Nasser Awadh H Alanazi, Tariq Hulayyil Alanazi
Clinical Cancer Investigation Journal.2022; 11(5): 42. CrossRef

Inherently high uncertainty in predicting the time evolution of epidemics: Seung-Nam Park, Hyong-Ha Kim, Kyoung Beom Lee; Epidemiol Health. 2021;43:e2021014. Published online February 8, 2021; DOI: https://doi.org/10.4178/epih.e2021014

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Abstract Summary PDF

Abstract

OBJECTIVES
Amid the spread of coronavirus disease 2019 (COVID-19), with its high infectivity, we have relied on mathematical models to predict the temporal evolution of the disease. This paper aims to show that, due to active behavioral changes of individuals and the inherent nature of infectious diseases, it is complicated and challenging to predict the temporal evolution of epidemics.

METHODS

A modified susceptible-exposed-infectious-hospitalized-removed (SEIHR) compartment model with a discrete feedback-controlled transmission rate was proposed to incorporate individuals’ behavioral changes into the model. To figure out relative uncertainties in the infection peak time and the fraction of the infected population at the peak, a deterministic method and 2 stochastic methods were applied.

RESULTS

A relatively small behavioral change of individuals with a feedback constant of 0.02 in the modified SEIHR model resulted in a peak time delay of up to 50% using the deterministic method. Incorporating stochastic methods into the modified model with a feedback constant of 0.04 suggested that the relative random uncertainty of the maximum fraction of infections and that of the peak time for a population of 1 million reached 29% and 9%, respectively. Even without feedback, the relative uncertainty of the peak time increased by up to 20% for a population of 100,000.

CONCLUSIONS

It is shown that uncertainty originates from stochastic properties of infections. Without a proper selection of the evolution scenario, active behavioral changes of individuals could serve as an additional source of uncertainty.

Summary

Korean summary
이 논문은 감염병에 대응하는 개인의 능동적 행동 변화와 감염병의 고유한 특성 때문에 그 진행을 예측하는 것은 복잡하고 도전적인 작업이라는 것을 보이기 위한 것이다. 이런 행동 변화를 고려하기 위하여 감염률에 피드백 제어를 줄 수 있는 SEIHR 수정 모델을 제안하였다. 최대 감염까지 경과 시간과 최대 감염률의 상대 불확도를 계산하기 위하여 하나의 결정론적 방법과 두 가지의 확률론적 방법 적용하였다. 감염병 예측의 불확도는 감염의 확률론적 성질에 기인하는 것을 알 수 있었다. 적절한 진행의 시나리오를 설정하지 못할 경우 개인의 능동적 행동 변화가 추가적인 불확도 요인이 될 것이다.

Key Message
This paper is to show that, due to active behavioral changes of individuals and inherent natures of infectious diseases, it is complicated and challenging to predict the temporal evolutions. A modified-SEIHR compartment model with a discretely feedback-controlled transmission rate was proposed to incorporate the behavioral changes of individuals into the model. To figure out relative uncertainties in the infection peak times and the fraction of the infected population at the peak, a deterministic method and two stochastic methods were applied. It is shown that the uncertainty of the prediction originates from stochastic properties of the infections. Without a proper selection of the evolution scenarios, the active behavioral changes of individuals could cause an additional uncertainty.

Citations

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Modeling Supply and Demand Dynamics of Vaccines against Epidemic-Prone Pathogens: Case Study of Ebola Virus Disease
Donovan Guttieres, Charlot Diepvens, Catherine Decouttere, Nico Vandaele
Vaccines.2023; 12(1): 24. CrossRef
Evolution and consequences of individual responses during the COVID-19 outbreak
Wasim Abbas, Masud M. A., Anna Park, Sajida Parveen, Sangil Kim, Siew Ann Cheong
PLOS ONE.2022; 17(9): e0273964. CrossRef

An alarmingly high and increasing prevalence of obesity in Jordan: Kamel Ajlouni, Yousef Khader, Anwar Batieha, Hashem Jaddou, Mohammed El-Khateeb; Epidemiol Health. 2020;42:e2020040. Published online June 6, 2020; DOI: https://doi.org/10.4178/epih.e2020040

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Abstract PDF

Abstract

OBJECTIVES
The aim of this study was to determine the prevalence of obesity in Jordan, to assess related trends, and to determine associated factors and comorbidities.

METHODS

A multipurpose national household survey of Jordanian adults was conducted over a 4-month period in 2017. Data were collected using a structured validated questionnaire. Anthropometric measurements including waist circumference (WC; measured midway between the iliac crest and the lower rib margin), body mass index (BMI), hip circumference, waist-to-hip ratio, and waist-to-height ratio were obtained to categorize participants with regard to overweight and obesity.

RESULTS

This study included 4,056 persons (1,193 men and 2,863 women) aged 18 years to 90 years (mean±standard deviation, 43.8±14.2 years). According to the International Diabetes Federation WC criteria, the age-standardized prevalence of obesity was 60.4% among men and 75.6% among women, while approximately three-quarters of men and women were overweight or obese as defined by BMI. The age-adjusted odds of obesity in 2017 were approximately twice those in 2009 in men (odds ratio [OR], 1.98) and women (OR, 1.96). In the multivariate analysis, age, region of residence, and marital status were significantly associated with obesity in both genders. Obesity was significantly associated with increased odds of diabetes mellitus, hypertension, elevated triglycerides, and low high-density lipoprotein cholesterol after adjusting for age.

CONCLUSIONS

The rate of obesity in Jordan is high and increasing, and obesity is associated with other metabolic abnormalities. Well-defined programs to control and prevent obesity, as well as intersectoral action, are urgently required to reverse current trends.

Summary

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Major enteropathogens in humans, domestic animals, and environmental soil samples from the same locality: prevalence and transmission considerations in coastal Odisha, India: Arpit Kumar Shrivastava, Nirmal Kumar Mohakud, Swagatika Panda, Saumya Darshana Patra, Subrat Kumar, Priyadarshi Soumyaranjan Sahu; Epidemiol Health. 2020;42:e2020034. Published online May 26, 2020; DOI: https://doi.org/10.4178/epih.e2020034

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Abstract PDF Supplementary Material

Abstract

Objectives
Regions with limited sanitation facilities have higher rates of infections with various enteric pathogens. It is therefore important to identify different hosts and their relative contribution to pathogen shedding into the environment, and to assess the subsequent health risks to humans.

Methods

In this study, human faecal (n=310), animal faecal (n=150), and environmental (soil) samples (n=40) were collected from the same locality and screened for selected enteric pathogens by immunochromatography and/or polymerase chain reaction.

Results

At least 1 microbial agent was detected in 49.0%, 44.7%, and 40.0% of the samples from human, animals, and soil, respectively. Among humans, rotavirus was predominantly detected (17.4%) followed by enteropathogenic Escherichia coli (EPEC) (15.4%), Shigella (13.8), and Shiga toxin-producing E. coli (STEC) (9.7%). Among animals, STEC was detected most frequently (28.0%), and EPEC was the major enteric pathogen detected in soil (30.0%). The detection rate of rotavirus was higher among younger children (≤2 years) than among older children. Single infections were more commonly detected than multiple infections in humans (p<0.01), unlike the observations in animal and soil samples. For diarrhoeagenic E. coli and Shigella, most of the human and animal isolates showed close relatedness, suggesting possible cross-infection between humans and domesticated animals in the area studied.

Conclusions

The present study provides an improved understanding of the distribution of major enteric pathogens coexisting in humans and animals in the region, thereby suggesting a high potential for possible transmission among livestock and communities residing in the studied locality.

Summary

Citations

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Estimating the reproductive number and the outbreak size of COVID-19 in Korea: Sunhwa Choi, Moran Ki; Epidemiol Health. 2020;42:e2020011. Published online March 12, 2020; DOI: https://doi.org/10.4178/epih.e2020011

55,972 View
3,328 Download
156 Web of Science
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Since the first novel coronavirus disease 2019 (COVID-19) patient in Korea was diagnosed on January 20, 2020, 30 patients were diagnosed until February 17, 2020. However, 5,298 additional patients were confirmed until March 4, 2020. Therefore, our objective was to estimate the reproduction number (R) and evaluate the effectiveness of preventive measures.

METHODS

A COVID-19 transmission model (SEIHR) was established to suit the Korean outbreak. The number of daily confirmed cases in Daegu and North Gyeongsang Province (NGP), the main area of outbreak, was used. The first patient’ symptom onset date in the Daegu/NGP outbreak was assumed as January 22, 2020. The R according to the start date of the effect of preventive measures was estimated.

RESULTS

The estimated R in Hubei Province, China, was 4.0281, whereas the estimated initial R in Korea was 0.555, but later in Daegu/NGP, the value was between 3.472 and 3.543. When the transmission period decreases from 4-day to 2-day, the outbreak ends early, but the peak of the epidemic increases, and the total number of patients does not change greatly. It was found that, if transmission rate decreases, the outbreak ends early, and the size of the peak and the total number of patients also decreases.

CONCLUSIONS

To end the COVID-19 epidemic, efforts to reduce the spread of the virus, such as social distancing and wearing masks, are absolutely crucial with the participation of the public, along with the policy of reducing the transmission period by finding and isolating patients as quickly as possible through the efforts of the quarantine authorities.

Summary

Korean summary
수학적 모델링을 통하여 코로나-19 감염재생산수( R )와 대구, 경북의 유행 규모와 유행 종료 시점 등을 예측해보았다. 그 결과 중국 후베이성의 R=4, 한국 초기 30일간의 유행은 R=0.5, 대구/경북의 3월 4일까지의 유행은 R=3.5 수준으로 나타났다. 하지만 방역당국의 적극적인 코로나-19검사로 환자들의 감염전파기간이 짧아지고, 국민들의 마스크 쓰기, 사회적 거리두기 등의 감염 예방조치 적극 참여로 전파율이 낮아져 5월 1일경에 하루 환자 1명 수준으로 예측되었다.

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COVID-19: Special Article

Epidemiologic characteristics of early cases with 2019 novel coronavirus (2019-nCoV) disease in Korea: Moran Ki, Task Force for 2019-nCoV; Epidemiol Health. 2020;42:e2020007. Published online February 9, 2020; DOI: https://doi.org/10.4178/epih.e2020007

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Abstract Summary PDF Supplementary Material

Abstract

In about 20 days since the diagnosis of the first case of the 2019 novel coronavirus (2019-nCoV) in Korea on January 20, 2020, 28 cases have been confirmed. Fifteen patients (53.6%) of them were male and median age of was 42 years (range, 20-73). Of the confirmed cases, 16, 9, and 3 were index (57.2%), first-generation (32.1%), and second-generation (10.7%) cases, respectively. All first-generation and second-generation patients were family members or intimate acquaintances of the index cases with close contacts. Fifteen among 16 index patients had entered Korea from January 19 to 24, 2020 while 1 patient had entered Korea on January 31, 2020. The average incubation period was 3.9 days (median, 3.0), and the reproduction number was estimated as 0.48. Three of the confirmed patients were asymptomatic when they were diagnosed. Epidemiological indicators will be revised with the availability of additional data in the future. Sharing epidemiological information among researchers worldwide is essential for efficient preparation and response in tackling this new infectious disease.

Summary

Korean summary
2020년 1월 20일 한국의 신종코로나바이러스 감염자가 확진된 이후 약 20일만에 28명이 확진되었다. 확진자중 지표환자가 16명(57.2%), 1세대환자 9명(32.1%), 2세대환자가 3명(10.7%)이다. 지표환자 16명중 15명은 1월 19일-24일에, 1명은 1월 31일에 국내에 입국하였다. 환자들의 잠복기는 평균 3.9일 (중위값 3일), 감염재생산수(R)는 0.48로 추정되었다. 확진자 중 3명은 증상이 없는 상태에서 확진이 되었다. 향후 새로운 정보가 나오면 역학 지표들이 수정될 것이다.

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COVID-19: Brief Communication

An interim review of the epidemiological characteristics of 2019 novel coronavirus: Sukhyun Ryu, Byung Chul Chun, Korean Society of Epidemiology 2019-nCoV Task Force Team; Epidemiol Health. 2020;42:e2020006. Published online February 6, 2020; DOI: https://doi.org/10.4178/epih.e2020006

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The 2019 novel coronavirus (2019-nCoV) from Wuhan, China is currently recognized as a public health emergency of global concern.

METHODS

We reviewed the currently available literature to provide up-to-date guidance on control measures to be implemented by public health authorities.

RESULTS

Some of the epidemiological characteristics of 2019-nCoV have been identified. However, there remain considerable uncertainties, which should be considered when providing guidance to public health authorities on control measures.

CONCLUSIONS

Additional studies incorporating more detailed information from confirmed cases would be valuable.

Summary

Korean summary
여러 국외 연구를 통해 2019 신종 코로나바이러스에 대한 역학적 특성이 보고되고 있다. 아직까지 지역사회 전파 예방 및 관리방안을 제시하기 위한 역학적 근거가 아직까지 밝혀지지 않은 부분이 많아 지속적인 추가 연구가 필요하다.

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Special Article

Causes and countermeasures for repeated outbreaks of hepatitis A among adults in Korea: Moran Ki, Hyunjin Son, Bo Youl Choi; Epidemiol Health. 2019;41:e2019038. Published online September 22, 2019; DOI: https://doi.org/10.4178/epih.e2019038

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Abstract Summary PDF Supplementary Material

Abstract

The 2019 hepatitis A outbreak has become increasingly prevalent among adults in Korea and is the largest outbreak since that in 2009-2010. The incidence in the current outbreak is highest among adults aged 35-44 years, corresponding to the peak incidence among those aged 25-34 years 10 years ago. This may indicate a cohort effect in the corresponding age group. Causes of these repeated outbreaks of hepatitis A in Korea are low level of immunity among adults, Korean food culture that consumes raw seafood such as salted clam and inadequate public health system. Among countermeasures, along with general infectious disease control measures including control of the infectious agent, infection spread, and host, urgent actions are needed to review the vaccination policy and establish an adequate public health system.

Summary

Korean summary
2019년 한국 성인의 A형 간염 유행은 10년전 대규모 유행 이후 가장 큰 규모로발생하고 있다. 주 발생 연령이 10년전 유행보다 10세가 증가한 35-44세로 나타나 연령 코호트 효과라 볼 수 있다. 우리나라의 A형 간염 반복 유행의 원인은 성인의 낮은 집단면역수준, 어패류 생식문화, 공중보건의료체계 미비 등으로 보인다. 이에 대한 대책은 일반적인 감염관리대책인 감염원관리, 전파관리, 숙주관리와 함께 효율적인 백신접종정책, 공고한 공중보건관리체계 마련 등의 근본적 대책이 시급하다.

Citations

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Hepatitis A vaccination
Li Zhang
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Current State and Problems of Hepatitis A and E in Japan
Jun Inoue, Atsushi Masamune
Nihon Naika Gakkai Zasshi.2020; 109(7): 1439. CrossRef

Case Report

Two cases of cholera O1 in South Batinah, Oman, April 2019: lessons learned: Zayid K. Al Mayahi, Nasser Al-Shaqsi, Hamid A. Elmutashi, Ali Al-Dhoyani, Azza Al Hattali, Khalid Salim, Issa S. Al Fulaiti, Mahmood S. Al Subhi; Epidemiol Health. 2019;41:e2019033. Published online July 12, 2019; DOI: https://doi.org/10.4178/epih.e2019033

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Abstract

Cholera represents an ongoing threat to many low-income and middle-income countries, but some cases of cholera even occur in high-income countries. Therefore, to prevent or combat cholera outbreaks, it is necessary to maintain the capacity to rapidly detect cholera cases, implement infection control measures, and improve general hygiene in terms of the environment, water, and food. The 2 cases, 1 imported and 1 secondary, described herein are broadly indicative of areas that require improvement. These cases were missed at the primary health care stage, which should be the first detection point even for unusual diseases such as cholera, and the absence of strict infection control practices at the primary care level is believed to contribute to secondary cases of infection. This report also encourages countries to ensure that rapid diagnostic stool tests are available to enable quick detection, as well as to provide information to people travelling to areas where cholera is endemic.

Summary

Citations

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Environmental and human drivers of cercarial emergence in freshwater snails of the Maha Oya River, Sri Lanka
Lakshmi Sakunthala, Rupika S. Rajakaruna, Gajaba Ellepola, Nuwandi U. K. Pathirana
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Original Articles

Geospatial analysis and epidemiological aspects of human infections with Blastocystis hominis in Mazandaran Province, northern Iran: Shabnam Asfaram, Ahmad Daryani, Shahabeddin Sarvi, Abdol Sattar Pagheh, Seyed Abdollah Hosseini, Reza Saberi, Seyede Mahboobeh Hoseiny, Masoud Soosaraei, Mehdi Sharif; Epidemiol Health. 2019;41:e2019009. Published online March 28, 2019; DOI: https://doi.org/10.4178/epih.e2019009

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Abstract PDF

Abstract

OBJECTIVES
Blastocystis hominis is a very common large intestinal protozoan with global prevalence in humans and non-human hosts. No precise statistics exist regarding the geographical distribution of Blastocystis that would enable the identification of high-risk communities. Therefore, the current research aimed to characterize the spatial patterns and demographic factors associated with B. hominis occurrence in northern Iran.

METHODS

The current study was performed among 4,788 individuals referred to health centers in Mazandaran Province, from whom stool samples were obtained. Socio-demographic data were gathered using a questionnaire. Samples were examined by a direct wet mount, the formalin-ethyl acetate concentration technique, and trichrome staining. Moran local indicators of spatial association and a geographically weighted regression model were utilized to analyze the results.

RESULTS

Generally, the infection rate of Blastocystis parasites was 5.2%, and was considerably higher in the age group of 10-14 years (10.6%) than in other age groups (p=0.005). Our data showed important associations between the occurrence of B. hominis and age, residence, job, contact with domestic animals, anti-parasitic drug consumption, and elevation above sea level (p<0.001).

CONCLUSIONS

The current study characterized for the first time the infection rate and risk of B. hominis in the north of Iran, and produced a prediction map. It is expected that this map will help policymakers to plan and implement preventive measures in high-risk areas and to manage already-infected patients.

Summary

Citations

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Prevalence of Blastocystis infection in patients with colorectal cancer in Taiwan
Chen-Chieh Liao, Chun-Hsien Chen, Chih-Ming Tsai, Pok-Man Cheang, Wei-Chen Lin, Po-Chuan Chen, Chien-Chin Chen, Chun-Ting Chu
BMC Infectious Diseases.2025;[Epub] CrossRef
A 11-year-old boy with Blastocystis hominis infection, presents as immune thrombocytopenia
Fajuan Tang, Dongqiong Xiao, Lin Chen, Xihong Li, Lina Qiao
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Blastocystis colonization and associations with population parameters in Thai adults
Vasana Jinatham, Amara Yowang, Christen Rune Stensvold, Eleni Michalopoulou, Thanakrit Vichasilp, Picha Suwannahitatorn, Siam Popluechai, Anastasios D. Tsaousis, Eleni Gentekaki, Funda Dogruman-Al
PLOS Neglected Tropical Diseases.2024; 18(7): e0012292. CrossRef
Molecular epidemiology and subtyping of Blastocystis sp. and its subtypes in celiac patients; a case control study
Sara Soleimani Jevinani, Hanieh Mohammad Rahimi, Nastaran Asri, Mohammad Rostami-Nejad, Shokoufeh Ahmadipour, Hamed Mirjalali
Microbial Pathogenesis.2023; 179: 106086. CrossRef
Development and evaluation of a loop-mediated isothermal amplification (LAMP) technique for rapid, accurate, and specific detection of Blastocystis spp. in AIDS patients
Ebrahim Badparva, Amirreza Javadi Mamaghani, Farnaz Kheirandish, Farzad Ebrahimzadeh, Shirzad Fallahi
Infection.2022; 50(5): 1295. CrossRef
In vitro susceptibility of human Blastocystis subtypes to simeprevir
Shereen F. Mossallam, Salwa A.T. El- Mansoury, Mona M. Tolba, Asmaa A. Kohla, Safaa I. Khedr
Saudi Journal of Biological Sciences.2021; 28(4): 2491. CrossRef
Epidemiology and subtype distribution of Blastocystis in humans: A review
Supaluk Popruk, Davin Edric V. Adao, Windell L. Rivera
Infection, Genetics and Evolution.2021; 95: 105085. CrossRef
The Coexistence of Blastocystis spp. in Humans, Animals and Environmental Sources from 2010–2021 in Asia
Adedolapo Aminat Rauff-Adedotun, Farah Haziqah Meor Termizi, Nurshafarina Shaari, Ii Li Lee
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Estimating causal associations of atopic dermatitis with depression using the propensity score method: an analysis of Korea Community Health Survey data, 2010-2013: Hayon Michelle Choi, Dahye Kim, Whanhee Lee, Ho Kim; Epidemiol Health. 2018;40:e2018059. Published online November 29, 2018; DOI: https://doi.org/10.4178/epih.e2018059

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Numerous studies have reported associations between atopic dermatitis (AD) and depression, but the causal relationship between the 2 diseases has not been established. Therefore, this study used the propensity score method to investigate whether there was a positive causal effect of AD on depression in 16 regions (cities and provinces) in Korea.

METHODS

The study analyzed 16 regions (cities and provinces) in Korea, using data obtained from the Korea Community Health Survey for the years 2010-2013. Propensity score matching was used to estimate the causal influence of AD on depression in Korea.

RESULTS

After propensity score matching, the standardized difference for each covariate among the 16 regions (cities and provinces) was less than 1, indicating a balance between the case and control groups. At the national level, those diagnosed with AD had a 2.31 times higher risk for being diagnosed with depression than those who had not been diagnosed with AD. In particular, the risk was highest in North Jeolla Province (odds ratio [OR], 4.87; 95% confidence interval [CI], 2.28 to 10.43) and lowest in Gwangju (OR, 1.82; 95% CI, 0.87 to 3.79), and the OR for Seoul was 2.23 (95% CI, 1.66 to 2.99).

CONCLUSIONS

This study provides insights into how causal inferences can be derived from observational studies, through an analysis of Korea Community Health Survey data. Furthermore, the study results have implications for region-specific guidelines for preventive health policies targeting depression.

Summary

Korean summary
성향 점수 매칭을 이용하여 전국 및 16개 시/도 별 아토피 피부염과 우울증 사이의 인과성을 추정한 결과, 전국에서 아토피 피부염을 진단 받은 사람이 진단 받지 않은 사람들에 비해 우울증 위험도가 2.38배 높았다(CI: 1.29-4.38).

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Xiao‐ce Cai, Si‐han Wang, Chun‐xiao Wang, Liu Liu, Jiao Wang, Yu‐hong Shen, Xin Li
Journal of the European Academy of Dermatology and Venereology.2024; 38(3): 496. CrossRef
Risk of depression in patients with atopic dermatitis: An updated systematic review and meta‐analysis of children, adolescent and adult groups
Lihua Cao, Jiangwei Su, Fang Tian, Yang Zhou, Songchun Liu, Fanglu Lou
Journal of Paediatrics and Child Health.2024; 60(11): 640. CrossRef
Analysis of Quality of Life and Mental Health in Patients With Atopic Dermatitis, Asthma and Allergic Rhinitis Using a Nation-wide Database, KNHANES VII
Gyu Na Lee, Ha Yeh Rin Koo, Kyungdo Han, Young Bok Lee
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Editorial

Lessons from radiation epidemiology: Won Jin Lee; Epidemiol Health. 2018;40:e2018057. Published online November 14, 2018; DOI: https://doi.org/10.4178/epih.e2018057

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Abstract

Radiation epidemiology has developed as a specialized field and has unique characteristics compared to the other fields of epidemiology. Radiation exposure assessment is highly quantified and health risk assessment can yield precise risks per unit dose in each organ. At the same time, radiation epidemiology also emphasizes the uncertainty of the estimated doses and risks. More radiation epidemiologists work in radiation societies rather than those of epidemiology. This specialization deepens the research of radiation studies but also results in fragmentation from general epidemiology. In addition to continued involvement with radiation-related sciences, therefore, more efforts to communicate with the other fields of epidemiology are necessary for radiation epidemiology.

Summary

Korean summary
방사선 역학은 역학의 세부 전공분야로서 다른 역학 분야와 구별되는 특성들이 있다. 노출 및 건강영향 평가에서의 정량화된 접근방법을 비롯하여 방사선 역학의 많은 장점들은 다른 역학분야에서도 응용될 필요가 있다. 이러한 전문화는 역학 연구의 내용을 깊게 발전시키는데 큰 역할을 하고 있는 반면, 일반 역학 분야와 분열되는 단점도 있다. 따라서 기존 방사선 관련 학문들과의 지속적인 교류뿐 아니라 다른 역학분야와의 활발한 교류를 통해 방사선 역학 및 전체 역학분야를 발전시키는 것이 중요하다.

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Data Profile

National Epidemiologic Survey of Thyroid cancer (NEST) in Korea: Chang-Mo Oh, Hyun-Joo Kong, Eunyang Kim, Hyejin Kim, Kyu-Won Jung, Sohee Park, Young-Joo Won; Epidemiol Health. 2018;40:e2018052. Published online October 26, 2018; DOI: https://doi.org/10.4178/epih.e2018052

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Abstract PDF

Abstract

The Korea Central Cancer Registry conducted the National Epidemiologic Survey of Thyroid cancer (NEST) to investigate changes in the epidemiological and clinical characteristics of thyroid cancer patients between 1999 and 2008. The NEST was designed to collect representative samples of patients with thyroid cancer diagnosed in the years 1999, 2005, and 2008 using a proportionally stratified and systematic random sampling method. Among 42,891 participants diagnosed with thyroid cancer, 5,796 participants were included in the final study population. This survey collected information on diagnostic methods and date, route of diagnosis, prior medical history and history of thyroid-related disease, tumor, lymph node, metastasis and collaborative stage, and treatment. The NEST dataset was also linked to the cause-of-death database from Statistics Korea. The mean age of the study participants was 46.9 years. The ratio of men to women was 1:5.5. In the analysis of the histologic type of cancer, the proportion of papillary thyroid carcinoma showed an increasing trend (p<0.01). In contrast, the proportion of distant metastasis and the mean tumor size of thyroid cancers showed decreasing trends over time (p<0.01, respectively).

Summary

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Original Articles

Community-based surveillance of Cryptosporidium in the indigenous community of Boliwong, Philippines: from April to December 2017: Ryan V. Labana, Julieta Z. Dungca, Veeranoot Nissapatorn; Epidemiol Health. 2018;40:e2018047. Published online September 28, 2018; DOI: https://doi.org/10.4178/epih.e2018047

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Abstract PDF

Abstract

OBJECTIVES
For the first time, Boliwong, an indigenous community in the Philippines, was surveyed for the prevalence of Cryptosporidium from April to December 2017.

METHODS

Cryptosporidium oocysts were detected in samples from the river, creek, and water pumps via immunomagnetic separation techniques, and from human and animal concentrated faecal samples using the modified Ziehl-Neelsen technique.

RESULTS

Seven of the 24 water samples (29.2%) were positive for Cryptosporidium, with the highest concentration (0.8 oocyst/L) detected in the creek. Of 35 fecal samples from different animal groups, 8 (21.6%) were positive for Cryptosporidium oocysts. The highest intensity of oocyst shedding was detected in dogs (χ2 =8.00). Of the 137 human fecal samples, 39 (28.5%) were infected with Cryptosporidium. In this study, 3 risk factors were found to be associated with infection: (1) location (crude odds ratio [cOR], 16.39; 95% confidence interval [CI], 2.11 to 127.41; p=0.008), (2) drinking water from the natural spring (cOR, 0.29; 95% CI, 0.11 to 0.82; p<0.05), and (3) using an open pit as a sanitary toilet facility (cOR, 2.44; 95% CI, 1.14 to 5.20; p<0.05). When the cOR was adjusted, using an open pit as a sanitary toilet facility remained a significant risk factor of infection (adjusted OR, 0.41; 95% CI, 0.19 to 0.90; p<0.05).

CONCLUSIONS

There is a potentially emerging Cryptosporidium zoonosis in Boliwong, Lagawe, Philippines. It is recommended that the toilet facilities and the water system in the community be rehabilitated to avoid any possible disease outbreak. Health education is also needed in the community to maintain proper hygiene and sanitation practices.

Summary

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Geographical distribution of health indicators related to snake bites and envenomation in Morocco between 1999 and 2013: Faiçal El hattimy, Fouad Chafiq, Hinde Hami, Abdelghani Mokhtari, Abdelmajid Soulaymani, Soulaymani Bencheikh Rachida; Epidemiol Health. 2018;40:e2018024. Published online June 16, 2018; DOI: https://doi.org/10.4178/epih.e2018024

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Abstract PDF

Abstract

OBJECTIVES
Envenomation from snake bites is a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the epidemiological features of snake bites in Morocco and to evaluate time-space trends in snake bite incidence, the mortality rate, and the case-fatality rate.

METHODS

This is a retrospective study of snake bite cases reported to the Moroccan Poison Control Center between 1999 and 2013.

RESULTS

During the study period, 2,053 people were bitten by snakes in Morocco. Most victims were adults (55.4%). The average age of the patients was 26.48±17.25 years. More than half of the cases (58.1%) were males. Approximately 75% of snake bites happened in rural areas, and 85 deaths were recorded during this period. The incidence of snake bites remained generally steady over the 15-year period of this study, with a marked increase noted since 2012. The mortality rate has increased slightly, from 0.02 deaths per 100,000 inhabitants in 1999 to 0.05 in 2013. The geographical distribution of snake bite cases in the regions of Morocco showed that Tanger-Tétouan had the highest annual incidence of snake bites (1.41 bites per 100,000 inhabitants). However, the highest annual mortality rates were recorded in the Guelmim-Es Semara and Souss-Massa-Drâa regions (0.09 deaths per 100,000 inhabitants for both regions).

CONCLUSIONS

The geographical distribution of the incidence, mortality, and case-fatality rates of snake bites in Morocco showed large disparities across regions during the three 5-year periods included in this study, meaning that certain areas can be considered high-risk for snake bites.

Summary

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Prevalence, awareness, treatment, control, and risk factors of hypertension among adults: a cross-sectional study in Iran: Maryam Eghbali, Alireza Khosravi, Awat Feizi, Asieh Mansouri, Behzad Mahaki, Nizal Sarrafzadegan; Epidemiol Health. 2018;40:e2018020. Published online May 18, 2018; DOI: https://doi.org/10.4178/epih.e2018020

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Abstract PDF

Abstract

OBJECTIVES
Hypertension (HTN) is an important risk factor for cardiovascular disease. Considering the importance of this disease for public health, this study was designed in order to determine the prevalence, awareness, treatment, control, and risk factors of HTN in the Iranian adult population.

METHODS

This cross-sectional study was conducted among 2,107 residents of Isfahan, Iran. Samples were selected through multi-stage random cluster sampling in 2015-2016. The outcome variable was HTN, determined by measuring blood pressure in the right arm via a digital arm blood pressure monitor. Awareness, treatment, and control of HTN were assessed by a validated and reliable researcher-developed questionnaire. Other demographic and clinical variables were assessed via a demographic questionnaire.

RESULTS

The overall prevalence of HTN was 17.3% (18.9 and 15.5% in men and women, respectively). The prevalence of HTN increased in both genders with age. The prevalence of awareness of HTN among people with HTN was 69.2%, of whom 92.4 and 59.9% were taking medication for HTN and had controlled HTN, respectively. Logistic regression identified age, body mass index, having diabetes and hyperlipidemia, and a positive family history of HTN as determinants of awareness of HTN.

CONCLUSIONS

The results showed that HTN was highly prevalent in the community, especially in men and in middle-aged and older adults. Approximately 30.8% of patients were unaware of their disease, and there was less awareness among younger adults. Despite the high frequency of taking medication to treat HTN, it was uncontrolled in more than 40.1% of patients. Health policy-makers should therefore consider appropriate preventive and therapeutic strategies for these high-risk groups.

Summary

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Abstract Summary PDF

Abstract

OBJECTIVES
The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status.

METHODS

Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results.

RESULTS

The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis.

CONCLUSIONS

The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.

Summary

Korean summary
2015년 국내 MERS 유행시에 자가격리를 시행하였던 접촉자 약 15,000명 (의료인과 비의료인 포함) 중에서 주요 유행지역, 노출 강도 등을 고려하여 선별된 3,291명을 대상으로 무증상 감염여부를 확인하기 위한 혈청 역학조사를 수행하였다. 최종 검사에 참여한 1,610명 중에서 7명이 ELISA 양성 반응을 보였고, 그 중 1명이 IFA와 PRNT에서도 양성 반응을 보여 무증상 감염률은 0.060%(95% CI: 0.002-0.346)로 기존 연구에 비하여 낮았다. 최종 양성을 보인 1명은 노출 당시 1번환자와 가까운 병실에 입원하였던 환자였다.

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Application of an artificial neural network model for diagnosing type 2 diabetes mellitus and determining the relative importance of risk factors: Shiva Borzouei, Ali Reza Soltanian; Epidemiol Health. 2018;40:e2018007. Published online March 10, 2018; DOI: https://doi.org/10.4178/epih.e2018007

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Abstract PDF

Abstract

OBJECTIVES
To identify the most important demographic risk factors for a diagnosis of type 2 diabetes mellitus (T2DM) using a neural network model.

METHODS

This study was conducted on a sample of 234 individuals, in whom T2DM was diagnosed using hemoglobin A1c levels. A multilayer perceptron artificial neural network was used to identify demographic risk factors for T2DM and their importance. The DeLong method was used to compare the models by fitting in sequential steps.

RESULTS

Variables found to be significant at a level of p<0.2 in a univariate logistic regression analysis (age, hypertension, waist circumference, body mass index [BMI], sedentary lifestyle, smoking, vegetable consumption, family history of T2DM, stress, walking, fruit consumption, and sex) were entered into the model. After 7 stages of neural network modeling, only waist circumference (100.0%), age (78.5%), BMI (78.2%), hypertension (69.4%), stress (54.2%), smoking (49.3%), and a family history of T2DM (37.2%) were identified as predictors of the diagnosis of T2DM.

CONCLUSIONS

In this study, waist circumference and age were the most important predictors of T2DM. Due to the sensitivity, specificity, and accuracy of the final model, it is suggested that these variables should be used for T2DM risk assessment in screening tests.

Summary

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Perspective

Interpretation of the hygiene and microflora hypothesis for allergic diseases through epigenetic epidemiology: Jong-Myon Bae; Epidemiol Health. 2018;40:e2018006. Published online March 10, 2018; DOI: https://doi.org/10.4178/epih.e2018006

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Abstract Summary PDF Supplementary Material

Abstract

The hygiene hypothesis (HH) proposed by Strachan in 1989 was expanded to explain the inverse association between the occurrence of allergy disorders and the risk of infectious diseases and parasite infestation. The microflora hypothesis (MH) suggests that gut microbial dysbiosis in early life might trigger hypersensitivity disorders. The sharing concept of both HH and MH is gene-environment interaction, which is also a key concept in epigenetics. The amalgamation of epidemiology and epigenetics has created a scientific discipline termed epigenetic epidemiology. To accomplish an era of gene-environment-wide interaction studies, it is necessary to launch a national human epigenome project.

Summary

Korean summary
1989년 제시된 위생가설 (Hygiene hypothesis)은 최근 체내미생물가설 (Microflora hypothesis) 대치되어 알레르기 질환의 발생기전을 해석하고 있다. 두 가설 모두 유전-환경 상호작용 gene-environment interaction) 을 강조하고 있다는 점에서 향후 후성유전역학 연구에 대한 활성화가 필요하다.

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Epidemiologic Investigation

Healthcare worker infected with Middle East Respiratory Syndrome during cardiopulmonary resuscitation in Korea, 2015: Hae-Sung Nam, Mi-Yeon Yeon, Jung Wan Park, Jee-Young Hong, Ji Woong Son; Epidemiol Health. 2017;39:e2017052. Published online November 12, 2017; DOI: https://doi.org/10.4178/epih.e2017052

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
During the outbreak of the Middle East Respiratory Syndrome (MERS) in Korea in 2015, the Korea Centers for Disease Control and Prevention (KCDC) confirmed a case of MERS in a healthcare worker in Daejeon, South Korea. To verify the precise route of infection for the case, we conducted an in-depth epidemiological investigation in cooperation with the KCDC.

METHODS

We reviewed the MERS outbreak investigation report of the KCDC, and interviewed the healthcare worker who had recovered from MERS. Using the media interview data, we reaffirmed and supplemented the nature of the exposure.

RESULTS

The healthcare worker, a nurse, was infected while performing cardiopulmonary resuscitation (CPR) for a MERS patient in an isolation room. During the CPR which lasted for an hour, a large amount of body fluid was splashed. The nurse was presumed to have touched the mask to adjust its position during the CPR. She suggested that she was contaminated with the MERS patient’s body fluids by wiping away the sweat from her face during the CPR.

CONCLUSIONS

The possible routes of infection may include the following: respiratory invasion of aerosols contaminated with MERS-coronavirus (MERS-CoV) through a gap between the face and mask; mucosal exposure to sweat contaminated with MERS-CoV; and contamination during doffing of personal protective equipment. The MERS guidelines should reflect this case to decrease the risk of infection during CPR.

Summary

Korean summary
2015년 한국의 Middle East respiratory syndrome (MERS) 유행 기간 중 질병관리본부는 MERS 환자 심폐소생술(cardio–pulmonary resuscitation, CPR)에 참여한 간호사에서 MERS를 확진하였다. 이 사례에 대해 대전광역시 메르스 대응 민간역학조사지원단에서 심층역학조사를 실시한 결과 (1) CPR 수행 중 MERS-CoV에 오염된 에어로졸의 호흡기 침투, (2) MERS-CoV에 오염된 땀의 점막 침투, (3) 보호구 탈의 과정에서 MERS-Cov에 오염 등이 가능한 감염 경로로 파악되었다. 본 사례는 MERS 환자에 대한 CPR 수행 및 수행자의 보호구 착용과 관련하여 MERS 관리 지침의 개정이 필요함을 시사한다.

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Original Article

Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014): Zineb Nabih, Latifa Amiar, Zakaria Abidli, Maria Windy, Abdelmajid Soulaymani, Abdelrhani Mokhtari, Rachida Soulaymani-Bencheikh; Epidemiol Health. 2017;39:e2017040. Published online September 1, 2017; DOI: https://doi.org/10.4178/epih.e2017040

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Abstract PDF

Abstract

OBJECTIVES
To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides.

METHODS

A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014.

RESULTS

During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%.

CONCLUSIONS

Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.

Summary

Citations

Citations to this article as recorded by

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