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- Volume 44(4); July 2011
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- How to Improve Influenza Vaccination Rates in the U.S.
- Byung-Kwang Yoo
- J Prev Med Public Health. 2011;44(4):141-148. Published online July 29, 2010
- DOI: https://doi.org/10.3961/jpmph.2011.44.4.141
- 13,519 View
- 125 Download
- 20 Crossref
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Abstract
PDF Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities.
This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.
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Citations to this article as recorded by
- A Description of Theoretical Models for Health Service Utilization: A Scoping Review of the Literature
Jordan A. Gliedt, Antoinette L. Spector, Michael J. Schneider, Joni Williams, Staci Young
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2023; 60: 004695802311768. CrossRef - Low Levels of Influenza Vaccine Uptake among the Diabetic Population in Spain: A Time Trend Study from 2011 to 2020
Jose J. Zamorano-Leon, Rodrigo Jimenez-Garcia, Ana Lopez-de-Andres, Javier de-Miguel-Diez, David Carabantes-Alarcon, Romana Albaladejo-Vicente, Rosa Villanueva-Orbaiz, Khaoula Zekri-Nechar, Sara Sanz-Rojo
Journal of Clinical Medicine.2021; 11(1): 68. CrossRef - Influenza vaccination among U.S. pediatric patients receiving care from federally funded health centers
Lydie A. Lebrun-Harris, Judith A. Mendel Van Alstyne, Alek Sripipatana
Vaccine.2020; 38(39): 6120. CrossRef - Emerging respiratory infections threatening public health in the Asia‐Pacific region: A position paper of the Asian Pacific Society of Respirology
Sunghoon Park, Ji Young Park, Yuanlin Song, Soon Hin How, Ki‐Suck Jung
Respirology.2019; 24(6): 590. CrossRef - Exploring Disparities in Influenza Immunization for Older Women
Sarah MacCarthy, Q Burkhart, Amelia M. Haviland, Jacob W. Dembosky, Shondelle Wilson‐Frederick, Debra Saliba, Sarah Gaillot, Marc N. Elliott
Journal of the American Geriatrics Society.2019; 67(6): 1268. CrossRef - Optimal Design of the Seasonal Influenza Vaccine with Manufacturing Autonomy
Osman Y. Özaltın, Oleg A. Prokopyev, Andrew J. Schaefer
INFORMS Journal on Computing.2018; 30(2): 371. CrossRef - Preventive Effects of Vitamin D on Seasonal Influenza A in Infants: A Multicenter, Randomized, Open, Controlled Clinical Trial
Jian Zhou, Juan Du, Leting Huang, Youcheng Wang, Yimei Shi, Hailong Lin
Pediatric Infectious Disease Journal.2018; 37(8): 749. CrossRef - Factors Influencing Vaccination in Korea: Findings From Focus Group Interviews
Bomi Park, Eun Jeong Choi, Bohyun Park, Hyejin Han, Su Jin Cho, Hee Jung Choi, Seonhwa Lee, Hyesook Park
Journal of Preventive Medicine and Public Health.2018; 51(4): 173. CrossRef - Prioritizing high-risk sub-groups in a multi-manufacturer vaccine distribution program
Sharon Hovav, Avi Herbon
The International Journal of Logistics Management.2017; 28(2): 311. CrossRef - Patterns of influenza vaccination coverage in the United States from 2009 to 2015
Alice P.Y. Chiu, Jonathan Dushoff, Duo Yu, Daihai He
International Journal of Infectious Diseases.2017; 65: 122. CrossRef - Estrategias para mejorar la cobertura de la vacunación antigripal en Atención Primaria
F. Antón, M.J. Richart, S. Serrano, A.M. Martínez, D.F. Pruteanu
SEMERGEN - Medicina de Familia.2016; 42(3): 147. CrossRef - Efforts to Improve Immunization Coverage during Pregnancy among Ob-Gyns
Katherine M. Jones, Sarah Carroll, Debra Hawks, Cora-Ann McElwain, Jay Schulkin
Infectious Diseases in Obstetrics and Gynecology.2016; 2016: 1. CrossRef - Association of influenza vaccine uptake with health, access to health care, and medical mistreatment among adults from low-income neighborhoods in New Haven, CT: A classification tree analysis
Kathryn Gilstad-Hayden, Amanda Durante, Valerie A. Earnshaw, Lisa Rosenthal, Jeannette R. Ickovics
Preventive Medicine.2015; 74: 97. CrossRef - Decomposing racial/ethnic disparities in influenza vaccination among the elderly
Byung-Kwang Yoo, Takuya Hasebe, Peter G. Szilagyi
Vaccine.2015; 33(26): 2997. CrossRef - Cost-Effectiveness Analysis of a Television Campaign to Promote Seasonal Influenza Vaccination Among the Elderly
Minchul Kim, Byung-Kwang Yoo
Value in Health.2015; 18(5): 622. CrossRef - Knowledge, Attitudes, and Practices of Obstetrician-Gynecologists Regarding Influenza Prevention and Treatment Following the 2009 H1N1 Pandemic
Katie L. Murtough, Michael L. Power, Jay Schulkin
Journal of Women's Health.2015; 24(10): 849. CrossRef - Effectiveness of hospital-based postpartum procedures on pertussis vaccination among postpartum women
Sylvia Yeh, ChrisAnna Mink, Matthew Kim, Scott Naylor, Kenneth M. Zangwill, Norma J. Allred
American Journal of Obstetrics and Gynecology.2014; 210(3): 237.e1. CrossRef - Can Routine Offering of Influenza Vaccination in Office-Based Settings Reduce Racial and Ethnic Disparities in Adult Influenza Vaccination?
Jürgen Maurer, Katherine M. Harris, Lori Uscher-Pines
Journal of General Internal Medicine.2014; 29(12): 1624. CrossRef - Influenza Vaccination Coverage among Adults in Korea: 2008–2009 to 2011–2012 Seasons
Hye Yang, Sung-il Cho
International Journal of Environmental Research and Public Health.2014; 11(12): 12162. CrossRef - Faible taux de couverture vaccinale contre la grippe des sujets âgés hospitalisés en France
E. Rouveix, S. Greffe, C. Dupont, D. Gherissi Cherni, A. Beauchet, H. Sordet Guepet, G. Gavazzi, J. Gaillat
La Revue de Médecine Interne.2013; 34(12): 730. CrossRef
Original Articles- Use of Senior Center and the Health-Related Quality of Life in Korean Older Adults
- Hyun-Shik Kim, Kazuhiro Harada, Masashi Miyashita, Eun-A Lee, Jin-Kee Park, Yoshio Nakamura
- J Prev Med Public Health. 2011;44(4):149-156. Published online July 29, 2010
- DOI: https://doi.org/10.3961/jpmph.2011.44.4.149
- 10,156 View
- 85 Download
- 16 Crossref
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Abstract
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Objective The purpose of the present study was to examine the relationship between the use of senior center and health-related quality of life in Korean older adults.
Methods A questionnaire survey was conducted to two types of older adults who lived in Busan, Korea: 154 older adults who used a senior center and 137 older adults who did not use a senior center. The Korean version of short-form 36-item health survey was administered to assess the health-related quality of life. Demographic variables were obtained from a questionnaire. These were gender, age, family status, marital status, education, monthly income, present illness, body mass index and physical activity.
Results The 8-domain scales of physical function and role-physical were significantly higher in the users of the senior center compared with the non-users (F=4.87, p=0.027 and F=7.02, p=0.009, respectively). The 8-domain scales of vitality was also significantly higher in the users of the senior center compared with the non-users (F=7.48, p=0.007).
Conclusions The present study showed that the users of the senior center have higher physical function, role-physical and vitality compared with the non-users. These findings suggest that although the results are unable to specify causal relationships using the senior center may lead to some improvement in health-related quality of life.
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Citations
Citations to this article as recorded by- Trajectories of Preventive Health Care Utilization Among Older Koreans: The Role of Social Relationships
Yunkyung Jung, Sunha Choi
Health Education & Behavior.2023; 50(3): 382. CrossRef - Prolonged social isolation and cognitive function in older adults: lack of informal social contact versus formal social activity as the source of social isolation
Jinho Kim, Gum-Ryeong Park
Aging & Mental Health.2023; 27(12): 2438. CrossRef - Functional Status, Quality of Life, and Physical Activity of Senior Club Members—A Cross-Sectional Study
Ilona Stolarz, Ewelina Magdalena Baszak, Magdalena Zawadka, Piotr Majcher
International Journal of Environmental Research and Public Health.2022; 19(3): 1900. CrossRef - Associations Between Deaf/Hard of Hearing and Social Participation Among Older Americans
Ethan Siu Leung Cheung, Zhe Zhang
The Journal of Deaf Studies and Deaf Education.2022;[Epub] CrossRef - Why Don't Older Adults Use Senior Centers? Evidence from Adults Age 50 and Older in Massachusetts
Ceara Somerville, Nidya Velasco Roldán, Cindy N. Bui, Caitlin Coyle, Jan Mutchler
Journal of Elder Policy.2022; 2(1): 103. CrossRef - Associations of the related factors of depression, social support and social participation in kyungro‐dang among older adults in South Korea: A structural equation modelling analysis
Hocheol Lee, Seokjun Moon, Geurum Song, Eun Woo Nam
Nursing Open.2021; 8(2): 562. CrossRef - Physical activity benefits of attending a senior center depend largely on age and gender: a study using GPS and accelerometry data
Oriol Marquet, Monika Maciejewska, Xavier Delclòs-Alió, Guillem Vich, Jasper Schipperijn, Carme Miralles-Guasch
BMC Geriatrics.2020;[Epub] CrossRef - Long-Term Care System in Korea
Hyuk Ga
Annals of Geriatric Medicine and Research.2020; 24(3): 181. CrossRef - Daily lifestyle behaviors and risks of sarcopenia among older adults
Pei-Lin Tzeng, Chien-Yu Lin, Ting-Fu Lai, Wan-Chi Huang, Evonne Pien, Ming-Chun Hsueh, Kun-Pei Lin, Jong-Hwan Park, Yung Liao
Archives of Public Health.2020;[Epub] CrossRef - Spiritual Religious Coping is Associated with Quality of Life in Institutionalized Older Adults
Luciano Magalhães Vitorino, Giancarlo Lucchetti, Ana Eliza Oliveira Santos, Alessandra L. G. Lucchetti, Eric Batista Ferreira, Nilce Piva Adami, Lucila Amaral Carneiro Vianna
Journal of Religion and Health.2016; 55(2): 549. CrossRef - The Role of Leisure Engagement for Health Benefits Among Korean Older Women
Junhyoung Kim, Lori Irwin, May Kim, Seungtae Chin, Jun Kim
Health Care for Women International.2015; 36(12): 1357. CrossRef - Psychosocial Well-Being of the Elderly and Their Perception of Matured Estate in Singapore
Keng Hua Chong, Wei Quin Yow, Debbie Loo, Ferninda Patrycia
Journal of Housing For the Elderly.2015; 29(3): 259. CrossRef - Leisure activities and attitude of institutionalized elderly people: a basis for nursing practice
Vivian Carla de Castro, Lígia Carreira
Revista Latino-Americana de Enfermagem.2015; 23(2): 307. CrossRef - Short-term Effects of a Systematized Bladder Training Program for Idiopathic Overactive Bladder: A Prospective Study
Hahn-Ey Lee, Sung Yong Cho, Sangim Lee, Myong Kim, Seung-June Oh
International Neurourology Journal.2013; 17(1): 11. CrossRef - Quality of life of seniors living in the community and in long term care facilities: a comparative study
Luciano Magalhães Vitorino, Lisiane Manganelli Girardi Paskulin, Lucila Amaral Carneiro Vianna
Revista Latino-Americana de Enfermagem.2013; 21(spe): 3. CrossRef - Psychological, Social, and Environmental Factors Associated With Utilization of Senior Centers Among Older Adults in Korea
Hyun-Shik Kim, Masashi Miyashita, Kazuhiro Harada, Jong-Hwan Park, Jae-Moo So, Yoshio Nakamura
Journal of Preventive Medicine and Public Health.2012; 45(4): 244. CrossRef
- Intraocular Pressure and Its Determinants in Subjects With Type 2 Diabetes Mellitus in India
- Sayantan Biswas, Rajiv Raman, Vaitheeswaran Koluthungan, Tarun Sharma
- J Prev Med Public Health. 2011;44(4):157-166. Published online July 29, 2010
- DOI: https://doi.org/10.3961/jpmph.2011.44.4.157
- 8,726 View
- 75 Download
- 6 Crossref
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Abstract
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Objectives This study was conducted to show the intraocular pressure (IOP) distribution and the factors affecting IOP in subjects with type 2 diabetes mellitus (DM) in India.
Methods We measured the anthropometric and biochemical parameters for confirmed type 2 DM patients. A comprehensive ocular examination was performed for 1377 subjects aged > 40 years and residing in Chennai.
Results A significant difference in IOP (mean ± standard deviation) was found between men and women (14.6±2.9 and 15.0±2.8 mmHg, p = 0.005). A significantly elevated IOP was observed among smokers, subjects with systemic hypertension and women with clinically significant macular edema (CSME). After a univariate analysis, factors associated significantly with higher IOP were elevated systolic blood pressure, elevated resting pulse rate and thicker central corneal thickness (CCT). In women, elevated glycosylated hemoglobin was associated with a higher IOP. After adjusting for all variables, the elevated resting pulse rate and CCT were found to be associated with a higher IOP.
Conclusions Systemic hypertension, smoking, pulse rate and CCT were associated with elevated intraocular pressure in type 2 DM. Women with type 2 DM, especially those with CSME, were more prone to have an elevated IOP.
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Citations
Citations to this article as recorded by- Cyclodiode vs micropulse transscleral laser treatment
Monica Kelada, Eduardo M. Normando, Francesca M. Cordeiro, Laura Crawley, Faisal Ahmed, Sally Ameen, Niten Vig, Philip Bloom
Eye.2024;[Epub] CrossRef - Neuroinflammation and neovascularization in diabetic eye diseases (DEDs): identification of potential pharmacotherapeutic targets
Siva Prasad Panda, P Hemachandra Reddy, Uma Sankar Gorla, DSNBK Prasanth
Molecular Biology Reports.2023; 50(2): 1857. CrossRef - Image-based insilico investigation of hemodynamics and biomechanics in healthy and diabetic human retinas
Kartika Chandra Tripathy, Ashish Siddharth, Ajay Bhandari
Microvascular Research.2023; 150: 104594. CrossRef - Retinal Nerve Fiber Layer Loss Is Associated with Urinary Albumin Excretion in Patients with Type 2 Diabetes
Jin A. Choi, Sun-Hee Ko, Yi Ryeung Park, Dong-Hyun Jee, Seung-Hyun Ko, Chan Kee Park
Ophthalmology.2015; 122(5): 976. CrossRef - The distribution of intraocular pressure and associated systemic factors in a Korean population: The Korea National Health and Nutrition Examination Survey
Mi Jeung Kim, Ki Ho Park, Chan Yun Kim, Jin Wook Jeoung, Seok Hwan Kim
Acta Ophthalmologica.2014;[Epub] CrossRef - Association between Urinary Albumin Excretion and Intraocular Pressure in Type 2 Diabetic Patients without Renal Impairment
Jin A. Choi, Kyungdo Han, Hyuk-Sang Kwon, Ariela Benigni, PhD.
PLoS ONE.2014; 9(5): e96335. CrossRef
- Trends in Body Mass Index and Associations With Physical Activity Among Career Soldiers in South Korea
- Kyoung-Ki Bae, Ho Kim, Sung-Il Cho
- J Prev Med Public Health. 2011;44(4):167-175. Published online July 29, 2010
- DOI: https://doi.org/10.3961/jpmph.2011.44.4.167
- 8,161 View
- 60 Download
- 2 Crossref
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Abstract
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Objective This study was designed to describe the trends in body mass index (BMI) during 6 years (2002 - 2008) and to identify associations between these trends and the amount of physical activity of South Korean career soldiers.
Method This study targeted the 40 993 (38 857 men and 2136 women) of the 58 657 career soldiers who had undergone four (2002, 2004, 2006, and 2008) biennial medical examinations conducted by the National Health Insurance Corporation; 17 664 soldiers with missing data on height, weight, and physical activity were excluded. A linear mixed-regression model was used to categorize changes in BMI due to age versus those due to amount of physical activity.
Results Career soldiers experienced significant increases in BMI compared with baseline data gathered in 2002. The increases in each age group were as follows: men aged 20- 29: 1.16, men aged 30 - 39: 0.61, men aged 40 - 49: 0.05, women aged 20- 29: 0.35, women aged 30- 39: 0.30, women aged 40-49: 0.26, and women aged 50- 59: 0.21. However, men aged 50 or older showed significant decreases (as high as 0.5) in BMI compared with baseline data obtained in 2002. They also experienced significant decreases in BMI compared with those who reported no physical activity. The differences between baseline and final BMIs were: 0.02 for men exercising 1- 2 times per week, -0.07 for men exercising 3-4 times per week, -0.19 for men exercising 5-6 times per week, -0.21 for men exercising seven times per week, -0.05 for women exercising 1- 2 times per week, -0.19 for women exercising 3- 4 times per week, -0.30 for women exercising 5-6 times per week, and -0.30 for women exercising seven times per week.
Conclusions Obesity in South Korean career soldiers increased markedly between 2002 and 2008, and our data showed that the amount of physical activity was inversely related to increases in BMI. Policies to prevent obesity are needed to reduce this trend.
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Citations
Citations to this article as recorded by- Effects of military life on changes in body mass index of enlisted men: a cross-sectional study
Bb Ni Lee, S W Bae, S Y Oh, J H Yoon, J Roh, J U Won
BMJ Military Health.2022; 168(3): 218. CrossRef - Association Between Diet, Physical Activity and Body Mass Index, Fat Mass Index and Bone Mineral Density of Soldiers of the Polish Air Cavalry Units
Anna Anyżewska, Roman Łakomy, Tomasz Lepionka, Ewa Szarska, Ewelina Maculewicz, Andrzej Tomczak, Jerzy Bertrandt
Nutrients.2020; 12(1): 242. CrossRef
- Trends in Cigarette Use Behaviors Among Adolescents by Region in Korea
- Nam Soo Hong, Keon Yeop Kim, Soon-Woo Park, Jong-Yeon Kim, Jisuk Bae, Won Kee Lee, Ki Su Kim
- J Prev Med Public Health. 2011;44(4):176-184. Published online July 29, 2010
- DOI: https://doi.org/10.3961/jpmph.2011.44.4.176
- 10,339 View
- 63 Download
- 8 Crossref
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Objectives Understanding recent trends in cigarette smoking among adolescents is important in order to develop strategies to prevent cigarette smoking. The aim of this study was to compare recent trends in cigarette smoking for adolescents living in rural areas, small towns and metropolitan cities in Korea.
Methods The raw data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2005 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Logistic regression models were used to evaluate significant linear time trends in cigarette smoking. The indicators of cigarette use behaviors were 'current smoking rate', 'frequent smoking rate', 'heavy smoking rate' and 'smoking experience rate before 13 years of age'. All analyses were conducted according to gender.
Results Statistically significant increasing trends in current smoking rate and frequent smoking rate were observed and borderline significant increasing trends in heavy smoking rate were shown among rural boys. Among metropolitan city boys, statistically significant increasing trends were also seen for frequent smoking. Statistically significant decreasing trends in current smoking rate were observed among small town and metropolitan city girls. Smoking experience rate before 13 years of age for rural girls decreased significantly.
Conclusions Cigarette smoking prevalence among adolescents in the rural areas has increased in the last five years especially among boys. Our findings suggest that anti-tobacco program for adolescents should be conducted primarily for those in rural areas.
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Citations
Citations to this article as recorded by- Differences in Health Behavior Profiles of Adolescents in Urban and Rural Areas in a Korean City
Myungah Chae, Kihye Han
Healthcare.2021; 9(3): 282. CrossRef - Gender differential secular trend in lifetime smoking prevalence among adolescents: an age-period-cohort analysis
Jun Hyun Hwang, Soon-Woo Park
BMC Public Health.2019;[Epub] CrossRef - Trends in the ease of cigarette purchase among Korean adolescents: evidence from the Korea youth risk behavior web-based survey 2005–2016
Seo Young Kang, Jung Ah. Lee, Hong-Jun Cho
BMC Public Health.2018;[Epub] CrossRef - Age-period-cohort analysis of smoking prevalence among young adults in Korea
Yong Ho Jee, Sung-il Cho
Epidemiology and Health.2016; 38: e2016010. CrossRef - Data Resource Profile: The Korea Youth Risk Behavior Web-based Survey (KYRBS)
Yoonjung Kim, Sunhye Choi, Chaemin Chun, Suyeon Park, Young-Ho Khang, Kyungwon Oh
International Journal of Epidemiology.2016; : dyw070. CrossRef - Incidence of Multiple Sclerosis and Related Disorders in Asian Populations of British Columbia
Joshua D. Lee, Colleen Guimond, Irene M. Yee, Carles Vilariño-Güell, Zhi-Ying Wu, Anthony L. Traboulsee, A. Dessa Sadovnick
Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.2015; 42(4): 235. CrossRef - Factors Related to Increasing Trends in Cigarette Smoking of Adolescent Males in Rural Areas of Korea
Nam Soo Hong, Sin Kam, Keon Yeop Kim
Journal of Preventive Medicine and Public Health.2013; 46(3): 139. CrossRef - Physical activity and cardiovascular risk factors in university students in the city of Leon, Mexico
Maciste H. Macías-Cervantes, Victoriano Pérez-Vázquez, Antonio E. Rivera-Cisneros, Andrés Martínez-Rivera, Joel Ramírez-Emiliano, Carlos Kornhauser
Health.2013; 05(11): 1861. CrossRef
Brief Report- Fifteen Years After the Gozan-Dong Glass Fiber Outbreak, Incheon in 1995
- Soo-Hun Cho, Joohon Sung, Jonghoon Kim, Young-Su Ju, Minji Han, Kyu-Won Jung
- J Prev Med Public Health. 2011;44(4):185-189. Published online July 29, 2010
- DOI: https://doi.org/10.3961/jpmph.2011.44.4.185
- 6,891 View
- 55 Download
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Objectives In 1995, an outbreak survey in Gozan-dong concluded that an association between fiberglass exposure in drinking water and cancer outbreak cannot be established. This study follows the subjects from a study in 1995 using a data linkage method to examine whether an association existed. The authors will address the potential benefits and methodological issues following outbreak surveys using data linkage, particularly when informed consent is absent.
Methods This is a follow-up study of 697 (30 exposed) individuals out of the original 888 (31 exposed) participants (78.5%) from 1995 to 2007 assessing the cancer outcomes and deaths of these individuals. The National Cancer Registry (KNCR) and death certificate data were linked using the ID numbers of the participants. The standardized incidence ratio (SIR) and standardized mortality ratio (SMR) from cancers were calculated by the KNCR.
Results The SIR values for all cancer or gastrointestinal cancer (GI) occurrences were the lowest in the exposed group (SIR, 0.73; 95% CI, 0.10 to 5.21; 0.00 for GI), while the two control groups (control 1: external, control 2: internal) showed slight increases in their SIR values (SIR, 1.18 and 1.27 for all cancers; 1.62 and 1.46 for GI). All lacked statistical significance. All-cause mortality levels for the three groups showed the same pattern (SMR 0.37, 1.29, and 1.11).
Conclusions This study did not refute a finding of non-association with a 13-year follow-up. Considering that many outbreak surveys are associated with a small sample size and a cross-sectional design, follow-up studies that utilize data linkage should become standard procedure.
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