Journal of Preventive Medicine and Public Health

Editorial

Our Valuable Contributors: Reviewers of 2023: Sue K. Park; J Prev Med Public Health. 2024;57(2):95-95. Published online March 29, 2024; DOI: https://doi.org/10.3961/jpmph.24.148

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Original Article

Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea: Jongmin Oh, Youn-Hee Lim, Changwoo Han, Dong-Wook Lee, Jisun Myung, Yun-Chul Hong, Soontae Kim, Hyun-Joo Bae; J Prev Med Public Health. 2024;57(2):185-196. Published online March 29, 2024; DOI: https://doi.org/10.3961/jpmph.23.514

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Abstract Summary PDF Supplementary Material: Objectives
Excess mortality associated with long-term exposure to fine particulate matter (PM_2.5) has been documented. However, research on the disease burden following short-term exposure is scarce. We investigated the cause-specific mortality burden of short-term exposure to PM_2.5 by considering the potential non-linear concentration–response relationship in Korea.
Methods
Daily cause-specific mortality rates and PM_2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM_2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM_2.5 concentrations below 15 μg/m³. Overall deaths attributable to short-term PM_2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM_2.5 exposure.
Results
Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM_2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovascular, and 708 respiratory deaths were attributed to short-term exposure to PM_2.5. The estimated number of all-cause excess deaths due to short-term PM_2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472).
Conclusions
Our findings indicate an association between short-term PM_2.5 exposure and various mortality rates (all-cause, non-accidental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short-term exposure to PM_2.5.; Summary

Korean summary
본 연구는 2010~2019년 한국의 초미세먼지 단기 노출로 인한 사망 부담을 추정하였으며 2010~2019년간, 초미세먼지 단기노출로 인한 전체원인 사망은 10,814명, 비사고 사망은 7,855명, 심혈관 사망은 1,642명, 호흡기 사망은 708명으로 추정하였다. 본 연구 결과는 대기오염 관리, 규제, 정책 수립에 있어 도움을 줄 것으로 예상한다.

Key Message
- We estimated mortality burden attributable to short-term exposure to PM 2.5 in Korea from 2010 to 2019 - Over the 10-years study period, the estimated excess deaths due to short-term exposure to PM 2.5 totaled 10,814 for all-causes, 7,855 for non-accidental, 1,642 for cardiovascular disease, and 708 for respiratory disease. - Our findings can assist in air pollution management, regulation, and policy-making.

Systematic Review

Food is Medicine Initiative for Mitigating Food Insecurity in the United States: Vidya Sharma, Ramaswamy Sharma; J Prev Med Public Health. 2024;57(2):96-107. Published online March 8, 2024; DOI: https://doi.org/10.3961/jpmph.23.505

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Abstract Summary PDF: Objectives
While several food assistance programs in the United States tackle food insecurity, a relatively new program, “Food is Medicine,” (FIM) initiated in some cities not only addresses food insecurity but also targets chronic diseases by customizing the food delivered to its recipients. This review describes federal programs providing food assistance and evaluates the various sub-programs categorized under the FIM initiative.
Methods
A literature search was conducted from July 7, 2023 to November 9, 2023 using the search term, “Food is Medicine”, to identify articles indexed within three major electronic databases, PubMed, Medline, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Eligibility criteria for inclusion were: focus on any aspect of the FIM initiative within the United States, and publication as a peer-reviewed journal article in the English language. A total of 180 articles were retrieved; publications outside the eligibility criteria and duplicates were excluded for a final list of 72 publications. Supporting publications related to food insecurity, governmental and organizational websites related to FIM and other programs discussed in this review were also included.
Results
The FIM program includes medically tailored meals, medically tailored groceries, and produce prescriptions. Data suggest that it has lowered food insecurity, promoted better management of health, improved health outcomes, and has, therefore, lowered healthcare costs.
Conclusions
Overall, this umbrella program is having a positive impact on communities that have been offered and participate in this program. Limitations and challenges that need to be overcome to ensure its success are discussed.; Summary

Key Message
In 2023, the United States Department of Health & Human Services (HHS), developed a "Food is Medicine" (FIM) initiative to address food insecurity and chronic diseases by providing healthy food options tailored to recipients' specific health needs. Programs categorized under the FIM initiative include Medically Tailored Meals, Medically Tailored Groceries, and Produce Prescriptions, which are described in this review. Overall, the program appears to have had a positive impact by improving health outcomes and enhancing the overall quality of life.

Original Articles

Symptoms, Mental Health, and Quality of Life Among Patients After COVID-19 Infection: A Cross-sectional Study in Vietnam: Hai Nguyen Thanh, Duc Cap Minh, Hien Hoang Thu, Duc Nguyen Quang; J Prev Med Public Health. 2024;57(2):128-137. Published online February 27, 2024; DOI: https://doi.org/10.3961/jpmph.23.511

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Abstract Summary PDF: Objectives
This study was conducted to characterize the symptoms, mental health, quality of life (QoL), and associated factors following the coronavirus disease 2019 (COVID-19) infection.
Methods
This cross-sectional study included 394 participants previously infected with COVID-19 in Ho Chi Minh City, Vietnam. Mental health was assessed using the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Participants self-reported health-related QoL was measured with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) scale.
Results
Among the participants, 76.4% reported experiencing at least one symptom following COVID-19 infection. The most common symptoms were fatigue (42.1%), cognitive dysfunction (42.9%), and hair loss (27.9%). According to the DASS-21 results, the proportions of depression, anxiety, and stress were 28.7%, 26.4%, and 20.6%, respectively. The mean scores on the EQ-5D-5L and the EuroQol Visual Analog Scale were 0.94±0.11 and 84.20±13.11, respectively. Regarding QoL issues, the highest proportion of participants (32.7%) reported experiencing anxiety or depression, followed by pain or discomfort (25.4%). Multivariable logistic regression analysis revealed that factors associated with the presence of symptoms following COVID-19 infection included female (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.65 to 4.91) and having QoL issues (OR, 3.25; 95% CI, 1.71 to 6.19).
Conclusions
The study investigated the prevalence rates of various symptoms following COVID-19 infection. These findings underscore the need to prioritize comprehensive care for individuals recovering from COVID-19 and to implement strategies to mitigate the long-term impact of the disease on mental health and QoL.; Summary

Key Message
This cross-sectional study in Vietnam investigated symptoms, mental health, and quality of life among patients recovering from COVID-19. The study found that most participants experienced post-infection symptoms, with fatigue, cognitive dysfunction, and hair loss being the most common. Mental health issues were prevalent, and participants reported varying levels of quality of life. The findings highlight the importance of comprehensive care and strategies to address the long-term impact of COVID-19 on mental health and quality of life.

Patterns of Health-related Quality of Life in Men Who Inject Drugs: A Survey in Southeast Iran: Marzieh Nojomi, Maysam Rezapour, Neda Soleimanvandi Azar, Mehdi Darabi, Mehran Asadi-Aliabadi; J Prev Med Public Health. 2024;57(2):148-156. Published online February 23, 2024; DOI: https://doi.org/10.3961/jpmph.23.379

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Abstract Summary PDF: Objectives
Understanding patterns of quality of life in people who inject drugs (PWID) can help healthcare providers plan and manage their health problems in a more focused manner. Therefore, the current study aimed to identify patterns of health-related quality of life in PWID in southeast Iran.
Methods
This cross-sectional study was conducted in southeast Iran on men who had injected drugs at least once during the last year. We used convenience sampling in 2 drop-in centers and venue-based sampling at 85 venues. Demographic characteristics, high-risk behaviors, and health-related quality of life were evaluated using the 5-level EQ-5D version (EQ-5D-5L) questionnaire. Latent profile analysis was used to identify patterns of quality of life.
Results
This study enrolled 398 PWID, who had a mean age of 34.1±11.4 years. About 47.9% reported a prison history in the last 10 years, 59.2% had injected drugs in the last month, and 31.6% had a history of sharing syringes. About 46.3% reported having 2 or more sexual partners in the last 6 months, and 14.7% had a history of sex with men. Out of the 5 EQ-5D-5L profiles, the fifth profile had the most people (36.6%). Most variations in quality of life were related to pain and discomfort.
Conclusions
We showed that the pain and discomfort dimension of EQ-5D-5L had more variation in PWID. This finding will be useful for allocating appropriate interventions and resources to promote health-related quality of life in this population.; Summary

Key Message
People who Inject drugs, as an at-risk population in physical and mental disorders, need support to reduce harm. This study found that the health-related quality of life of these people is affected more by the pain and discomfort dimension. This can be caused by their social exclusion and marginalization. Hence, regular planning is necessary to organize the health status of these people. Due to the hard-to-reach nature of this population, special arrangements such as utilizing peer groups may be effective to provide them with services.

Knowledge, Attitudes, and Practices Regarding Dengue Prevention Among Health Volunteers in an Urban Area – Malang, Indonesia: Alidha Nur Rakhmani, Lilik Zuhriyah; J Prev Med Public Health. 2024;57(2):176-184. Published online February 21, 2024; DOI: https://doi.org/10.3961/jpmph.23.484

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Abstract Summary PDF: Objectives
The dengue prevention program known as “One House One Mosquito Larva Inspector” involves health volunteers who play a crucial role in the surveillance of mosquito larvae and reporting their findings to local public health officials. This study aimed to identify factors related to the knowledge, attitudes, and practices (KAP) of dengue prevention behavior among these health volunteers.
Methods
A study was conducted in 5 sub-districts in Malang, an urban area in Indonesia. We employed a cross-sectional design and utilized a semi-structured questionnaire to assess the KAP of 400 health volunteers. Data were collected through face-to-face interviews.
Results
Multiple logistic regression analysis revealed that individuals with a more positive attitude (odds ratio [OR], 1.69; p<0.05) and those with family sizes greater than five persons (OR, 1.90; p<0.05) were more likely to engage in effective dengue prevention practices. Additionally, possesing good knowledge was significantly assocated with more positive attitude (OR, 2.24; p<0.001). Furthermore, 40% reduction in positive attitude was observed in those over 45 years (OR, 0.60; p<0.05). The best practices most frequently reported by the majority of respondents included always reporting their surveillance activities (75.8%) and cleaning the water container in the bathroom at least once a week (65.2%). However, only 52.2% of respondents regularly checked for mosquito larvae in their neighborhood.
Conclusions
Sustainable promotion and training for the “One House One Mosquito Larva Inspector” initiative are necessary, particularly among young health volunteers, to improve dengue prevention behaviors both within their own homes and in the surrounding environment.; Summary

Key Message
The study among health volunteers emphasizes that better knowledge and younger age < 45 were associated with a positive attitude. While a positive attitude and family size > 5 persons were associated with better dengue prevention practices. Therefore, there is a need for sustained promotion and training among health volunteers to enhance the knowledge and attitude that may shape good dengue prevention practices.

Environmental Health Literacy Regarding Fine Particulate Matter and Related Factors Among Village Health Volunteers in Upper Northern Thailand: Nattapon Pansakun, Warangkana Naksen, Waraporn Boonchieng, Parichat Ong-artborirak, Tippawan Prapamontol; J Prev Med Public Health. 2024;57(2):138-147. Published online February 10, 2024; DOI: https://doi.org/10.3961/jpmph.23.434

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Abstract PDF: Objectives
Fine particulate matter pollution has emerged as a significant life-threatening issue in Thailand. Recognizing the importance of environmental health literacy (EHL) in disease prevention is crucial for protecting public health. This study investigated EHL levels and aimed to identify associated factors among village health volunteers (VHVs) in the upper northern region of Thailand.
Methods
A cross-sectional study was conducted to collect data from 710 VHVs using the EHL assessment tool developed by the Department of Health, Thailand.
Results
The overall EHL score was moderate (mean, 3.28 out of a possible 5.0), with the highest and lowest domain-specific mean score for the ability to make decisions (3.52) and the ability to access (3.03). Multiple linear regression revealed that the factors associated with EHL score were area of residence (urban areas in Chiang Mai: B=0.254; urban areas in Lampang: B=0.274; and rural areas in Lampang: B=0.250 compared to rural areas in Chiang Mai), higher education levels (senior high school: B=0.212; diploma/high vocational certificate: B=0.350; bachelor’s degree or above: B=0.528 compared to elementary school or lower), having annual health checkups compared to not having annual health check-ups (B=0.142), monthly family income (B=0.004), and individuals frequently facing air pollution issues around their residence (B=0.199) compared to those who reported no such issues.
Conclusions
The VHVs exhibited moderate EHL associated with residence area, education, health check-ups, family income, and residential air pollution. Considering these factors is vital for enhancing VHVs’ EHL through strategic interventions.; Summary

Excess Deaths During the COVID-19 Pandemic in Southern Iran: Estimating the Absolute Count and Relative Risk Using Ecological Data: Mohammadreza Zakeri, Alireza Mirahmadizadeh, Habibollah Azarbakhsh, Seyed Sina Dehghani, Maryam Janfada, Mohammad Javad Moradian, Leila Moftakhar, Mehdi Sharafi, Alireza Heiran; J Prev Med Public Health. 2024;57(2):120-127. Published online February 7, 2024; DOI: https://doi.org/10.3961/jpmph.23.198

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Abstract Summary PDF Supplementary Material: Objectives
The coronavirus disease 2019 (COVID-19) pandemic led to increased mortality rates. To assess this impact, this ecological study aimed to estimate the excess death counts in southern Iran.
Methods
The study obtained weekly death counts by linking the National Death Registry and Medical Care Monitoring Center repositories. The P-score was initially estimated using a simple method that involved calculating the difference between the observed and expected death counts. The interrupted time series analysis was then used to calculate the mean relative risk (RR) of death during the first year of the pandemic.
Results
Our study found that there were 5571 excess deaths from all causes (P-score=33.29%) during the first year of the COVID-19 pandemic, with 48.03% of these deaths directly related to COVID-19. The pandemic was found to increase the risk of death from all causes (RR, 1.26; 95% confidence interval [CI], 1.19 to 1.33), as well as in specific age groups such as those aged 35-49 (RR, 1.21; 95% CI, 1.12 to 1.32), 50-64 (RR, 1.38; 95% CI, 1.28 to 1.49), and ≥65 (RR, 1.29; 95% CI, 1.12 to 1.32) years old. Furthermore, there was an increased risk of death from cardiovascular diseases (RR, 1.17; 95% CI, 1.11 to 1.22).
Conclusions
There was a 26% increase in the death count in southern Iran during the COVID-19 pandemic. More than half of these excess deaths were not directly related to COVID-19, but rather other causes, with cardiovascular diseases being a major contributor.; Summary

Key Message
During the first year of the COVID-19 pandemic in southern Iran, there was a notable increase in excess deaths, representing a 33.29% rise compared to expected figures. Approximately half of these excess deaths were directly attributed to COVID-19. Moreover, the pandemic heightened the risk of death across all causes by 26%, with specific age groups, notably those aged 50-64, experiencing heightened vulnerability. Notably, cardiovascular diseases emerged as a significant contributor to excess mortality during this period, while decreases were observed in deaths related to chronic respiratory diseases and cancers.

Empowering Rural Housewives in Iran: Utilizing the Transtheoretical Model to Increase Physical Activity: Mahboobe Borhani, Zakieh Sadat Hosseini, Najme Shahabodin, Ali Mehri, Mohadese Kiani, Marzieh Abedi; J Prev Med Public Health. 2024;57(2):167-175. Published online January 31, 2024; DOI: https://doi.org/10.3961/jpmph.23.457

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Abstract Summary PDF: Objectives
Rural housewives are integral to household management and family care, yet their sedentary lifestyles present significant health risks. This study used the transtheoretical model (TTM) to investigate strategies that encourage and maintain regular exercise habits among rural housewives.
Methods
A semi-experimental study was conducted in 2021 with 114 housewives aged 30 to 59 who attended rural health centers in Gorgan, Iran. Participants were randomly assigned to 1 of 2 groups. Data collection involved a validated questionnaire that gathered demographic information and constructs of the TTM. The intervention group participated in a comprehensive educational program, which included four 60-minute sessions. Data were collected again 6 months post-intervention and analyzed using descriptive and inferential statistics in SPSS version 21.
Results
The study encompassed women with an average age of 39.75±6.05 years, the majority of whom had educational levels below a diploma, and over 90% were married. We observed strong correlations between the processes of change, self-efficacy, and decisional balance. At the outset, there were no significant differences in demographics or model structures between the 2 groups. However, 6 months post-intervention, the intervention group exhibited statistically significant differences in the mean scores of model structures, stages of change, and body mass index (<>p<0.05).
Conclusions
This study highlights the importance of physical activity training for rural housewives. The findings suggest that the educational intervention, which utilized the TTM, significantly impacted the participants’ model structures and their stages of change.; Summary

Key Message
The study aimed to investigate strategies for promoting and sustaining regular exercise habits among rural housewives using the transtheoretical model (TTM). A semi-experimental study was conducted with 114 housewives aged 30 to 59 in Iran. The intervention group received a comprehensive educational program, and after 6 months, they exhibited significant differences in model structures, stages of change, and body mass index compared to the control group. These findings underscore the importance of physical activity training for rural housewives and suggest that the educational intervention utilizing the TTM substantially impacted the participants' model structures and stages of change.

Understanding the Perspectives of Paediatric Physicians on Physiotherapy in Paediatric Rehabilitation in Chennai, India: A Qualitative Approach: Vadivelan Kanniappan, Abishek Jayapal Rajeswari, Pearlyn Esther Padma Lawrence, Subash Sundar; J Prev Med Public Health. 2024;57(2):157-166. Published online January 21, 2024; DOI: https://doi.org/10.3961/jpmph.23.426

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Abstract Summary PDF Supplementary Material: Objectives
Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics.
Methods
For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis.
Results
A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients’ parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists.
Conclusions
Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.; Summary

Key Message
The paper investigates the views of pediatricians in Chennai, Tamil Nadu, India, about pediatric physiotherapy. It finds themes including the value of a multidisciplinary approach, the function of experienced physiotherapists, and parental access restrictions via qualitative interviews with ten doctors. To maximize patient outcomes, recommendations include raising awareness, strengthening multidisciplinary cooperation, and creating centralized pediatric rehabilitation centers.

Alleviation of PM_2.5-associated Risk of Daily Influenza Hospitalization by COVID-19 Lockdown Measures: A Time-series Study in Northeastern Thailand: Benjawan Roudreo, Sitthichok Puangthongthub; J Prev Med Public Health. 2024;57(2):108-119. Published online January 19, 2024; DOI: https://doi.org/10.3961/jpmph.23.349

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Abstract Summary PDF Supplementary Material: Objectives
Abrupt changes in air pollution levels associated with the coronavirus disease 2019 (COVID-19) outbreak present a unique opportunity to evaluate the effects of air pollution on influenza risk, at a time when emission sources were less active and personal hygiene practices were more rigorous.
Methods
This time-series study examined the relationship between influenza cases (n=22 874) and air pollutant concentrations from 2018 to 2021, comparing the timeframes before and during the COVID-19 pandemic in and around Thailand’s Khon Kaen province. Poisson generalized additive modeling was employed to estimate the relative risk of hospitalization for influenza associated with air pollutant levels.
Results
Before the COVID-19 outbreak, both the average daily number of influenza hospitalizations and particulate matter with an aerodynamic diameter of 2.5 μm or less (PM_2.5) concentration exceeded those later observed during the pandemic (p<0.001). In single-pollutant models, a 10 μg/m³ increase in PM_2.5 before COVID-19 was significantly associated with increased influenza risk upon exposure to cumulative-day lags, specifically lags 0-5 and 0-6 (p<0.01). After adjustment for co-pollutants, PM_2.5 demonstrated the strongest effects at lags 0 and 4, with elevated risk found across all cumulative-day lags (0-1, 0-2, 0-3, 0-4, 0-5, and 0-6) and significantly greater risk in the winter and summer at lag 0-5 (p<0.01). However, the PM_2.5 level was not significantly associated with influenza risk during the COVID-19 outbreak.
Conclusions
Lockdown measures implemented during the COVID-19 pandemic could mitigate the risk of PM_2.5-induced influenza. Effective regulatory actions in the context of COVID-19 may decrease PM_2.5 emissions and improve hygiene practices, thereby reducing influenza hospitalizations.; Summary

Key Message
In the present research, both single- and multi-pollutant models indicated that the level of PM2.5 was significantly related to the daily number of influenza cases in Khon Kaen, Thailand, prior to the COVID-19 outbreak. Additionally, a significant risk difference was observed between the pre-outbreak and the pandemic periods due to the reduction in air pollutant concentrations because of lockdown measures to control the spread of COVID-19. These findings could be useful for developing environmental policies and strategies accordingly to mitigate respiratory health issues.

Trends in Research on Patients With COVID-19 in Korean Medical Journals: Heejeong Choi, Seunggwan Song, Heesang Ahn, Hyobean Yang, Hyeonseong Lim, Yohan Park, Juhyun Kim, Hongju Yong, Minseok Yoon, Mi Ah Han; J Prev Med Public Health. 2024;57(1):47-54. Published online January 17, 2024; DOI: https://doi.org/10.3961/jpmph.23.254

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Abstract Summary PDF Supplementary Material: Objectives
This study was conducted to systematically summarize trends in research concerning patients with coronavirus disease 2019 (COVID-19) as reported in Korean medical journals.
Methods
We performed a literature search of KoreaMed from January 2020 to September 2022. We included only primary studies of patients with COVID-19. Two reviewers screened titles and abstracts, then performed full-text screening, both independently and in duplicate. We first identified the 5 journals with the greatest numbers of eligible publications, then extracted data pertaining to the general characteristics, study population attributes, and research features of papers published in these journals.
Results
Our analysis encompassed 142 primary studies. Of these, approximately 41.0% reported a funding source, while 3.5% disclosed a conflict of interest. In 2020, 42.9% of studies included fewer than 10 participants; however, by 2022, the proportion of studies with over 200 participants had increased to 40.6%. The most common design was the cohort study (48.6%), followed by case reports/series (35.2%). Only 3 randomized controlled trials were identified. Studies most frequently focused on prognosis (58.5%), followed by therapy/intervention (20.4%). Regarding the type of intervention/exposure, therapeutic clinical interventions comprised 26.1%, while studies of morbidity accounted for 13.4%. As for the outcomes measured, 50.7% of studies assessed symptoms/clinical status/improvement, and 14.1% evaluated mortality.
Conclusions
Employing a systematic approach, we examined the characteristics of research involving patients with COVID-19 that was published in Korean medical journals from 2020 onward. Subsequent research should assess not only publication trends over a longer timeframe but also the quality of evidence provided.; Summary

Korean summary
본 연구는 2020년 이후 국내 의학저널에 보고된 코로나19 환자를 대상으로 진행된 연구의 특성을 체계적 방법론을 통해 살펴보았다. 142개 연구 중 5개는 국제 연구자들과 협력했으며 약 50%가 자금 지원에 관해 보고하였으며, 2022년에는 2020년에 비해 대규모 환자 코호트를 포함하는 연구 수가 증가하였다. 연구의 약 20%는 약물 치료와 같은 개입의 영향을 평가하였으며, 향후 연구에서는 장기간에 걸친 연구 경향 뿐만 아니라 연구의 질도 평가해야 할 것이다.

Key Message
This study employed a systematic approach to examine the characteristics of research conducted among patients with COVID-19, as reported in Korean medical journals from 2020 onward. Of 142 studies, 5 involved collaborations with international researchers, and approximately 50% made any declaration regarding funding, and By 2022, an increase was evident in the number of studies that included a large patient cohort relative to the year 2020. Roughly 20% of the studies assessed the impact of interventions, such as pharmaceutical treatments, and further research should assess not only publication trends over a longer timeframe but also the quality of evidence provided.

Perspective

The Paradox of the Ugandan Health Insurance System: Challenges and Opportunities for Health Reform: Emmanuel Otieno, Josephine Namyalo; J Prev Med Public Health. 2024;57(1):91-94. Published online December 30, 2023; DOI: https://doi.org/10.3961/jpmph.23.110

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Abstract Summary PDF: For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of healthcare reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda’s health sector.; Summary

Key Message
For the Ugandans, nearly the last four decades have been years of hope, conflict, and resilience in a myriad of contexts for healthcare reform. Health insurance system has no legal framework and provides benefits not to the entire national population. The 2019 National Health Insurance scheme Bill was passed in 2021. If the President of Uganda assents to the National Health Insurance Bill, it will be a compelling policy in health and health for all policies. But this Bill has several drawbacks. In this perspective, we aimed to provide intricacies and mix of challenges and opportunities for the health sector.

Original Article

Relationship Between Pesticide Exposure Factors and Health Symptoms Among Chili Farmers in Northeast Thailand: Ratchadaporn Pengpan, Kulthida Y. Kopolrat, Sribud Srichaijaroonpong, Nutta Taneepanichskul, Patiwat Yasaka, Ratanee Kammoolkon; J Prev Med Public Health. 2024;57(1):73-82. Published online December 20, 2023; DOI: https://doi.org/10.3961/jpmph.23.353

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Abstract Summary PDF: Objectives
The unsafe use of pesticides in agriculture represents a major hazard to human health. This study was conducted to investigate the association between pesticide exposure and health symptoms among chili farmers in northeast Thailand.
Methods
This cross-sectional analytic study included 141 chili farmers in Sakon Nakhon Province, in northeast Thailand. Data regarding health symptoms were gathered using a self-report questionnaire. A medical technician tested blood cholinesterase activity using an erythrocyte method, and an occupational medicine specialist at Ramathibodi Hospital in Bangkok, Thailand reviewed the results. Associations between personal characteristics, pesticide exposure factors, and health symptoms were analyzed using multiple logistic regression.
Results
Of the 141 chili farmers studied, 66.7% experienced pesticide poisoning, as indicated by below-normal cholinesterase levels. Fatigue was the most frequently reported symptom associated with pesticide exposure, affecting 37.6% of participants. This was followed by nausea and vomiting (31.9%), dizziness (14.9%), and dry throat (14.9%). Multivariate logistic regression analysis revealed that several factors were significantly associated with adverse symptoms: amount of work experience, volume of pesticides used, use of chemical pesticides, use of leaking containers during spraying, direct pesticide exposure while working, contact with pesticide-soaked clothing, consumption of food and drinks in the fields, and blood cholinesterase level indicating risk.
Conclusions
This study suggests potential health risks for chili farmers stemming from exposure to and contamination by pesticides used in agricultural practices. To mitigate these risks, it is essential to supply personal protective equipment and to implement educational programs aimed at improving protective behaviors among farmers.; Summary

Key Message
This study aimed to demonstrate the impact of pesticide exposure on health symptoms. In a cross-sectional study, the effects of pesticide exposure on acetylcholinesterase erythrocyte activity in blood during agricultural practices were examined as potential health risks for chili farmers. It is crucial to provide personal protective equipment and to implement educational initiatives targeted at encouraging farmers to adopt more protective behaviors to reduce these risks.

Systematic Review

Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis: Suchitra Hudrudchai, Charin Suwanwong, Pitchada Prasittichok, Kanu Priya Mohan, Nopphadol Janeaim; J Prev Med Public Health. 2024;57(1):8-17. Published online December 12, 2023; DOI: https://doi.org/10.3961/jpmph.23.345

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Abstract Summary PDF Supplementary Material: Objectives
The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors.
Methods
The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale.
Results
Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM.
Conclusions
Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.; Summary

Key Message
This systematic review and meta-analysis confirmed that factors such as education, number of sexual partners, engagement in sexual activities with an HIV-positive partner, substance use, and lower levels of depression were associated with higher rates of PrEP adherence among MSM. Healthcare providers and interventions should take these aspects into consideration when developing strategies to promote optimal PrEP adherence and reduce the risk of HIV transmission.

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