Journal of Preventive Medicine and Public Health

Original Articles

Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia: Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito; J Prev Med Public Health. 2024;57(5):461-470. Published online August 2, 2024; DOI: https://doi.org/10.3961/jpmph.24.246

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Objectives
This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia.
Methods
This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs.
Results
The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001).
Conclusions
An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.

Summary

Key Message
In Indonesia, Acute Respiratory Infections (ARI) cases were predominantly concentrated in central Sumatra, western and eastern Java, and eastern Papua, while malnutrition cases were more prevalent in northern Sumatra, central Kalimantan, central Sulawesi, and central Papua. A negative association was observed between malnutrition and ARIs. Additionally, wealth had significant negative associations with the environment, malnutrition, and ARIs, suggesting socio-environmental disparities contribute to health outcomes in these regions.

Citations

Citations to this article as recorded by

Multidimensional energy poverty and childhood respiratory health across 26 low and lower middle income countries
Cailiang Xia, Maryam Sadiq, Sidra Younas
Scientific Reports.2026;[Epub] CrossRef
Prevalence and risk factors of acute respiratory infection and diarrhea among children under 5 years old in low-middle wealth household, Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Reiko Saito
Infectious Diseases of Poverty.2025;[Epub] CrossRef
Geographical variation in community-acquired pneumonia prevalence during the COVID-19 pandemic in northern Sumatra, Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito
Discover Public Health.2025;[Epub] CrossRef

Associations Between Indoor Air Pollutants and Risk Factors for Acute Respiratory Infection Symptoms in Children Under 5: An Analysis of Data From the Indonesia Demographic Health Survey: Ichtiarini Nurullita Santri, Yuniar Wardani, Yohane Vincent Abero Phiri, Gunchmaa Nyam, Tyas Aisyah Putri, Khoiriyah Isni, Dyah Suryani, Grace Sambo; J Prev Med Public Health. 2023;56(3):255-263. Published online April 18, 2023; DOI: https://doi.org/10.3961/jpmph.22.470

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Abstract PDF

Objectives
The study investigated the association between indoor air pollution (IAP) and risk factors for acute respiratory infection (ARI) symptoms in children under 5 years of age.
Methods
A cross-sectional study was conducted using data derived from Indonesia Demographic and Health Survey in 2017. Binary logistic regression modeling was employed to examine each predictor variable associated with ARI among children under 5 years of age in Indonesia.
Results
The study included a total of 4936 households with children. Among children under 5 years old, 7.2% reported ARI symptoms. The presence of ARI symptoms was significantly associated with the type of residence, wealth index, and father’s smoking frequency, which were considered the sample’s socio-demographic characteristics. In the final model, living in rural areas, having a high wealth index, the father’s smoking frequency, and a low education level were all linked to ARI symptoms.
Conclusions
The results revealed that households in rural areas had a substantially higher level of reported ARI symptoms among children under 5 years old. Furthermore, the father’s smoking frequency and low education level were associated with ARI symptoms.

Summary

Citations

Citations to this article as recorded by

Trends and inequalities in acute respiratory tract infections in Indonesia: an application of the World Health Organization’s Health Equity Assessment Toolkit
Qorinah Estiningtyas Sakilah Adnani, Khadijat Adeleye, Bibek Giri, Augustus Osborne, Richard Gyan Aboagye, Bright Opoku Ahinkorah
Tropical Medicine and Health.2026;[Epub] CrossRef
Factors Associated with Acute Respiratory Infections in Children Under Five Years Old: Analysis of the Demographic and Family Health Survey
Diego A. Polo-Pucho, Javier J. Gonzales-Carrillo, Miguel A. Arce-Huamani
Children.2025; 12(9): 1242. CrossRef
Indoor air pollution exposure and acute respiratory infection among under-five children in low- and middle-income countries: a systematic review and meta-analysis of epidemiological studies
Belay Desye, Abebe Kassa Geto, Chala Daba, Gete Berihun, Leykun Berhanu
BMC Infectious Diseases.2025;[Epub] CrossRef

COVID-19: Perspective

Characteristics of the COVID-19 Outbreak in Korea From the Mass Infection Perspective: Yun Jung Kang; J Prev Med Public Health. 2020;53(3):168-170. Published online March 19, 2020; DOI: https://doi.org/10.3961/jpmph.20.072

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Abstract PDF

On December 31, 2019, the Chinese government officially announced that the country had some cases of pneumonia with an unknown cause. By February 8, 2020, there were 24 confirmed cases in Korea, and the number of cases has steadily increased since then. On March 9, 2020, the cumulative number of confirmed cases in Korea was 7382, with 51 deaths. This study examines the characteristics of the coronavirus disease 2019 (COVID-19) outbreak from the perspective of the large-scale number of confirmed COVID-19 cases and deaths. This study is significant in that it emphasizes the precautionary principle in preventing and managing infectious diseases, and makes suggestions for urgently needed public health policies.

Summary

Citations

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Modeling Infectious Disease Epidemics in Mass Religious Gatherings: A Systematic Review
Sultanah Alshammari, Mohammed Ba-Aoum, Nofe Alganmi, Ahmad Showail
ACM Transactions on Modeling and Computer Simulation.2025; 35(3): 1. CrossRef
Outbreaks of COVID-19 in indoor places of worship: a systematic review
F Bert, G Lo Moro, A Peano, C Previti, R Siliquini
Perspectives in Public Health.2024; 144(2): 86. CrossRef
Super-spreaders of novel coronaviruses that cause SARS, MERS and COVID-19: a systematic review
Julii Brainard, Natalia R. Jones, Florence C.D. Harrison, Charlotte C. Hammer, Iain R. Lake
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Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study
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Journal of Korean Medical Science.2022;[Epub] CrossRef
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Heewon Kim, Hyungsub Choi
East Asian Science, Technology and Society: An International Journal.2022; 16(1): 97. CrossRef
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Emmanuel Udomiaye, Edidiong Ukpong, Kalu Cheche Kalu, Chris Odum, U. Okon Ibok
IOP Conference Series: Earth and Environmental Science.2022; 1054(1): 012015. CrossRef
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
Epidemiology and Health.2022; 44: e2022065. CrossRef
Perceived Crowding and Risk Perception According to Leisure Activity Type during COVID-19 Using Spatial Proximity
Young-Jae Kim, Seung-Woo Kang
International Journal of Environmental Research and Public Health.2021; 18(2): 457. CrossRef
Preparedness for containing COVID-19 outbreak in mass religious gathering with non-pharmaceutical interventions (NPIs)
Chen-Yang Hsu, Ya-Mei Chen, Chiu-Wen Su, Mei-Sheng Ku, Yeol Kim, Tim Jensen, Dih-Ling Luh
Journal of the Formosan Medical Association.2021; 120: S57. CrossRef
COVID-19 outbreak in a military unit in Korea
Chanhee Kim, Young-Man Kim, Namwoo Heo, Eunjung Park, Sojin Choi, Sehyuk Jang, Nayoung Kim, Donghyok Kwon, Young-Joon Park, Byeongseop Choi, Beomman Ha, Kyounghwa Jung, Changbo Park, Sejin Park, Heeyoung Lee
Epidemiology and Health.2021; 43: e2021065. CrossRef
Telemedicine Center of Korean Medicine for treating patients with COVID-19: a retrospective analysis
Dong-su Kim, Hongmin Chu, Baek Ki Min, YoungJoo Moon, Seongjun Park, Kwangho Kim, Shin-Hyeok Park, Young-Don Kim, Mideok Song, Gun-hee Choi, Eunkyoung Lee
Integrative Medicine Research.2020; 9(3): 100492. CrossRef
Factors Influencing Preventive Behavior against Coronavirus Disease 2019 (COVID-19) among Medically Inclined College Students
Hae Ran Kim, Eun Young Choi, Shin Young Park, Eun A Kim
Journal of Korean Academy of Fundamentals of Nursing.2020; 27(4): 428. CrossRef
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Cho Ryok Kang, Sae Kyung Joo, Ho Jun Kim, Yoojin Park, In Sil Huh, Young Sin Moon, Kwang Hwan Oh, Hyon Jeen Ham, Jin Kyeong Han, Jung Il Kim, Jin Yong Lee, Baeg Ju Na
Public Health Affairs.2020; 4(1): e6. CrossRef

Original Articles

Development of a Social Contact Survey Instrument Relevant to the Spread of Infectious Disease and Its Application in a Pilot Study Among Korean Adults: Hyang Soon Oh, Youngran Yang, Mikyung Ryu; J Prev Med Public Health. 2020;53(2):106-116. Published online February 9, 2020; DOI: https://doi.org/10.3961/jpmph.19.251

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to develop a valid social contact survey instrument and to verify its feasibility for use among Korean adults.
Methods
The Delphi technique was used to develop an instrument to assess social contacts, which was then applied in a cross-sectional pilot study. A panel of 15 medical professionals reviewed the feasibility and validity of each item. The minimum content validity ratio was 0.49. Thirty participants used the developed measure to record contacts during a 24-hour period.
Results
After a systematic review, the survey instrument (parts I and II) was developed. Part I assessed social contact patterns over a 24-hour period, and part II assessed perceptions of contacts in daily life and preventive behaviors (hand hygiene and coughing etiquette). High validity and feasibility were found. In the pilot study, the 30 participants had a combined total of 198 contacts (mean, 6.6 daily contacts per person). The participants’ age (p=0.012), occupation (p<0.001), household size (p<0.001), education (p<0.001), personal income (p=0.003), and household income (p<0.001) were significantly associated with the number of contacts. Contacts at home, of long duration, and of daily frequency were relatively likely to be physical. Assortative mixing was observed between individuals in their 20s and 50s. Contact type differed by location, duration, and frequency (p<0.001).
Conclusions
The developed social contact survey instrument demonstrated high validity and feasibility, suggesting that it is viable for implementation.

Summary

Korean summary
본 연구에서는 감염접촉전파에 대한 인식과 사회적접촉을 측정 도구를 델파이 방법으로 개발하여 국내최초로 한국 성인의 사회적접촉을 측정하였다. 참여자 30명은 24시간 동안 총 198명을 접촉하였으며(6.6명/일/인), 접촉자수는 연령 (p=0.012), 직업(p<0.001), 가구수 (p<0.001), 교육수준 (p<0.001), 개인소득 (p=0.003), 가구소득 (p<0.001)에 따라 차이가 있었다. 동질성 혼합(assortative mixing)은 20대와 50대에서 보였으며, 접촉유형은 접촉장소, 접촉기간, 접촉빈도에 따라 유의하였다(p<0.001). 향후 국내 사회적 접촉 양상과 특성에 관한 전국적인 후속연구를 제언한다.

Citations

Citations to this article as recorded by

A Nationwide Social Contact Survey Dataset for Public Health and Social Sciences Research in South Korea
Min-Kyung Chae, Woo-Sik Son, Kyeongah Nah, Minsoo Kim, Jong-Hoon Kim, Jonggul Lee
Scientific Data.2026;[Epub] CrossRef
A pilot study investigating the social contact patterns of Korean elderly
Hyang Soon Oh, Sun Young Jeong, Youngran Yang
Public Health Nursing.2021; 38(5): 926. CrossRef
Prospective Diary Survey of Preschool Children's Social Contact Patterns: A Pilot Study
Hyang Soon Oh, Mikyung Ryu
Child Health Nursing Research.2020; 26(4): 393. CrossRef

Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy: Taejae Kim, Young Kyung Do; J Prev Med Public Health. 2020;53(2):82-88. Published online November 18, 2019; DOI: https://doi.org/10.3961/jpmph.19.090

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Abstract Summary PDF

Objectives
The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

Summary

Korean summary
이 연구에서는 요양급여 청구자료를 기준으로 급성 상기도 감염에서 스테로이드를 처방하는 경우와 관련하여 다음과 같은 특징을 확인하였다. 첫째, 환자 특성과 기관 특성을 모두 고려하였을 때 진료과목과 기관의 종별 구분에서 감기 스테로이드 처방률은 상당한 변이를 보였다. 둘째, 약제급여적정성평가 항목에서 스테로이드가 제외된 직후 처방률이 시계열적으로 상승하였으며, 이는 처방 행태에 정책 요인이 중요한 영향을 미칠 수 있음을 뜻한다.

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Assessment of systemic steroid use and its determinants among admitted patients at Debre Berhan University Hakim Gizawu Teaching Hospital
Abate Wondesen Tsige, Kalkidan Simegn, Dessale Abate Beyene, Kassahun Dires Ayenew, Yehualashet Teshome Wondmkun, Bedilu Linger Endalifer, Abyou Seyfu Ambaye, Samuel Berihun Dagnew, Siraye Genzeb Ayele
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Pediatrics.2023;[Epub] CrossRef
Trends and Patterns of Systemic Glucocorticoid Prescription in Primary Care Institutions in Southwest China, from 2018 to 2021
Xiaoyi Li, Zhen Zeng, Xingying Fan, Wenju Wang, Xiaobo Luo, Junli Yang, Yue Chang
Risk Management and Healthcare Policy.2023; Volume 16: 2849. CrossRef
Effects of monthly evaluations on the rates of irrational antimicrobial prescription in the outpatient and emergency departments at Ningbo No. 6 Hospital, Ningbo, China
Qiong Yang, Fangfang Yuan, Li Li, Jianfeng Jin, Junhong He
European Journal of Medical Research.2022;[Epub] CrossRef
Systemic glucocorticoid prescriptions pattern and factors of inappropriate use in primary care institutions of Southwest China
Xiaobo Luo, Shitao Yu, Zhen Zeng, Xunrong Zhou, Yuxi Liu, Lei Wang, Jiaqi Hu, Yue Chang
Frontiers in Public Health.2022;[Epub] CrossRef
Effects of Antiviral Therapy and Glucocorticoid Therapy on Fever Duration in Pediatric Patients with Influenza
Ji Yoon Han, Eun Ae Yang, Jung-Woo Rhim, Seung Beom Han
Medicina.2021; 57(12): 1385. CrossRef

Brief Report

Epidemiological and Clinical Characteristics of Confirmed Cases of Severe Fever With Thrombocytopenia Syndrome in Jeju Province, Korea, 2014-2018: Jinhee Kim, Jong-Myon Bae; J Prev Med Public Health. 2019;52(3):195-199. Published online April 3, 2019; DOI: https://doi.org/10.3961/jpmph.18.289

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Abstract Summary PDF Supplementary Material

Objectives
Jeju Province is well known as the region showing the highest incidence of severe fever with thrombocytopenia syndrome (SFTS) in South Korea. The aim of this study was to evaluate the epidemiological and clinical characteristics of SFTS patients in Jeju Province.
Methods
The primary data for this study were obtained from the Integrated Diseases and Health Control System of the Korea Centers for Disease Control and Prevention (KCDCIS). The selection criteria were confirmed cases of SFTS with a residence listed in Jeju Province at the time of diagnosis, reported to the KCDCIS between July 16, 2014 and November 30, 2018.
Results
Of 55 confirmed cases of SFTS, the case fatality rate was 10.9% (95% confidence interval [CI], 4.1 to 22.2). The most common presenting symptoms at diagnosis of severe fever, myalgia, and diarrhea had incidences of 83.6% (95% Cl, 71.2 to 92.2), 45.5% (95% Cl, 32.0 to 59.5), and 40.0% (95% CI, 27.0 to 54.1), respectively.
Conclusions
Compared to SFTS patients nationwide in 2013-2015, the subjects of this study exhibited a lower case fatality rate and had a lower incidence of severe fever, myalgia, and confusion.

Summary

Korean summary
2014-2018년 제주도 SFTS 환자의 치명률은 10.9% (95%CI: 4.1-22.2)로, 2014-2017년 전국 SFTS 환자의 치명률 19.3% (95%CI: 16.1-22.8)와 유사한 수준이다. 중국환자에 비하여 제주도 환자는 고열, 근육통, 혼수 발현률이 상대적으로 낮으며, 설사는 유사한 수준이었다

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Survey of hard ticks in high-incidence area of Severe Fever with Thrombocytopenia Syndrome in China
Min Wang, Lei Gong, Yujie Wang, Lesheng Zhang, Fengfeng Wang, Qi Wang, Qingyue Li, Xiaohe Ma, Zhiguo Cao, Jiabing Wu
Experimental and Applied Acarology.2026;[Epub] CrossRef
The impact of climate change on ecology of tick associated with tick-borne diseases
Heejin Choi, Chang Hyeong Lee, Narendra M Dixit
PLOS Computational Biology.2025; 21(4): e1012903. CrossRef
Activated partial thromboplastin time predicts mortality in patients with severe fever with thrombocytopenia syndrome: A multicenter study in north China
Wenjuan Peng, Junnan Li, Hong Yu, Wei Zhou, Ling Lin, Ziruo Ge, Jianming Lai, Zhihai Chen, Liuluan Zhu, Zhenghua Zhao, Yi Shen, Ronghua Jin, Jianping Duan, Wei Zhang
Heliyon.2024; 10(11): e31289. CrossRef
Seroprevalence of severe fever with thrombocytopenia syndrome using specimens from the Korea National Health & Nutrition Examination Survey
Choon-Mee Kim, Mi Ah Han, Na Ra Yun, Mi-Seon Bang, You Mi Lee, Beomgi Lee, Dong-Min Kim, Eric H. Y. Lau
PLOS Neglected Tropical Diseases.2023; 17(3): e0011097. CrossRef
Analysis of fatal cases of severe fever with thrombocytopenia syndrome in Jiangsu province, China, between 2011 and 2022: A retrospective study
Shuyi Liang, Wei Xie, Zhifeng Li, Nan Zhang, Xiaochen Wang, Yuanfang Qin, Changjun Bao, Jianli Hu
Frontiers in Public Health.2023;[Epub] CrossRef
Epidemiological and spatiotemporal analysis of severe fever with thrombocytopenia syndrome in Eastern China, 2011–2021
Shuyi Liang, Zhifeng Li, Nan Zhang, Xiaochen Wang, Yuanfang Qin, Wei Xie, Changjun Bao, Jianli Hu
BMC Public Health.2023;[Epub] CrossRef
Genetic Diversity, Regional Distribution, and Clinical Characteristics of Severe Fever with Thrombocytopenia Syndrome Virus in Gangwon Province, Korea, a Highly Prevalent Region, 2019–2021
Mi-Young Moon, Hyeon Kyu Kim, Se-Jin Chung, Jae Hwan Byun, Ha-Na Kim, Woan Lee, Soon-Won Lee, Sezim Monoldorova, Sungkyeong Lee, Bo-Young Jeon, Eun-Joo Lim
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Clinical symptoms associated with fatality of severe fever with thrombocytopenia syndrome: A systematic review and meta-analysis
Yao Wang, Zexuan Song, Xiaoying Xu, Xuemin Wei, Haowen Yuan, Hao Liang, Hongling Wen
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Clinical manifestations of death with severe fever and thrombocytopenia syndrome: A meta‐analysis and systematic review
Xiankun Wang, Xingxiang Ren, Ziruo Ge, Shuping Cui, Lin Wang, Zhihai Chen, Di Tian
Journal of Medical Virology.2021; 93(6): 3960. CrossRef
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Jing Li, Shen Li, Li Yang, Pengfei Cao, Jianhong Lu
Critical Reviews in Microbiology.2021; 47(1): 112. CrossRef
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Application of a decision tree model in the early identification of severe patients with severe fever with thrombocytopenia syndrome
Bohao Wang, Zhiquan He, Zhijie Yi, Chun Yuan, Wenshuai Suo, Shujun Pei, Yi Li, Hongxia Ma, Haifeng Wang, Bianli Xu, Wanshen Guo, Xueyong Huang, Sam R. Telford
PLOS ONE.2021; 16(7): e0255033. CrossRef
Spatial-temporal characteristics of severe fever with thrombocytopenia syndrome and the relationship with meteorological factors from 2011 to 2018 in Zhejiang Province, China
Haocheng Wu, Chen Wu, Qinbao Lu, Zheyuan Ding, Ming Xue, Junfen Lin, Elvina Viennet
PLOS Neglected Tropical Diseases.2020; 14(4): e0008186. CrossRef
Hazardous alcohol consumption and aging synergistically increase the risk of death in patients with severe fever with thrombocytopenia syndrome
Yang-yang Zhang, Dong-xiao Liu, Wen-bo Fan, Jin-hong Yu, Li Liu, Wen-jun Du, Qiang Li
Ticks and Tick-borne Diseases.2020; 11(6): 101505. CrossRef
Severe fever with thrombocytopenia syndrome virus: a systematic review and meta-analysis of transmission mode
X. Y. Huang, Z. Q. He, B. H. Wang, K. Hu, Y. Li, W. S. Guo
Epidemiology and Infection.2020;[Epub] CrossRef
Four Year Surveillance of the Vector Hard Ticks for SFTS, Ganghwa-do, Republic of Korea
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The Korean Journal of Parasitology.2019; 57(6): 691. CrossRef

Special Article

Researches of Epigenetic Epidemiology for Infections and Radiation as Carcinogen: Jong-Myon Bae; J Prev Med Public Health. 2018;51(4):169-172. Published online July 2, 2018; DOI: https://doi.org/10.3961/jpmph.18.070

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Abstract PDF Supplementary Material

In recent years, a number of studies have been reported on the various types of cancer arising from epigenetic alterations, including reports that these epigenetic alterations occur as a result of radiation exposure or infection. Thyroid cancer and breast cancer, in particular, have high cancer burden, and it has been confirmed that radiation exposure or onco-viral infection are linked to increased risk of development of these two types of cancer, respectively. Thus, the environment-epigenetic alteration-cancer occurrence (EEC) hypothesis has been suggested. This paper reviews the trends in research supporting this hypothesis for radiation exposure and onco-viral infection. If more evidences accumulate for the EEC hypothesis from future research, those findings may greatly aid in the prevention, early diagnosis, treatment, and prognosis of the thyroid cancer and breast cancer.

Summary

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Expression level and function analysis of serum miRNAs in workers with occupational exposure to benzene series
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International Journal of Molecular Sciences.2019; 20(2): 454. CrossRef

Original Article

Knowledge, Perceptions, and Self-reported Performance of Hand Hygiene Among Registered Nurses at Community-based Hospitals in the Republic of Korea: A Cross-sectional Multi-center Study: Hyang Soon Oh; J Prev Med Public Health. 2018;51(3):121-129. Published online May 14, 2018; DOI: https://doi.org/10.3961/jpmph.17.188

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Abstract PDF Supplementary Material

Objectives
To assess the nurses’ hand hygiene (HH) knowledge, perception, attitude, and self-reported performance in small- and medium-sized hospitals after Middle East Respiratory Syndrome outbreak.
Methods
The structured questionnaire was adapted from the World Health Organization’s survey. Data were collected between June 26 and July 14, 2017.
Results
Nurses showed scores on knowledge (17.6±2.5), perception (69.3±0.8), self-reported HH performance of non-self (86.0±11.0), self-reported performance of self (88.2±11.0), and attitude (50.5±5.5). HH performance rate of non-self was Y₁=36.678+ 0.555X₁ (HH performance rate of self) (adjusted R²=0.280, p<0.001). The regression model for performance was Y₄=18.302+0.247X₄₁ (peception)+0.232X₄₂ (attitude)+0.875X₄₂ (role model); coefficients were significant statistically except attitude, and this model significant statistically (adjusted R²=0.191, p<0.001).
Conclusions
Advanced HH education program would be developed and operated continuously. Perception, attitude, role model was found to be a significant predictors of HH performance of self. So these findings could be used in future HH promotion strategies for nurses.

Summary

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Brief Report

Community-acquired Legionnaires’ Disease in a Newly Constructed Apartment Building: Sukhyun Ryu, Kyungho Yang, Byung Chul Chun; J Prev Med Public Health. 2017;50(4):274-277. Published online June 28, 2017; DOI: https://doi.org/10.3961/jpmph.17.066

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Abstract PDF

Objectives
Legionnaires’ disease (LD) is a severe type of pneumonia caused by inhalation of aerosols contaminated with Legionella. On September 22, 2016, a single case of LD was reported from a newly built apartment building in Gyeonggi province. This article describes an epidemiologic investigation of LD and identification of the possible source of infection. Methods: To identify the source of LD, we interviewed the patient’s husband using a questionnaire based on the Legionella management guidelines from the Korea Centers for Disease Control and Prevention. Water samples from the site were collected and analyzed. An epidemiological investigation of the residents and visitors in the apartment building was conducted for 14 days before the index patient’s symptoms first appeared to 14 days after the implementation of environmental control measures. Results: Legionella pneumophila serogroup 1 was isolated from the heated-water samples from the patient’s residence and the basement of the apartment complex. Thirty-two suspected cases were reported from the apartment building during the surveillance period, yet all were confirmed negative based on urinary antigen tests. Conclusions: The likely source of infection was the building’s potable water, particularly heated water. Further study of effective monitoring systems in heated potable water should be considered.

Summary

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Original Articles

Bacterial Contamination and Disinfection Status of Laryngoscopes Stored in Emergency Crash Carts: Jae Hyung Choi, Young Soon Cho, Jung Won Lee, Hee Bong Shin, In Kyung Lee; J Prev Med Public Health. 2017;50(3):158-164. Published online April 4, 2017; DOI: https://doi.org/10.3961/jpmph.17.013

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Abstract PDF

Objectives
To identify bacterial contamination rates of laryngoscope blades and handles stored in emergency crash carts by hospital and area according to the frequency of intubation attempts.
Methods
One hundred forty-eight handles and 71 blades deemed ready for patient use from two tertiary hospitals were sampled with sterile swabs using a standardized rolling technique. Samples were considered negative (not contaminated) if no colonies were present on the blood agar plate after an 18-hour incubation period. Samples were stratified by hospital and according to the frequency of intubation attempts (10 attempts per year) using the χ²-test and Fisher exact test.
Results
One or more species of bacteria were isolated from 4 (5.6%) handle tops, 20 (28.2%) handles with knurled surfaces, and 27 (18.2%) blades. No significant differences were found in microbial contamination levels on the handle tops and blades between the two hospitals and two areas according to the frequency of intubation attempts. However, significant differences were found between the two hospitals and two areas in the level of microbial contamination on the handles with knurled surfaces (p<0.05).
Conclusions
Protocols and policies must be reviewed to standardize procedures to clean and disinfect laryngoscope blades and handles; handles should be re-designed to eliminate points of contact with the blade; and single-use, one-piece laryngoscopes should be introduced.

Summary

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Current Status of Infection Prevention and Control Programs for Emergency Medical Personnel in the Republic of Korea: Hyang Soon Oh, Dong Choon Uhm; J Prev Med Public Health. 2015;48(6):330-341. Published online November 25, 2015; DOI: https://doi.org/10.3961/jpmph.15.058

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Abstract PDF Supplementary Material

Objectives
Emergency medical personnel (EMPs) are pre-hospital emergency responders who are at risk of exposure to infections and may also serve as a source for the transmission of infections. However, few studies of infection control have specifically addressed EMPs in the Republic of Korea (hereafter Korea). The goal of this study was to assess the current status of infection prevention and control programs (IPCPs) for EMPs in Korea.
Methods
A cross-sectional survey was conducted to quantitatively assess the resources and activities of IPCPs. A total of 907 EMPs in five metropolitan cities completed a structured questionnaire from September 2014 to January 2015. The data were analyzed using descriptive statistics, multi-response analysis, and the chi-square test.
Results
The mean age of the participants was 34.8±15.1 years. IPCPs were found to have weaknesses with regard to the following resources: the assignment of infection control personnel (ICP) (79.5%), hand hygiene resources such as waterless antiseptics (79.3%), the use of paper towels (38.9%), personal protective equipment such as face shields (46.9%), and safety containers for sharps and a separated space for the disposal of infectious waste (10.1%). Likewise, the following activities were found to be inadequately incorporated into the workflow of EMPs: education about infection control (77.5%), post-exposure management (35.9%), and the decontamination of items and spaces after use (88.4%). ICP were found to have a significant effect on the resources and activities of IPCPs (p<0.001). The resources and activities of IPCPs were found to be significantly different among the five cities (p<0.001).
Conclusions
IPCPs for EMPs showed some limitations in their resources and activities. IPCPs should be actively supported, and specific IPCP activities for EMPs should be developed.

Summary

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Respiratory Syncytial Virus Outbreak in the Basic Military Training Camp of the Republic of Korea Air Force: Won-Ju Park, Seok-Ju Yoo, Suk-Ho Lee, Jae-Woo Chung, Keun-Ho Jang, Jai-Dong Moon; J Prev Med Public Health. 2015;48(1):10-17. Published online January 14, 2015; DOI: https://doi.org/10.3961/jpmph.14.037

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Abstract PDF

Objectives
An outbreak of acute febrile illness occurred in the Republic of Korea Air Force boot camp from May to July 2011. An epidemiological investigation of the causative agent, which was of a highly infective nature, was conducted.
Methods
Throat swabs were carried out and a multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) assay was performed to identify possible causative factors.
Results
The mean age of patients who had febrile illness during the study period was 20.24 years. The multiplex RT-PCR assay identified respiratory syncytial virus (RSV) as the causative agent. The main symptoms were sore throat (76.0%), sputum (72.8%), cough (72.1%), tonsillar hypertrophy (67.9%), and rhinorrhea (55.9%). The mean temperature was 38.75°C and the attack rate among the recruits was 15.7% (588 out of 3750 recruits), while the mean duration of fever was 2.3 days. The prognosis was generally favorable with supportive care but recurrent fever occurred in 10.1% of the patients within a month.
Conclusions
This is the first epidemiological study of an RSV outbreak that developed in a healthy young adult group. In the event of an outbreak of an acute febrile illness of a highly infective nature in facilities used by a young adult group, RSV should be considered among the possible causative agents.

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Hye Young Kim, Ki Wook Yun, Hee Jin Cheong, Eun Hwa Choi, Hoan Jong Lee
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Nurse-perceived Patient Adverse Events and Nursing Practice Environment: Jeong-Hee Kang, Chul-Woung Kim, Sang-Yi Lee; J Prev Med Public Health. 2014;47(5):273-280. Published online September 12, 2014; DOI: https://doi.org/10.3961/jpmph.14.019

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Abstract PDF

Objectives
To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, ‘physician- nurse relationship’ correlated with medication errors while ‘education for improving quality of care’ affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

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Brief Report

Epidemiological Investigation of an Outbreak of Salmonellosis in Gyeongju, Korea: Seok-Ju Yoo, Hyun-Sul Lim, Kwan Lee; J Prev Med Public Health. 2014;47(3):177-181. Published online May 30, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.3.177

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Abstract PDF

Objectives

A salmonellosis outbreak occurred within a community of Gyeongju residents who ingested catered food from a wedding in June 2009. We aimed to epidemiologically investigate the probable vehicle of the infection.

Methods

We conducted a retrospective cohort study on 34 local residents who ingested the wedding food.

Results

Among the 34 residents, 31 (91.2%) reported symptoms of infection after eating the food. Among all of the wedding foods, pan-fried foods were highly associated with the diarrheal attack rate. On bacteriological examination, Salmonella species were detected in the pan-fried foods among the leftover foods and in 17 of the 31 stool specimens from the cases. There were five different types of pan-fried foods, but the onset of symptoms was independent of the ingredients used. We found that the pan-fried food was prepared at a food store in Seoul and that eggs were a common ingredient.

Conclusions

The major cause of the salmonellosis in this population was presumed to be the pan-fried food prepared with contaminated eggs. These food items might have been partially undercooked because of their irregular shape, which allowed the Salmonella species to survive and multiply before ingestion.

Summary

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Original Articles

Epidemiological Investigation of an Outbreak of Hepatitis A at a Residential Facility for the Disabled, 2011: Hyun-Sul Lim, Kumbal Choi, Saerom Lee; J Prev Med Public Health. 2013;46(2):62-73. Published online March 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.2.62

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Abstract PDF

Objectives

An outbreak of hepatitis A occurred at a residential facility for the disabled in July 10, 2011. This investigation was carried out to develop a response plan, and to find the infection source of the disease.

Methods

A field epidemiologist investigated the symptoms, vaccination histories, living environments, and probable infection sources with 51 residents and 31 teachers and staff members. In July 25, 81 subjects were tested for the hepatitis A virus antibody, and specimens of the initial 3 cases and the last case were genetically tested.

Results

Three cases occurred July 10 to 14, twelve cases August 3 to 9, and the last case on August 29. Among the teachers and staff, no one was IgM positive (on July 25). The base sequences of the initial 3 and of the last case were identical. The vehicle of the outbreak was believed to be a single person. The initial 3 patients were exposed at the same time and they might have disseminated the infection among the patients who developed symptoms in early August, and the last patient might have, in turn, been infected by the early August cases.

Conclusions

The initial source of infection is not clear, but volunteers could freely come into contact with residents, and an infected volunteer might have been the common infection source of the initial patients. Volunteers' washing their hands only after their activity might be the cause of this outbreak. Although there may be other possible causes, it would be reasonable to ask volunteers to wash their hands both before and after their activities.

Summary

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Epidemiology and Infection.2014; 142(7): 1450. CrossRef

Prevalence of Positive Carriage of Tuberculosis, Methicillin-resistant Staphylococcus aureus, and Vancomycin-resistant Enterococci in Patients Transported by Ambulance: A Single Center Observational Study: Young Sun Ro, Sang Do Shin, Hyun Noh, Sung-Il Cho; J Prev Med Public Health. 2012;45(3):174-180. Published online May 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.3.174

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Abstract PDF

Objectives

An ambulance can be a potential source of contagious or droplet infection of a community. We estimated the prevalence of positive carriage of tuberculosis (TB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococci (VRE) in patients transported by ambulance.

Methods

This was a retrospective observational study. We enrolled all patients who visited a tertiary teaching hospital emergency department (ED). Blood, sputum, urine, body fluid, and rectal swab samples were taken from patients when they were suspected of TB, MRSA, or VRE in the ED. The patients were categorized into three groups: pre-hospital ambulance (PA) group; inter-facility ambulance (IA) group; and non-ambulance (NA) group. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated using a multivariable logistic regression model for the prevalence of each infection.

Results

The total number of patients was 89206. Of these, 9378 (10.5%) and 4799 (5.4%) were in the PA and IA group, respectively. The prevalence of TB, MRSA, and VRE infection were 0.3%, 1.1%, and 0.3%, respectively. In the PA group, the prevalence of TB, MRSA, and VRE were 0.3%, 1.8%, and 0.4%. In the IA group, the prevalence of TB, MRSA, and VRE were 0.7%, 4.6%, and 1.5%, respectively. The adjusted ORs (95% CI) of the PA and IA compared to the NA group were 1.02 (0.69 to 1.53) and 1.83 (1.24 to 2.71) for TB, 2.24 (1.87 to 2.69) and 5.47 (4.63 to 6.46) for MRSA, 2.59 (1.78 to 3.77) and 8.90 (6.52 to 12.14) for VRE, respectively.

Conclusions

A high prevalence of positive carriage of TB, MRSA, and VRE in patients transported by metropolitan ambulances was found.

Summary

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English Abstracts

Association Between Prophylactic Antibiotic Use and Surgical Site Infection Based on Quality Assessment Data in Korea.: Kyoung Hoon Kim, Choon Seon Park, Jin Hee Chang, Nam Soon Kim, Jin Seo Lee, Bo Ram Choi, Byung Ran Lee, Kyoo Duck Lee, Sun Min Kim, Seon A Yeom; J Prev Med Public Health. 2010;43(3):235-244.; DOI: https://doi.org/10.3961/jpmph.2010.43.3.235

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Abstract PDF

OBJECTIVES
To examine the prophylactic antibiotic use in reducing surgical site infection. METHODS: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. RESULTS: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. CONCLUSIONS: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.

Summary

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Shi‐Peng Gong, Hong‐Xia Guo, Hong‐Zhen Zhou, Li Chen, Yan‐Hong Yu
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Mumps Transmission Control Status and Inapparent Infection Rate among Middle and High School Students during the 2007-2008 Mumps Outbreak in Daegu.: Kyo Hyun Kim, Chang Hwi Kim, Bo Youl Choi, Un Yeong Go, Dong Han Lee, Moran Ki; J Prev Med Public Health. 2009;42(6):408-415.; DOI: https://doi.org/10.3961/jpmph.2009.42.6.408

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OBJECTIVES
This study was performed to investigate the mumps transmission control status and inapparent infection rate among middle and high school students in Daegu City during a mumps outbreak. METHODS: Nine schools (two middle schools and seven high schools), which reported a number of mumps cases between 2007 and 2008 were selected for investigation. During March-May 2008, a standard questionnaire was distributed to gather information about case identification, instructed isolation measure, isolation status of mumps cases and related factors, and outdoor activities of non-isolated mumps case. Inapparent infection rate was estimated by serum mumps IgM and IgG antibodies status and self-reported mumps symptoms in three of the nine schools. RESULTS: Among 2,560 respondents, more than half of students answered that they did not receive instructions in mumps transmission control measures during the outbreak. Among the 327 mumps cases identified by the questionnaire, 131 cases (40.1%) were considered as isolated and the isolation rates were significantly different among schools, grades, and gender. Of the non-isolated cases, 88.3% continued attending school. Inapparent mumps infection rates were between 56.3% and 70.2%. CONCLUSIONS: Mumps transmission control was inadequate to control the mumps outbreak. Although high inapparent infection rate would mitigate the transmission control effect of case isolation, this measure is fundamental for infection control. The reasons of this inadequate status need to be explored to develop an effective intervention strategy.

Summary

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Evaluation Studies

Association between the Pattern of Prophylactic Antibiotic Use and Surgical Site Infection Rate for Major Surgeries in Korea.: Pilyong Sakong, Jin Seok Lee, Eun Jung Lee, Kwang Pil Ko, Cheol Hwan Kim, Yoon Kim, Yong Ik Kim; J Prev Med Public Health. 2009;42(1):12-20.; DOI: https://doi.org/10.3961/jpmph.2009.42.1.12

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Abstract PDF

OBJECTIVES
The purpose of this study was to analyze the association between the pattern of prophylactic antibiotic use (PAU) and the surgical site infection (SSI) rate for major surgeries in Korea. METHODS: We retrospectively reviewed the medical records of patients who underwent cardiac, colon and gastric surgery, hysterectomies and hip/knee replacements at 20 hospitals, and inclusive of over 500 beds. We randomly sampled 60 cases per surgery type for patients discharged between September and November, 2006. A total fo 2,924 cases were included in our analysis. Cox's proportional hazard analysis was conducted to evaluate the association between the pattern of PAU and SSI rate. RESULTS: The proportion of patients who received their first prophylactic antibiotics (PA) 1 hour before incision was 65.5%, who received inappropriate PAs was 80.8%, and the proportion of patients whose PA was discontinued within 24 hours of surgery was 0.5%. The average duration of PAU after surgery was 9 days. The relative risk (RR) of SSI in patients who received their first PA more than 1 hour before incision was significantly higher than for those who received it within 1 hour prior to incision (RR=8.20, 95% CI=4.81-13.99). Inappropriate PA selection increased SSI rate, albeit with marginal significance (RR=1.97, 95% CI=0.96-4.03). Also, prolonged PAU following surgery had no effect on SSI rate. CONCLUSIONS: These results suggest that the pattern of PAU in the surgeries examined was not appropriate. Errors in the timing of PAU and of PA selection increase SSI rate. SSI rate remained unaltered following prolonged PAU after surgery.

Summary

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English Abstract

A Nationwide Survey on the Hand Washing Behavior and Awareness.: Jae Sim Jeong, Jun Kil Choi, Ihn Sook Jeong, Kyong Ran Paek, Hye Kyung In, Ki Dong Park; J Prev Med Public Health. 2007;40(3):197-204.; DOI: https://doi.org/10.3961/jpmph.2007.40.3.197

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OBJECTIVES
This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. METHODS: Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. RESULTS: Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. CONCLUSIONS: This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to Bpromote adherence to hand washing.

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Jong-Gyu Kim, Jeong-Young Park, Joong-Soon Kim
Korean Journal of Environmental Health Sciences.2009; 35(1): 36. CrossRef
A scale for measuring hygiene behavior: Development, reliability and validity
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Original Articles

Cause of Enterohemorrhagic Escherichia coli Infection in Ulju County, Korea.: Geun Ryang Bae, Sang Won Lee, Byung Guk Yang, Bok Kwon Lee, Jae Gu Park, Byeong Hun Hwang, Hyun Sul Lim; Korean J Prev Med. 2003;36(1):77-84.

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Abstract PDF: OBJECTIVES
Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. METHODS: We performed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we performed rectal swabs on the cattle raised by the household of the index patient. RESULTS: We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. CONCLUSIONS: We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.; Summary

Prediction of HIV and AIDS Incidence Using a Back-calculation Model in Korea.: Ju Young Lee, Jin Soo Hwang, Un Yeong Goh, Mee Kyung Kee, Jee Yun Kim; Korean J Prev Med. 2002;35(1):65-71.

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Abstract PDF: OBJECTIVE
To estimate the status of HIV infection and AIDS incidence using a back-calculation model in Korea. METHODS: Back-calculation is a method for estimating the past infection rate using AIDS incidence data. The method has been useful for obtaining short-term projections of AIDS incidence and estimating previous HIV prevalence. If the density of the incubation periods is known, together with the AIDS incidence, we can estimate historical HIV infections and forecast AIDS incidence in any time period up to time t. In this paper, we estimated the number of HIV infections and AIDS incidence according to the distribution of various incubation periods RESULTS: The cumulative numbers of HIV infection from 1991 to 1996 were 708~1,426 in Weibull distribution and 918~1,980 in Gamma distribution. The projected AIDS incidence in 1997 was 16~25 in Weibull distribution and 13~26 in Gamma distribution. CONCLUSIONS: The estimated cumulative HIV infections from 1991 to 1996 were 1.4~4.0 times more than notified cumulative HIV infections. Additionally, the projected AIDS incidence in 1997 was less than the notified AIDS cases. The reason for this underestimation derives from the very low level of HIV prevalence in Korea. Further research is required for the distribution of the incubation period of HIV infection in Korea, particularly for the effects of combination treatments.; Summary

Seroepidemiologic Study of Hepatitis B Virus(HBV) and Hepatitis C Virus(HCV) Infection among Koreans in Rural Area, Korea.: Hai Rim Shin, Joon Youn Kim, Jue Bok Song, Byung Seong Suh, Jung Man Kim, Bu Ok Lee, Su Ryang Kim, Mu Guan Yang, Chae Un Lee, Jin Ho Chun, Keun Young Yoo, Yoon Ok Ahn; Korean J Prev Med. 1997;30(1):17-30.

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Abstract PDF: To estimate the prevalence of hepatitis B virus(HBV) and hepatitis C virus(HCV) infection and to determine associated risk factors, a population-based seroepidemiologic study was carried out. In 1993, a health examination survey of the population was carried out in rural area known to have a high incidence of liver cancer. The study population were those who volunteered to participate in a health survey over 10 years of age. Examinees were interviewed by specially trained staffs. Sera from 1,033 study subjects were tested for hepatitis B surface antigen (HBsAg) by reverse passive hemagglutinin (RPHA) estimation and for hepatitis C virus antibody (anti-HCV) by 2nd generation passive hemagglutinin (PHA) estimation, The age and sex standardized prevalence of HBsAg was 6.3% which was similar to national average, but that of anti-HCV was 5.1% which was 4 to 5 times higher than that of blood or other health examinees in Korea. In a multivariate analysis, transfusion history, surgical operative history, and acupuncture history were not associated with HBsAg positivity. In contrast, acupuncture history (adjusted odds ratio[OR]=2.2 : 95% Confidence interval[CI] 1.0-4.7) and surgical operative history(adjusted OR=2.0 : 95% CI 1.0-4.1) were associated with anti-HCV positivity. The present study suggest that there is an highly endemic area of HCV infection in Korea and probably this endemicity is associated with a parenteral source of HCV infection other than blood transfusion.; Summary

Epidemiological characteristics of HIV infected homosexuals in Korea(1992).: Young Keol Cho, Yung Oh Shin, Young Bong Kim; Korean J Prev Med. 1993;26(4):541-550.

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Abstract PDF: In order to investigate psychological and behavioral characteristics homosexuals and to present evidence that homosexuals are in danger of HIV infection in Korea, this study was done by self-administered questionnaire and then direct interview with the 28(35%) HIV infected homosexual/bisexuals of 79 HIV infected persons reported in 1992. Homosexuals without heterosexual activity were 9 and the others were bisexuals. Sixty-five percent of respondents had a guilty conscience for their homosexual activity. Twenty(71%) were in twenties and 5(18%) in thirties. Twelve(43%) were detected via health card checking by health office, 21% by blood donation, 18% by hospital visit, and 7% by partner notification. Motivations for homosexual activity were curiosity(36%), temptation or recommendation(14%) and compulsion(11%). Eighteen(72%) never used condom on anal sex. Nine of 26 respondents had experience for anal sex with foreigners. Fourteen(54%) of 26 respondents had history for sexually transmitted diseases. Fightly percent did not have sexual contact after HIV infection and the others usually used condom. It was confirmed that over 57% of the respondents were infected within 1 year before HIV diagnosis and over 82% within 2 years. These data suggest that HIV infection among homosexual group is rapidly spreading.; Summary

Seroepidemiology of Hepatitis B virus Infection in Healthy Korean Adults in Seoul.: Keun Young Yoo, Byung Joo Park, Yoon Ok Ahn; Korean J Prev Med. 1988;21(1):89-98.

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Abstract PDF: While there have been not a few reports on the seroepidemiological characteristics of hepatitis B virus (HBV) infection in Korea, most of them, however, have had several limitations; operational definition of HBV infection, validity of detection methods of HBV serologic markers, size of the study population, and confirmation of the vaccination history against HBV, etc. In order to avoid such limitations, authors randomly selected 1,495 healthy adults among the 217,511 insured (target population) of Korean Medical Insurance Corporation, living in seoul, and tested HBV(HBsAg, anti-HBs and anti-HBc) of all the subjects were tested, 392(26.2%) of interview failure cases 742 nonvaccinee were excluded from the actual population. Finally, the serologic markers tested of 742 nonvaccinee (study population) only were analyzed for the seroepidemiologic observation of the natural infection of HBV. The seroepidemiological characteristics of HBV infection in Korea were as follows ; 1 Point prevalence of HBs antigenemia was 11.7(9.1-14.3)% in male, which was slightly higher than that of female, 9.5(3.7-15.3)%. This level was one of the highest among those of Asian-Pacific countries. Decreasing tendency of HBsAg prevalence after the age of 50 was observed, which seems to be due to selective attrition of HBV chronic carriers among the healthy adults and/or to the limited-lasting duration of the HBs antigenemia, in part. 2. Point prevalence of anti-HBc(78.8% in male, 50.9% in female) was higher than that of anti-HBs(65.2% in male, 46.6% in female), respectively. And both of them were higher in male than in female. Increasing tendency of the prevalence of both antibodies was observed by age, which seems to be largely due to recurrent infection in adults and to some cumulative effect, in part, of their relatively longer-lasting duration. 3. The level of HBV infection defined by positive for at least one of the 3 serologic markers of HBV by RIA method was 84.7(81.8-87.6)% in male and 61.2(51.9-70.5)% in female, which was also one of the highest among those of Asian-Pacific countries. The proportion of susceptible population to HBV infection among healthy adults was 15.3% in male and 38.8% in female. 4. The relative frequency of current or past infection and chronic carrier among HBV infected person was estimated. The currently or past infected was estimated 75.7% in male and 71.8% in female, and chronic carrier state, 13.8% in male and 14.1% in female. The analysis of the geometric mean of the antibody titer in anti-HBs positive sera indicated also to be compatible with the above findings, suggesting that active, even though inapparent, infection of HBV occur so frequently among healthy adults in Korea.; Summary

English Abstracts

Biosafety of Microbiological Laboratories in Korea.: Jin Yong Lee, Sang Jun Eun, Ki dong Park, Jong Kyun Kim, Jeong Soo Im, Yoo Sung Hwang, Yong Ik Kim; J Prev Med Public Health. 2005;38(4):449-456.

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Abstract PDF: OBJECTIVES
The biosafety level (BSL) practiced in microbiology laboratories in Korea according to the laboratory biosafety manual published by the World Health Organization (WHO) was evaluated using the data obtained by a survey. METHODS: Under the advise of Clinical Laboratory Physicians, 144 types of microorganisms were screened based on the guidelines of biosafety in microbiological and biomedical laboratories published by the US Center for Disease Control and Prevention and classified into 1-4 risk groups. A questionnaire containing 21 questions in 5 areas was developed using the biosafety manual by published WHO. Of the 1, 876 different organizations sent the survey, 563 responded to the survey (response rate: 30.0%). The species of microoganisms handled by as well as the biosafety level in microbiology laboratories were analyzed. RESULTS: There were 123 species of microorganisms handled in microbiology labs in Korea. The BSL required in 512 microbiology labs was answered by the survey responders as the first grade in 33 labs (6.4%), 2nd in 437 (85.4%), 3rd in 42 (8.2%), and 4th in none. The average number of items satisfied was 12.2, showing only a 57.9% satisfactory rate and normal distribution. CONCLUSIONS: The state of overall observance of BSL in most microbiology labs of Korea was evaluated as lagging compared with the standard set up by WHO. Therefore, the Korean government need to produce and distribute a biosafety manual in microbiology laboratories and make efforts to prevent this threat through measures such as training in biosafety in microbiology labs.; Summary

Factors Influencing Antibiotics Prescribing of Primary Health Physicians in Acute Upper Respiratory Infections.: Nam Soon Kim, Soong Nang Jang, Sun Mee Jang; J Prev Med Public Health. 2005;38(1):1-8.

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Abstract PDF: OBJECTIVES
To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections (URI). METHODS: We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. RESULTS: We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR=2.400, 95% CI=1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR=6.773, 95% CI=1.816-25.254). CONCLUSION: These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians' prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.; Summary

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