Objectives This study provides insights on the impact of a targeted intervention (TI) programme on behaviour change among injecting drug users (IDUs) in India.
Methods This paper examined the data from the Integrated Biological and Behavioural Surveillance 2014-2015 for IDUs in India. Logistic regression was performed to understand the factors (TI programme services) that affected injecting risk behaviours by adjusting for covariates. Propensity score matching was conducted to understand the impact of the TI programme on using new needles/syringes and sharing needles/syringes in the most recent injecting episode by accounting for the covariates that predicted receiving the intervention.
Results Participants who received new needles and syringes from peer educators or outreach workers were 1.3 times (adjusted odds ratio, 1.29; 95% confidence interval [CI], 1.09 to 1.53) more likely to use new needles/syringes during most recent injecting episode than participants who did not receive needles/syringes. The matched-samples estimate (i.e., average treatment effect on treated) of using new needles in the most recent injecting episode showed a 2.8% (95% CI, 0.0 to 5.6) increase in the use of new needles and a 6.5% (95% CI, -9.7 to -3.3) decrease in needle sharing in the most recent injecting episode in participants who received new needles/syringes. There was a 2.2% (95% CI, -3.8 to -0.6) decrease in needle sharing in the most recent injecting episode among participants who were referred to other services (integrated counselling and testing centre, detox centres, etc.).
Conclusions The TI programme proved to be effective for behaviour change among IDUs, as substantiated by the use of new needles/syringes and sharing of needles/syringes.
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We aimed to review the current data composition of the Korean Tuberculosis and Post-Tuberculosis Cohort, which was constructed by linking the Korean Tuberculosis Surveillance System (KNTSS; established and operated by the Korean Disease Control and Prevention Agency since 2000) and the National Health Information Database (NHID; established by the National Health Insurance Service in 2012). The following data were linked: KNTSS data pertaining to patients diagnosed with tuberculosis between 2011 and 2018, NHID data of patients with a history of tuberculosis and related diseases between 2006 and 2018, and data (obtained from the Statistics Korea database) on causes of death. Data from 300 117 tuberculosis patients (177 206 men and 122 911 women) were linked. The rate of treatment success for new cases was highest in 2015 (86.7%), with a gradual decrease thereafter. The treatment success rate for previously treated cases showed an increasing trend until 2014 (79.0%) and decreased thereafter. In total, 53 906 deaths were confirmed among tuberculosis patients included in the cohort. The Korean Tuberculosis and Post-Tuberculosis Cohort can be used to analyze different measurement variables in an integrated manner depending on the data source. Therefore, these cohort data can be used in future epidemiological studies and research on policy-effect analysis, treatment outcome analysis, and health-related behaviors such as treatment discontinuation.
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Korean summary
TB Post 코호트(Korean Tuberculosis and Post-Tuberculosis Cohort)는 한국의 결핵 모니터링 및 관리에 대한 인구집단 수준에서의 새로운 근거를 마련하고자 구축한 우리나라 결핵 환자 코호트입니다. 국가 결핵감시체계의 일환으로 구축된 질병관리청의 결핵신고자료와 국민건강보험공단의 국민건강정보DB 자료, 통계청 사망원인 자료의 연계로 구축되었으며, 각 자료원이 보유한 정보를 활용하여 통합적인 결핵 환자 연구가 가능할 것으로 기대하고 있습니다. 결핵의 정책 효과 연구뿐만 아니라, 치료 성공, 실패, 중단 등 치료결과에 대한 영향 요인 및 환자들의 건강 관련 행태에 대한 역학 연구 등 향후 다양한 연구에 활용될 수 있을 것으로 기대됩니다.
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OBJECTIVES This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. METHODS: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP > or =140 mmHg, a diastolic BP > or =90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. RESULTS: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. CONCLUSIONS: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.
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OBJECTIVES To estimate the awareness, treatment and control rate, as well as to identify the awareness-related factors for hypertension. METHODS: The study participants were 482 adults (men 206, women 276), aged 45 or over, diagnosed with hypertension and living in Chuncheon. The awareness rate was defined as the proportion of persons among those with hypertension who had previously been diagnosed by a physician. The treatment rate was defined as the proportion of persons who had used anti-hypertensive medication, among those who were aware of their hypertension. The control rate was defined as the proportion of persons who kept blood pressure normal, among those who had been treated for their hypertension. Multivariable logistic regression analysis was carried out for the awarenessrelated factors using SAS VER 8.1. RESULTS: The awareness, treatment, and control rate were 55.8% (53.4% for men; 57.6% for women), 89.6% (87.2% for men; 91.2% for women), and 34.4% (28.1% for men; 38.6% for women), respectively. The awarenessrelated factors included a family history of hypertension (odds ratio[OR], 5.63; 95% confidence interval[95% CI]=1.53-20.72), smoking([Ex; OR 0.38, 95% CI= 0.15- 0.96)], [Current; OR 0.28, 95% CI=0.10-0.80]), and alcohol intake ([Ex; OR 3.22, 95% CI 1.03-10.09],[Current; OR 3.36, 95% CI=1.30-8.71]) for men, and education(OR 2.23, 95% CI=1.10-4.53), body mass index(OR 2.72, 95% CI=1.13-6.53), and self-rated health(OR 2.38, 95% CI=1.07-5.30) for women. CONCLUSIONS: The awareness rate of hypertension among the middle aged and elderly in Chuncheon was 55.8%. The related factors of awareness were gender specific. Further studies are needed to elucidate the putative reasons for these gender differences.
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OBJECTIVES To identify the factors related to awareness, treatment, and control of hypertension in a Gwacheon population. METHODS: This study surveyed 1, 176 Gwacheon residents older than 40 years, and measured blood pressure using a standardized guideline in 1999. The study subjects were 473 adults (175 males, 298 females) with hypertension defined as a systolic blood pressure > or= 140 mmHg, diastolic blood pressure > or= 90 mmHg or reported treatment with antihypertensive medications. Information on awareness, treatment, and control of hypertension, and sociodemographic and health-related factors was collected through person-to-person interviews with a structured questionnaire. RESULTS: Overall, 252 (53.3%) of hypertensive subjects were aware of their condition, of whom as many as 193 (76.6%) were being treated, and 81 (42.0%) had their blood pressure controlled at the recommended level (< 140/90 mmHg). However, of the 473 subjects found to have hypertension, only 40.8% were being treated, and 17.1% were under control. There were no significant differences in the proportions of awareness, treatment, and control of hypertension. In multiple logistic regression models, awareness of hypertension was positively associated with age and family history of hypertension in females. Control of hypertension was also positively associated with having a partner and marital status in females. CONCLUSION: These findings demonstrate that much greater efforts on improving awareness, treatment, and control of hypertension are needed, even in urban community settings, considering related factors such as age, family history, and marital status. However, these factors should be further investigated for their causal relationship.
OBJECTIVES To analyse the psychosocial factors associated with hypertension management(drug treatment and life style modification) of newly detected cases and to understand and assess their behavioral intention or behaviors. METHODS: The survey area was a combined urban and rural area in Chungnam province, Korea, and the sampling method was cluster sampling. Study subjects included 541 newly detected cases of hypertension rated above stage 2 by JNC-VI from a community survey. The first survey was applied to 383 of these patients in order to discern their psychosocial characteristics. A follow-up survey was given to 345 persons with an 11-month interval following monthly telephone counseling concerning medication and life style modification by trained nurses. The final study subjects for analysis comprised 271 persons after excluding cases of incomplete data and change of address. RESULTS: Among the 85(33.2%) new patients who had intended to undergo drug treatment, 30(35.3%) persons were treated with antihypertensive agent after 11- month interval, while among the patients with no intention to receive treatment, only 36(21.1%) persons were treated. Hypertensive patients with a high intention score revealed a high score in life style modification compliance as well. Seventy three percent of the variance of behavioral intention to undergo hypertension management was explained by the patients attitude toward performing the behavior and subjective norm associated with behaviors related to the theory of reasoned action in structural modeling. Actual behaviors related positively with behavioral intention. The coefficient of determination was 0.255. CONCLUSION: Improving the compliance level of hypertensive patients in respect to drug treatment or life style modification requires a build up of positive behavioral intention, and caregivers must pay more attention to eventually converting behavioral intention to actual behaviors.
OBJECTIVES To estimate the prevalence of hypertension, rates of awareness, treatment modalities, and control of hypertension, and also to identify factors in rural Korea that are related to these aspects of hypertension. METHODS: A cross-sectional survey, including blood pressure(BP) measurements and interviews, investigating the variables in the health belief model was performed from August to November, 1999 on 1,426 (79.4%) study subjects out of 1,797 registered residents over 30 years old in Ibansong-Myun, Chinju City. A second survey was performed from January to March, 2000 on 376 (80.0%) subjects out of 470 hypertensive (or suspected hypertensive) subjects found in the first survey. Two BP readings were taken in each survey using a standard mercury sphygmomanometer. Hypertension was defined as either a BP reading < 140/90 mmHg in both surveys, or as subjects on oral hypertensive medication. RESULTS: Estimated hypertension prevalence was 24.9% for men, and 30.4% for women. Rates of hypertension awareness, treatment (the regular use of oral hypertensives), and control (reduction of BP to <140/90 mmHg) were 52.5%, 34.4%, and 12.9%, respectively. The factors related to lower hypertension awareness in the logistic regression analysis were male gender, farming occupation, and higher perceived barrier to medical treatment (those for whom visiting health professionals is a burden). CONCLUSIONS: To improve the low awareness, treatment, and control of hypertension, a more active and out-reaching hypertension control program, including routine BP measurements for every visitor to primary care facilities, is needed in rural Korea.
OBJECTIVES This study was conducted to determine, by reviewing the literature, whether treatment of Helicobacter pylori infection in patients with non-ulcer dyspepsia affects symptoms. METHODS: We retrieved the literature using MEDLINE search, with nonulcer dyspepsia and Hericobacter pylori and treatment as key words, which were reported from 1984 to 1998, and manual literature search. The criteria for inclusion was as follows; 1) The paper should have confirmed nonulcer dyspepsia as case definition. 2) The paper should have performed a randomized, blind trial. 3) Confirmation of Helicobacter pylori eradication should be done 4 weeks after treatment. 4) studies with no information on measurement of symptoms after treatment were not accepted. The percentage of patients with symptom improvement after eradication therapy for Helicobacter pylori infection was calculated. Cumulative odds ratio was compared by fixed effect model and random effect model as sensitivity and funnel plot was used to evaluate publication bias. RESULTS: The overall effect size of symptom improvement was calculated by cumulative odds ratio. Cumulative odds ratio of random effect model was 4.16(95% CI: 1.55-11.19). Before integrating each effect sizes into common effect size, the homogeneity test was conducted and random effect model was selected(Cochran's Q=41.08 (d.f=10, p<0.001)). The heterogeneity across studies was evaluated and the different methodological aspects of studies led to differences between study results. CONCLUSIONS: The results suggest that the eradication of Helicobacter pylori in patients with non-ulcer dyspepsia results more symptom improvement. In studies that shows the opposite results there are methodological aspects explaining the heterogeneity.
This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing or pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.