Osong Public Health and Research Perspectives最新文献

Background: The main Brucella species causing human infections in the Republic of Korea is Brucella abortus, which uses cattle as its host. However, since 2014, Brucella melitensis, which uses sheep and goats as hosts, has also been identified. This study investigated whether a shift has occurred in the predominant species of Brucella pathogens.

Methods: Brucellosis is a class 3 infectious disease requiring mandatory reporting and registration in the Korea Disease Control and Prevention Agency's infectious disease surveillance system (http://is.kdca.go.kr). Cases from 2014 to 2023 were studied, and whole-genome sequencing analysis was conducted using BruMLSA21.

Results: Out of 51 patients, males (45 patients, 88.2%) were predominantly affected. Twenty-five patients (49%) came from the livestock industry, and within the livestock sector group, the route of infection occurred exclusively through contact (25/25, 100%), whereas in other occupations, it was split between contact (9/26 patients, 34.6%) and ingestion (8/26 patients, 30.8%). Among the 31 patients who underwent Brucella culture tests, B. melitensis was found to be more prevalent than B. abortus (14 patients, 45.2% vs. 11 patients, 35.5%). In all cases where B. melitensis was isolated, the infections were of foreign origin, consistent with the results of BruMLSA21.

Conclusion: Regular monitoring of the causative agent of brucellosis is necessary due to its varying host preferences and antibiotic resistance. Furthermore, given the increasing prevalence of B. melitensis worldwide, changes in dietary habits (e.g., increased lamb consumption), and the increase in foreign workers and Chinese immigrants, a multi-ministerial One Health response will be required.

Background: Malaria remains a serious public health challenge in tropical and subtropical regions, including Indonesia. Children under 5 years old face particular risk of contracting malaria due to low immunity. We examined potential factors associated with malaria infection among under-5 children in Papua Province, Indonesia.

Methods: The study utilized secondary data from Indonesia Basic Health Research 2018. Multistage random sampling was employed, from the province level to census blocks (CBs). In Papua Province, interviews were conducted in 928 CBs. All 2,745 under-5 children were selected. The dependent variable was laboratory-confirmed malaria positivity; independent factors included residential area, socioeconomic characteristics, and behaviors such as sleeping under an insecticide net impregnated ≤3 years ago and the use of ventilation barriers. We also examined the conditions of the bedroom, kitchen, and living room according to the frequency of window-opening, proportion of ventilation area to the floor, and radiance.

Results: Not sleeping under an insecticide net impregnated within the last 3 years (adjusted odds ratio [aOR], 0.518; 95% confidence interval [CI], 0.391-0.685; p<0.001); having a kitchen without windows (aOR, 0.491; 95% CI, 0.285-0.844; p=0.01); rarely opening the living room window (aOR, 2.804; 95% CI, 1.232-6.383; p=0.01), and having a windowless living room (aOR, 3.027; 95% CI, 1.369-6.696; p=0.01) displayed significant relationships with malaria infection among under-5 children.

Conclusion: Not using an insecticide-treated net impregnated ≤3 years ago, along with opening the living room window daily and having a kitchen without windows, appear preventive of malaria infection among under-5 children.

This study aimed to establish a foundation for future collaborations aimed at preparing for and responding to infectious diseases by examining the vaccine injury compensation programs (VICPs) of East Asian countries. We reviewed the current status of VICPs in the Republic of Korea, Japan, and Taiwan by searching national government websites and reviewing relevant literature. Additionally, we conducted email inquiries targeting experts from Japan and Taiwan. Through the comprehensive analysis of VICPs in these 3 countries covered various aspects, we identified several similarities and differences in the VICPs across these countries. While the governments of the Republic of Korea, Japan, and Taiwan play a central role in supporting investigations into vaccine injuries and managing compensation procedures based on legal statutes, they differ in terms of financial resources for compensation, the range of vaccines covered, and the criteria for assessing causality. In the Republic of Korea, Japan, and Taiwan, compensation is typically paid in a lump sum, although the specific benefits available vary by country. This study on VICPs in the Republic of Korea, Japan, and Taiwan provides valuable insights for the further development and management of domestic systems.

Background: The purpose of this study was to explore the relationships among obstructive sleep apnea (OSA), dyspnea, and health-related quality of life (HRQOL), as well as the factors influencing HRQOL.

Methods: A total of 129 lung cancer survivors (mean age, 53.4 years; 77 men and 52 women; mean time since diagnosis, 1.6 years; and cancer stage [1/2/3/4/relapse], 43/31/19/34/2, respectively) completed a questionnaire that included demographic and clinical information, as well as questions about the severity of sleep apnea, dyspnea, and HRQOL. The severity of OSA, dyspnea, and HRQOL were assessed using the Berlin questionnaire, the Dyspnea-10 item (FACIT-Dyspnea), and the European Organization for Research and Treatment of Cancer QLQ-C30, respectively.

Results: The severity of OSA and dyspnea exhibited negative correlations with HRQOL (p<0.05). Multiple regression analysis revealed that several factors significantly impacted the HRQOL of lung cancer survivors. These included the extent of dyspnea (β=-0.369, p<0.01), weight loss (β=0.192, p<0.01), OSA score (β=-0.215, p<0.01), stage 2 cancer (β=-0.181, p<0.01), and poor perceived health status (β=-0.179, p<0.05).

Conclusion: These findings suggest that breathing difficulties, including OSA and dyspnea, contribute to decreased HRQOL. This study offers valuable insights for researchers and clinicians, aiding in the development of effective strategies to manage these issues in daily life.

Background: This study investigated factors influencing intentional self-harm in Chungcheongbuk Province (hereinafter, Chungbuk) compared to Seoul in the Republic of Korea.

Methods: Raw data from the Discharge In-depth Injury Survey conducted by the Korea Disease Control and Prevention Agency were utilized. From 2,329,149 cases recorded over 9 years (2013-2021), 911 were identified as intentional self-harm cases (248 from Chungbuk and 633 from Seoul). We analyzed the differences in and influencing factors of intentional self-harm in Chungbuk relative to Seoul using the independent sample t-test, chi-square test, and binomial logistic regression analysis.

Results: Intentional self-harm was found to be 1.232 times more prevalent among females than males (p<0.05); 2.327 times more prevalent among middle-aged and older adults, ages 50 to 64, compared to those under 50 years old (p<0.01); 8.603 times more prevalent among those using hospitals with fewer than 500 beds compared to those with 500 beds or more (p<0.001); 2.412 times more prevalent among individuals using hospitals in different regions compared to those within the same region (p<0.01); 2.217 times more prevalent among those attempting intentional self-harm during daily activities compared to other specified activities (p<0.01); and 6.987 times more prevalent among those using pesticides or herbicides compared to other poisons (p<0.001) in Chungbuk relative to Seoul.

Conclusion: In the Chungbuk region, intentional self-harm prevention programs should be implemented, specifically targeting women, particularly those aged 50 to 64. Additionally, due to the high incidence of intentional self-harm involving pesticides or herbicides in Chungbuk, these substances should be stringently monitored to restrict access.

Background: This study aimed to summarize the results of coronavirus disease 2019 (COVID-19) risk assessments and to examine the associations between risk levels and various indicators, including COVID-19 incidence, risk perception, community mobility, and government policy.

Methods: The results of the risk assessment and the indicators utilized were summarized. From November 2021 to May 2022, the COVID-19 risk level was evaluated on a weekly basis, and its correlation with these indicators was analyzed. Data were obtained from press releases by the Korea Disease Control and Prevention Agency, regular surveys conducted by Hankook Research, and information available on the Google and Oxford websites.

Results: Weekly risk assessments were conducted for 30 weeks, using different indices depending on the phases. Correlation analysis revealed the strongest positive correlation between risk level and risk perception (r=0.841). The risk level from "1-week lead" demonstrated a strong positive correlation with the time-varying reproduction number (Rt). Similarly, the risk level from "week lagged value" showed a strong positive correlation with the number of severe cases in the hospital.

Conclusion: At the time of risk assessment, the Rt precedes the risk level, while severe cases in hospitals follow. Therefore, the assessed risk level functioned as an early warning system. Risk perception demonstrated the strongest correlation with the risk level, suggesting consistency throughout the assessment period. Contextual indicators (e.g., risk perception) that consider time lags and implementation scales, could improve the evaluation of future risk assessment results, particularly when there are challenges in reflecting specific situations in coordinated emergency response.

Background: Breast cancer poses a significant global health challenge, characterized by complex origins and the potential for life-threatening metastasis. The critical need for early and accurate detection is underscored by the 685,000 lives claimed by the disease worldwide in 2020. Deep learning has made strides in advancing the prompt diagnosis of breast cancer. However, obstacles persist, such as dealing with high-dimensional data and the risk of overfitting, necessitating fresh approaches to improve accuracy and real-world applicability.

Methods: In response to these challenges, we propose BCED-Net, which stands for Breast Cancer Ensemble Diagnosis Network. This innovative framework leverages transfer learning and the extreme gradient boosting (XGBoost) classifier on the Breast Cancer RSNA dataset. Our methodology involved feature extraction using pre-trained models-namely, Resnet50, EfficientnetB3, VGG19, Densenet121, and ConvNeXtTiny-followed by the concatenation of the extracted features. Our most promising configuration combined features extracted from deep convolutional neural networks-namely Resnet50, EfficientnetB3, and ConvNeXtTiny-that were classified using the XGBoost classifier.

Results: The ensemble approach demonstrated strong overall performance with an accuracy of 0.89. The precision, recall, and F1-score values, which were all at 0.86, highlight a balanced trade-off between correctly identified positive instances and the ability to capture all actual positive samples.

Conclusion: BCED-Net represents a significant leap forward in addressing persistent issues such as the high dimensionality of features and the risk of overfitting.

Background: The onset of common mental disorders (CMDs) is most prevalent among youth; thus, mental health management is crucial. We examined differences in risk and risk factor determinants regarding CMDs prevalence among youth in rural and urban Indonesia.

Methods: This cross-sectional study utilized data from the 2018 Indonesia National Health Survey. The population comprised 122,114 respondents, aged 15 to 24 years, who had completed the 20-item Self-Report Questionnaire along with providing demographic and health behavior data. Chi-square testing and logistic regression were employed for analysis.

Results: The CMDs risk was higher among urban than rural youth. Risk factors impacting both populations included being female, having a lower education level, consuming fewer than 7 portions of vegetables weekly, smoking, and drinking alcohol (p<0.05). Consuming under 7 portions of fruit weekly and being in the highest or lowest wealth quintile were significant risk factors only in urban youth, while unemployment and divorce were significant only among rural respondents (p<0.05). Marriage was protective against CMDs among rural participants.

Conclusion: Being male, possessing a college degree, consuming at least 7 portions of vegetables weekly, not smoking, and not consuming alcohol were associated with reduced CMDs risk in urban and rural youth. Among rural youth, marriage and employment were linked to decreased risk, whereas divorce displayed the opposite relationship. In urban populations, consuming at least 7 portions of fruit weekly and belonging to neither the highest nor the lowest economic quintile were protective factors. Management strategies for CMDs in young people must address these considerations.

Background: This study aimed to comprehensively outline the methodological approaches used in published research comparing the vaccine effectiveness (VE) of coronavirus disease 2019 (COVID-19) vaccines.

Methods: A systematic search was conducted on June 13, 2024, to identify comparative studies evaluating the effectiveness of mRNA versus non-mRNA and monovalent versus bivalent COVID-19 vaccines. We screened titles, abstracts, and full texts, collecting data on publication year, country, sample size, study population composition, study design, VE estimates, outcomes, and covariates. Studies that reported relative VE (rVE) were analyzed separately from those that did not.

Results: We identified 25 articles comparing rVE between mRNA and non-mRNA COVID-19 vaccines, as well as between monovalent and bivalent formulations. Among the studies assessing VE by vaccine type, 126 did not provide rVE estimates. Comparative VE studies frequently employed retrospective cohort designs. Among the definitions of rVE used, the most common were hazard ratio and absolute VE, calculated as (1-odds ratio)×100. Studies were most frequently conducted in the United Kingdom and the United States, and the most common outcome was infection. Most targeted the general population and assessed the VE of mRNA vaccines using the AstraZeneca vaccine as a reference. A small proportion, 7.3% (n=11), did not adjust for any variables. Only 3 studies (2.0%) adjusted for all core confounding variables recommended by the World Health Organization.

Conclusion: Few comparative studies of COVID-19 vaccines have incorporated rVE methodologies. Reporting rVE and employing a consistent set of covariates can broaden our understanding of COVID-19 vaccines.