Osong Public Health and Research Perspectives最新文献

Background: This study aimed to analyze the epidemiology and trends of hemorrhagic fever with renal syndrome (HFRS) in Weifang, China (2013-2021) and to guide prevention strategies.

Methods: The study examined the prevalence and incidence trends of HFRS in Weifang (2013-2021). Spearman correlation and wavelet analysis were employed to explore variable relationships and their associations with HFRS incidence. Generalized additive models (GAMs) were used to identify key risk factors, while structural equation modeling (SEM) quantified direct and indirect pathways influencing HFRS transmission. Finally, Bayesian time-series models were applied to predict future HFRS risk.

Results: Weifang reported 2,118 HFRS cases, which displayed distinct seasonality. Spearman correlation linked economic factors (gross domestic product [GDP], crop area, grain output, green space) and meteorological factors (temperature, pressure) to incidence (r>0.8). Wavelet analysis identified Mus musculus (2013-2016) and Rattus norvegicus (2017-2021) as dominant reservoirs, with temperature, precipitation, and humidity correlating with incidence. GAMs revealed a U-shaped relationship between rodent density and HFRS and an inverted U-shaped relationship between temperature (threshold, 11.64 °C) and HFRS. SEM highlighted the direct and indirect effects of climate via rodent density, mirrored by economic factors (e.g., GDP). Bayesian models effectively predicted HFRS (root mean square error, 7.36; mean absolute percentage error, 0.28; R2=0.65).

Conclusion: Climate, economic, and anthropogenic factors drive the spread of HFRS. Prevention strategies should integrate local economic conditions with meteorological and anthropogenic factors. Bayesian time-series modeling effectively predicts HFRS trends, supporting precision prevention strategies.

Background: This study aimed to examine trends and factors associated with severe physical and psychological consequences following induced abortion among women in the Republic of Korea.

Methods: An online survey was conducted of adolescent and adult Korean women aged 13 to 64 years, termed the 2022 Sex and Reproductive Health Survey. Respondents who reported a history of induced abortion were analyzed. Logistic regression models that accounted for individual risk factors were fitted to calculate adjusted odds ratios (aOR).

Results: The prevalence of induced abortion was 20.1% (914 of 4,552 respondents). The most frequent indications for abortion were social reasons, and across all periods, approximately half of the women or more reported non-medical challenges at the time of their most recent abortion. Severe physical and psychological sequelae after abortion increased 5-fold from 1980-1992 to 2013-2022. Among those whose most recent abortion occurred in 2003 or later, the risk of severe psychological sequelae was higher in 2013-2022, after the Korean Constitutional Court upheld the existing criminal codes, than in 2003-2012 (aOR, 2.31; 95% confidence interval, 1.09-4.91).

Conclusion: In the absence of institutionalized safe and respectful abortion services, severe physical and psychological sequelae among women who underwent induced abortion were more likely to occur. These findings highlight the importance of safe, affordable, nondiscriminatory, and respectful abortion care.

Objectives: This study aimed to investigate the association of demographic variables and serum calcium with hypercalciuria among the Meitei adult population of Manipur, Northeast India.

Methods: A cross-sectional study was conducted involving 413 participants (272 females and 141 males) aged 19 to 60 years. Participants were selected through a multistage sampling method from 5 valley districts of Manipur. Demographic and biochemical parameters were collected, including serum calcium, creatinine, and spot urine calcium and creatinine levels. One-way analysis of variance, Tukey's post hoc test, chi-square test, multinomial logistic regression, and receiver operating characteristic (ROC) curve analysis were performed. The area under the ROC curve was calculated to determine the cut-off value of random urine calcium.

Results: The overall prevalence of hypercalciuria was 18.64%. The incidence of hypercalciuria increased with age; 41 to 60 age group were 3 times more likely to develop hypercalciuria than those in the 19 to 40 age group (95% confidence interval [CI], 1.86-5.47; p<0.001). A significant association (p<0.05) was also found between serum calcium and urine calcium levels. Hypocalcemic individuals were 3.5 times more likely to have hypercalciuria than normocalcemic individuals (95% CI, 1.33-9.31; p=0.01). ROC analysis revealed a predictive cut-off value of 23.07 mg/dL for random urine calcium.

Conclusion: This study demonstrates a high prevalence of hypercalciuria exceeding the global average. Given that Manipur has also been reported to have a high prevalence of kidney stones, this finding indicates a considerable health risk. Early intervention could therefore improve public health outcomes related to calcium and mineral metabolism.

Objectives: The aim of this study was to investigate the relationship between diabetes medication self-efficacy and quality of life in older adults with diabetes.

Methods: The study included 192 older adults who attended the diabetes clinic of a public hospital in Istanbul. Data were collected between June and October 2024. Participants were informed about the study and provided both verbal and written consent. Data collection instruments comprised a sociodemographic questionnaire, the diabetes medication self-efficacy scale, and the quality of life scale for older adults.

Results: Of the participants, 98 (51.0%) were women and 105 (54.7%) were aged 65 to 74 years. The mean diabetes medication self-efficacy score was 38.95±10.31, and the mean quality of life score was 18.24±6.37. A weak but statistically significant positive correlation was observed between the autonomy and satisfaction subscale of quality of life and the necessity subscale of self-efficacy (p<0.05).

Conclusion: This study, which examined the relationship between self-efficacy in diabetes management and quality of life in older adults, provides valuable guidance for clinical practice aimed at improving care for this population.

Objectives: Adherence to anti-tuberculosis treatment is essential for achieving successful outcomes and preventing the emergence of drug-resistant strains. This study aimed to evaluate adherence levels and identify factors associated with non-adherence among tuberculosis patients in the Béni Mellal-Khénifra region of Morocco. We hypothesized that sociodemographic, clinical, and behavioral factors influence adherence.

Methods: A facility-based cross-sectional study was conducted from January 2023 to December 2024 in 2 Tuberculosis and Respiratory Disease Diagnostic Centers in the Béni Mellal-Khénifra region. A total of 481 patients who had been on treatment for at least 2 months were recruited using convenience sampling. Data were collected through structured, pre-tested questionnaires administered in face-to-face interviews and verified against treatment cards and medical records. Adherence was defined as taking ≥90% of prescribed doses. Multivariable logistic regression was used to identify independent predictors of non-adherence.

Results: Among the 481 participants, 8.1% were non-adherent. Significant predictors of non-adherence included forgetfulness (adjusted odds ratio [AOR], 38.84; 95% confidence interval [CI], 11.35-132.88), adverse effects (AOR, 14.26; 95% CI, 3.17-64.13), male sex (AOR, 6.77; 95% CI, 1.45-31.60), rural residence (AOR, 4.42; 95% CI, 1.37-14.25), self-adjusted dosing (AOR, 5.83; 95% CI, 1.20-28.34), stopping treatment after symptom improvement (AOR, 6.56; 95% CI, 1.34-32.14), and missed follow-up visits (AOR, 6.74; 95% CI, 1.56-29.19).

Conclusion: Although overall adherence was high, 8.1% of patients were non-adherent. Strategies to improve adherence should focus on addressing forgetfulness, managing side effects, enhancing access in rural areas, and reinforcing patient education and follow-up systems to improve treatment outcomes in this and similar settings.

Objectives: This study examined the associations between digital literacy and self-rated health (SRH), depression, and life satisfaction among older adults in the Republic of Korea.

Methods: Data were obtained from the 2023 National Survey of Older Koreans (n=9,951). Digital literacy was evaluated based on participants' ability to use 8 smartphone functions and their perceived difficulty adapting to a digital society. Dependent variables included SRH, depression (measured using the short form of Geriatric Depression Scale), and life satisfaction (assessed through a composite score across 7 domains). Multiple logistic regression was applied for SRH and depression, while linear regression was conducted for life satisfaction, adjusting for sociodemographic and health-related covariates.

Results: Higher digital literacy was significantly associated with better SRH and greater life satisfaction. Compared to participants with no digital skills, those with moderate or high digital literacy had higher odds of reporting good SRH and significantly higher life satisfaction scores. Older adults who reported difficulty adapting to a digital society demonstrated significantly lower SRH and life satisfaction. However, after adjusting for covariates, the association between digital literacy and depression was not statistically significant.

Conclusion: Higher digital literacy is linked to better SRH and greater life satisfaction. Moreover, digital literacy reduced the explanatory power of socioeconomic variables, suggesting that it serves as an important behavioral determinant. These findings underscore the importance of promoting digital literacy as a means of improving health equity and well-being in aging populations.

Objectives: Scrub typhus, caused by Orientia tsutsugamushi, is a climate-sensitive vector-borne disease with high incidence in the Republic of Korea. This study examined long-term epidemiological trends and changing meteorological influences in the context of climate change.

Methods: A retrospective time-series study was conducted using national surveillance data on 149,289 scrub typhus cases (2001-2024) across 4 surveillance phases. Temporal trends in age-standardized incidence rates were evaluated using Joinpoint regression. Associations between monthly meteorological variables and incidence were assessed with Spearman correlation analysis and time-series regression analysis using distributed lag non-linear models.

Results: The national incidence increased until 2017 and has decreased since 2018, whereas the AAPC rebound to 4.32% during phase IV (2019-2024). The proportion of female cases decreased, while that of adults ≥70 years increased significantly. In phase IV, the average annual percent change increased in central and urban regions. The lag effect of meteorological factors lengthened from 4 to 6 months, with mean temperature (Tmean) and relative humidity (RH) representing the primary predictors. Phase III (2013-2018) displayed the highest cumulative relative risk (RR) for Tmean at 25.2 °C (RR, 5.86; 95% confidence interval [CI], 2.56-13.42), whereas in phase IV, only moderate RH (58%) remained significantly associated with incidence (RR, 1.68; 95% CI, 1.29-2.20).

Conclusion: Over the past 2 decades, the influence of meteorological factors on scrub typhus has shifted, with recent years marked by greater uncertainty under increasing climate variability and instability. For timely risk prediction and targeted prevention, adaptive surveillance systems that integrate dynamic climate indicators-capturing the intensity, frequency, and variability of extreme weather events-are needed.

Objectives: This study aimed to validate the psychometric properties of the recently developed knowledge, attitudes, and perceptions questionnaire for community-based surveillance of infectious diseases (KAP-CBS-ID questionnaire), using confirmatory factor analysis (CFA) and item response theory (IRT).

Methods: A cross-sectional study using multistage sampling recruited 470 schoolteachers from Kelantan, Malaysia. The self-administered KAP-CBS-ID questionnaire consists of 3 domains: knowledge (31 items), attitudes (23 items), and perceptions (21-items). Two-parameter logistic (2-PL) IRT analysis and CFA were performed to validate the knowledge section. For attitudes and perceptions sections, CFA proceeded using a 4-factor model to evaluate both model fit and construct validity.

Results: Two-PL IRT analysis of the knowledge section resulted in elimination of 14 items due to inadequate discrimination or difficulty parameters. The 3-factor CFA model demonstrated good fit indices for knowledge (root mean square error of approximation [RMSEA], 0.028; comparative fit index [CFI], 0.945; Tucker-Lewis index [TLI], 0.941) without any modifications. The attitudes section required re-specification, ultimately yielding 21 items across 4 factors with acceptable fit indices (standardized root mean square residual [SRMR], 0.067; RMSEA, 0.055; CFI, 0.937; TLI, 0.927). Similarly, the perceptions section was refined to 17 items across 4 factors, showing good model fit (SRMR, 0.055; RMSEA, 0.059; CFI, 0.962; TLI, 0.954). Factor loadings ranged from 0.33 to 0.98, while Raykov's rho reliability estimates ranged from 0.71 to 0.93. Factor determinacy exceeded 80% for all factors.

Conclusion: The KAP-CBS-ID is a valid and reliable instrument for assessing community representatives' knowledge, attitudes, and perceptions regarding community-based surveillance of infectious diseases.

Objectives: This study aimed to assess the impact of high-level versus low-level construal messages about the coronavirus disease 2019 (COVID-19) Vaccine Injury Compensation Program (CVICP) on public attitudes toward the program and COVID-19 vaccination.

Methods: A randomized controlled experimental design was employed. Adults aged 18 to 64 residing in the Republic of Korea were randomly assigned to either an experimental group (high-level construal message) or a control group (low-level construal message). Both groups viewed a 2-minute video about the CVICP, with construal level as the sole variable. Pre- and post-intervention questionnaires evaluated attitudes toward the CVICP and COVID-19 vaccination, including satisfaction, perceived necessity, and perceived effectiveness in enhancing vaccine acceptance. Data were analyzed using the paired t-test, repeated measures 2-way analysis of variance, and multiple linear regression.

Results: The experimental group showed statistically significant improvements across all 6 attitude measures following exposure to the high-level construal message. By contrast, the control group demonstrated significant improvement in only 3 attitudes: satisfaction with the CVICP, willingness to recommend vaccination, and willingness for future vaccination. A significant difference between groups was observed for perceived effectiveness of the CVICP in enhancing vaccine acceptance (p=0.01), with high-level construal messaging being more impactful.

Conclusion: High-level construal messages are more effective than low-level messages in shaping public perceptions and addressing vaccine hesitancy. Policymakers and health authorities should incorporate high-level construal elements into communication strategies to build trust and support for vaccination programs.