Osong Public Health and Research Perspectives最新文献

Background: Anopheles sinensis is a predominant malaria vector found throughout the Republic of Korea (ROK). Population genetic analysis can provide insights into the origins and migration patterns of malaria vectors by assessing genetic variation and distribution among populations.

Methods: In this study, we examined the population genetic structure of An. sinensis in the ROK using mitochondrial cytochrome c oxidase subunit I (COI) marker.

Results: A total of 903 specimens of An. sinensis were collected from 9 sampling regions, including malaria-endemic and non-endemic areas. All populations displayed characteristics typical of migrant populations, with high haplotype diversity (Hd) and low nucleotide diversity (Pi). Network analysis identified 124 haplotypes grouped into 2 clusters. Both clusters included haplotypes from malaria-endemic and non-endemic areas. Cluster I shared its most recent common ancestry with Chinese reference sequences, while cluster II had related with Japanese reference sequences. Pairwise genetic distance (FST) analysis indicated generally low genetic differentiation among populations. Furthermore, FST values tended to increase proportionally with geographical distance between regions. Analysis of molecular variance confirmed that individual mosquitoes within the population had a large effect on the overall variation. Neutrality tests using 4 methods (Tajima's D, Fu's Fs, Fu and Li's D, and Fu and Li's F) yielded negative values, suggesting that An. sinensis populations are expanding in all studied regions.

Conclusion: This study characterizes the genetic attributes of An. sinensis in the ROK, providing valuable insights into the biology of this important malaria vector and contributing useful data for malaria control strategies.

Background: This study was performed to evaluate the prevalence of medication adherence and its determinants among Moroccan patients with type 2 diabetes mellitus.

Methods: A multicenter cross-sectional survey was conducted from February to June 2024, involving 584 patients from the Casablanca-Settat and Rabat-Sale-Kenitra regions of Morocco. Medication adherence was assessed using the general medication adherence scale. Associations between independent variables and adherence were analyzed using chi-square tests and multivariate logistic regression.

Results: Medication adherence was observed in 96.2% of participants. Multivariate analysis revealed significantly lower medication adherence among patients using 2 or more oral antidiabetic drugs (adjusted odds ratio [aOR], 0.026; 95% confidence interval [CI], 0.001-0.642; p=0.026) and those with a diabetes duration of 11 to 15 years (aOR, 0.037; 95% CI, 0.001-0.956; p=0.047).

Conclusion: Despite a high overall adherence rate, patients on dual or polytherapy and those with longer disease duration exhibited lower adherence in multivariate analysis. Targeted interventions are needed to improve adherence in these high-risk groups.

Background: Severe trauma remains a leading cause of death in the Republic of Korea. In response, regional trauma centers were established in 2012. This study evaluated the impact of direct prehospital transport to trauma centers on in-hospital mortality among patients with severe trauma using the national trauma registry.

Methods: This nationwide observational study utilized data from the Korean community-based trauma registry between 2016 and 2020. Patients with an injury severity score >15 who were directly transported from the prehospital setting were included. Variables analyzed encompassed demographics, injury mechanism, transport time, hospital level, and outcomes. The primary outcome was in-hospital mortality. Both logistic regression and decision tree models were employed.

Results: A total of 24,567 patients were included. Overall mortality decreased by 5.2% during the study period. Patients transported to level 1 or 2 trauma centers had a lower mortality rate (23.6%) compared to those transported to level 3 or 4 hospitals (28.0%). The proportion of direct transports to high-level centers increased from 46.7% to 64.1% between 2016 and 2020. Despite longer transport times, patients transported to high-level institutions exhibited improved survival, particularly when transport exceeded 30 minutes, suggesting that hospital selection may be more critical than minimizing transport time.

Conclusion: Direct transport to high-level trauma centers improves survival among patients with severe trauma, even when transport times are prolonged. These findings support the importance of a well-organized trauma system that emphasizes hospital capability in prehospital triage decisions.

Background: In the Republic of Korea, the previous surveillance system for zoonotic tuberculosis (TB) involved the X-ray testing of humans in contact with Mycobacterium bovis-infected livestock. In contrast, the updated surveillance system incorporates the genotyping of cultured Mycobacterium isolates for high-risk occupational groups. This study aimed to systematically document the detection, diagnosis, assessment, and response in the epidemic investigation of zoonotic TB in a laboratory worker in the Republic of Korea.

Methods: M. bovis was confirmed using spoligotyping and whole genome sequencing. Clinical characteristics were reviewed through epidemiological investigation and interviews with the affected individual. Transmission routes and secondary spread were assessed via field epidemiological investigations and contact evaluations using chest X-ray and interferon gamma release assay for latent TB infection.

Results: A 56-year-old laboratory worker presented with chest X-ray findings compatible with TB and subsequently tested positive for M. bovis. She had no clinical or family history of TB and remained asymptomatic. She completed a 6 month treatment regimen of isoniazid, rifampin, ethambutol, and pyrazinamide without hospitalization. Although no direct transmission pathways for zoonotic TB were identified, her work in a laboratory, processing specimens for zoonotic TB, indicated potential laboratory related exposure.

Conclusion: This case underscores the importance of stringent use of personal protective equipment among high-risk occupational groups and the implementation of an enhanced surveillance system to report zoonotic TB. These findings highlight the need for a One Health approach and proactive surveillance, emphasizing the necessity of refining and strengthening surveillance systems for precise monitoring and an effective response.

Background: Vitamin D regulates immune function, cell proliferation, and differentiation. Its deficiency is linked to sepsis, although the causal relationship remains unclear. Studies suggest a strong correlation between FokI polymorphism and sepsis in the context of vitamin D deficiency. This study examined the association between vitamin D levels, the VDR FokI polymorphism, and sepsis risk through a systematic review and meta-analysis.

Methods: Relevant articles from 2014-2024 were identified from various databases, including PubMed, Scopus, and Cochrane. A meta-analysis was conducted to assess the difference in vitamin D levels between the sepsis and control groups, as well as the relationship between VDR FokI genotypes (TT, CT, CC) and sepsis risk.

Results: Vitamin D levels in sepsis patients were consistently lower than in the control group, with a mean difference of -4.17 ng/mL (95% confidence interval, -7.87 to -0.47; p=0.03). However, the relationship between VDR FokI genotype and sepsis risk was not statistically significant (p>0.05), although several individual studies showed a positive correlation. High heterogeneity was found in the analysis of vitamin D levels (I2=100%) and FokI genotypes (I2=91%), which affected the interpretation of the results.

Conclusion: Vitamin D deficiency is a potential risk factor for sepsis, while the relationship between the VDR FokI polymorphism and sepsis risk requires further investigation. These findings highlight the importance of early detection of vitamin D deficiency as a preventive strategy in at-risk populations, although additional studies with more standardized designs are needed to definitively confirm this relationship.

Background: The objectives of this review and meta-analysis were twofold: first, to critically evaluate the effectiveness of cognitive behavioral therapy (CBT)-based interventions relative to standard care or control conditions in promoting smoking abstinence at the end of treatment, and second, to determine abstinence rates at 3 and 6 months of follow-up.

Methods: A comprehensive search of electronic databases, including PubMed, Cochrane Library, PsycINFO, Embase, and ClinicalTrials.gov, was conducted for randomized controlled trials published from 2001 to September 2024. Studies evaluating the effect of CBT on abstinence rates among healthy smokers (aged ≥12 years) were included and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results: Out of 1,514 study records screened, 7 studies (comprising 17 arms and 1,438 participants) met eligibility criteria for inclusion in the final analysis. The pooled analysis revealed that CBT significantly improved smoking abstinence rates, demonstrating a fourfold increase in effectiveness compared to controls (odds ratio [OR], 4.04; 95% confidence interval [CI], 2.73-5.99; I2=19%; p<0.00001). Additionally, CBT significantly impacted smoking cessation at 3-month follow-up (OR, 1.62; 95% CI, 1.11-2.38; I2=0%; p=0.01) and 6-month follow-up (OR, 2.19; 95% CI, 1.59-3.00; I2=0%; p<0.00001).

Conclusion: CBT has demonstrated efficacy in facilitating smoking abstinence, particularly immediately after treatment, with sustained but diminished effects over time. However, robust conclusions on the efficacy of CBT require further studies involving larger sample sizes, diverse geographical regions, and longer follow-up periods.

Background: This study investigated the correlation between food insecurity and infectious diseases among toddlers in Indonesia.

Methods: This research employed a cross-sectional study design using data from the 2021 Indonesian Nutrition Status Survey, which included a sample of 84,115 toddlers. Food insecurity levels were assessed using the food insecurity experience scale, developed by the Food and Agriculture Organization. The dependent variable, infectious disease, was defined as a toddler experiencing 1 or more of the following conditions: acute respiratory infections, diarrhea, pneumonia, measles, or worms. Multivariate analysis was conducted using multiple logistic regression to determine adjusted odds ratios (ORs).

Results: The findings indicate that 23.78% of toddlers experienced at least 1 infectious disease. While more than half of the respondents were food secure, 26.5% faced mild food insecurity, 13.6% moderate food insecurity, and 6.5% severe food insecurity. Toddlers from households experiencing mild, moderate, and severe food insecurity had higher risks of infectious diseases compared to those from food-secure households, with adjusted ORs of 1.367 (95% confidence interval [CI], 1.308-1.428), 1.490 (95% CI, 1.399-1.588), and 1.500 (95% CI, 1.374-1.638), respectively.

Conclusion: In conclusion, more severe food insecurity is correlated with an increased risk of toddlers suffering infectious diseases.

Background: This study aimed to identify safe, conserved, and highly immunogenic epitopes from all proteins of human-infecting norovirus (NoV) and to design a multi-epitope subunit vaccine construct from these epitopes using an immunoinformatics approach. Additionally, the vaccine construct was evaluated using both sequence- and structure-based assessments.

Methods: Conserved fragments were identified from all proteins of human-infecting NoV, and B and T lymphocyte epitopes were subsequently predicted using multiple epitope prediction tools. The selected epitopes were linked to form a multi-epitope construct, incorporating various adjuvants in the design. Vaccine constructs with different adjuvants were analyzed for their physicochemical properties and immune simulation profiles, and the optimal combination was selected as the final vaccine candidate for further study. Finally, molecular docking and dynamics simulations were performed to visualize the interaction between the construct and a host immune receptor.

Results: Twenty-two safe, conserved, and highly immunogenic epitopes were identified from all human-infecting NoV proteins. The construct adjuvanted with 50S ribosomal protein L7/L12 (50SrpL7/L12) was chosen as the final vaccine candidate due to its optimal physicochemical properties and favorable immune simulation profile. Furthermore, the construct exhibited high binding affinity and a stable interaction with toll-like receptor 4).

Conclusion: The multi-epitope subunit vaccine designed in this study shows promise as a potential NoV vaccine candidate for human immunization. Further in vitro and in vivo experiments are warranted to validate these findings.

Background: This study presents the standardized protocols developed by the Clinical-Based Human Microbiome Research and Development Project (cHMP) in the Republic of Korea.

Methods: It addresses clinical metadata collection, specimen handling, DNA extraction, sequencing methods, and quality control measures for microbiome research.

Results: The cHMP involves collecting samples from healthy individuals and patients across various body sites, including the gastrointestinal tract, oral cavity, respiratory system, urogenital tract, and skin. These standardized procedures ensure consistent data quality through controlled specimen collection, storage, transportation, DNA extraction, and sequencing. Sequencing encompasses both amplicon and whole metagenome methods, followed by stringent quality checks. The protocols conform to international guidelines, ensuring that the data generated are both reliable and comparable across microbiome studies.

Conclusion: The cHMP underscores the importance of methodological standardization in enhancing data integrity, reproducibility, and advancing microbiome-based research with potential applications for improving human health outcomes.