Osong Public Health and Research Perspectives最新文献

Background: Tuberculosis (TB) and drug-resistant TB (DR-TB) are national health burdens in Vietnam. In this study, we investigated the prevalence of rifampicin (RIF) and/or isoniazid (isonicotinic acid hydrazide, INH) resistance in patients with suspected TB, and applied appropriate techniques to help rapidly target DR-TB.

Methods: In total, 1,547 clinical specimens were collected and cultured using the BACTEC MGIT system (Becton Dickinson and Co.). A resazurin microtiter assay (REMA) was used to determine the proportions of RIF and/or INH resistance. A real-time polymerase chain reaction panel with TaqMan probes was employed to identify the mutations of rpoB and katG associated with DR-TB in clinical isolates. Genotyping of the identified mutations was also performed.

Results: A total of 468 Mycobacterium tuberculosis isolates were identified using the REMA. Of these isolates, 106 (22.6%) were found to be resistant to 1 or both antibiotics. Of the resistant isolates, 74 isolates (69.8%) were resistant to isoniazid (INH) only, while 1 isolate (0.94%) was resistant to RIF only. Notably, 31 isolates (29.24%) were resistant to both antibiotics. Of the 41 phenotypically INH-resistant isolates, 19 (46.3%) had the Ser315Thr mutation. There were 8 different rpoB mutations in 22 (68.8%) of the RIF-resistant isolates. The most frequently detected mutations were at codons 531 (37.5%), 526 (18.8%), and 516 (6.3%).

Conclusion: To help prevent new cases of DR-TB in Vietnam, it is crucial to gain a comprehensive understanding of the genotypic DR-TB isolates.

Background: We evaluated the effectiveness of coronavirus disease 2019 vaccination in high-risk facilities in the Republic of Korea during the period when the highly transmissible Delta variant was prevalent. Additionally, we aimed to explore any disparities in vaccine effectiveness (VE) across various types of institutions, specifically distinguishing between non-medical and medical establishments.

Methods: We examined 8 outbreak clusters covering 243 cases and 895 contacts from 8 high-risk facilities divided into 2 groups: group A (4 non-medical institutions) and group B (4 medical institutions). These clusters were observed from July 27, 2021 to October 16, 2021 for the attack rate (AR) and VE with respect to disease severity. A generalized linear model with a binomial distribution was used to determine the odds ratio (OR) for disease severity and death.

Results: AR was notably lower in group B (medical institutions). Furthermore, VE analysis revealed that group A exhibited higher effectivity for disease severity and death than group B. The OR for disease severity was 0.24 (95% confidence interval [CI], 0.03-2.16) for group A and 0.27 (95% CI, 0.12-0.64) for group B, with the OR for death at 0.12 (95% CI, 0.01-1.32) in group A and 0.34 (95% CI, 0.14-0.87) in group B.

Conclusion: Although VE may vary across institutions, our findings underscore the importance of implementing vaccinations in high-risk facilities. Customized vaccination programs, tailored response plans, and competent management personnel are essential for effectively addressing and mitigating public health challenges.

Background: The global prevalence of psychiatric disturbances is rising, detrimentally affecting the quality of care and treatment outcomes for individuals, particularly those with diabetes.This study investigated the association of risk factors for psychiatric disturbances among productive-age patients with diabetes (ages 30-59 years), considering sociodemographic characteristics and co-existing diseases. The risk factors considered included sociodemographic factors (e.g., residence, age, sex, marital status, education, and occupation) and co-existing diseases (e.g., hypertension, heart disease, stroke, renal failure, rheumatism, asthma, and cancer).

Methods: This cross-sectional study utilized data from the 2018 Indonesian National Health Survey (Riskesdas). The study population comprised respondents aged between 30 and 59 years who had diabetes and had completed the 20-question self-reporting questionnaire (SRQ-20). After the exclusion of incomplete SRQ-20 data, the sample included 8,917 respondents. Data were analyzed using logistic regression.

Results: Approximately 18.29% of individuals with diabetes displayed symptoms indicative of psychiatric disturbances. After adjusting for sociodemographic factors such as age, sex, education level, occupation, marital status, and place of residence, patients with diabetes who had co-existing conditions such as hypertension, heart diseases, rheumatic disorders, asthma, or cancer had a higher risk for developing psychiatric disturbances than those with diabetes alone (adjusted odds ratio, 6.67; 95% confidence interval, 4.481-9.928; p<0.001).

Conclusion: The elevated risk of psychiatric disturbances among patients with diabetes who had comorbidities underscores the importance of addressing mental health issues in the management of diabetes, especially in patients with concurrent disease conditions.

Background: To identify factors associated with general and abdominal obesity in middle-aged and older Korean women based on the biopsychosocial model.

Methods: Data from 4,076 women aged ≥45 years who participated in the Korea National Health and Nutrition Examination Survey from 2015 to 2020 were analyzed. Complex sampling analysis was performed using IBM SPSS ver. 26.0.

Results: The combination of general and abdominal obesity was positively associated with age ≥65 years, postmenopausal status, and without breastfeeding experience among biomedical factors; depressive symptoms and prolonged (≥8 hours a day) sedentary behavior among psychosocial factors; and an educational level lower than middle or high school graduation and the first and second income quantiles among biosocial factors.

Conclusion: Healthcare providers in communities and public societies should screen for risk factors for the combination of general and abdominal obesity while considering non-modifiable biomedical (e.g., age) and biosocial factors (e.g., educational level). In addition, intervention strategies should be developed by considering modifiable psychosocial factors such as sedentary behavior.

The emergence of antimicrobial resistance raises the fear of untreatable diseases. Antimicrobial resistance is a multifaceted and dynamic phenomenon that is the cumulative result of different factors. While Gram-positive pathogens, such as methicillin-resistant Staphylococcus aureus and Clostridium difficile, were previously the most concerning issues in the field of public health, Gram-negative pathogens are now of prime importance. The World Health Organization's priority list of pathogens mostly includes multidrug-resistant Gram-negative organisms particularly carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa, and extensively drug-resistant Acinetobacter baumannii. The spread of Gram-negative bacterial resistance is a global issue, involving a variety of mechanisms. Several strategies have been proposed to control resistant Gram-negative bacteria, such as the development of antimicrobial auxiliary agents and research into chemical compounds with new modes of action. Another emerging trend is the development of naturally derived antibacterial compounds that aim for targets novel areas, including engineered bacteriophages, probiotics, metal-based antibacterial agents, odilorhabdins, quorum sensing inhibitors, and microbiome-modifying agents. This review focuses on the current status of alternative treatment regimens against multidrug-resistant Gram-negative bacteria, aiming to provide a snapshot of the situation and some information on the broader context.

Background: With the recent global mpox outbreak, the JYNNEOS vaccine (Modified Vaccinia Ankara-Bavarian Nordic) was developed as a third-generation smallpox vaccine and initially favored for mpox immunization. Vaccine-associated side effects contribute to vaccine hesitancy. Consequently, tracking adverse events post-immunization is crucial for safety management. This study used data from the national active vaccine safety surveillance conducted in Korea from August 25 to November 24, 2022 to detect potential safety signals and adverse events.

Methods: Data on health conditions following vaccination were gathered from web-based surveys and reported via active surveillance through the Immunization Registry Information System. This follow-up system functioned via a text message link, surveying adverse events and health conditions beginning on the second day post-vaccination. Information about specific adverse events, including both local and systemic reactions, was collected.

Results: The study included 86 healthcare workers who had received at least 1 dose of the JYNNEOS vaccine. Among the respondents, 79.1% reported experiencing at least 1 adverse event, with the majority being local reactions at the injection site. The incidence of adverse events was higher following the first dose (67.9%) than after the second dose (34.4%). The most frequently reported adverse event for both doses was mild pain at the injection site.

Conclusion: The study provides crucial information on the safety of the JYNNEOS vaccine, demonstrating that most adverse events were manageable and predominantly localized to the injection site. Nonetheless, additional research is needed on the safety of various vaccine administration techniques and the vaccine's effects on broader demographics.

Background: We investigated differences in high-sensitivity C-reactive protein (hs-CRP) levels by age group according to working hours, socioeconomic level, health behavior and status, and occupational class, and aimed to identify factors affecting hs-CRP levels in various age groups using data from the Korean National Health and Nutrition Examination from 2016 to 2018.

Methods: The study included a total of 4,786 male wage workers across the nation, aged between 19 and 65. Data from 4,674 workers were analyzed using multiple logistic regression analysis.

Results: Obesity, metabolic syndrome, and weekly working hours were associated with hs-CRP, a biomarker of inflammation. Participants with a body mass index (BMI) ≥25.0 kg/m2 showed significantly higher hs-CRP levels than those with a BMI 23.0 to 25.0 kg/m2. Workers with high-risk drinking and metabolic syndrome showed significantly higher hs-CRP levels in the 50 to 65 years group. Obesity, walking 0 to 149 min/wk, and working ≥61 hours a week were associated with significantly higher hs-CRP levels in the 35 to 49 years group. The factors that significantly affected hs-CRP levels were different among age groups.

Conclusion: Plans to adjust working hours should be considered health behaviors, such as drinking and physical activity, and health conditions, such as metabolic syndrome and obesity, according to workers' age.

Background: Patients with coronavirus disease 2019 (COVID-19) present with a variety of oral manifestations. Therefore, we conducted a systematic review to estimate the prevalence of oral lesions among COVID-19 patients.

Methods: An extensive literature search of several electronic bibliographic databases (PubMed, Scopus, Science Direct, Litcovid) was conducted to retrieve all articles published in the English language from January 1, 2020 to March 31, 2023 that reported the prevalence of oral manifestations among COVID-19 patients. A meta-analysis of pooled prevalence was performed using Jamovi ver. 2.3 (2022). The I2 and Q statistics were used to assess heterogeneity between studies, and p-values <0.01 were considered statistically significant.

Results: In total, 79 studies with data from 13,252 patients were included. The articles were predominantly published in 2020 (n=33), and Italy was the most common country (n=14). Most of the affected patients more than 50 years old and women (56.6%). The most common sites of involvement were the tongue (n=65), followed by the oral mucosa (n=37) and lips (n=19). High heterogeneity was found between studies. The most common oral manifestation was taste alteration, followed by xerostomia and ulceration, showing pooled prevalence rates of 48%, 35%, and 21%, respectively.

Conclusion: COVID-19 patients show various oral manifestations that may help clinicians identify the disease promptly. Recognition of the signs and symptoms of COVID-19 is critical for an early diagnosis and better prognosis.

Background: The number of reported cases of Legionnaires' disease (LD) in the Republic of Korea surged nationally in 2016; however, in 2022, this number was higher in Jeju Province than the previous national peak. A descriptive epidemiological study was conducted to analyze trends in the incidence of reported LD cases in Jeju Island from 2015 to 2022.

Methods: The data for this study were obtained from case reports submitted to the Korea Disease Control and Prevention Agency through its Disease and Health Integrated Management System. The selection criteria were cases or suspected cases of LD reported among Jeju residents between 2015 and 2022. The 95% confidence interval of the crude incidence rate was calculated using the Poisson distribution.

Results: Since 2020, the incidence rate of LD in Jeju has risen sharply, showing a statistically significant difference from the national incidence rate. A particular medical institution in Jeju reported a significant number of LD cases. Screening with the urine antigen test (UAT) also increased significantly.

Conclusion: Our findings indicate that the rapid increase in cases of LD in Jeju Province since 2020 was due to the characteristics of medical-care use among Jeju residents, which were focused on a specific medical institution. According to their clinical practice guidelines, this medical institution conducted UATs to screen patients suspected of pneumonia.