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Bo Youl Choi 43 Articles
Comparison of HIV characteristics across 3 datasets: the Korea HIV/AIDS Cohort Study prospective, retrospective, and national reporting system
Yunsu Choi, Jun Yong Choi, Bo Youl Choi, Bo Young Park, Shin-Woo Kim, Joon Young Song, Jung Ho Kim, Sang Il Kim
Epidemiol Health. 2024;46:e2024055.   Published online June 18, 2024
DOI: https://doi.org/10.4178/epih.e2024055
  • 1,088 View
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The Korea HIV/AIDS Cohort Study has been conducted prospectively for 18 years. However, it faces limitations in representing the entire population of patients with human immunodeficiency virus (HIV) in Korea. To address these limitations and validate the study design, we analyzed characteristics across several HIV datasets.
METHODS
We compared epidemiological and clinical characteristics from 3 datasets: the Korea HIV/AIDS Cohort Study (dataset 1, n=1,562), retrospective cohort data (dataset 2, n=2,665), and the national HIV reporting system of the Korea Disease Control and Prevention Agency (KDCA) (dataset 3, n=17,403).
RESULTS
The demographic characteristics of age, sex, and age at HIV diagnosis did not differ significantly across datasets. However, dataset 3 contained a higher proportion of patients diagnosed after 2008 (69.5%) than the other datasets. Regarding transmission routes, same-sex contact accounted for a greater proportion of dataset 1 (59.8%) compared to datasets 2 (20.9%) and 3 (32.6%). The proportion of patients with CD4 T-cell counts below 200/mm<sup>3</sup> at HIV diagnosis was higher in datasets 1 (39.4%) and 2 (33.3%) compared to dataset 3 (16.3%). Initial HIV viral load measurements were not obtained for dataset 3.
CONCLUSIONS
The Korea HIV/AIDS Cohort Study demonstrated representativeness regarding the demographic characteristics of Korean patients. Of the sources, dataset 1 contained the most data on transmission routes. While the KDCA data encompassed all HIV patients, it lacked detailed clinical information. To improve the representativeness of the Korea HIV/AIDS Cohort Study, we propose expanding and revising the cohort design and enrolling more patients who have been recently diagnosed.
Summary
Korean summary
장기간 운영된 코호트 연구는 다양한 편향으로 인해 모집단의 대표성을 잃을 수 있다. 대표성을 높이기 위해서는 편향을 최소화하고 지속적으로 변화하는 임상 역학적 지침과 특성을 반영할 수 있어야 한다. 지난 18년간 운영된 한국 HIV/AIDS 코호트 연구에서는 코호트 연구 참여 기관에 방문하는 감염인 중 연구 참여자와 비참여자의 특성을 비교하고, 질병관리청 신고자료와의 분포를 비교한 결과, 코호트 연구에 참여하는 것만으로도 대상자 특성에 차이가 있음을 밝혔다. 이에 따라 편향을 최소화하고 대표성을 높일 수 있도록 코호트 연구 설계를 대대적으로 개편하고, 향후 지속될 연구 설계를 제안한다.
Trends in gastrointestinal infections before and during non-pharmaceutical interventions in Korea in comparison with the United States
Soyeoun Kim, Jinhyun Kim, Bo Youl Choi, Boyoung Park
Epidemiol Health. 2022;44:e2022011.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022011
Correction in: Epidemiol Health 2022;44(0):e2022011.E
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  • 490 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study examined how trends in the weekly frequencies of gastrointestinal infectious diseases changed before and during the coronavirus disease 2019 (COVID-19) pandemic in Korea, and compared them with the trends in the United States.
METHODS
We compared the weekly frequencies of gastrointestinal infectious diseases (16 bacterial and 6 viral diseases) in Korea during weeks 5-52 before and after COVID-19. In addition, the weekly frequencies of 5 gastrointestinal infectious diseases in the United States (data from the Centers for Disease Control and Prevention) that overlapped with those in Korea were compared.
RESULTS
The mean weekly number of total cases of gastrointestinal infectious diseases in Korea showed a significant decrease (from 522 before COVID-19 to 245 after COVID-19, p<0.01). Only bacterial gastrointestinal infectious diseases caused by <i>Campylobacter</i> increased significantly; other bacterial gastrointestinal infectious diseases showed either a decrease or no change. The incidence of all other viral diseases decreased. In the United States, the weekly numbers of <i>Salmonella</i>, <i>Campylobacter</i>, typhoid, shigellosis, and hepatitis A virus cases sharply decreased after the COVID-19 outbreak. The weekly case numbers of all viral diseases markedly decreased in both countries; however, bacterial gastrointestinal infectious diseases showed a different pattern.
CONCLUSIONS
The incidence of gastrointestinal infectious diseases decreased after the COVID-19 outbreak. In contrast, <i>Campylobacter</i> infections showed an increasing trend in Korea, but a decreasing trend in the United States. Further studies are needed to elucidate the different trends in bacterial and viral infectious diseases before and after non-pharmaceutical interventions and between different countries.
Summary
Korean summary
한국과 미국 모두 코로나-19 발생 이후 위장관 감염 질환의 발생은 감소하고 있습니다. 하지만, 미국과 달리 한국에서는 캄필로박터 감염은 증가 하고 있습니다. 이는 COVID-19이 발생한 이후 캄필로박터 감염의 열악한 통제의 가능성을 설명할 수 있습니다.
Key Message
The incidence of gastrointestinal infectious diseases decreased after the COVID-19 outbreak, however, campylobacter infections showed an increasing trend in Korea, unlike the United States, which could explain the poor control of Campylobacter.

Citations

Citations to this article as recorded by  
  • Trends for Syndromic Surveillance of Norovirus in Emergency Department Data Based on Chief Complaints
    Soyeoun Kim, Sohee Kim, Bo Youl Choi, Boyoung Park
    The Journal of Infectious Diseases.2024; 230(1): 103.     CrossRef
  • Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea
    Taehee Chang, Sung-il Cho, Dae sung Yoo, Kyung-Duk Min
    Emerging Infectious Diseases.2024;[Epub]     CrossRef
  • Impact of the COVID‐19 pandemic on the circulation of other pathogens in England
    Lauren J. Hayes, Hannah Uri, Denisa Bojkova, Jindrich Cinatl, Mark N. Wass, Martin Michaelis
    Journal of Medical Virology.2023;[Epub]     CrossRef
  • Understanding the impact of the COVID-19 pandemic response on GI infection surveillance trends in England, January 2020–April 2022
    Nicola K. Love, Amy Douglas, Saheer Gharbia, Helen Hughes, Roger Morbey, Isabel Oliver, Gillian E. Smith, Alex J. Elliot
    Epidemiology and Infection.2023;[Epub]     CrossRef
  • Trends in Gastrointestinal Infections during the COVID-19 Pandemic and Concerns of Post-Pandemic Resurgence in Japan
    Takuma Higurashi, Shigeki Tamura, Noboru Misawa, Nobuyuki Horita
    Diseases.2023; 12(1): 4.     CrossRef
  • Characteristics and related factors of waterborne and foodborne infectious disease outbreaks before and after the onset of the COVID-19 pandemic (2017–2021) in the Republic of Korea: a descriptive study
    Eunkyoung Kim, Bryan Inho Kim
    Osong Public Health and Research Perspectives.2023; 14(6): 483.     CrossRef
Erratum: Trends in gastrointestinal infections before and during non-pharmaceutical interventions in Korea in comparison with the United States
Soyeoun Kim, Jinhyun Kim, Bo Youl Choi, Boyoung Park
Epidemiol Health. 2022;44:e2022011.E.   Published online December 31, 2022
DOI: https://doi.org/10.4178/epih.e2022011.E
Corrects: Epidemiol Health 2022;44:e2022011
  • 3,738 View
  • 145 Download
  • 2 Crossref
PDF
Abstract
Summary

Citations

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  • Impact of COVID-19-related nonpharmaceutical interventions on diarrheal diseases and zoonotic Salmonella
    Linlin Huang, Haiyang Zhou, Jiaqi Chen, Chenghao Jia, Abubakar Siddique, Beibei Wu, Haoqiu Wang, Biao Tang, Fang He, Guoping Zhao, Min Yue
    hLife.2024; 2(5): 246.     CrossRef
  • Impact of the COVID‐19 pandemic on the circulation of other pathogens in England
    Lauren J. Hayes, Hannah Uri, Denisa Bojkova, Jindrich Cinatl, Mark N. Wass, Martin Michaelis
    Journal of Medical Virology.2023;[Epub]     CrossRef
Associations of depression and anxiety with cardiovascular risk among people living with HIV/AIDS in Korea
Kyong Sil Park, Seon Young Hwang, Bo Youl Choi, June Kim, Sang Il Kim, Woo-Joo Kim, Chun Kang
Epidemiol Health. 2021;43:e2021002.   Published online December 24, 2020
DOI: https://doi.org/10.4178/epih.e2021002
  • 14,678 View
  • 394 Download
  • 2 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
As HIV/AIDS is becoming a chronic disease, the risk of developing cardiovascular disease (CVD) among people living with HIV/AIDS is rising. Anxiety and depression, which are common among people living with HIV/AIDS, have been linked with CVD. This study investigated the risk of CVD in people living with HIV/AIDS and explored the effects of depression and anxiety on CVD risk.
METHODS
Data were collected for 457 people enrolled in the Korea Cohort HIV/AIDS study after 2010. Framingham risk scores were calculated to quantify the 10-year risk of developing CVD. Depression and anxiety variables were re-coded as a single combined variable. Multivariable logistic regression analysis was performed, adjusting for age, body mass index, low-density lipoprotein (LDL) cholesterol, triglycerides (TG), duration of human immunodeficiency virus (HIV) positivity after entry into the cohort, and depression/anxiety.
RESULTS
Participants with both depression and anxiety were 2.28 times more likely than those with neither depression nor anxiety to have moderate/high-risk CVD risk. The 10-year risk of developing CVD was affected by LDL cholesterol, TG, age, and duration of HIV infection. LDL cholesterol and TG levels change according to the duration of HIV infection, and metabolic disorders affect the risk of CVD. Thus, a longer duration of HIV infection is associated with a higher risk of developing CVD.
CONCLUSIONS
Screenings for depression and anxiety need to be provided regularly to assess the severity of those symptoms. To help decrease their risk of developing CVD, people living with HIV/AIDS should be offered behavioral modification interventions aimed at developing healthy lifestyle habits.
Summary
Korean summary
본 연구를 통해 우울과 불안이 심혈관질환 발생위험을 증가시키는 영향요인임을 확인하였다. 따라서, HIV 감염자의 우울과 불안에 대한 정기적인 검사 및 상담이 필요하며, 우울 또는 불안한 환자의 심혈관질환의 발병 위험을 줄이기위해 좋은 생활 습관을 위한 행동 수정 및 동기 부여 교육프로그램의 개발이 필요하다.
Key Message
healthcare providers need to provide motivational education for behavioral modifications to decrease patients’ risk of developing CVD, especially among those with depression or anxiety symptoms.

Citations

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  • Depressive Symptoms and Left Ventricular Diastolic Dysfunction Among Men and Women with HIV
    Claudia Martinez, Nel Jason Haw, Violeta J. Rodriguez, Jorge R. Kizer, Wendy S. Post, Katherine C. Wu, Joao A. C. Lima, Jenni M. Wise, Maria L. Alcaide, Michael Plankey, Deborah Konkle-Parker, Sofia Kozlova, Margaret A. Fischl, Adaora A. Adimora, Matthew
    EMJ Cardiology.2024;[Epub]     CrossRef
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    Shuzhen Liu, Xiangju Hu, Meijie Jiang, Ninghao Huang, Hailun Liang, Ruimao Zheng, Shuyan Wang, Jian Qin, Zhiyong Zhang, Tao Huang, Xu Gao
    npj Cardiovascular Health.2024;[Epub]     CrossRef
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    Shyfuddin Ahmed, Angel B. Algarin, Hsu Thadar, Zhi Zhou, Tanjila Taskin, Krishna Vaddiparti, Karina Villalba, Yan Wang, Nicole Ennis, Jamie P. Morano, Charurut Somboonwit, Robert L Cook, Gladys E. Ibañez
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  • Elevated frequency and everyday functioning implications of vascular depression in persons with HIV disease
    Ilex Beltran-Najera, Andrea Mustafa, Desmond Warren, Zach Salling, Maria Misiura, Steven Paul Woods, Vonetta M. Dotson
    Journal of Psychiatric Research.2023; 160: 78.     CrossRef
  • MENTE X CORAÇÃO: AS DOENÇAS PSIQUICAS E AS CONSENQUÊNCIAS CARDIOVASCULARES: UMA REVISÃO DA LITERATURA
    Beatriz da Silva Araújo, Morgana Gonçalves da Silva
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Time-variant reproductive number of COVID-19 in Seoul, Korea
Seong-Geun Moon, Yeon-Kyung Kim, Woo-Sik Son, Jong-Hoon Kim, Jungsoon Choi, Baeg-Ju Na, Boyoung Park, Bo Youl Choi
Epidemiol Health. 2020;42:e2020047.   Published online June 28, 2020
DOI: https://doi.org/10.4178/epih.e2020047
  • 14,202 View
  • 343 Download
  • 2 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To estimate time-variant reproductive number (R<sub>t</sub>) of coronavirus disease 19 based on either number of daily confirmed cases or their onset date to monitor effectiveness of quarantine policies.
METHODS
Using number of daily confirmed cases from January 23, 2020 to March 22, 2020 and their symptom onset date from the official website of the Seoul Metropolitan Government and the district office, we calculated R<sub>t</sub> using program R’s package “EpiEstim”. For asymptomatic cases, their symptom onset date was considered as -2, -1, 0, +1, and +2 days of confirmed date.
RESULTS
Based on the information of 313 confirmed cases, the epidemic curve was shaped like ‘propagated epidemic curve’. The daily R<sub>t</sub> based on R<sub>t_c</sub> peaked to 2.6 on February 20, 2020, then showed decreased trend and became <1.0 from March 3, 2020. Comparing both R<sub>t</sub> from R<sub>t_c</sub> and from the number of daily onset cases, we found that the pattern of changes was similar, although the variation of R<sub>t</sub> was greater when using R<sub>t_c</sub>. When we changed assumed onset date for asymptotic cases (-2 days to +2 days of the confirmed date), the results were comparable.
CONCLUSIONS
R<sub>t</sub> can be estimated based on R<sub>t_c</sub> which is available from daily report of the Korea Centers for Disease Control and Prevention. Estimation of R<sub>t</sub> would be useful to continuously monitor the effectiveness of the quarantine policy at the city and province levels.
Summary
Korean summary
우리나라 전체와 각 시도별 일별 증상 발현자 수 또는 확진자 수를 이용하여 추정한 Rt로 방역정책의 효과를 국가 및 시도 수준에서 지속적으로 모니터링 할 필요가 있다.

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  • Reproduction Factor Based Latent Epidemic Model Inference: A Data-Driven Approach Using COVID-19 Datasets
    Sujin Ahn, Minhae Kwon
    IEEE Journal of Biomedical and Health Informatics.2023; 27(3): 1259.     CrossRef
  • 코로나19 핵심 지표 산출체계 국제 비교 및 활용도 제고 방안 연구
    나애 이, 연경 김, 승필 정, 우주 이, 주환 오, 승식 황
    Public Health Weekly Report.2023; 16(29): 973.     CrossRef
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    Haejun Hyun, Myungje Woo
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Prospective cohort data quality assurance and quality control strategy and method: Korea HIV/AIDS Cohort Study
Soo Min Kim, Yunsu Choi, Bo Youl Choi, Minjeong Kim, Sang Il Kim, Jun Young Choi, Shin-Woo Kim, Joon Young Song, Youn Jeong Kim, Mee-Kyung Kee, Myeongsu Yoo, Jeong Gyu Lee, Bo Young Park
Epidemiol Health. 2020;42:e2020063.   Published online September 4, 2020
DOI: https://doi.org/10.4178/epih.e2020063
  • 13,014 View
  • 215 Download
  • 3 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The aim of effective data quality control and management is to minimize the impact of errors on study results by identifying and correcting them. This study presents the results of a data quality control system for the Korea HIV/AIDS Cohort Study that took into account the characteristics of the data.
METHODS
The HIV/AIDS Cohort Study in Korea conducts repeated measurements every 6 months using an electronic survey administered to voluntarily consenting participants and collects data from 21 hospitals. In total, 5,795 sets of data from 1,442 participants were collected from the first investigation in 2006 to 2016. The data refining results of 2015 and 2019 were converted into the data refining rate and compared.
RESULTS
The quality control system involved 3 steps at different points in the process, and each step contributed to data quality management and results. By improving data quality control in the pre-phase and the data collection phase, the estimated error value in 2019 was 1,803, reflecting a 53.9% reduction from 2015. Due to improvements in the stage after data collection, the data refining rate was 92.7% in 2019, a 24.21%p increase from 2015.
CONCLUSIONS
Despite this quality management strategy, errors may still exist at each stage. Logically possible errors for the post-review refining of downloaded data should be actively identified with appropriate consideration of the purpose and epidemiological characteristics of the study data. To improve data quality and reliability, data management strategies should be systematically implemented.
Summary
Korean summary
이 연구는 한국 에이즈 코호트 자료의 연구 목적과 역학적 특성을 고려한 체계적인 질 관리 방법과 결과를 제시한다. 시간적 선후 관계를 고려한 로직을 활용한 자료정제 과정을 비롯한 3단계의 체계적인 질 관리 방법은 이제껏 없었던 국내 코호트 자료 질 관리에 도움이 될 것으로 사료된다.

Citations

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  • Adopting Data to Care to Identify and Address Gaps in Services for Children and Adolescents Living With HIV in Mozambique
    Belmiro Sousa, Sergio Chiale, Hayley Bryant, Lisa Dulli, Tanya Medrano
    Global Health: Science and Practice.2024; 12(2): e2300130.     CrossRef
  • Effect of characteristics on the clinical course at the initiation of treatment for human immunodeficiency virus infection using dimensionality reduction
    Yunsu Choi, Bo Youl Choi, Sang Il Kim, Jungsoon Choi, Jieun Kim, Bo Young Park, Soo Min Kim, Shin-Woo Kim, Jun Yong Choi, Joon Young Song, Youn Jeong Kim, Hyo Youl Kim, Jin-Soo Lee, Jung Ho Kim, Yoon Hee Jun, Myungsun Lee, Jaehyun Seong
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Epidemiological characteristics of HIV infected Korean: Korea HIV/AIDS Cohort Study
Yunsu Choi, Bo Youl Choi, Soo Min Kim, Sang Il Kim, June Kim, Jun Young Choi, Shin-Woo Kim, Joon Young Song, Youn Jeong Kim, Dae Won Park, Hyo Youl Kim, Hee-Jung Choi, Mee-Kyung Kee, Young Hyun Shin, Myeongsu Yoo
Epidemiol Health. 2019;41:e2019037.   Published online September 3, 2019
DOI: https://doi.org/10.4178/epih.e2019037
  • 16,919 View
  • 353 Download
  • 21 Web of Science
  • 20 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To manage evidence-based diseases, it is important to identify the characteristics of patients in each country.
METHODS
The Korea HIV/AIDS Cohort Study seeks to identify the epidemiological characteristics of 1,442 Korean individuals with human immunodeficiency virus (HIV) infection (12% of Korean individuals with HIV infection in 2017) who visited 21 university hospitals nationwide. The descriptive statistics were presented using the Korea HIV/AIDS cohort data (2006-2016).
RESULTS
Men accounted for 93.3% of the total number of respondents, and approximately 55.8% of respondents reported having an acute infection symptom. According to the transmission route, infection caused by sexual contact accounted for 94.4%, of which 60.4% were caused by sexual contact with the same sex or both males and females. Participants repeatedly answered the survey to decrease depression and anxiety scores. Of the total participants, 89.1% received antiretroviral therapy (ART). In the initial ART, 95.3% of patients were treated based on the recommendation. The median CD4 T-cell count at the time of diagnosis was 229.5 and improved to 331 after the initial ART. Of the patients, 16.6% and 9.4% had tuberculosis and syphilis, respectively, and 26.7% had pneumocystis pneumonia. In the medical history, sexually transmitted infectious diseases showed the highest prevalence, followed by endocrine diseases. The main reasons for termination were loss to follow-up (29.9%) and withdrawal of consent (18.7%).
CONCLUSIONS
Early diagnosis and ART should be performed at an appropriate time to prevent the development of new infection.
Summary
Korean summary
국내 감염인은 대부분 성 접촉으로 인해 감염되었고, 감염인의 약 90%가 치료를 경험하였다. 하지만 여전히 결핵, 매독, 주폐포자충 폐렴 등과 같은 HIV 관련 질환의 유병률이 높았고, 치료를 통해 수명이 연장되어 노화 혹은 치료 약제 부작용과 관련된 HIV 비 관련 만성 질환의 유병률도 높았다. 향후 감염인의 HIV/AIDS 비 관련 질환에 대한 연구 및 사망 원인 등에 대한 후속 연구가 필요하겠다.

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Causes and countermeasures for repeated outbreaks of hepatitis A among adults in Korea
Moran Ki, Hyunjin Son, Bo Youl Choi
Epidemiol Health. 2019;41:e2019038.   Published online September 22, 2019
DOI: https://doi.org/10.4178/epih.e2019038
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The 2019 hepatitis A outbreak has become increasingly prevalent among adults in Korea and is the largest outbreak since that in 2009-2010. The incidence in the current outbreak is highest among adults aged 35-44 years, corresponding to the peak incidence among those aged 25-34 years 10 years ago. This may indicate a cohort effect in the corresponding age group. Causes of these repeated outbreaks of hepatitis A in Korea are low level of immunity among adults, Korean food culture that consumes raw seafood such as salted clam and inadequate public health system. Among countermeasures, along with general infectious disease control measures including control of the infectious agent, infection spread, and host, urgent actions are needed to review the vaccination policy and establish an adequate public health system.
Summary
Korean summary
2019년 한국 성인의 A형 간염 유행은 10년전 대규모 유행 이후 가장 큰 규모로발생하고 있다. 주 발생 연령이 10년전 유행보다 10세가 증가한 35-44세로 나타나 연령 코호트 효과라 볼 수 있다. 우리나라의 A형 간염 반복 유행의 원인은 성인의 낮은 집단면역수준, 어패류 생식문화, 공중보건의료체계 미비 등으로 보인다. 이에 대한 대책은 일반적인 감염관리대책인 감염원관리, 전파관리, 숙주관리와 함께 효율적인 백신접종정책, 공고한 공중보건관리체계 마련 등의 근본적 대책이 시급하다.

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Asymptomatic Middle East Respiratory Syndrome coronavirus infection using a serologic survey in Korea
Yeong-jun Song, Jeong-Sun Yang, Hee Jung Yoon, Hae-Sung Nam, Soon Young Lee, Hae-Kwan Cheong, Woo-Jung Park, Sung Han Park, Bo Youl Choi, Sung Soon Kim, Moran Ki
Epidemiol Health. 2018;40:e2018014.   Published online April 15, 2018
DOI: https://doi.org/10.4178/epih.e2018014
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status.
METHODS
Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results.
RESULTS
The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis.
CONCLUSIONS
The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.
Summary
Korean summary
2015년 국내 MERS 유행시에 자가격리를 시행하였던 접촉자 약 15,000명 (의료인과 비의료인 포함) 중에서 주요 유행지역, 노출 강도 등을 고려하여 선별된 3,291명을 대상으로 무증상 감염여부를 확인하기 위한 혈청 역학조사를 수행하였다. 최종 검사에 참여한 1,610명 중에서 7명이 ELISA 양성 반응을 보였고, 그 중 1명이 IFA와 PRNT에서도 양성 반응을 보여 무증상 감염률은 0.060%(95% CI: 0.002-0.346)로 기존 연구에 비하여 낮았다. 최종 양성을 보인 1명은 노출 당시 1번환자와 가까운 병실에 입원하였던 환자였다.

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Korea HIV/AIDS Cohort Study: study design and baseline characteristics
Bo Youl Choi, Jun Yong Choi, Sang Hoon Han, Sang Il Kim, Mee-Kyung Kee, Min Ja Kim, Shin-Woo Kim, Sung Soon Kim, Yu-Mi Kim, Nam Su Ku, Jin-Soo Lee, Joo-Shil Lee, Yunsu Choi, Kyong Sil Park, Joon Young Song, Jun Hee Woo, Moon Won Kang, June Kim
Epidemiol Health. 2018;40:e2018023.   Published online June 6, 2018
DOI: https://doi.org/10.4178/epih.e2018023
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The number of persons infected by HIV/AIDS has consistently increased in Korea since the first case of HIV/AIDS infection in 1985 and reached 15,208 by 2016. About 1,100 new patients with HIV/ AIDS infections have emerged every year since 2013. In Korea, the Korea HIV/AIDS Cohort Study was established for the evidenced-based prevention, treatment, and effective management of patients infected with human immunodeficiency virus (HIV) in December 2006. This study monitored 1,438 patients, who accounted for about 10% of all patients with HIV/AIDS in Korea, for 10 years with the following aims: (1) to develop an administrative system for the establishment of a HIV/AIDS cohort-based study; (2) to standardize methodologies and the case report forms; and (3) to standardize multi-cohort data and develop a data cleaning method. This study aims to monitor at least 1,000 patients (excluding those for whom investigation had been completed) per year (estimated number of patients who can be monitored by January 2018: 939). By December 2016, the sex distribution was 93.3% for men, and 6.7% for women (gender ratio, 13.9:1.0), and 98.9% of all participants were Korean. More than 50.0% of the participants were confirmed as HIV positive after 2006. This study reports competitive, long-term research that aimed to develop policies for the prevention of chronic infectious diseases for patients with HIV. The data collected over the last decade will be used to develop indices for HIV treatment and health promotion.
Summary
Korean summary
세계적으로 HIV 감염인은 감소하고 있으나, 한국의 HIV 감염은 증가하여 2013년 이후 매년 1,000명이 넘는 신규 감염인이 보고되고 있다. HIV/AIDS 코호트 연구진은 2006년부터 HIV 감염인과 AIDS 환자를 대상으로 6개월 간격의 반복 조사를 시행하여 역학과 임상 자료를 수집하여 데이터베이스를 구축하고, 생물검체를 채취하여 인체자원은행에 보관하여, HIV/AIDS의 발생 기전을 구명하고, 자연사를 파악하며, 예방과 진단, 치료, 관리 방법을 개발하기 위한 기초와 임상, 역학 연구에 활용하고 있다.

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The coverage rates for influenza vaccination and related factors in Korean adults aged 50 and older with chronic disease: based on 2016 Community Health Survey data
Kyeong Hyang Byeon, Jaiyong Kim, Boyoung Choi, Bo Youl Choi
Epidemiol Health. 2018;40:e2018034.   Published online July 24, 2018
DOI: https://doi.org/10.4178/epih.e2018034
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aims to identify the coverage rates for influenza vaccination and related factors depending on chronic disease in Korean adults aged 50 and older.
METHODS
The 2016 Korea Community Health Survey was used for analysis. Chi-square test was performed to investigate the coverage rates for influenza vaccination depending on chronic disease, and a multiple logistic regression analysis was used to identify the factors associated with influenza vaccination, by chronic disease.
RESULTS
In men with ≥1 chronic disease, 39.8% of 50-64 years of age, and 86.8% of elderly (over 65 years of age) received influenza vaccination. In women with ≥1 chronic disease, 58.7% of 50-64 years of age, and 89.9% of elderly (over 65 years of age) received influenza vaccination (p<0.001). The chronic diseases associated with influenza vaccination were hypertension (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19 to 1.37), diabetes (OR, 1.41; 95% CI, 1.28 to 1.55) in men aged 50-64, hypertension (OR, 1.34; 95% CI, 1.20 to 1.49), diabetes (OR, 1.17; 95% CI, 1.02 to 1.33), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.07 to 1.60) in elderly (over 65 years of age). In women aged 50-64, hypertension (OR, 1.39; 95% CI, 1.30 to 1.49), diabetes (OR, 1.51; 95% CI, 1.35 to 1.68), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.05 to 1.64), and hypertension (OR, 1.55; 95% CI, 1.40 to 1.71), diabetes (OR, 1.27; 95% CI, 1.12 to 1.43) in elderly (over 65 years of age).
CONCLUSIONS
Populations in aged 50-64 are recommendation subject for vaccination or classified as high-risk group in case with chronic disease. Though subject over 60 years old is age close to the elderly, the coverage rates for vaccination was low. It is necessary to devise strategies to raise the coverage rates for vaccination.
Summary
Korean summary
매년 인플루엔자 환자수는 증가하는 추세이며 인플루엔자로 인한 의료이용의 질병부담은 커질 것으로 생각된다. 국내에서는 우선접종 권장대상자들에게 예방접종을 받도록 권고하고 있으며, 예방접종은 인플루엔자를 예방할 수 있는 비용 효과적인 방법이다. 65세 이상 대상자는 국가 무료 예방접종 사업 대상으로 인해 예방접종률이 높은 것으로 확인되었다. 50-64세 인구는 예방접종 권고 대상자임에도 불구하고 낮은 것으로 나타났고, 50-64세 연령에서 만성질환을 동반할 경우 고위험군이지만 여전히 낮은 예방접종률을 보였다. 또한 50-64세 연령에서 1개 이상 만성질환을 동반할 경우 대도시, 중소도시에 거주하는 것보다 군지역에 거주할 경우 높은 예방접종률을 확인함으로써 대도시 및 중소도시에 거주하는 50-64세 연령에 대해 예방접종률을 올릴 수 있는 적극적인 예방접종 홍보가 필요할 것으로 생각한다.

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Correlation between depressive symptoms and subjective mastication ability and ability to pronunciation among Korean elderly
Min Sun Park, Kyung-Gyun Hwang, Bo Youl Choi
Epidemiol Health. 2016;38:e2016035.   Published online July 25, 2016
DOI: https://doi.org/10.4178/epih.e2016035
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The present study examines the relationship between depressive symptoms and subjective chewing and pronunciation ability in Korean seniors. Our goal is to provide the data required to develop appropriate oral health interventions programs for seniors.
METHODS
The Center for Epidemiologic Studies-Depression Scale (CES-D) is widely used depressive symptoms assessment. A Korean version was used for the 2009 Community Health Survey, which was consulted to extract the present study’s participants comprising 50,694 Korean seniors (males, 20,582; females, 30,112) aged ≥65 years. Those with a CES-D score ≥16 were rated ‘depressed.’ SAS version 9.3 was used for the data analysis.
RESULTS
Prevalence of depressive symptoms increased as the participants socioeconomic status decreased, number of health issues increased, health behavior worsened, and chewing and pronunciation discomfort increased. Males with chewing difficulties were found to have 1.45 times (95% confidence interval [CI], 1.29 to 1.63) greater risk of depressive symptoms than those without, while males with pronunciation discomfort were found to have 1.97 times greater risk of depressive symptoms than those without (95% CI, 1.76 to 2.20). Females with chewing difficulty were found to have 1.50 times (95% CI, 1.39 to 1.61) greater risk of depressive symptoms than those without, and females with pronunciation discomfort were found to have 1.55 times greater risk of depressive symptoms than those without (95% CI, 1.44 to 1.67).
CONCLUSIONS
Intervention programs designed to help with oral health management and alleviate depressive symptoms in seniors are urgently needed. As the prevalence of depressive symptoms may vary geographically, research examining potential variance at city, district, and town levels would be beneficial.
Summary
Korean summary
The Center for Epidemiologic Studies-Depression Scale(CES-D)을 번역하여 조사된 2009년 지역사회건강조사 원시자료를 이용하여 전국 노인의 구강 보건 관리와 우울증상 관리를 중재하는 프로그램의 개발 및 접근에 있어 기초 자료를 제공하고자 하였다. 한국 노인의 주관적 구강저작능력과 발음능력상태와 우울증상은 인구 사회학적 특성, 건강수준 및 건강행태 관련 요인에 유의한 차이가 있었으며, 이에 따른 체계적이고 지속할 수 있는 중재프로그램의 기획 및 적용이 필요할 것으로 생각된다.

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  • Association and mediators between the impact of oral health‐related quality of life and depression
    Tianjiao Xin, Fangfang Hu, Lingzhong Xu, Fanlei Kong, Haifeng Yang, Lei Li, Afei Qin, Binghong Bao, Chiqi Chen, Jing Lan
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Evaluation report on the causal association between humidifier disinfectants and lung injury
Mina Ha, Soon Young Lee, Seung-sik Hwang, Hyesook Park, Seungsoo Sheen, Hae Kwan Cheong, Bo Youl Choi
Epidemiol Health. 2016;38:e2016037.   Published online August 18, 2016
DOI: https://doi.org/10.4178/epih.e2016037
  • 23,179 View
  • 521 Download
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
As of November 2011, the Korean government recalled and banned humidifier disinfectants (HDs) from the market, because four case-control studies and one retrospective epidemiological study proved the association between HDs and lung injury of unknown cause. The report reviewed the causal role of HDs in lung injury based on scientific evidences.
METHODS
A careful examination on the association between the HDs and lung injury was based on the criteria of causality inference by Hill and the US Surgeon General Expert Committee.
RESULTS
We found that all the evidences on the causality fulfilled the criteria (strength of association, consistency, specificity, temporality, biologic gradient, plausibility, coherence, experiment, analogy, consideration of alternative explanations, and cessation of exposure), which proved the unknown cause lung injury reported in 2011 was caused by the HDs. In particular, there was no single reported case of lung injury since the ban in selling HDs in November 2011 as well as before the HDs were sold in markets.
CONCLUSIONS
Although only a few epidemiological studies in Korea have evaluated the association between lung injury and the use of HDs, those studies contributed to proving the strong association between the use of the HDs and lung injury, based on scientific evidence.
Summary
Korean summary
본 논문에서는 Hill의 기준과 US Surgeon General 전문위원회에서 제시하는 기준에 근거하여 가습기살균제와 폐손상과의 인과성을 검토하였다. 검토결과, 11개 조건(관련성의 강도, 일관성, 특이성, 시간적 선후관계, 생물학적 용량-반응 관계, 개연성, 기존 지식과의 일치성, 실험, 유사성, 다른 가능한 해석에 대한 고려 및 노출의 중단) 을 모두 충족함을 확인하므로 써, 2011년 발생한 원인미상 폐손상의 원인이 가습기살균제 노출로 인한 것임을 알 수 있었다. 무엇보다도 가습기살균제 시판 전에는 원인미상 폐손상이 보고된 바가 없었고, 2011년 11월 가습기살균제 판매중지 이후 폐손상이 한 건도 발생하지 않은 것은 원인미상의 폐손상이 가습기살균제로 인한 것임을 강력하게 지지하는 것으로 판단된다.

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Preventive behaviors by the level of perceived infection sensitivity during the Korea outbreak of Middle East Respiratory Syndrome in 2015
Soon Young Lee, Hee Jeong Yang, Gawon Kim, Hae-Kwan Cheong, Bo Youl Choi
Epidemiol Health. 2016;38:e2016051.   Published online November 16, 2016
DOI: https://doi.org/10.4178/epih.e2016051
  • 16,904 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study was performed to investigate the relationship between community residents’ infection sensitivity and their levels of preventive behaviors during the 2015 Middle East Respiratory Syndrome (MERS) outbreak in Korea.
METHODS
Seven thousands two hundreds eighty one participants from nine areas in Gyeonggi-do including Pyeongtaek, the origin of the outbreak in 2015 agreed to participate in the survey and the data from 6,739 participants were included in the final analysis. The data on the perceived infection sensitivity were subjected to cluster analysis. The levels of stress, reliability/practice of preventive behaviors, hand washing practice and policy credibility during the outbreak period were analyzed for each cluster.
RESULTS
Cluster analysis of infection sensitivity due to the MERS outbreak resulted in classification of participants into four groups: the non-sensitive group (14.5%), social concern group (17.4%), neutral group (29.1%), and overall sensitive group (39.0%). A logistic regression analysis found that the overall sensitive group with high sensitivity had higher stress levels (17.80; 95% confidence interval [CI], 13.77 to 23.00), higher reliability on preventive behaviors (5.81; 95% CI, 4.84 to 6.98), higher practice of preventive behaviors (4.53; 95% CI, 3.83 to 5.37) and higher practice of hand washing (2.71; 95% CI, 2.13 to 3.43) during the outbreak period, compared to the non-sensitive group.
CONCLUSIONS
Infection sensitivity of community residents during the MERS outbreak correlated with gender, age, occupation, and health behaviors. When there is an outbreak in the community, there is need to maintain a certain level of sensitivity while reducing excessive stress, as well as promote the practice of preventive behaviors among local residents. In particular, target groups need to be notified and policies need to be established with a consideration of the socio-demographic characteristics of the community.
Summary
Korean summary
2015년 한국에서 발생한 메르스 유행 시 지역 주민이 인식하는 민감도와 예방행위 수준을 파악하고 연관성을 밝히고자 2015년 경기도 9개 시의 지역사회건강조사 대상자 6,739명을 대상으로 감염 민감도와 예방행위 등을 조사 분석하였다. 감염 민감도는 성별, 연령, 직업, 건강행위와 연관성이 있었으며, 감염에 대한 민감도가 높을수록 스트레스를 많이 받는 한편, 예방행위 실천에 긍정적인 영향을 미침을 알 수 있었다. 따라서 감염병 유행 시 지나친 스트레스는 줄이되 공중보건 위기에 대한 적정 수준의 민감도를 유지하고, 인구사회학적 특성을 고려한 관리정책이 요구된다.

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Epidemiologic features of the first MERS outbreak in Korea: focus on Pyeongtaek St. Mary’s Hospital
Kyung Min Kim, Moran Ki, Sung-il Cho, Minki Sung, Jin Kwan Hong, Hae-Kwan Cheong, Jong-Hun Kim, Sang-Eun Lee, Changhwan Lee, Keon-Joo Lee, Yong-Shik Park, Seung Woo Kim, Bo Youl Choi
Epidemiol Health. 2015;37:e2015041.   Published online September 17, 2015
DOI: https://doi.org/10.4178/epih/e2015041
  • 23,868 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated the epidemiologic features of the confirmed cases of Middle East Respiratory Syndrome (MERS) in Pyeongtaek St. Mary’s Hospital, where the outbreak first began, in order to identify lessons relevant for the prevention and control of future outbreaks.
METHODS
The patients’ clinical symptoms and test results were collected from their medical records. The caregivers of patients were identified by phone calls.
RESULTS
After patient zero (case #1) was admitted to Pyeongtaek St. Mary’s Hospital (May 15-May 17), an outbreak occurred, with 36 cases between May 18 and June 4, 2015. Six patients died (fatality rate, 16.7%). Twenty-six cases occurred in the first-generation, and 10 in the second-generation. The median incubation period was five days, while the median period from symptom onset to death was 12.5 days. While the total attack rate was 3.9%, the attack rate among inpatients was 7.6%, and the inpatients on the eighth floor, where patient zero was hospitalized, had an 18.6% attack rate. In contrast, caregivers and medical staff showed attack rates of 3.3% and 1.1%, respectively.
CONCLUSIONS
The attack rates were higher than those of the previous outbreaks in other countries. The outbreak spread beyond Pyeongtaek St. Mary’s Hospital when four of the patients were moved to other hospitals without appropriate quarantine. The best method of preventing future outbreaks is to overcome the vulnerabilities observed in this outbreak, such as ward crowding, patient migration without appropriate data sharing, and the lack of an initial broad quarantine.
Summary
Korean summary
평택성모병원에서는 총 36명의 메르스 환자가 발생하여 이중 6명이 사망하였다. 또한 평택성모병원 유행의 발병률은 기존에 알려진 것보다 높았다. 한국의 메르스 유행이 시작된 평택성모병원에서 나타난 초기 방역 부족, 적절한 정보공유 없이 환자들이 병원간에 이동하는 것, 혼잡한 병동 문제 등의 감염병 전파 취약점을 극복하는 것이 향후 새로운 감염병 유행을 막을 수 있는 최선의 방법이 될 것이다.

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Test-retest reliability of health behavior items in the Community Health Survey in South Korea
Soo Jeong Kim, Jin A Han, Young Hwa Kim, Bo Youl Choi, Su Young Kim, Hun Je Lee, In Hwan Oh, Sung-il Cho, Jakyoung Lee, Soon Young Lee
Epidemiol Health. 2015;37:e2015045.   Published online October 20, 2015
DOI: https://doi.org/10.4178/epih/e2015045
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Responses to health-related items on the Community Health Survey (CHS) provide evidence that is used to develop community-based health policy. This study aimed to assess the test-retest reliability of selected health behavioral items on the CHS according to item category, response period, and response scale.
METHODS
A sample of 159 men and women 20 to 69 years of age participated in a test-retest with an interval of 14 to 21 days. A total of 28 items relating to smoking, alcohol consumption, diet and weight control, and mental health were selected. We evaluated the test-retest reliability of the items using kappa statistics.
RESULTS
Kappa values ranged from 0.44 to 0.93. Items concerning habits had higher kappa values (mean, 0.7; standard error, 0.05) than items concerning awareness or attitudes (p=0.012). The kappa value of items with two- to four-point scales was 0.63, which was higher than the value of 0.59 for items with scales involving five or more points, although this difference was not statistically significant. Different kappa values were observed for each reference period, but no statistically significant differences were noted.
CONCLUSIONS
The test-retest reliability of the CHS items that we studied was associated with item category. Further study of the relationship between item category and reliability in domains other than health behaviors is required.
Summary
Korean summary
이 연구는 지역사회건강조사의 건강행태 문항 중 28개 문항에 대하여 문항의 특성, 준거기간, 보기의 척도에 따라 조사-재조사 신뢰도의 차이를 분석하였다. 전체 문항의 카파값의 범위는 0.44-0.93이었다. 문항의 특성별로는 인지 또는 태도에 비해 습관에 관한 문항의 신뢰도가 높았으며, 보기의 척도가 5점 척도 이상에 비해 2-4점 척도의 신뢰도가 높음을 확인하였다.

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Community mental health status six months after the Sewol ferry disaster in Ansan, Korea
Hee Jung Yang, Hae Kwan Cheong, Bo Youl Choi, Min-Ho Shin, Hyeon Woo Yim, Dong-Hyun Kim, Gawon Kim, Soon Young Lee
Epidemiol Health. 2015;37:e2015046.   Published online October 23, 2015
DOI: https://doi.org/10.4178/epih/e2015046
  • 20,036 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The disaster of the Sewol ferry that sank at sea off Korea’s southern coast of the Yellow Sea on April 16, 2014 was a tragedy that brought grief and despair to the whole country. The aim of this study was to evaluate the mental health effects of this disaster on the community of Ansan, where most victims and survivors resided.
METHODS
The self-administered questionnaire survey was conducted 4 to 6 months after the accident using the Korean Community Health Survey system, an annual nationwide cross-sectional survey. Subjects were 7,076 adults (≥19 years) living in two victimized communities in Ansan, four control communities from Gyeonggi-do, Jindo and Haenam near the accident site. Depression, stress, somatic symptoms, anxiety, and suicidal ideation were measured using the Center for Epidemiologic Studies-Depression Scale, Brief Encounter Psychosocial Instrument, Patient Health Questionnaire-15, and Generalized Anxiety Disorder 7-Item Scale, respectively.
RESULTS
The depression rate among the respondents from Ansan was 11.8%, and 18.4% reported suicidal ideation. Prevalence of other psychiatric disturbances was also higher compared with the other areas. A multiple logistic regression analysis revealed significantly higher odds ratios (ORs) in depression (1.66; 95% confidence interval [CI], 1.36 to 2.04), stress (1.37; 95% CI, 1.10 to 1.71), somatic symptoms (1.31; 95% CI, 1.08 to 1.58), anxiety (1.82; 95% CI, 1.39 to 2.39), and suicidal ideation (1.33; 95% CI, 1.13 to 1.56) compared with Gyeonggi-do. In contrast, the accident areas of Jindo and Haenam showed the lowest prevalence and ORs.
CONCLUSIONS
Residents in the victimized area of Ansan had a significantly higher prevalence of psychiatric disturbances than in the control communities.
Summary
Korean summary
본 연구는 2014년 4월 16일 발생한 세월호 침몰 사고가 지역사회의 정신건강 수준에 미친 영향을 평가하기 위해 실시하였다. 2014년 지역사회건강조사를 활용, 사고 후 6개월 시점에 조사를 시행하였다. 대부분의 희생자가 발생한 안산시 대상자의 11.8%가 우울군으로 분류되었으며, 18.4%가 자살생각을 호소하였고, 그 밖의 유병률도 대조 지역에 비해 높았다.

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    Dirk Bethmann, Jae Il Cho
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    Hamid Safarpour, Sanaz Sohrabizadeh, Leila Malekyan, Meysam Safi-Keykaleh, Davoud Pirani, Salman Daliri, Jafar Bazyar
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The costs of hepatitis A infections in South Korea
Kyohyun Kim, Baek-Geun Jeong, Moran Ki, Mira Park, Jin Kyung Park, Bo Youl Choi, Weon-Seob Yoo
Epidemiol Health. 2014;36:e2014011.   Published online August 18, 2014
DOI: https://doi.org/10.4178/epih/e2014011
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AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The incidence of hepatitis A infections among young adults has recently increased in South Korea. Although universal vaccination has often been suggested to mitigate the problem, its rationale has not been well-understood. Estimating the societal costs of hepatitis A infections might support the development of intervention strategies.
METHODS
We classified hepatitis A infections into eight clinical pathways and estimated the number of occurrences and cost per case for each clinical pathway using claim data from National Health Insurance and several national surveys as well as assumptions based on previous studies. To determine the total costs of a hepatitis A infection, both direct and indirect costs were estimated. Indirect costs were estimated using the human-capital approach. All costs are adjusted to the year 2008.
RESULTS
There were 30,240 identified cases of hepatitis A infections in 2008 for a total cost of 80,873 million won (2.7 million won per case). Direct and indirect costs constituted 56.2% and 43.8% of the total costs, respectively. People aged 20-39 accounted for 71.3% of total cases and 74.6% of total costs. Medical costs per capita were the lowest in the 0-4 age group and highest in the 20-29 age group.
CONCLUSIONS
This study could provide evidence for development of cost-effective interventions to control hepatitis A infections. But the true costs including uncaptured and intangible costs of hepatitis A infections might be higher than our results indicate.
Summary

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Epidemiological Characteristics of Imported Influenza A (H1N1) Cases during the 2009 Pandemic in Korea
Jun Kil Choi, Sang Won Lee, Bo Youl Choi
Epidemiol Health. 2012;34:e2012009.   Published online December 31, 2012
DOI: https://doi.org/10.4178/epih/e2012009
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AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>Quarantine measure for prevention of epidemic disease and further evaluations of their efficiency are possible only by elaborating analyses of imported cases. The purpose of this study was to analyze descriptive epidemiological characteristics of pandemic influenza A (H1N1) cases imported to Korea.</p></sec><sec><title>METHODS</title><p>We collected two sets of data. The first set, comprised daily reported cases of H1N1 obtained from local cities in accordance with government policy about mandatory reporting of all H1N1 cases during May 1 to August 19, 2009. The second set, including 372 confirmed imported H1N1 cases, identified from 13 National Quarantine Stations in the Korea Centers for Disease Control and Prevention from May 24 to December 31, 2009. However, given the lack of information on the nature of the imported H1N1 cases from the two data sets during the over lapping period from May 24 to August 19, we express the number of imported cases as a range for this period.</p></sec><sec><title>RESULTS</title><p>We estimated that the number of imported H1N1 cases from May 1 to August 19, 2009, was between 1,098 and 1,291 and the total number of cases was 2,409 to 2,580. We found the number of imported cases was beginning to diminish as of August. A analysis of the second data set showed that the distribution of sex was similar (males 50.7%, females 49.3%) and the age distribution from 20 to 59 was 61.5% and that of 60 and over was 0.8% of the 372 cases. We identified 25 countries where people infected with H1N1 traveled and 67.5% were in Asia. But the proportion of cases (/1,000) by region shows Oceania (0.199), South America (0.118), Southeast Asia (0.071), North America (0.049), Europe (0.035), and Northeast Asia (0.016) in that order. The order of H1N1 peaking was the Southern Hemisphere, Tropics, and the Nothern Hemisphere.</p></sec><sec><title>CONCLUSIONS</title><p>This study provided information that could make possible the evaluation of the government quarantine measure for stopping imported disease from causing community-acquired spread in the future.</p></sec>
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  • Social Distancing and Transmission-reducing Practices during the 2019 Coronavirus Disease and 2015 Middle East Respiratory Syndrome Coronavirus Outbreaks in Korea
    Won Mo Jang, Deok Hyun Jang, Jin Yong Lee
    Journal of Korean Medical Science.2020;[Epub]     CrossRef
Relations of Pulse Wave Velocity to Waist Circumference Independent of Hip Circumference
Min Jung Ko, Mi Kyung Kim, Jinho Shin, Bo Youl Choi
Epidemiol Health. 2010;32:e2010004.   Published online May 3, 2010
DOI: https://doi.org/10.4178/epih/e2010004
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Abstract
<sec><title>OBJECTIVES</title><p>Little is known about the effect of waist circumference (WC) on brachial artery pulse wave velocity (baPWV) independent of hip circumference (HC). Therefore, this study aimed to dissociate specific effect of WC on baPWV independent of HC.</p></sec><sec><title>METHODS</title><p>Of 1,053 rural residents (2004-2005), 777 subjects with no known history of coronary artery diseases or diabetes mellitus over 40 yr were included. To reduce collinearity, we assessed the independent effect of WC with HC on PWV by residual method (WC [RM]).</p></sec><sec><title>RESULTS</title><p>In women, most correlation coefficients were significant between measures of abdominal obesity and baPWV, with the highest (0.32) in waist to hip ratio (WHR), whereas no significance was found in men. All mean values of baPWV among the abdominally obese were higher than those of normal group in women, which were in the order of WHR, WC (RM), and WC. Adjusted OR with 95% CI for baPWV was significantly elevated by increase of WC (RM) upto 4.8 (95% CI: 2.1-11.2), and as 4.3 by WHR (95% CI: 1.6-11.4).</p></sec><sec><title>CONCLUSION</title><p>Considering the difficulty in biologically interpreting WHR, WC (RM) may be a useful indicator of abdominal obesity among females in that it reflects the risk of pulse wave velocity.</p></sec>
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  • Cardiometabolic risk factors, peripheral arterial tonometry and metformin in adults with type 1 diabetes participating in the REducing with MetfOrmin Vascular Adverse Lesions trial
    David Chen, Alicia J Jenkins, Nicola Greenlaw, Katie Dudman, Tamsin Fernandes, David M Carty, Alun D Hughes, Andrzej S Januszewski, Coen DA Stehouwer, John R Petrie
    Diabetes and Vascular Disease Research.2023;[Epub]     CrossRef
  • Relationship between anthropometric indices and arterial stiffness: Insights from an epidemiologic study
    Sahar Sobhani, Saba Vakili, Dina Javid Jam, Reihaneh Aryan, Majid Khadem‐Rezaiyan, Saeid Eslami, Maryam Alinezhad‐Namaghi
    Obesity Science & Practice.2022; 8(4): 494.     CrossRef
  • Metabolic syndrome is related to vascular structural alterations but not to functional ones both in hypertensives and healthy subjects
    Alessandro Maloberti, Michele Bombelli, Paola Vallerio, Martina Milani, Iside Cartella, Giovanni Tavecchia, Chiara Tognola, Enzo Grasso, Jinwei Sun, Benedetta De Chiara, Salvatore Riccobono, Guido Grassi, Cristina Giannattasio
    Nutrition, Metabolism and Cardiovascular Diseases.2021; 31(4): 1044.     CrossRef
  • High Systolic Blood Pressure is Associated with Increased Cardio-ankle Vascular Index in the Elderly
    Thapanee Roengrit, Ruchada Sri-amad, Nawiya Huipao
    Artery Research.2021; 27(1): 25.     CrossRef
  • Effect of carbohydrate restriction-induced weight loss on aortic pulse wave velocity in overweight men and women
    Majid M. Syed-Abdul, Qiong Hu, Miriam Jacome-Sosa, Jaume Padilla, Camila Manrique-Acevedo, Colette Heimowitz, Elizabeth J. Parks
    Applied Physiology, Nutrition, and Metabolism.2018; 43(12): 1247.     CrossRef
  • Changes in truncal obesity and fat distribution predict arterial health
    Frank E. Corrigan, Heval Mohamed Kelli, Devinder S. Dhindsa, Robert E. Heinl, Ibhar Al Mheid, Muhammad Hammadah, Salim S. Hayek, Salman Sher, Danny J. Eapen, Greg S. Martin, Arshed A. Quyyumi
    Journal of Clinical Lipidology.2017; 11(6): 1354.     CrossRef
  • The role of abnormal metabolic conditions on arterial stiffness in healthy subjects with no drug treatment
    Hyo-Sang Hwang, Kwang-Pil Ko, Myeong Gun Kim, Sihun Kim, Jeonggeun Moon, Wook Jin Chung, Mi Seung Shin, Seung Hwan Han
    Clinical Hypertension.2016;[Epub]     CrossRef
  • Effects of Short-Term Exenatide Treatment on Regional Fat Distribution, Glycated Hemoglobin Levels, and Aortic Pulse Wave Velocity of Obese Type 2 Diabetes Mellitus Patients
    Ju-Young Hong, Keun-Young Park, Byung-Joon Kim, Won-Min Hwang, Dong-Ho Kim, Dong-Mee Lim
    Endocrinology and Metabolism.2016; 31(1): 80.     CrossRef
  • Abdominal obesity vs general obesity for identifying arterial stiffness, subclinical atherosclerosis and wave reflection in healthy, diabetics and hypertensive
    Jose I Recio-Rodriguez, Manuel A Gomez-Marcos, Maria C Patino-Alonso, Cristina Agudo-Conde, Emiliano Rodriguez-Sanchez, Luis Garcia-Ortiz
    BMC Cardiovascular Disorders.2012;[Epub]     CrossRef
  • Prevalence and Determinants of Hyperlipidemia in Moderate Altitude Areas of the Yunnan-Kweichow Plateau in Southwestern China
    Bingjun Deng, Tingguang Luo, Yanfei Huang, Tianhang Shen, Jing Ma
    High Altitude Medicine & Biology.2012; 13(1): 13.     CrossRef
Welcome to Epidemiology and Health
Bo Youl Choi
Epidemiol Health. 2009;31:e2009001.   Published online October 29, 2009
DOI: https://doi.org/10.4178/epih/e2009001
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Abstract
<p>The Korean Society of Epidemiology publishes a scholarly journal titled 'Korean Journal of Epidemiology', which announces and discusses the results of epidemiological studies from the past 30 yr. Since its first publication in 1979, the journal has contributed to the advancement of epidemiology as well as the prevention and control of disease, and the promotion of health in Korea.</p><p>In 2009, the editorial board has decided to publish the journal in English to contribute internationally, and change the journal's name. The new name of the journal is 'Epidemiology and Health'.</p><p>The abstract and full text of articles will be published as an open access online journal, which will be posted onto the homepage (<ext-link ext-link-type="uri" xlink:href="http://www.e-epih.org/">http://www.e-epih.org/</ext-link>) in real time for anyone in the world to access free of charge. Our editorial policy is that 'Epidemiology and Health' is open to every researcher in fields related to epidemiology, regardless of membership, his or her major and nationality.</p><p>Editorials, lectures, review papers, original articles, epidemic and case investigations, brief communications and letters will be published to generate active discussion through the journal along with the publication of the papers.</p><p>'Epidemiology and Health' welcomes articles from various fields of epidemiology, such as 1) infectious diseases epidemiology, 2) chronic diseases epidemiology, 3) nutritional epidemiology, 4) clinical epidemiology, 5) pharmacoepidemiology, 6) genetic or molecular epidemiology, 7) social epidemiology, 8) environmental or occupational epidemiology, 9) epidemiological methods and biostatistics, 10) disease prevention and control, 11) health promotion and, 12) all other fields related to epidemiology.</p>
Summary
A review of mathematical models and strategies for Pandemic Influenza Control.
Seong Sun Kim, Sang Won Lee, Bo Youl Choi
Korean J Epidemiol. 2008;30(2):156-167.   Published online December 31, 2008
DOI: https://doi.org/10.4178/kje.2008.30.2.156
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Abstract
Despite many countries' current effort to make mathematical models for pandemic influenza (PI) and predict the impact of an outbreak, natural history of PI is remains incomplete, so that any assumption or model is unable to completely predict the impact. Our objective is to review and summarize previous studies on parameters and models of PI, and to make suggestions for the controls in order to decrease the impact of PI. We searched PubMed to retrieve literature about the PI model systematically . Reference lists and review papers on the topic were searched, as well. We found 35 articles that examined the PI model over the period of May 2003 to August 2008. We reviewed modelling methods that were focused on the PI, and their parameters i.e. latent period, and basic reproductive number (R0). Then, we summarized PI controls: antivirals, vaccines, and social distancing. Recent studies showed with mathematical models that Targeted Antiviral Prophylaxis (TAP) is the best strategy for containing PI at the source. In case of an outbreak, quick measures of social distancing, including therapeutic and prophylatic antiviral for cases and closing contacts - school closure, workplace closure, border quarantine, and home isolation - were found to be most effective. We reviewed strengths and weaknesses of models that are adaptable in Korea, and summarized their parameters. It is our hope that these strategies with various interventions give important information for future preparation for and response to PI in Korea.
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  • Stochastic methods for epidemic models: An application to the 2009 H1N1 influenza outbreak in Korea
    Hyojung Lee, Sunmi Lee, Chang Hyeong Lee
    Applied Mathematics and Computation.2016; 286: 232.     CrossRef
Overview of Emerging Infectious Diseases in Korea.
Bo Youl Choi
Korean J Epidemiol. 2008;30(2):147-155.   Published online December 31, 2008
DOI: https://doi.org/10.4178/kje.2008.30.2.147
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Abstract
The term and concept of emerging infectious diseases (EID) has been burgeoned out in the early 1990s and EID were expected as the most important public health problems of all of countries and global community as a whole. EID have been confirmed as the most important health and security problems when the global community has been experienced a lot of outbreaks of EID including avian influenza in Hong Kong (1997), Nipah encephalitis in Malaysia and Singapore (1999), and anthrax bioterrorism in U.S.A. (2001), and SARS outbreaks in global community (2003). Pandemic influenza could be a big disaster in global community in the near future in the situation of the occurrence of H5N1 avian influenza and it's human cases in southeastern Asian countries. This paper described the EIDs in terms of two epidemiologic transition theories, and described the important EID in global community since 1970s and reviewed the remarkable emerging and re-emerging infectious diseases in Korea since 1990. Seven factors contributing to EID and the convergence model for EID were introduced. In conclusion, the preparedness and response plan of public health authority the role of epidemiologist was suggested. Especially the cooperative activities between epidemiologists and other field or sector's professionals were emphasized to find out the etiology or risk factors of EID and preparedness and response plan.
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  • Infectious disease-related laws: prevention and control measures
    Mijeong Park
    Epidemiology and Health.2017; 39: e2017033.     CrossRef
Evaluation of Mumps Vaccine Effectiveness by outbreak investigation in one kindergarten in Ulsan city, 2006.
Kyo Hyun Kim, Heran Ki, Bo Youl Choi, Chang Hui Kim, Dong Han Lee, Un Young Ko, Moran Ki
Korean J Epidemiol. 2008;30(1):110-118.   Published online June 30, 2008
DOI: https://doi.org/10.4178/kje.2008.30.1.110
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Abstract
PURPOSE
Despite of the high MMR vaccine coverage, the mumps outbreaks is continued in most developed countries including South Korea. To evaluate the effectiveness of MMR vaccine, we carried out mumps outbreak investigation in one kindergarten.
METHODS
In Dec. 2006, a mumps outbreak occurred in a kindergarten. Retrospective study was conducted among 212 respondents (205 children and 7 teachers) in 230 study populations (study participation rate: 92%). To define mumps cases, a questionnaire survey, telephone survey, and mumps antibody test with serum were conducted. MMR vaccination status was verified in 198 children using children's vaccination records, National Immunization Registration System and/or medical records of private clinics or hospitals.
RESULTS
Over 90% children had received one dose of MMR vaccination. However, 2nd dose of MMR vaccination rate was 45.1%. Attack rates of mumps were 22.9%(22/96) for one dose MMR vaccinees and 3.3%(3/92) for two doses vaccinees. MMR vaccine effectiveness of two doses over one dose was 86%. Mumps attack rate in one dose MMR vaccinees increased by the duration after MMR vaccination. Among all mumps cases, asymptomatic mumps infection identified by IgM positive or IgG over 10,000mIU/ml was 58% (26/ 45).
CONCLUSIONS
MMR one dose coverage rate was high(92.1%), but the second dose vaccination rate was very low (45.1%). Mumps attack rate was increased by the duration after the MMR vaccination, and the maximum effectiveness of one dose MMR vaccination was low (77.1%). Therefore, to prevent mumps outbreaks in the kindergarten, second MMR vaccination should be scheduled in 4 years old age, and the coverage rate should be increased over 90%. Further studies for the effectiveness of MMR two doses after 5 and more years are needed.
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  • Differential Demographic and Clinical Characteristics between MMR Vaccinated and Unvaccinated Children in South Korea: A Nationwide Study
    Dongwon Yoon, Juhwan Kim, Juyoung Shin
    Vaccines.2021; 9(6): 653.     CrossRef
  • Seroprevalence of mumps in healthcare workers in South Korea
    Sun-Kyung Kim, Jiwon Jung, Sun Hee Kwak, Min Jee Hong, Sung-Han Kim
    Clinical and Experimental Vaccine Research.2020; 9(1): 64.     CrossRef
  • Resurgence of Mumps in Korea
    Sun Hee Park
    Infection & Chemotherapy.2015; 47(1): 1.     CrossRef
  • Mumps outbreak in Incheon, Korea, 2009
    Seon Young Cho, Soo Young Lee, Jin Han Kang, Hui Seung Hwang
    Korean Journal of Pediatrics.2010; 53(1): 67.     CrossRef
  • Mumps Transmission Control Status and Inapparent Infection Rate among Middle and High School Students during the 2007-2008 Mumps Outbreak in Daegu
    Kyo Hyun Kim, Chang Hwi Kim, Bo Youl Choi, Un Yeong Go, Dong Han Lee, Moran Ki
    Journal of Preventive Medicine and Public Health.2009; 42(6): 408.     CrossRef
Normal Value for Serum Homocysteine and the Prevalence of Hyperhomocysteinemia in a Rural Population.
Jeong Uk Kim, Hyun Ja Kim, Bo Youl Choi
Korean J Epidemiol. 2008;30(1):100-109.   Published online June 30, 2008
DOI: https://doi.org/10.4178/kje.2008.30.1.100
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Abstract
PURPOSE
Homocysteine is a known independent risk factor for cardiovascular diseases and its blood levels are influenced by several factors such as race, diet, and lifestyle, so on. Considering these factors, the normal value for total homocysteine has not been determined in Korea. The objective of this study is to establish the normal value for serum total homocysteine and elucidate the prevalence rate of hyperhomocysteinemia by gender and age. SUBJECTS AND METHODS: Among the participants of a community-based cohort study conducted in Yangpyeong province, 889 subjects were measured the biochemical analytes including homocysteine. Those who had the medical histories of angina, myocardial infarction and/orstroke, those who had low levels of folate and/or vitamin B12 and those who had high creatinine level were excluded. Finally, 506 subjects were selected as the reference population. A normal value was established with Clinical and Laboratory Standards Institute C28-A2 protocol.
RESULTS
Homocysteine concentrations of total 889 population and 506 reference population were 10.3+/-5.7 micromol/L (1.9 ~ 93.9 micromol/L) and 8.8+/-2.5 micromol/L (4.3 ~ 21.4 micromol/L), respectively. Homocysteine level was significantly higher in men compared to women (P<0.001) and was significantly increased with age. Normal values were 6.7~15.3micromol/L for men and 5.2~12.7 micromol/L for women. With the normal values, the prevalence rates of hyperhomocysteinemia were 13.3% for men and 8.5% for women in total 889 population. The prevalence rate was highest for individuals aged 60 years or older.
CONCLUSIONS
These data on homocysteine concentrations are similar to from different countries. The established normal value might be used to evaluate quantitatively the risk for hyperhomocysteinemia.
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  • Major Determinants of Serum Homocysteine Concentrations in a Korean Population
    Hyun Ja Kim, Mi Kyung Kim, Jeong Uk Kim, Hun Young Ha, Bo Youl Choi
    Journal of Korean Medical Science.2010; 25(4): 509.     CrossRef
  • Prevalence of Hyperhomocysteinemia and Related Factors in a Community-based Health Examination Survey: A Cross-sectional Study
    Soo Jeong Kim, Kyung Sook Lim, Mi Sook Song, Yeonji Kang, Soon Young Lee
    Journal of Preventive Medicine and Public Health.2009; 42(5): 337.     CrossRef
Correlation between YMCA step-test and maximum oxygen consumption (VO2max) as measurement tools for cardiorespiratory.
On Lee, Sung Soo Kim, Yeon Soo Kim, Hyun Jin Son, Yu Mi Kim, Bo Youl Choi
Korean J Epidemiol. 2008;30(1):73-81.   Published online June 30, 2008
DOI: https://doi.org/10.4178/kje.2008.30.1.73
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Abstract
The purpose of this study is to determine that YMCA step-test is useful method of cardiovascular fitness field-test for large scale study of epidemiology. 57 adults participated in this study. They are recruited considering subject's clinic status and gender proportion. Cardiorespiratory fitness of each participant was determined by grade exercise testing(GXT) with gas analysis and YMCA step-test. There are at least more two days an interval between the tests. Data were analyzed with a statistics program, SPSS version 14.0, by applying Spearman correlation coefficient and independent t-test and Fisher's exact test with a statistical significant level of alpha<.05. The results of this study were as followed. VO2max value exhibited significant correlation with YMCA step test scale(male : r =-.611, p=.001 ; female: r=-.656, p>.001). Our result is that validity of YMCA step-test is acceptable. YMCA step test is vary efficient as dimension of investigator's and subject's effort then the other field-test for assessment of cardiorespiratory. Therefore, Step test is useful for large scale study of epidemiology.
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  • Development of the Korean Firefighter Performance Battery
    Ji-Been Kim, Chae-Been Kim, Ying-Ying Xiang, Seo Dong-il, Song Wook, Han-Joon Lee, Hyun-Joo Kang, Chung-Gun Lee, Yeon Soon Ahn, Jung-Jun Park
    Journal of Occupational & Environmental Medicine.2023; 65(5): e346.     CrossRef
  • Test-Retest Reliability of Home-Based Fitness Assessments Using a Mobile App (R Plus Health) in Healthy Adults: Prospective Quantitative Study
    I-I Lin, You-Lin Chen, Li-Ling Chuang
    JMIR Formative Research.2021; 5(12): e28040.     CrossRef
  • Effects of 12 weeks of high intensity circuit training on abdominal fat, physical fitness, blood lipids, and insulin resistance in middle-aged obese women
    Won-Beom Park, Hyun-Seok Cho, Man-Gyoon Lee
    Korean Journal of Sport Science.2019; 30(2): 236.     CrossRef
  • Cardiopulmonary Fitness Is Independently Associated with Insulin Resistance in Non-Diabetes Mellitus Patients of a University Hospital in Korea
    Eun-Hye Jun, Bo-Yoon Choi, Duk-Chul Lee, Ji-Won Lee, Jee-Yon Lee
    Korean Journal of Family Medicine.2013; 34(2): 139.     CrossRef
The Current System and Future Directions of Health Examination Survey.
Soon Young Lee, Bo Youl Choi, Kyungwon Oh, Eunkyeong Jeong, Soo Jeong Kim
Korean J Epidemiol. 2007;29(2):129-138.
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Abstract
Summary
The Current Status and the Perspectives of Nutrition Survey.
Mi Kyung Kim, Kirang Kim, Cho Il Kim, Kyungwon Oh, Yoo Jin Oh, Bo Youl Choi
Korean J Epidemiol. 2007;29(2):111-128.
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Abstract
The Korea National Health and Nutrition Examination Survey is a nationwide health survey in Korea. This survey is composed of three parts: the Health Interview Survey, the Health Examination Survey, and the Nutrition Survey. The aim of this study was to refine the nutrition survey system in the Korean National Health and Nutrition Examination Survey (KNHANES). Based on the literature review, we summarized international survey systems and the limitations of the current system in Korea and proposed an improved system. We suggested the following: 1) A government agency which will be exclusively responsible for KNHANES overall is needed. 2) The current short-term nutrition survey should be a year-round survey. 3) The objectives of this survey should be written with more clarity and detail. 4) Biochemical measures in relation to nutritional status should be added. 5) The budget to set up various databases in the nutrition survey should be increased. 6) Various other issues should be addressed, including the definition of raw data (i.e., whether nutrient intake data per day is raw data), ethical issues in survey techniques, and strategies to produce evidence for the public using this survey data. Not all suggestions could be adopted in the short-term, but should be integrated into long-term goals for survey system improvement.
Summary
The Current Status and the Direction for Development of the Health Interview Survey.
Eunjeong Kang, Myoung Hee Kim, Yeon Kyeng Lee, Bo Youl Choi
Korean J Epidemiol. 2007;29(2):103-110.
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Abstract
The Health Interview Survey in the Korean National Health and Nutrition Examination Survey is a major source for planning and evaluating the national health promotion policy. The aim of the study is to find the areas for improvement of the current Health Interview Survey in light of its stated purpose and to propose possible means for the improvement. In terms of the survey content, there were several areas that needed improvement: the lack of comparability across the waves, the limit of the number of questions due to the Nutrition Survey and the Examination Survey, non-availability of seasonal statistics, and the dearth of evidence on socioeconomic position variables. To make improvements in the survey content, there is a need to clarify the purpose of the HIS in the KNANES. Second, more items need to be developed to produce the indicators of the Health Plan 2010. Third, core questions and elective questions should be defined. Fourth, multi-level socioeconomic position indicators need to be developed. In terms of the survey methods, the difficulty of managing interviewers and the inefficiency of data input and processing were found to be the areas for improvement. Possible solutions include a survey through the year and the introduction of the CAPI system. In addition, we suggest that a two-year survey period to better synchronize with the local health interview surveys which should be the major data source for the community health promotion plan.
Summary
Trend of the Anthropometric Indices Among Adolescents in a Urban and a Rural Area Over the Period 1996~2005.
SoHyun Park, Minjung Ko, Shin Ah Kim, Mi Kyung Kim, Soo Hun Cho, Bo Youl Choi
Korean J Epidemiol. 2006;28(2):189-198.
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Abstract
This study investigated the secular trend of anthropometric parameters of 2,153 high school students in one urban and one rural area in Korea. The cross-sectional data was collected in 1996 and 2005 in Seoul and Gyung-gi province. As a result, the height of boys has increased by 2cm, whereas the weight has increased by 6.3kg from 1996 to 2005. By contrast, those parameters, including height or weight, did not change in girls. The prevalence of obesity has been more than doubled from 9.3% in 1996 to 20.5% in 2005 in boys; while that of girls was almost same for the same period (1998, 11.1%; 2005, 11.4%). In particular, the greater increase of obesity among boys was found in urban, which implicates the importance of environmental factor in determining weight gains among adolescents. This result emphasizes that the tailored intervention is strongly warranted, in particular among boys residing in urban area.
Summary
Perspectives of Policies on HIV/AIDS and Tuberculosis Control in Korea.
Bo Youl Choi
Korean J Epidemiol. 2006;28(1):75-84.
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Abstract
Since the early 1990s, Korea has made efforts to strengthen its National Communicable Disease Control System. In 2005, the Korea government developed various goals for communicable diseases control as a part of Health Plan 2010. The goals include 40 objectives, for the achievement of which a variety of programs and research subjects have been developed. These efforts will contribute to raising the preparedness for and response to the global threat of emerging and reemerging infectious diseases. The author reviewed the status, management goals and future tasks of HIV/AIDS and tuberculosis in Korea. HIV/AIDS is an emerging infectious disease, and tuberculosis is an endemic disease in Korea. These two diseases are included in the UN Millennium Development Goal 6. The number of HIV/AIDS cases reported in Korea at the end of December 2005 was 3,829, of which 721 have died. The reported HIV prevalence rate among adults aged in 15-49 years is below 0.1%, and the infection level is categorized as "very low". However, the number of newly infected cases has been rising rapidly. The goal of HIV/AIDS control in Health Plan 2010 is to reduce the increasing rate of HIV/AIDS to 35% in 2010. Compared with the global Millennium Development Goal, which is to halt and reverse the spread of HIV/AIDS by 2015, we should set up long-term, high level goals, in addition to a comprehensive national plan for the prevention and control of HIV/AIDS. Korea first implemented a Nationwide Tuberculosis Control Program in the 1960s. By 2005, the prevalence of radiologically active tuberculosis had fallen to 0.35% which is one-fifteenth of the level of 1965. Nevertheless, the current prevalence of and death rate from tuberculosis continue to be much higher than those of advanced nations. Given this such a level of infection, the goals of tuberculosis control need to be specified, and an enhanced tuberculosis control program needs to be implemented to reduce the incidence of tuberculosis and associated death rates.
Summary
A study on epidemiological characteristics and control methods of EHEC infection in Korea.
Sang Won Lee, Bok Kwon Lee, Yong Jae Lee, Hee Soo Lee, Suk Chan Jung, Kwak Hyo Sun, Bo Youl Choi
Korean J Epidemiol. 2005;27(1):37-52.
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Abstract
E. coli is a bacterium that is commonly found in the gut of humans and warm-blooded animals. Most strains of E. coli are harmless. But some strains such as Enterohaemorrhagic E. coli(EHEC), can cause severe food borne disease. It is transmitted to humans primarily through consumption of contaminated foods, such as raw or undercooked ground meat. There is no widely agreed definition of when a shiga-toxin producing E. coli is considered to be an EHEC. But in Korea, the word "EHEC", "STEC", "VTEC" are often used as same meaning, which refer to the E.coli those producing shiga-toxin. We suggest the term STEC refers to those E. coli produce one or more shiga-toxins(stx), and the term EHEC refers only to STEC that cause a clinical illness. EHEC infection were designated as the class 1 notifiable disease in Korea in 2000. Although EHEC/STEC cases were not common in Korea, the number of STEC infection cases reported has increased since 2001. From 2001 to 2004, the number of STEC infection cases in Korea were 11, 8, 52, 118 respectively. These cases included 17 due to E. coli O157, 136 due to E. coli, serogroup non-O157, and 15 due to E. coli that were not serogrouped. The most common serotype implicated is E. coli O91 without virulent factor and clinical symptoms. But those cases involve in one epidemic in primary school in 2004. STEC infections in Korea occur in all age groups, with the highest frequencies in children less than 5 years old. Healthy cattle are the main animal reservoir for STEC and they harbor the organism as part of the bowel flora. The proportion of STEC in E. coli in animal feces was examined by using stool samples from 283 Korean beef cattle on 27 farms, 169 milk cattle on 28 frams, 455 swine on 50 farms. As determined by culture and toxin assay, the proportion of STEC was 25.8%(16 STEC/62 E. coli) in milk cattle, 18.8%(19 STEC/101 E.coli) in Korean beef cattle, 14.0%(25 STEC/178 E. coli) in swine. Effective surveillance of EHEC/STEC in humans is essential in order to protect the public health. EHEC infection is notifiable in many countries including USA, Japan, and Belgium, Finland, Italy, Netherlands, and the United Kingdom(UK), have sentinel systems. England, Wales, and Scotland have comprehensive national laboratory reporting schemes for STEC. And there has been an increase in the number of reported cases and outbreaks during the past decades in many countries Prevention of STEC infection requires control measures at all stages of surveillace, investigations and special pathogen tracing such as PulseNet.
Summary
Incidence of complication and societal cost of measles in Korea, 2000.
Weon Young Lee, Moran Ki, Jin Kyoung Oh, Jong Koo Lee, Myung Bin Kim, Bo Youl Choi
Korean J Epidemiol. 2004;26(2):71-80.
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Abstract
OBJECTIVES
To estimate the complication rate and the societal cost of measles, a survey was conducted in Seoul, Jeonju city, and Kyonggi province in 2001.
METHODS
A telephone survey was conducted in Jeonju city (175/307) and four local areas of Kyonggi province (793/1,238) to gather information on the complications of measles. To estimate societal cost, the telephone survey was conducted for the sampled subject by complication type and the age group. The response rate was 78% (180/230). Paid bills were examined for direct cost estimation, and the time cost and the transportation expense were analyzed for indirect cost estimation.
RESULTS
The incidence of a complication of measles was 3.1% which found to be higher in younger age group. The incidence of pneumonia, otitis media, and encephalitis were 2.1%, 0.8%, and 0.2% respectively. Direct and indirect costs of in-patients without a complication were $417.00 (US $1.00 = 1,000 won) and $256.00 per case, respectively, and the out-patients who have no complication were $54.00 and $65.00, respectively. The average cost for a patient with measles without complication was $119.00 as the result. The societal cost of encephalitis was high as $6,660. Estimated total societal cost of measles ranges from $14 million to $69 million in the year 2000.
CONCLUSION
Complication rate of measles was fairly low compared to foreign countries. The lower rate could result from the difference in vaccination rate and the age distribution of the measles patients. The cost of measles without complication was not high. However, the cost for the complication and the total disease burden caused by measles shown to be high in the year 2000.
Summary
The Effect of Anthropometric Change on Blood Lipids in Adolescents in Rural Area of Korea.
Kyeong Soo Cheon, Myoung Hee Kim, Kirang Kim, Mi Kyung Kim, Young Jeon Shin, Bo Youl Choi
Korean J Epidemiol. 2002;24(1):17-28.
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Abstract
Primary prevention of atherosclerosis is important for reducing morbidity and mortality from cardiovascular disease. As modifiable risk factors for atherosclerosis which appears and progresses in early life, obesity and hyperlipidemia are related with each other. Especially hyperlipidemia during adolescent period is closely related to cardiovascular morbidity and mortality in later life, but the association between anthropometric changes in growth period and lipids level in adolescence is not known yet. Therefore we investigated the effect of anthropometric changes in growth period on adolescent lipids level among 615 high school students in rural area of Korea. The study results were as the followings; In childhood, the weight and the height of boys didn't differ from those of girls, however, began to exceed them at 14 and 15 years old respectively. The body mass index(BMI) of both genders was appeared to increase with age. The BMI increase of girls was greater than that of boys from twelve years of age. The BMI slope (annual average increment of BMI; coefficient of regression line) of girls was greater than that of boys(t-test, p<0.01). The proportion of high obesity tracking group was 13.1%(82 persons). In multivariate analysis, total cholesterol and LDL-cholesterol were positively correlated with obesity tracking in boys; BMI slope and BMI at 7 years old in girls. The HDL-cholesterol didn't show any significant association with those factors. The triglyceride was related to BMI slope and obesity tracking in boy, but nothing in girls. In this study, the obesity at 7 years old, the BMI slope, and the obesity tracking are associated with adolescent serum lipid level. For primary prevention of cardiovascular disease, it is needed to develop more active prevention or health promotion program for children and adolesecents in Korea.
Summary
A Seroepidemiologic Study on Rubella Antibody Positivity: Primary School Students in Gyenggi-Do.
Bo Youl Choi, Hung Bae Park, Young Jeon Shin, Bae Joong Yoon, Jong Surk Hahn
Korean J Epidemiol. 1995;17(2):156-166.
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Abstract
PURPOSE
The purpose of this seroepidmiologic study was to examine the immunization and infection history of rubella, positivity of rubella specific antibody, seroconversion rate of two rubella vaccines and to develop an adequate immunization program of rubella. Research Methods : Subjects of the study were 2.071 students of 8 priamary schools in Gyenggi-Do. Questionnaire and blood sampling were done. Test method of Rubella specific antibody was ELISA (Abbott IMx autoanalyzer). The anayltic methods for the study were chi-square-test, t-test and ANOVA.
RESULTS
The results of the study were as follows : (1)The number of subjects who had infection history of rubella were only 28 students(1.5%). (2)The immunization rate of rubella was the highest in 6 year-old group(65%), it decrease as subjects grow older. (3)The positivity of rubella antibody was 76. 6%, it is the highest in 6 year old group and the lowest in 7 year-old group and it increase again as subjects grow older. (4)Average antibody titer was 53.3 IU(SD 79.2), the trend of antibody titer by age was similar to that of positivity. (5)The seroconversion rates of both vaccines, vaccine A,vaccine B, were 99.5% and 99.6%, the ratio of increase of antibody titer after immunization was higer than 400. it means that both vaccines are very efficacious.
CONCLUSION
Results of the study suggest that it is necessary to increase the coverage of rubella immunization, and further studies are necessary to get more information for rubella.
Summary
Epidemiological Study on the Mumps Epidemic: In one Primary School in Hwasung-Kun, Kyonggi-Do.
Joung Soon Kim, Bo Youl Choi, Hung Bae Park, Young Jon Shin, Jeong Il Son, Mo Ran Ki, Yong Wha Oh, Keum Nie Bang, In Suk Choi
Korean J Epidemiol. 1995;17(1):105-115.
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Abstract
In the last years, according to the increasing incidence of measles and other viral diseases, it have been needed to study on not only the fundamental epidemiological characteristics of mumps and measles but also judgement on the effectiveness of vaccine that meet our domestic situation. The author carried out questionnaire to obtain epidemiological characteristics and vaccine efficacy of mumps on epidemics of mumps in one primary school in Hwasung-kun, Kyonggi Do from Feb. to July, 1994. The results are summarized as follows: 1. Total students was 556, but 446(78.4%) responded to the questionnaire. Among that 446,130(29. 1%) have suffered from mumps. From 9 to 10 year old students had the high attack rates, especially 10 year olds has the highest(39. 7%). 2. From Feb. 2, 1994, first case was on, to July 6, 1994, the epidemic was continues, and attack rate was higest in May(50. 5%). 3. Among the 130 mumps patients, 5 have suffered from complication(3.8%) : encephalitis 3(2 in male, 1 in female). 4. Vaccination rate was 91%, and as ages were lowered, the rates were higher. 5. Attack rate was higher in group who had time interval after vaccination less than 5 years than total attack rate, and was higher in group who had been vaccined after 5 year old. 6. Attack rate in vaccinated group was 27.3%. 7. Vaccine efficacies, be judged by three methods of analysis according to case definition and vaccination status, were 37.4 39. 2%. 8. Factors that have significantly affected the mumps epidemic were vaccination status and vaccination age.
Summary
Semiquantitative Food Frequency Method as an Epidemiological tool in a Rural community, Korea.
Mi Kyung Kim, Bo Youl Choi, Young Jeon Shin, Yoon Ok Ahn, Sang Sun Lee, Young Sun Cho
Korean J Epidemiol. 1994;16(1):54-65.
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Abstract
This study was performed to evaluate the semiquantitative food frequency questionnaire used to obtain information about. dietary patterns of adults in a rural county, Yang-pyeung Gun. The study population was 1311 adults aged 17~85 years. And well-trained interviewers interviewed subjects in 1990, 1992, 1993. The results are as follows. 1) Nutrients intake calculated from each questionnaire showed significant difference, because the number of question was not same(fifty questions in 1990, eighty questions in 1992, 1993). 2) Estimated nutrients intake from separate food items was significantly different when food items are combined in one question. 3) The agreement of nutrients intake level except vit C were high when the subjects are cross-classified by their ranks on the nutrients intake level from items in both questionnaires and on the nutrient intake level from items in each questionnaire. 4) And analysing this study data by multiple stepwise regression, we selected twenty seven food items whic could explained over 85% of inter-individual variation of nutrients(energy, carbohydrate, fat, protein, vit A, vit B1, vit B2, vit C, Ca). From above results, we suggested that it is neccessary to standardize questionnaire and perform validity studies.
Summary
A stochastic analysis on the force of infection by hepatitis B virus in Korea.
Keun Young Yoo, Moo Song Lee, Youngjo Lee, Bo Youl Choi, Heon Kim, Yong Sik Kim
Korean J Epidemiol. 1992;14(2):128-137.
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Abstract
Hepatitis B virus infection is still one of the major health problems in Korea, because of its high prevalence and its deleterious sequellae to liver cirrhosis and hepatocellular carcinoma. However, little is known about incidence (force of infection) of the viral infection. Investigation on the natural history of the virus, such as age-dependency of occurrence, is thus necessary to establish the efficient measures of prevention and management. This study was done to estimate the incidence of hepatitis B virus infection, as well as to assess the prevalent age group of the infection through a stochastic analysis using mathematical models. Data on positivity of hep¬atitis B virus markers (HBsAg, anti-HBs,anti-HBc) were obtained from two different population; a typical rural population in Kyunggi province (n=741) and a health insurance beneficiaries in the Seoul City (n=726). As results, force of infection by the virus was decreasing until the age group around 20, and afterwards remained stationary. The annual incidence of the infection was 15 per 100 persons at birth, 5 per 100 persons at the age, of 10, and about 3 per 100 persons after the age of 20. Proportion of antigen positivity among persons infected by the virus was also decreasing with age increasing. These results suggest that new infection of hepatitis B virus mostly occurs early in life in Korea, resulting in subsequent high prevalence of the infection.
Summary
An epidemiologic study on the leptospiral infection in the period of an anticipated epidemic: for soldires stationed in a rural area.
Bo Youl Choi, Dae Eun Chung, Soo Jin Lee, Hung Bae Park, Jeoung Bae Park, Kyung Hee Lee, Jeong Soon Kim
Korean J Epidemiol. 1992;14(2):91-101.
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AbstractAbstract
Abstract
No abstract available.
Summary
A seroepidemiological study on leptospiral infection in a ruralcommunity.
Soon Jin Lee, Seok Yong Lee, Bo Youl Choi, Ung Ring Ko, Sae Jung Oh, Joung Soon Kim
Korean J Epidemiol. 1992;14(1):79-90.
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Abstract
A seroepidemiological follow-up survey for antibody to Leptospirae was undertaken twice, the first one in Oct.-Dec. 1988 and the second in Dec. 1989-Mar. 1990 among adult inhabitants of over 20 years of age in Yang-pyeong Gun, Kyeong-ki Do. The sera of 480 persons in 1988 and 328 persons in 1989 were tested for Leptospirae by microscopic agglutination test (MAT) and interview was used for additional inforamtion. The serologic test was performed against 4 strains, which were Icterohemorrhagiae lai and Canicola canicola Hond Utrecht IV as standard strains, and 6P-049-1 and YP-35-1 as strains isolated in 1986 in Korea, in accordance with WHO guideline. The results of the test showed that 106 of 480 sera(22.1%) in 1988, and 84 of 328 sera(25.6%) in 1989 turned out to be positive to Leptospirae. The seropositive rates for Leptospirae by district in 1988 and 1989 were 12.9~33.3% and 15.0~42.2% respectively and the difference was statistically significant. One district, mainly a commercial area was newly added in 1989. The seropositive rate of that district was 15% and it was significantly low when compared with 32.8% of seropositive rate of the other rural districts. No difference was observed among age groups of 20~30, 40~50 and over 60 years as well as among sexes. The seropositive rate of farmers and non-farmers were 23.0% versus 10.0% in 1988 and 31.1% versus 17.7% in 1989 showing higher rate among farmers. A total of 143 persons were followed up 14 months and it was observed that 37.0% (10/27) of seropositive subjects remained positive, and 31.9%(37/116) of seronegatives were converted to seropositive. The duration of persistent antibody titer over 1 : 80 against Leptospirae that be calculated by formula(prevalence=incidence*duration) was 8.3 months. As for the seropositive reaction with or without febril illness, 29.3% (17/58) of subjects with febrile illness and 24.7 (66/267) of subjects without febrile illness turned out to be positive, showing no significant difference between them.
Summary
An Epidemiologic Study on the Leptospiral Infection in the Period of an Anticipated Epidemic
Bo Youl Choi, Dae Eun Chung, Soo Jin Lee, Hung-Bae Park, Jeoung Bae Park, Kyung Hee Lee, Jeong Soon Kim
Korean J Epidemiol. 1992;14(1):91-101.   Published online June 30, 1992
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Abstract
A large epidemic of leptospirosis was anticipated in September 1990 because flood has resulted the heavy rain for 4 consecutive days from the 8th of September, 1990, in the Yang-pyeung Gun (Country), a farm area of Central Korea. Actually, patients were already appearing sporadically soon after the flood. Soldiers of ROK Army units stationed in this area were under the higher risk since many of them participated in field works (such as tieing rice plant fallen by the flood) as a part of Civil Aid Plan. The objectives of this study were 1) to detect infected ones at early stage 2) to estimate the attack rates of infection and apparent infection through serologic examinations, 3) to estimate pathogenecity and case-fatality rate and 4) to compare the rates of infection by the type of work and the use of protective devices. All of those with febrile episode were interviewed and the leptospiral antibody was examined during the one month period after the field work. Serologic examinations (including the interview) were done twice with 1 week interval (first on 8th to 10th of October, about 4 weeks following the days of field work) for 446 soldiers belong to three companies stationed in the country area. The serologic test (Microscopic agglutination test) were performed with 4 strains. Icterohemorrhagiae lai and Canicola canicola Hond Utrecht IV as standard strains, and 6P-049-1 and YP-35-1 as strains isolated in Korea in 1986, in accordance with WHO guideline. The results are as follows. 1. Among 57 febrile, suspected cases, 37 had serological tests twice and, 20 of them (54.1%) were serologically confirmed to be infected whereas among other 20 subjects who had single serological test, only 2 persons (10.0%) were serologically positive. 2. The dates of onset of fever in confirmed cases were clustered in 10 to 20 days from late September to early October, which coincided well with the duration of exposure (Sep. 13-18). 3. The attack rate of infection and apparent infection were estimated to be 11.2% (95% C. I. ; 8.3-14.1%), 1.8% (95% C. I. ; 0.7-3.1%). Pathogenecity and case-fatality rate were estimated to be 16.0% (95% C. I. ; 6.0-26.0%) and 0%, respectively. 4. The attack rate of infection of persons who worked in rice paddy for 3-6 days, for 1-2 days and participated in other field work were 3.5, 2.7 and 2.1 time high respectively as high as that of persons who did not join in field work (p<0.05). 5. The effectiveness of protective devices shown in this study was rater poor; perhaps the preparation of the protective devices was not sufficient because the mobilization of army is usually a sudden order. For more satisfactory prevention in the future, a complete clothing (including glove and boots) and chemoprophyaxis (with doxycycline) are recommended.
Summary
A follow-up study on the chronological changes of HBV serologicmarkers in a rural community, Korea.
Bo Youl Choi, Yeong Tae Kim, Ung Ring Ko, Sae Jung Oh, Hung Bae Park
Korean J Epidemiol. 1991;13(1):6-22.
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Abstract
To estimate incidence rate of HBV infection, prevalence rate of chronic carrier and seroconversion rate of anti-HBs, the chronological changes of HBV serologic markers including HBsAg, Anti-HBs and Anti-HBc were studied using radio-immunoassay(RIA). Two consecutive prevalence surveys were carried out in 14 months ; the first one, from September to December, 1988 and the follow-up, from November, 1989 to March, 1990. Total study subjects were 314 persons(2-85 years in age) who had never been vaccinated against HBV and lived in a typical rural community (Yangpyeong Gun, Gyeong-Gi Do, Korea). The results are summarized as follows. 1. The HBV serological markers chronologically changed in a wide variety of pattern. Serologic profiles with HBsAg were more variable than the other profiles. 2. The incidence rate of HBV infection was estimated at 10.26% (95% CI ; 5.77-15.38%) and prevalence rate of HBsAg chronic carrier, at 5.40% (95% CI ; 3.18-7.96%). There were no statistically significant differences by age and sex in both the incidence rate of HBV infection and the prevalence rate of chronic carrier. 3. Seroconversion rate of Anti-HBs positives was 9.76% (95% CI ; 4.88-15.45%). 4. The level of HBsAg and Anti-HBs titer at the first prevalence survey had a predictive value in forecasting the chronic carrier state of HBsAg and seroconversion of Anti-HBs positive. Seroconversion rate of only Anti-HBs positives(25.00%) was substantially higher than that of the cases of Anti-HBs and Anti- HBc both positive(6.45%),. The result suggests that further follow-up study, for a longer period with the more frequent examinations of HBV serologic markers, will be necessary to make a better understanding of the natural course of HBV infection.
Summary
A study on the chronological changes of serologic markers of HBV infection among the school children in a rural community of Korea
Bo Youl Choi, Yeun Ho Lee, Ung Ring Ko
Korean J Epidemiol. 1990;12(1):81-92.
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Abstract
In Korea, thr reported prevalence of HBsAg in apparently health persons varies as 7.5 to 13.3% in adults and 3.9 to 5.9% in school children. Suggesting, this country belongs to high prevalent area in the world. B hepatitis has been classified into acute and chronic, apparent and inapparent infection, and the prognosis of HBsAg chronic carrier is also variable from complete recovery to fatal outcome such as liver cirrhosis and primary hepatocellular carcinoma. In order to assess the status of infection accurately, the follow-up examination on HBV serologic markers for the considerable period is necessary. To study the chronological change of serologic markers of HBV infection, authors carried out three successive examinations on HBsAg(by RP-HA) and Anti-HBs(by PHA) of the school children in June, 1985, April 1986 and June 1987. Vaccinees was excluded in the analysis of data. The results are summarized as follows. 1. HBsAg positive rates in 1985, 1986 and 1987 were 5.89%, 5.67% and 4.29%, and Anti-HBs positive rates 9.68%, 16.75% and 13.50%, repectively. 2. The various chronological changes of serologic markers of HBV infection was observed. All 5 cases who became HBsAg positive in 1986 reversed to be HBsAg negative in 1987, suggesting the newly infected persons in this age group do not ordinarily turn to chronic carrier. Any Anti-HBs positive (58 cases) in 1985 and 1986 did not became HBsAg positives in the next years. So, it is confirmed that Anti-HBs has protective property to HBV infection. 3. Average incidence rate of HBV infection was 7.00(95% C.I.; 4.86-9.34) per 100 person-years. The rate showed a trend of increase as the age increased(5-9yrs; 4.87, 10-14yrs; 5.99, 15-17; 18.87), and the rate in male(8.80) was higher than in female(5.45). Average loss rate of Anti-HBs was 26.64(95% C.I.; 15.42-39.25) per 100 person-years. Period prevalence rate of HBsAg chronic carrier was 4.36%(95% C.I.; 2.18-6.85) and no sex difference was observed. The rate was highest(6.42%) in 5-9 years group and lowest(3.13%) in 10-14 years group, though statistically not significant.
Summary

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