Epidemiology and Health

Original Articles

Associations of self-rated health, depression, and work ability with employee control over working time: Heejoo Ko, Seong-Sik Cho, Jaesung Choi, Mo-Yeol Kang; Epidemiol Health. 2025;47:e2025036. Published online July 8, 2025; DOI: https://doi.org/10.4178/epih.e2025036

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Abstract Summary PDF: Abstract
OBJECTIVES
Work-time control (WTC), defined as employees’ ability to influence their work schedules, is a crucial determinant of work-life balance and well-being. This study aims to evaluate the associations between WTC and health-related outcomes among Korean workers and examine potential effect modifications by working hours and shift work status.
METHODS
This study analyzed data from the 2024 wave of the Korean Work, Sleep, and Health Study, a nationwide panel study of workers aged 19 years to 70 years (n=5,195). WTC was measured using a 6-item scale, and participants were categorized into low (≤12) or high (>12) WTC groups. Outcomes included self-rated health (SRH), depression (measured by the Patient Health Questionnaire-9), and work ability (WA; measured by the Work Ability Index). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for poor SRH, moderate-to-severe depression, and poor WA, adjusting for demographic and occupational variables. Subgroup analyses assessed effect modifications by working hours and shift work.
RESULTS
Higher WTC was associated with lower odds of poor SRH (OR, 0.73; 95% CI, 0.62 to 0.86), moderate-to-severe depression (OR, 0.71; 95% CI, 0.61 to 0.83), and poor WA (OR, 0.62; 95% CI, 0.46 to 0.84). These associations were significant among daytime workers but not shift workers. The protective effects of WTC were attenuated among workers whose working hours exceeding 52 hr/wk.
CONCLUSIONS
Higher WTC is associated with better health and work outcomes, emphasizing its importance for employee well-being. However, its benefits may be limited among shift workers and employees working excessive hours.; Summary

Korean summary
- 근로시간 통제권(WTC)이 높은 근로자는 주관적 건강상태가 더 좋고, 우울 위험이 낮으며, 근로능력이 높은 것으로 나타났다. - 이러한 보호 효과는 주간 근로자에서만 유의하였으며, 근로시간이 주 52시간을 초과할 경우 효과가 약화되었다.

Key Message
- Higher work-time control (WTC) was associated with better self-rated health, lower risk of depression, and improved work ability among Korean workers. - The protective effects of WTC were significant for daytime workers but not for shift workers, and benefits diminished when weekly working hours exceeded 52.

Interaction between vitamin E intake and a COMT gene variant on colorectal cancer risk among Korean adults: a case-control study: Shinyoung Jun, Madhawa Gunathilake, Jeonghee Lee, Jae Hwan Oh, Hee Jin Chang, Dae Kyung Sohn, Aesun Shin, Jeongseon Kim; Epidemiol Health. 2023;45:e2023100. Published online November 14, 2023; DOI: https://doi.org/10.4178/epih.e2023100

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Abstract

OBJECTIVES
Previous human trials have not supported the anticarcinogenic effect of vitamin E despite biological plausibility and considerable epidemiological evidence. A possible explanation for this inconsistency is the interactive effect of the catechol-O-methyltransferase (COMT) gene and supplemental vitamin E on cancer. We examined whether a COMT gene variant modulates the effect of dietary vitamin E intake on colorectal cancer (CRC) risk.

METHODS

In this case-control study of Korean adults (975 cases and 975 age- and sex-matched controls), dietary vitamin E density (mg/1,000 kcal) was measured using a semiquantitative food frequency questionnaire, COMT single nucleotide polymorphism (SNP) rs740603 (A>G) was genotyped, and CRC was verified histologically. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression models with adjustments for potential confounders.

RESULTS

Higher vitamin E density was associated with a lower risk of CRC (highest vs. lowest quartiles: OR, 0.72; 95% CI, 0.55 to 0.96; p-for-trend=0.002). When stratified by COMT SNP rs740603 genotype, the inverse association between vitamin E density and CRC risk was confined to those with at least 1 A allele (≥median vs. <median: OR, 0.63; 95% CI, 0.51 to 0.78). The interaction between rs740603 and vitamin E density was significant (p-for-interaction=0.020). No direct association was observed between COMT SNP rs740603 and CRC risk (OR, 1.08; 95% CI, 0.83 to 1.41).

CONCLUSIONS

Our findings support a role for a genetic polymorphism in COMT in modifying the association between dietary vitamin E intake and CRC.

Summary

Korean summary
본 연구는 국립암센터에서 수집한 대장암 환자-대조군 자료를 활용하여, catechol-O-methyltransferase (COMT) 유전자의 단일염기다형성(SNP)에 따라 비타민 E 섭취와 대장암 위험 간의 연관성이 달라지는지 파악하고자 하였다. 분석 결과, COMT SNP rs740603의 유전자형에 따라 식이를 통한 비타민 E 섭취 밀도와 대장암 위험 간의 연관성이 다르게 나타나 COMT 유전자와 비타민 E 섭취 간의 상호작용이 대장암 발생 위험에 영향을 미칠 가능성이 있음을 제시하였다.

Key Message
In this case-control study of Korean adults, we examined whether a polymorphism in the catechol-O-methyltransferase (COMT) gene modulates the effect of dietary vitamin E intake on colorectal cancer risk. Our results suggest that the inverse association between vitamin E density and colorectal cancer risk is confined to carriers of the COMT rs740603 A allele. The findings of our study support the interactive effect of the COMT gene and vitamin E intake on colorectal cancer risk.

Citations

Citations to this article as recorded by

Dietary and Circulating Vitamins, Polymorphisms of Vitamin Metabolism Genes, and the Risk of Gastrointestinal Cancers: A Systematic Review and Meta-Analysis
Xin-Ling Wang, Heng-Min Xu, Zhi-Qiang Hu, Kai-Feng Pan, Wen-Qing Li
Clinical and Translational Gastroenterology.2025; 16(9): e00899. CrossRef
The Role of Dietary Vitamins and Antioxidants in Preventing Colorectal Cancer: A Systematic Review
Mohammed Ajebli, Christopher R Meretsky, Mourad Akdad, Ayoub Amssayef, Morad Hebi
Cureus.2024;[Epub] CrossRef

Association between PM_2.5 exposure and risk of Parkinson’s disease in individuals with chronic obstructive pulmonary disease in Taiwan: a nested case-control study: Ci-Wen Luo, Yu-Hsiang Kuan, Wen-Ying Chen, Chun-Jung Chen, Frank Cheau-Feng Lin, Stella Chin-Shaw Tsai; Epidemiol Health. 2023;45:e2023094. Published online October 17, 2023; DOI: https://doi.org/10.4178/epih.e2023094

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Abstract

OBJECTIVES
This cohort study investigated the correlation between Parkinson’s disease (PD) risk and chronic obstructive pulmonary disease (COPD) risk under particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) exposure.

METHODS

Data from the National Health Research Institutes of Taiwan were used in this study. The Environmental Protection Administration of Taiwan established an air quality monitoring network for monitoring Taiwan’s general air quality. COPD was indicated by at least 3 outpatient records and 1 hospitalization for COPD. After the implementation of age, sex, and endpoint matching at a 1:4 ratio, 137 patients and 548 patients were included in the case group and control group, respectively. Based on the 2005 World Health Organization (WHO) standards, monthly air particle concentration data were classified into the following 4 groups in analyses of exposure–response relationships: normal level, and 1.0, 1.5, and 2.0 times the WHO level ([concentration ≥2]×25 μg/m3×number of exposure months).

RESULTS

A multivariate logistic regression revealed that the 1.0 and 1.5 WHO level groups did not significantly differ from the normal level group, but the 2.0 WHO level did (odds ratio, 4.091; 95% confidence interval, 1.180 to 14.188; p=0.038).

CONCLUSIONS

Elevated PM2.5 concentrations were significantly correlated with an increased risk of PD among patients with COPD. Furthermore, exposure to high PM2.5 levels can further increase the risk of PD.

Summary

Key Message
This nested case-control study, utilizing data from Taiwan's National Health Research Institutes and after meticulous matching, found that higher exposure to PM2.5 was associated with an increased risk of developing Parkinson's disease among individuals with chronic obstructive pulmonary disease, with those exposed to PM2.5 levels at 2 times the WHO standards having a 4 times higher odds of Parkinson's disease compared to those exposed to normal levels, indicating that air pollution may exacerbate neurological disease risk in those with existing respiratory conditions.

Citations

Citations to this article as recorded by

A machine learning model and identification of immune infiltration for chronic obstructive pulmonary disease based on disulfidptosis-related genes
Sijun Li, Qingdong Zhu, Aichun Huang, Yanqun Lan, Xiaoying Wei, Huawei He, Xiayan Meng, Weiwen Li, Yanrong Lin, Shixiong Yang
BMC Medical Genomics.2025;[Epub] CrossRef
Pathways to the Brain: Impact of Fine Particulate Matter Components on the Central Nervous System
Yasuhiro Ishihara, Miki Tanaka, Naoyuki Nezu, Nami Ishihara, Ami Oguro, Christoph F. A. Vogel
Antioxidants.2025; 14(6): 730. CrossRef

Risk of lymphadenopathy from SARS-CoV-2 vaccination in Korea: a self-controlled case series analysis: Mi-Sook Kim, Bongyoung Kim, Jeong Pil Choi, Nam-Kyong Choi, Jung Yeon Heo, Jun Yong Choi, Joongyub Lee, Sang Il Kim; Epidemiol Health. 2023;45:e2023090. Published online October 13, 2023; DOI: https://doi.org/10.4178/epih.e2023090

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
To assess the risk of lymphadenopathy following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination.
METHODS
A self-controlled case series design was used to determine whether the risk of lymphadenopathy was higher in the 1-day to 42-day risk interval after coronavirus disease 2019 (COVID-19) vaccination compared to the control period. In addition, subgroup analyses were conducted according to baseline characteristics, time since vaccination, and sensitivity analyses adjusted for the length of the risk interval.
RESULTS
The risk of developing lymphadenopathy in the risk interval (1-42 days) after COVID-19 vaccination compared to the control period was significantly increased, with a relative incidence (RI) of 1.17 (95% confidence interval [CI], 1.17 to 1.18) when the first, second, and third doses were combined. The RI was greater on the day of vaccination (1.47; 95% CI, 1.44 to 1.50). In subgroup analyses by baseline characteristics, a significantly increased risk or trend toward increased risk was observed in most subgroups except for those aged 70 years and older, with a significant increase in risk in younger individuals, those with a Charlson’s comorbidity index <5, and those who received mRNA vaccines (mRNA-1273>BNT162b2). Within the 1-day to 42-day post-dose risk period, the relative risk was highest during the 1-day to 7-day post-dose period (1.59; 95% CI, 1.57 to 1.60) compared to the control period, and then the risk declined. In the sensitivity analysis, we found that the longer the risk window, the smaller the RI.
CONCLUSIONS
SARS-CoV-2 vaccination is associated with a statistically significant increase in the risk of lymphadenopathy, and this risk was observed only with mRNA vaccines.; Summary

Korean summary
질병관리청의 코로나19 예방접종자료와 국민건강보험공단 자료를 이용하여 수행한 본 자기대조환자군 연구에서 코로나19 백신접종은 42일 내 림프절병증 발생위험을 1.17배 (95% 신뢰구간, 1.17-1.18) 증가시키는 것으로 나타났다. 이러한 위험의 증가는 mRNA 백신에 국한하여 관찰되었으며 연령이 낮을수록, 여성일수록 상대위험도가 높은 것으로 나타났다.

Key Message
This self-controlled case series study, using the Korea Disease Control and Prevention Agency COVID-19 vaccination database and the National Health Insurance Service database, showed an increased risk of developing lymphadenopathy following vaccination (RR 1.17; 95% CI, 1.17 to 1.18). The elevated risk of lymphadenopathy is specifically associated with mRNA platform vaccines, not viral vector vaccines, and is more pronounced in younger individuals and females.

Effects of multigrain rice and white rice on periodontitis: an analysis using data from the Korea National Health and Nutrition Examination Survey 2012-2015: Seung-Hee Ryu, Zi-lan Wang, Seon-Jip Kim, Hyun-Jae Cho; Epidemiol Health. 2023;45:e2023063. Published online July 3, 2023; DOI: https://doi.org/10.4178/epih.e2023063

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Abstract Summary PDF

Abstract

OBJECTIVES
Numerous studies have investigated the efficacy of whole grains; however, research on multigrain remains limited. Grains exhibit combined positive effects against various diseases. The purpose of this study was to examine the impact of multigrain and white rice consumption on periodontitis.

METHODS

We analyzed data from the Korea National Health and Nutrition Examination Survey V-3 and VI, collected between 2012 and 2015, which included 12,450 patients (4,859 male and 7,591 female) aged 19-64 years. The World Health Organization’s Community Periodontal Index (CPI) was utilized to assess the presence of periodontitis, with periodontitis defined as a CPI index score of ≥3. Multivariable logistic regression analysis was performed after adjusting for potential confounding variables.

RESULTS

The group that consumed only multigrain rice was less likely to have periodontitis than the group that consumed only white rice (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.69 to 0.93). When stratified by sex, the risk of periodontitis demonstrated a 24% decrease in female who consumed only multigrain rice (OR, 0.76; 95% CI, 0.62 to 0.93). A similar result was observed in the age group of 40-64 years (OR, 0.84; 95% CI, 0.71 to 0.99). In the diabetes stratification model, the normal group that consumed only multigrain rice exhibited a 25% decrease in the odds of periodontitis (OR, 0.75; 95% CI, 0.62 to 0.91).

CONCLUSIONS

Our findings suggest that the prevalence of periodontitis may vary depending on the type of rice consumed.

Summary

Korean summary
본 연구에서는 우리나라의 대규모 자료를 이용하여 쌀 섭취 종류가 치주염 위험에 미치는 영향을 살펴보았다. 우리의 연구 결과는 잡곡밥을 매일 2회 이상 섭취하는 것이 흰쌀밥을 먹는 것보다 치주염 예방에 더 효과적이라는 것을 보여준다. 이러한 결과는 당뇨병이 있는 사람에 비해 건강한 사람, 남성보다는 여성, 40~64세에서 더 큰 예방 효과를 시사한다.

Key Message
In this study, we examined the impact of different types of rice consumption on the risk of periodontitis using large-scale data from Korea. The group that consumed only multigrain rice was less likely to have periodontitis than the group that consumed only white rice (odds ratio [OR]=0.80; 95% confidence interval [CI], 0.69–0.93). The risk of periodontitis was reduced by 24% in female who consumed only multigrain rice, 16% decrease in the 40–64 age group, and in the diabetic stratification model, the normal group who consumed only multigrain rice had a 25% decrease in periodontitis risk.

Citations

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Is Starch Intake Associated With Periodontal Status? An 11‐Year Longitudinal Analysis Among Finnish Adults
F. H. Jangda, A. L. Suominen, A. Lundqvist, S. Männistö, A. Golkari, E. Bernabé
Journal of Clinical Periodontology.2025; 52(3): 353. CrossRef
Trends and Characteristics of Brown Rice Consumption among Adults in Japan: An Analysis of the National Health and Nutrition Surveys, 2012–2019
Nayu Ikeda, Miwa Yamaguchi, Nobuo Nishi
Nutrients.2024; 16(10): 1473. CrossRef

Outbreak of carbapenem-resistant Enterobacterales at a long-term care facility in Seoul, Korea: surveillance and intervention mitigation strategies: Yoojin Park, Euncheol Son, Young June Choe, Cho Ryok Kang, Sangmi Roh, Young Ok Hwang, Sung-il Cho, Jihwan Bang; Epidemiol Health. 2023;45:e2023057. Published online June 9, 2023; DOI: https://doi.org/10.4178/epih.e2023057

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Abstract Summary PDF

Abstract

OBJECTIVES
Because effective decolonization options are not available, and treatment options are limited, carbapenem-resistant Enterobacterales (CRE) constitute increasingly threatening nosocomial pathogens. To prevent CRE-associated transmission and ensure patient safety, healthcare personnel and everyone in contact with CRE-infected patients must implement stringent infection control practices. This report describes a CRE outbreak, possibly related to a caregiver at a long-term care facility (LTCF), and presents a new surveillance model to improve the infection control of CRE in Seoul, Korea.

METHODS

The Seoul Metropolitan Government surveillance system identified an outbreak of CRE in an LTCF in 2022. We obtained data on the demographic characteristics and contact histories of the inpatients, medical staff, and caregivers. To isolate the inpatients and employees exposed to CRE, we used rectal swab samples and environmental sampling during the study period (May-December 2022).

RESULTS

We identified 18 cluster cases (1 caregiver and 17 inpatients) and 12 sporadic cases with CRE, and conducted a complete 197-day follow-up of all cases in the LTCF’s isolation wards.

CONCLUSIONS

This investigation demonstrated that our surveillance model and targeted intervention, based on the cooperation of the municipal government, public health center, and infection control advisory committee, effectively contained the epidemic at the LTCF. Measures to improve the compliance of all employees in LTCFs with infection control guidelines should also be adopted.

Summary

Korean summary
서울시 CRE 감시체계를 통해 2022년 한 요양병원의 집단발생을 인지하였다. 현장역학조사를 실시하여 18명의 집단발생 사례(1명 간병인, 17명 입원환자)와 12명의 산발적인 사례를 확인하였고 감염관리 컨설팅을 통해 유행을 확산을 방지하는 중재를 시행하였다.

Key Message
The Seoul Metropolitan Government surveillance system identified an outbreak of carbapenem-resistant Enterobacterales (CRE) in a long-term care facility (LTCF) in 2022. We identified 18 cluster cases (1 caregiver and 17 inpatients) and 12 sporadic cases with CRE. In the current study, we could demonstrate that our surveillance model and targeted intervention, based on the cooperation of the municipal government, public health center, and infection control advisory committee, effectively contained the epidemic at the LTCF. Measures to improve the compliance of all employees in LTCFs with infection control guidelines should also be adopted.

Citations

Citations to this article as recorded by

Significant reduction in norovirus outbreaks and secondary transmission of acute gastroenteritis in Seoul schools following the COVID-19 pandemic: a retrospective epidemiological study
Euncheol Son, Young-Hoon Kim
Journal of Yeungnam Medical Science.2025; 42: 65. CrossRef
Combating Antimicrobial Resistance Through a Data-Driven Approach to Optimize Antibiotic Use and Improve Patient Outcomes: Protocol for a Mixed Methods Study
Jonathan Mayito, Conrad Tumwine, Ronald Galiwango, Elly Nuwamanya, Suzan Nakasendwa, Mackline Hope, Reuben Kiggundu, Dathan M Byonanebye, Flavia Dhikusooka, Vivian Twemanye, Andrew Kambugu, Francis Kakooza
JMIR Research Protocols.2024; 13: e58116. CrossRef
The prevention and response to infectious diseases in long-term care facilities in Korea: a nationwide survey
Sun Hee Na, Joong Sik Eom, Sun Bean Kim, Hyung Jin Yoon, So Yeon Yoo, Kyeong Sook Cha, Jong Rim Choi, Ji Youn Choi, Si Hyeon Han, Jin Ju Park, Tark Kim, Jacob Lee
Epidemiology and Health.2024; 46: e2024084. CrossRef
Role of Probiotics in Preventing Carbapenem-Resistant Enterobacteriaceae Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study
Jung-Hwan Lee, Jongbeom Shin, Soo-Hyun Park, Boram Cha, Ji-Taek Hong, Don-Haeng Lee, Kye Sook Kwon
Microorganisms.2023; 11(12): 2970. CrossRef

Epidemiologic Investigation

Epidemiological investigation of a food-borne outbreak in a kindergarten, Jeju Province, Korea: Kyoung Mi Kim, Eun Suk Cho, Seong Bae Ahn, Eun Ok Kang, Jong-Myon Bae; Epidemiol Health. 2023;45:e2023047. Published online April 17, 2023; DOI: https://doi.org/10.4178/epih.e2023047

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
On Monday, September 6, 2021, at a kindergarten in Jeju Province, a large number of children vomited and developed food poisoning symptoms, and this necessitated an epidemiological investigation.

METHODS

The team surveyed symptoms and food intake history of kindergarten children, teachers, and workers who ate lunch between September 2 (Thursday) and September 6 (Monday), excluding weekends. In addition to rectal swabs, environmental samples from preserved foods, cooking utensils, drinking water, and refrigerator handles were collected. Pulsed field gel electrophoresis (PFGE) for genetic fingerprint analysis was also performed.

RESULTS

There were 19 cases among 176 subjects, which indicated an attack rate of 10.8%. The epidemic curve showed a unimodal shape, and the average incubation period was 2.6 hours. While no food was statistically significant in food intake history, the analysis of 35 rectal smear samples detected Bacillus cereus in 7 children, 4 teachers, and 1 cooking staff. Enterotoxins were also detected in 12 samples. Out of 38 environmental samples, B. cereus and enterotoxins were detected in the morning snack cereal, lunch bean sprouts, and afternoon snack steamed potatoes on Monday, September 6th. The result of the PFGE test on 10 isolates of B. cereus showed that there was no genetic homology.

CONCLUSIONS

Our results indicated that this outbreak was simultaneously caused by various strains of B. cereus from the environment.

Summary

Korean summary
모 유치원에서 제공한 급식 취식아동에서 발열이 없고 구토형의 주증상인 식중독이 발생되었다. 평균 잠복기 2.6시간 (최소 0.8, 최대 4.5시간)이며, 인체 및 환경 검체에서 바실러스 세레우스 균이 분리되었다. 이에 해당 집단발생은 구토형 바실러스 세레우스 감염증에 의한 식중독을 결론지었다.

Key Message
A large number of children in a kindergarten vomited suddenly. The average incubation period was 2.6 hours (min 0.8, max 4.5 hours) with uni-modal shape in the epidemic curve. Bacillus cereus and entertoxin were detected in rectal smear and environmental samples.

Citations

Citations to this article as recorded by

Significant reduction in norovirus outbreaks and secondary transmission of acute gastroenteritis in Seoul schools following the COVID-19 pandemic: a retrospective epidemiological study
Euncheol Son, Young-Hoon Kim
Journal of Yeungnam Medical Science.2025; 42: 65. CrossRef
Surge of acute gastroenteritis outbreaks due to rising norovirus GII.4 transmission in Seoul childcare centers and kindergartens in 2022 compared to 2019–2021
Euncheol Son, Young-Hoon Kim
Archives of Virology.2024;[Epub] CrossRef

Original Articles

Smokeless tobacco consumption and its association with tobacco control factors in the Western Pacific Region: results from the Global Youth Tobacco Survey 2015-2019: Chandrashekhar T. Sreeramareddy, Anusha Manoharan; Epidemiol Health. 2022;44:e2022103. Published online November 8, 2022; DOI: https://doi.org/10.4178/epih.e2022103

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We estimated the prevalence of smokeless tobacco (ST) consumption and its associations with tobacco control factors among school-going youth in 18 Western Pacific Region (WPR) countries.

METHODS

We analyzed school-based Global Youth Tobacco Survey (2014-2019) microdata from 18 WPR countries and estimated weighted prevalence rates of ST consumption, cigarette smoking, and dual use. We used multilevel binary logistic regression to examine the associations of ST consumption and dual use with demographic variables, exposure to pro-tobacco and anti-tobacco factors, national income, and MPOWER indicators.

RESULTS

Data from 58,263 school-going youth were analyzed. The prevalence of past 30-day ST consumption was highest in Kiribati (42.1%), the Marshall Islands (26.1%), Micronesia (21.3%), Palau (16.0%), and Papua New Guinea (15.2%). In adjusted multilevel models, ST consumption and dual use were significantly associated with sex, age, parental smoking, pro-tobacco factors, national income, and MPOWER score. For each unit increase in score for cessation programs, we observed approximately 1.4-fold increases in the odds of youth ST consumption (adjusted odds ratio [aOR], 1.38; 95% confidence interval [CI], 1.15 to 1.66) and dual use (aOR, 1.47; 95% CI, 1.16 to 1.86). Similarly, for each unit increase in score for health-related warnings, the odds of both ST consumption (aOR, 0.47; 95% CI, 0.42 to 0.53) and dual use (aOR, 0.35; 95% CI, 0.30 to 0.42) decreased by approximately 60%.

CONCLUSIONS

The prevalence of youth ST consumption was substantial in the Pacific Islands, exceeding that of cigarette smoking in some countries. Implementing MPOWER measures for ST products could help reduce ST consumption.

Summary

Key Message
The prevalence of smokeless tobacco consumption, and cigarette smoking is considerably high among the school going youth in five pacific island nations of Western Pacific Region. Exposure to pro-tobacco factors and parental smoking were positively associated with youth smokeless tobacco consumption as well as dual use (both smokeless tobacco and cigarettes smoking) Closer monitoring and strict tobacco control policies are needed to prevent further escalation of smokeless tobacco consumption.

Citations

Citations to this article as recorded by

Single, Dual, and Poly Use of Tobacco Products, and Associated Factors Among Adults in 18 Global Adult Tobacco Survey Countries During 2015–2021
Chandrashekhar T. Sreeramareddy, Kiran Acharya, N. RamakrishnaReddy
International Journal of Mental Health and Addiction.2025; 23(5): 4118. CrossRef
Impact of Smokeless Oral Nicotine Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment: A Policy Statement From the American Heart Association
Cheryl R. Dennison Himmelfarb, Neal L. Benowitz, Melissa D. Blank, Aruni Bhatnagar, Paul J. Chase, Esa M. Davis, Jessica L. Fetterman, Brittney Keller-Hamilton, Oluwabunmi Ogungbe, Robert L. Page, Mary Rezk-Hanna, Rose Marie Robertson, Laurie P. Whitsel
Circulation.2025;[Epub] CrossRef
Regional Variations in the Prevalence of Risk Factors and Non-Communicable Diseases in Papua New Guinea: A Scoping Review
Bobby Porykali, Ryley Gronau, Phyllis Tran, Juliana Chen, Margaret Allman-Farinelli, Anna Rangan, Shelina Porykali, Robin Oge, Hans Nogua, Alyse Davies
International Journal of Environmental Research and Public Health.2025; 22(1): 102. CrossRef

The association between tobacco or nicotine product use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic: a cross-sectional study in Korea: Da-eun Lee, Heewon Kang, Sung-il Cho; Epidemiol Health. 2022;44:e2022087. Published online October 7, 2022; DOI: https://doi.org/10.4178/epih.e2022087

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
It is necessary to investigate tobacco or nicotine product (TNP) use which acts as a risk factor for coronavirus disease 2019 (COVID-19) infection. Especially, wearing a mask is difficult to practice while using TNP. Therefore, this study aimed to examine the association between TNP use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic.
METHODS
The samples of 208,618 Korean adults from 2020 Community Health Survey in Korea were used. As an independent variable, TNP use behaviors such as TNP use status, changes in TNP use after the COVID-19 outbreak, TNP types, and attempt to quit were analyzed. Logistic regression was performed on gender-stratified participants.
RESULTS
Among men, the odds ratio (OR) of current and former TNP users were 2.00 (95% confidence interval [CI], 1.66 to 2.40) and 1.32 (95% CI, 1.09 to 1.60), respectively, compared to never users. In women, OR was 1.50 (95% CI, 1.00 to 2.26) for former users. Cigarette use was more associated with not wearing a mask than non-cigarette tobacco or nicotine product (NCTNP) use (OR, 1.53; 95% CI, 1.12 to 2.08). Men whose TNP use decreased had lower non-compliance (OR, 0.52; 95% CI, 0.36 to 0.74); while women whose TNP use increased had lower non-compliance (OR, 0.13; 95% CI, 0.07 to 0.26).
CONCLUSIONS
Current and former users were less likely to wear masks. Cigarette use was more associated with not wearing a mask than NCTNP use. Changes in TNP use showed association for men and women; however, in the opposite direction. Therefore, more attention should be paid to TNP use prevention and cessation support during the epidemic of respiratory infectious diseases. Moreover, it is necessary to identify risk factors of cigarette users in compliance with mask-wearing.; Summary

Korean summary
담배 또는 니코틴 제품 (Tobacco or Nicotine Products, TNPs) 현재사용자와 과거사용자는 비사용자 대비 마스크 미착용 연관성이 높고, 비궐련 담배 또는 니코틴 제품 (Non-Cigarette Tobacco or Nicotine Products, NCTNPs) 사용자보다는 일반담배 사용자의 마스크 미착용 연관성이 높다. 남성에서는 코로나19 유행 이전 대비 TNPs 사용이 감소했을 때, 여성에서는 증가했을 때 마스크 미착용 연관성이 낮았다. 따라서 호흡기 감염병 유행 시기에는 더욱 TNPs 사용 예방과 금연 지원에 관심을 가질 것을 제안한다.

Key Message
During the epidemic of respiratory infectious diseases, more attention should be paid to tobacco or nicotine products (TNPs) use prevention and cessation support.

Epidemiologic Investigation

Investigation of a human brucellosis outbreak in Douz, Tunisia, 2018: Nejib Charaa, Rabaa Ghrab, Aicha Ben Othman, Mohamed Makhlouf, Hejer Ltaief, Nissaf Ben Alaya, Mohamed Chahed; Epidemiol Health. 2022;44:e2022048. Published online May 18, 2022; DOI: https://doi.org/10.4178/epih.e2022048

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Abstract Summary PDF

Abstract

OBJECTIVES
In 2017, the incidence of human brucellosis in Tunisia was 9.8 per 100,000 population. In the Douz district, 2 cases were reported in March 2018. Prior to that date, the last indigenous cases to be reported in Douz had been in 2015. This study aimed to identify the source of this new contamination and recommend control interventions.

METHODS

This case-control study included residents of Douz who presented with clinical symptoms of brucellosis and had a subsequent Wright test antibody titer ≥ 1/160. The controls were neighbors of the infected cases who had a negative Rose Bengal test. Univariate and multivariate analyses were performed to estimate the odds ratios of risk factors. Goats belonging to the cases and controls were actively screened.

RESULTS

Twenty-five infected cases and 52 uninfected controls were enrolled. All infected cases had consumed goat milk and 92% had purchased it from the same breeder. Consumption of goat milk from this breeder (adjusted odds ratio [aOR], 30.78; 95% confidence interval [CI], 6.47 to 235.91) and overall consumption of raw goat milk (aOR, 14.84; 95% CI, 2.04 to 310.44) were independent risk factors for brucellosis. The breeder had 18 goats, 5 of which were smuggled from a neighboring country. Three of those goats were diagnosed with brucellosis.

CONCLUSIONS

Consumption of raw milk from smuggled sick goats was the main risk factor in this outbreak. The sick goats were slaughtered and an education campaign was conducted. Vaccination, control of cross-border animal movements, and control of goat milk sales must be strengthened to prevent the spread of brucellosis in southwestern Tunisia.

Summary

Key Message
Human brucellosis, despite being a major economic and health problem and the availability of proven control methods, is still endemic in North African countries. The scarcity of epidemiological data, under-reporting, certain weaknesses in surveillance systems and the lack of well-conducted outbreak investigations, contribute to this endemic state. This field epidemiological investigation of a human brucellosis outbreak highlighted the importance of serological surveillance, the slaughter of infected animals, vaccination, control of animal movements across borders and pasteurization of milk in the fight against this disease.

Citations

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Utilization of AI – reshaping the future of food safety, agriculture and food security – a critical review
Jerina Rugji, Zeki Erol, Fulya Taşçı, Laura Musa, Ambreen Hamadani, Migena Gjoni Gündemir, Esa Karalliu, Shahida Anusha Siddiqui
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Systematic Review

The effect of peer support in diabetes self-management education on glycemic control in patients with type 2 diabetes: a systematic review and meta-analysis: Akhmad Azmiardi, Bhisma Murti, Ratih Puspita Febrinasari, Didik Gunawan Tamtomo; Epidemiol Health. 2021;43:e2021090. Published online October 22, 2021; DOI: https://doi.org/10.4178/epih.e2021090

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466 Download
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Diabetes self-management education (DSME) programs are a strategy to maintain healthy behaviors. Nevertheless, limited evidence has been reported from systematic evaluations of the effects of DSME integrated with peer support on glycemic control. This study aimed to review the effectiveness of DSME interventions integrated with peer support on glycemic control in patients with type 2 diabetes.

METHODS

A systematic search was carried out in electronic databases, including PubMed, Cochrane Library, ProQuest, SpringerLink, ScienceDirect, Scopus, and Google Scholar, for English-language articles published from 2005 until 2020. The effect size was estimated as the standard mean difference (SMD). The Cochrane Collaboration’s Risk of Bias tool was employed to assess the risk of bias.

RESULTS

Twelve studies were included in this study. DSME integrated with peer support effectively reduced glycated hemoglobin A1c (HbA1c) levels, with a statistically significant effect (SMD, -0.41; 95% confidence interval [CI], -0.69 to -0.13; p<0.001). Programs with a sample size <100 (SMD, -0.45; 95% CI, -0.79 to -0.11; p=0.009), duration of intervention ≤6 months (SMD, -0.52; 95% CI, -0.96 to -0.07; p=0.020), baseline HbA1c <8.5% (SMD, -0.42; 95% CI, -0.77 to -0.07; p=0.020), delivery by group (SMD, -0.28; 95% CI, -0.51 to -0.06; p=0.010), and high frequency of contact (SMD, -0.29; 95% CI, -0.48 to -0.10; p=0.003) had statistically significant effects on reducing HbA1c levels in patients with type 2 diabetes.

CONCLUSIONS

DSME integrated with peer support effectively enhances glycemic control in patients with type 2 diabetes. Programs with smaller participants groups, shorter interventions, weekly meetings, and closer group sessions improved glycemic control in patients with type 2 diabetes.

Summary

Key Message
We reviewed and assessed the quality of the twelve articles included in this systematic review and meta-analysis. The findings of this review show that peer support integrated with diabetes self-management education programs can significantly enhance glycemic control in type 2 diabetes patients. Peer support is a critical component of a successful diabetes self-management programme in patients with type 2 diabetes. interventions programme with smaller groups, shorter durations, lower HbA1c baseline levels, group sessions, and high frequencies of sessions significantly enhanced glycemic control.

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COVID-19: Perspective

Dengue and COVID-19 infections in the ASEAN region: a concurrent outbreak of viral diseases: Lowilius Wiyono, Ian Christoper N. Rocha, Trisha Denise D. Cedeño, Adriana Viola Miranda, Don Eliseo Lucero-Prisno III; Epidemiol Health. 2021;43:e2021070. Published online September 16, 2021; DOI: https://doi.org/10.4178/epih.e2021070

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Abstract Summary PDF

Abstract

Member countries of the Association of Southeast Asian Nations (ASEAN) have faced dengue outbreaks for decades, and the region has one of the highest rates of dengue globally. Outbreaks continue to occur concurrently with the coronavirus disease 2019 (COVID-19) pandemic in the 10 ASEAN countries. Both infectious diseases pose a tremendous burden in these countries related to both infection control and the economy. Increases in the number of dengue cases occurred in part due to disruptions in the pathogen-host-vector relationship caused by changes in human behaviour in response to the COVID-19 pandemic. The spread of dengue was further aggravated by the implementation of lockdowns and social distancing policies. These measures limited the coverage of dengue preventive programs and delayed the medical management of both diseases due to co-infection and misdiagnosis. It is of the utmost importance for the population to remain aware of both diseases, and dengue vector control strategies must be devised to properly address outbreaks using digitalization and remote surveillance. Similarly, critical triage algorithms and further research are also needed to combat co-infection and misdiagnosis. Controlling the spread of COVID-19 though vaccination should also be undertaken to reduce the impact of the pandemic.

Summary

Key Message
The rising dengue infection amidst the COVID-19 pandemic has indicated the need of response to mitigate the dangers of both dengue and COVID-19. Appropriate measurement from all ASEAN countries are needed to lower the number of cases and ease the burden of both dengue and COVID-19 management."

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Ramesh Thevendran, Sivalingam Rogini, Glenn Leighton, Atherton Mutombwera, Sarah Shigdar, Thean-Hock Tang, Marimuthu Citartan
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Rabeya Yousuf, Md Wasek Salam, Shaima Akter, Susmita Sinha, Mainul Haque
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Original Articles

Bacillus of Calmette and Guérin (BCG) and the risk of leprosy in Ciudad del Este, Paraguay, 2016-2017: Nancy Carolina Cuevas, Victor M. Cardenas; Epidemiol Health. 2021;43:e2021060. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021060

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Abstract Summary PDF

Abstract

OBJECTIVES
Paraguay has experienced a 35% reduction in the detected incidence of leprosy during the last ten years, as the vaccination coverage against tuberculosis (Bacillus of Calmette and Guérin [BCG] vaccine) reached ≥95% among infants. The objective of this case-control study was to evaluate the protective effect of BCG on the risk of leprosy.

METHODS

We used a population-based case-control study of 20 leprosy confirmed cases reported among residents of Ciudad del Este, Paraguay, diagnosed in 2016-2017. Three controls were selected from a random sample of households from the city. We assessed vaccine effectiveness using 1- odds ratio [OR], and confounding for age, gender, education, occupation, and marital status using stratified and exact logistic regression, and explored if there was effect modification calculating the synergy factor (SF) and relative excess risk due to interaction (RERI).

RESULTS

After controlling for age, gender, education, occupation and marital status, the OR of BCG scar on the risk of leprosy was 0.10 (95% confidence interval [CI], 0.02 to 0.45), for an estimate of vaccine effectiveness of 89.5% reduced risk of leprosy (95% CI, 55.2 to 98.1). There was evidence of heterogeneity by which the effectiveness of BCG seemed stronger among younger persons (Breslow-Day and Z-test of the SF had a p<0.05), and both the RERI and SF indicated a less then multiplicative and additive interaction of BCG and younger age.

CONCLUSIONS

BCG vaccination was associated with a decreased risk of leprosy in the study population, particularly in persons born after 1980.

Summary

Key Message
Paraguay had the second highest reported incidence in the Americas, but no previous study had investigated the topic of BCG for leprosy in Paraguay. We confirmed that BCG protected from leprosy, hence it may have contributed to the observed decline of leprosy.

Citations

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An update of the diagnosis, treatment, and prevention of leprosy: A narrative review
Chien-Yuan Huang, Shih-Bin Su, Kow-Tong Chen
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Comparison of Antiphenolic Glycolipid-1 Antibody Levels in Seropositive Contacts of Leprosy after 2 Years of Single-dose Rifampicin as Postexposure Prophylaxis
Odelia Jovita Jusuf Fantoni, Rusmawardiana, Yulia Farida Yahya, Erial Bahar, Theresia Lumban Toruan, Muhammad Izazi Hari Purwoko
The International Journal of Mycobacteriology.2023; 12(4): 399. CrossRef
BCG and SARS-CoV-2—What Have We Learned?
Jakub Kulesza, Ewelina Kulesza, Piotr Koziński, Wojciech Karpik, Marlena Broncel, Marek Fol
Vaccines.2022; 10(10): 1641. CrossRef

Modeling the relationship between malaria prevalence and insecticide-treated bed net coverage in Nigeria using a Bayesian spatial generalized linear mixed model with a Leroux prior: Oluyemi A. Okunlola, Oyetunde T. Oyeyemi, Adewale F. Lukman; Epidemiol Health. 2021;43:e2021041. Published online June 4, 2021; DOI: https://doi.org/10.4178/epih.e2021041

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Abstract Summary PDF

Abstract

OBJECTIVES
To evaluate malaria transmission in relation to insecticide-treated net (ITN) coverage in Nigeria.

METHODS

We used an exploratory analysis approach to evaluate variation in malaria transmission in relation to ITN distribution in 1,325 Demographic and Health Survey clusters in Nigeria. A Bayesian spatial generalized linear mixed model with a Leroux conditional autoregressive prior for the random effects was used to model the spatial and contextual variation in malaria prevalence and ITN distribution after adjusting for environmental variables.

RESULTS

Spatial smoothed maps showed the nationwide distribution of malaria and ITN. The distribution of ITN varied significantly across the 6 geopolitical zones (p<0.05). The North-East had the least ITN distribution (0.196±0.071), while ITN distribution was highest in the South-South (0.309±0.075). ITN coverage was also higher in rural areas (0.281±0.074) than in urban areas (0.240±0.096, p<0.05). The Bayesian hierarchical regression results showed a non-significant negative relationship between malaria prevalence and ITN coverage, but a significant spatial structured random effect and unstructured random effect. The correlates of malaria transmission included rainfall, maximum temperature, and proximity to water.

CONCLUSIONS

Reduction in malaria transmission was not significantly related to ITN coverage, although much could be achieved in attempts to curtail malaria transmission through enhanced ITN coverage. A multifaceted and integrated approach to malaria control is strongly advocated.

Summary

Key Message
Scaling up equity in ITN distribution and coverage, awareness and knowledge on ITN utilization are important integrated approaches to mitigate malaria transmission in Nigeria.

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Angelina Mageni Lutambi, Basiliana Emidi, Fredrick George Mbuya, Michael Ryoba, Thadei Damas Sagamiko, Alfred Kisuda Hugo, Isambi Sailon Mbalawata, Collins Otieno Asweto
PLOS Global Public Health.2025; 5(8): e0005075. CrossRef
Mapping of access and usage of insecticide-treated nets in Nigeria
Faith Eshofonie, Osafu Augustine Egbon, Ezra Gayawan
Malaria Journal.2025;[Epub] CrossRef
Bayesian hierarchical spatial ecological model assessing the nexus of vegetation index, insecticide-treated bed-nets and livestock cattle density on lymphatic filariasis transmission
Oluyemi Adewole Okunlola, Dorcas Modupe Okewole, Oyetunde Timothy Oyeyemi
BMC Public Health.2025;[Epub] CrossRef
Vegetation index and livestock practices as predictors of malaria transmission in Nigeria
Oluyemi Okunlola, Segun Oloja, Ayooluwade Ebiwonjumi, Oyetunde Oyeyemi
Scientific Reports.2024;[Epub] CrossRef
Assessing the relationship between malaria incidence levels and meteorological factors using cluster-integrated regression
Miracle Amadi, K. K. W. Hasitha Erandi
BMC Infectious Diseases.2024;[Epub] CrossRef
Determinants of malaria spread among under-five children in Nigeria: results from a 2021 Nigerian malaria indicator cross-sectional survey
Isaac Isiko, Simon Nyegenye, Aaron Mwesigwa, Jackson Micheal Asingwire, Haron Olot, Shekina-Rhoda Chioma Amaka, Lenz Nwachinemere Okoro, Praise Amarachi Amaka Etane
BMC Pediatrics.2024;[Epub] CrossRef
Socio-demographic factors, housing characteristics, and clinical symptoms associated with falciparum malaria in two rapidly urbanizing areas in the Ashanti region of Ghana
Stephen Opoku Afriyie, Kwasi Baako Antwi, Abdul-Hakim Mutala, Dawood Ackom Abbas, Kofi Agyapong Addo, Austine Tweneboah, Thomas Kwame Addison, Eric Osei, Cristian Koepfli, Kingsley Badu
Malaria Journal.2024;[Epub] CrossRef
A Systematic Review of Areal Units and Adjacency Used in Bayesian Spatial and Spatio-Temporal Conditional Autoregressive Models in Health Research
Zemenu Tadesse Tessema, Getayeneh Antehunegn Tesema, Susannah Ahern, Arul Earnest
International Journal of Environmental Research and Public Health.2023; 20(13): 6277. CrossRef
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Oluyemi A. Okunlola, Oyetunde T. Oyeyemi, Luzia Helena Carvalho
PLOS ONE.2022; 17(5): e0268080. CrossRef
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Brief Communication

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

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Abstract Summary PDF Supplementary 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.

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Arezoo Abasi, Haleh Ayatollahi, Seyed Abbas Motevalian
BMC Medical Research Methodology.2025;[Epub] CrossRef
한국 HIV/AIDS 코호트 연구의 과거, 현재, 그리고 미래
윤수 최, 윤정 김, 보영 박, 준용 최, 신우 김, 준영 송, 보율 최, 상일 김
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Belmiro Sousa, Sergio Chiale, Hayley Bryant, Lisa Dulli, Tanya Medrano
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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
Scientific Reports.2023;[Epub] CrossRef
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Jaqueline Driemeyer Correia Horvath, Marina Bessel, Natália Luiza Kops, Flávia Moreno Alves Souza, Gerson Mendes Pereira, Eliana Marcia Wendland
JMIR Research Protocols.2022; 11(1): e31365. CrossRef

COVID-19: Original Article

Estimation of the number of working population at high-risk of COVID-19 infection in Korea: Juyeon Lee, Myounghee Kim; Epidemiol Health. 2020;42:e2020051. Published online July 9, 2020; DOI: https://doi.org/10.4178/epih.e2020051

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We aimed to identify occupational groups at high-risk of coronavirus disease 2019 (COVID-19) infection in Korea, to estimate the number of such workers, and to examine the prevalence of protective resources by employment status.

METHODS

Based on the sixth Standard Occupational Classification codes, 2015 census data were linked with data from the fifth Korean Working Conditions Survey, which measured how frequently workers directly come into contact with people other than fellow employees in the workplace.

RESULTS

A total of 30 occupational groups, including 7 occupations from the healthcare and welfare sectors and 23 from other sectors, were classified as high-risk occupational groups involving frequent contact with people other than fellow employees in the workplace (more than half of the working hours). Approximately 1.4 million (women, 79.1%) and 10.7 million workers (46.3%) are employed in high-risk occupations. Occupations with a larger proportion of women are more likely to be at a high-risk of infection and are paid less. For wage-earners in high-risk occupations, protective resources to deal with COVID-19 (e.g., trade unions and health and safety committees) are less prevalent among temporary or daily workers than among those with permanent employment.

CONCLUSIONS

Given the large number of Koreans employed in high-risk occupations and inequalities within the working population, the workplace needs to be the key locus for governmental actions to control COVID-19, and special consideration for vulnerable workers is warranted.

Summary

Korean summary
코로나바이러스감염증-19 (코로나19) 유행 상황에서 감염 고위험 직업군 종사자는 보건의료복지 업종에서 총 140만 명, 그 외 업종에서 총 1,073만 명으로 추정된다. 고위험 사업장에 대해 정부가 안전보건 관리·감독·규제 및 지원 체계를 수립하고, 방역대책의 중심에 노동자의 안전과 건강 보호를 두는 관점의 전환이 필요하다. 우선 당장 역학조사 과정에서 직업관련 요소를 자세히 확인하고, 직업관련 감염에 대한 모니터링과 그에 걸맞는 대책을 마련해야 한다.

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Brief Communication

Effect of premature rupture of membranes on preterm labor: a case-control study in Cilegon, Indonesia: Ita Marlita Sari, Asri C. Adisasmita, Sabarinah Prasetyo, Dwirani Amelia, Ratih Purnamasari; Epidemiol Health. 2020;42:e2020025. Published online April 10, 2020; DOI: https://doi.org/10.4178/epih.e2020025

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Abstract PDF

Abstract

OBJECTIVES
The global prevalence of preterm labor is approximately 11.1% of live births. However, preterm labor contributes to 75-80% of neonatal morbidity and mortality. The morbidity experienced by preterm infants may continue to influence their subsequent development, imposing physical, psychological, and economic burdens. Premature rupture of membranes (PROM) is a causal factor that may affect preterm birth. Previous studies have shown an association between PROM and preterm labor, but this association should be investigated in more diverse populations. Therefore, this study was conducted in Cilegon, Indonesia to determine the magnitude of the risk of preterm labor associated with PROM at Cilegon Hospital from July 2014 to December 2015.

METHODS

This case-control study used data from patients’ medical records. The cases were all mothers who delivered at less than 37 weeks of gestation, while the control population comprised all mothers who delivered at greater or equal to 37 weeks. The data were analyzed using logistic regression.

RESULTS

The bivariate analysis yielded an odds ratio (OR) of 2.97 (95% confidence interval [CI], 1.92 to 4.59) before controlling for covariates. The model derived through multiple regression analysis after controlling for education, history of preterm labor, and anemia resulted in an OR of 2.58 (95% CI, 1.68 to 3.98).

CONCLUSIONS

Mothers who experience PROM during pregnancy were at a 2.58 times higher risk of preterm labor after controlling for education, history of preterm labor, and anemia.

Summary

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Case Report

Two cases of cholera O1 in South Batinah, Oman, April 2019: lessons learned: Zayid K. Al Mayahi, Nasser Al-Shaqsi, Hamid A. Elmutashi, Ali Al-Dhoyani, Azza Al Hattali, Khalid Salim, Issa S. Al Fulaiti, Mahmood S. Al Subhi; Epidemiol Health. 2019;41:e2019033. Published online July 12, 2019; DOI: https://doi.org/10.4178/epih.e2019033

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172 Download
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Abstract PDF

Abstract

Cholera represents an ongoing threat to many low-income and middle-income countries, but some cases of cholera even occur in high-income countries. Therefore, to prevent or combat cholera outbreaks, it is necessary to maintain the capacity to rapidly detect cholera cases, implement infection control measures, and improve general hygiene in terms of the environment, water, and food. The 2 cases, 1 imported and 1 secondary, described herein are broadly indicative of areas that require improvement. These cases were missed at the primary health care stage, which should be the first detection point even for unusual diseases such as cholera, and the absence of strict infection control practices at the primary care level is believed to contribute to secondary cases of infection. This report also encourages countries to ensure that rapid diagnostic stool tests are available to enable quick detection, as well as to provide information to people travelling to areas where cholera is endemic.

Summary

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Environmental and human drivers of cercarial emergence in freshwater snails of the Maha Oya River, Sri Lanka
Lakshmi Sakunthala, Rupika S. Rajakaruna, Gajaba Ellepola, Nuwandi U. K. Pathirana
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Original Articles

Risk factors associated with the recent cholera outbreak in Yemen: a case-control study: Fekri Dureab, Albrecht Jahn, Johannes Krisam, Asma Dureab, Omer Zain, Sameh Al-Awlaqi, Olaf Müller; Epidemiol Health. 2019;41:e2019015. Published online April 21, 2019; DOI: https://doi.org/10.4178/epih.e2019015

37,545 View
564 Download
14 Web of Science
13 Crossref

Abstract PDF

Abstract

OBJECTIVES
The cholera outbreak in Yemen has become the largest in the recent history of cholera records, having reached more than 1.4 million cases since it started in late 2016. This study aimed to identify risk factors for cholera in this outbreak.

METHODS

A case-control study was conducted in Aden in 2018 to investigate risk factors for cholera in this still-ongoing outbreak. In total, 59 cholera cases and 118 community controls were studied.

RESULTS

The following risk factors were associated with being a cholera case in the bivariate analysis: a history of travelling and having had visitors from outside Aden Province; eating outside the house; not washing fruit, vegetables, and khat (a local herbal stimulant) before consumption; using common-source water; and not using chlorine or soap in the household. In the multivariate analysis, not washing khat and the use of common-source water remained significant risk factors for being a cholera case.

CONCLUSIONS

Behavioural factors and unsafe water appear to be the major risk factors in the recent cholera outbreak in Yemen. In order to reduce the risk of cholera, hygiene practices for washing khat and vegetables and the use and accessibility of safe drinking water should be promoted at the community level.

Summary

Citations

Citations to this article as recorded by

The Decimation of Gaza's Health Care System—Hospitals Destroyed and Lives Endangered
Bilal Hamamra, Maysa Abuzant, Fayez Mahamid
International Journal of Social Determinants of Health and Health Services.2026; 56(1): 30. CrossRef
On Bayesian Generalized Linear Mixed Modeling of Cholera Risk Factors: A Case Study of Masvingo Province, Zimbabwe
Ever Moyo, Sipho Sibanda, Alice Chimhondoro, Senzenia Chakauya, Davidon Jani
African Journal of Empirical Research.2025; 6(2): 283. CrossRef
Associations of water quality with cholera in case-control studies: a systematic review and meta-analysis
Thuy Tien Nguyen, Chaelin Kim, Gerard Goucher, Jong-Hoon Kim
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Cholera Outbreaks in Low- and Middle-Income Countries in the Last Decade: A Systematic Review and Meta-Analysis
Anastasia A. Asantewaa, Alex Odoom, Godfred Owusu-Okyere, Eric S. Donkor
Microorganisms.2024; 12(12): 2504. CrossRef
Knowledge, attitudes, and practices toward COVID-19 prevention in Yemen: a community-based cross-sectional study
Ola El Hajj Hassan, Ahmed Asa’ad Al-Aghbari, Maureen McGowan, Maureen Dar Iang, Huda Omer Basaleem, Khaled Abdulla Al-Sakkaf, Dalia Hyzam, Albrecht Jahn, Fekri Dureab
Frontiers in Public Health.2023;[Epub] CrossRef
Inadequate Hand Washing, Lack of Clean Drinking Water and Latrines as Major Determinants of Cholera Outbreak in Somali Region, Ethiopia in 2019
Jemal Mussa Challa, Tamirat Getachew, Adera Debella, Melkamu Merid, Genanaw Atnafe, Addis Eyeberu, Abdi Birhanu, Lemma Demissie Regassa
Frontiers in Public Health.2022;[Epub] CrossRef
Determining factors associated with cholera disease in Ethiopia using Bayesian hierarchical modeling
Tsigereda Tilahun Letta, Denekew Bitew Belay, Endale Alemayehu Ali
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Cholera outbreak investigation report in Mille woreda, Afar region, Ethiopia, 2019
Hana Mekonen, Kefyalew Amene, Dr Samrawit Bisrat, Tesfahun Abye
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Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study
Abdulqawi Mohammed Qaserah, Mohammed Abdullah Al Amad, Abdulwahed Abduljabbar Al Serouri, Yousef Saleh Khader
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Nutrient intake patterns and breast cancer risk among Jordanian women: a case-control study: Reema Fayez Tayyem, Reema Ibrahim Mahmoud, Muna Hussien Shareef, Lina Salah Marei; Epidemiol Health. 2019;41:e2019010. Published online March 30, 2019; DOI: https://doi.org/10.4178/epih.e2019010

47,667 View
284 Download
12 Web of Science
15 Crossref

Abstract PDF

Abstract

OBJECTIVES
Breast cancer (BC) is the most common type of cancer worldwide. Globally, BC is rapidly becoming a major common health problem among women. This study aimed to evaluate the association between nutrient intake patterns and BC risk among Jordanian women.

METHODS

A total of 400 Jordanian women 20-65 years of age were recruited in this case-control study. Two hundred women recently diagnosed with BC were matched in age, income, and marital status to 200 BC-free women. A food frequency questionnaire was used to assess nutrient intake patterns.

RESULTS

In this study, 3 nutrient intake patterns were identified: a high vitamin C and β-carotene nutrient intake pattern; a high calcium, phosphorus, and vitamin D nutrient intake pattern; and a high-fat nutrient intake pattern. A significant increase in BC risk was associated with the high vitamin C and β-carotene nutrient pattern (the highest for the fourth quartile; odds ratio [OR], 5.42; 95% confidence interval [CI], 2.11 to 13.91; ptrend=0.001). In the high calcium, phosphorus, and vitamin D nutrient pattern, a significant inverse trend was detected for the risk of BC. The high-fat nutrient pattern showed a significant direct association with BC risk in the third (OR, 3.88; 95% CI, 1.58 to 9.51) and fourth (OR, 3.87; 95% CI, 1.53 to 9.77) quartiles (ptrend=0.001).

CONCLUSIONS

A significant increase in BC risk was detected for the high vitamin C and β-carotene nutrient intake pattern and the high-fat nutrient intake pattern. However, for the high calcium, phosphorus, and vitamin D nutrient intake pattern, a significant inverse trend was observed.

Summary

Citations

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Associations Between Dietary Factors and Breast Cancer Risk: A Systematic Review of Evidence from the MENA Region
Najoua Lamchabbek, Chaimaa Elattabi, Abdellatif Bour, Bernadette Chimera, Saber Boutayeb, Lahcen Belyamani, Elodie Faure, Inge Huybrechts, Mohamed Khalis
Nutrients.2025; 17(3): 394. CrossRef
Diet, Dyslipidemia and Breast Cancer: Macronutrients Imbalance as Dietary Risk of Breast Cancer among the Pakhtun Women of Khyber Pakhtunkhwa, Pakistan
Hira Ayub, Fazia Ghaffar
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Samira Daw Ameigaal, Almuthanna K. Alkaraki, May Fouad Sadiq
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Farimah Dehghani, Bahareh Sasanfar, Fatemeh Toorang, Kazem Zendehdel, Amin Salehi-Abargouei
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Reema I. Mahmoud, Reema F. Tayyem
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The Intake of Some Nutrients is Associated with the Risk of Breast Cancer: Results from Jordanian Case-Control Study
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Dietary patterns, nutrition, and risk of breast cancer: a case-control study in the west of Iran: Behjat Marzbani, Javad Nazari, Farid Najafi, Behnaz Marzbani, Sara Shahabadi, Mahin Amini, Mehdi Moradinazar, Yahya Pasdar, Ebrahim Shakiba, Saeed Amini; Epidemiol Health. 2019;41:e2019003. Published online January 24, 2019; DOI: https://doi.org/10.4178/epih.e2019003

36,016 View
1,037 Download
47 Web of Science
49 Crossref

Abstract PDF

Abstract

OBJECTIVES
Unhealthy dietary patterns are the most important changeable risk factors for breast cancer. The aim of this study was to assess the relationship between dietary patterns and the risk of breast cancer among under-50 year women in the west of Iran.

METHODS

All women under 50 years old with pathologically confirmed breast cancer between 2013 and 2015 who were referred to oncology clinics in the west of Iran, and 408 under-50 women referred to other outpatient clinics who were without breast or other cancers at the time of the study and 2 years later were selected as the control group. The data were collected using the middle-aged periodical care form of the Iranian Ministry of Health and analyzed using univariate and multivariate logistic regression in Stata.

RESULTS

The most powerful risk factor for breast cancer was fried foods; the odds ratio of consuming fried foods more than once a month for breast cancer was 4.5 (95% confidence interval, 2.1 to 9.4). A dose-response model indicated that increasing vegetable and fruit consumption up to 90 servings per month decreased the odds of breast cancer, but consuming more than 90 servings per month increased the risk.

CONCLUSIONS

Inadequate consumption of vegetables and consumption of soft drinks, industrially produced juices, fried foods, and sweets were identified as risk factors for breast cancer. In response to these findings, it is necessary to raise awareness and to provide education about healthy diets and the need to change unhealthy dietary patterns.

Summary

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Brief Communication

Prophylactic efficacy of probiotics on travelers’ diarrhea: an adaptive meta-analysis of randomized controlled trials: Jong-Myon Bae; Epidemiol Health. 2018;40:e2018043. Published online August 29, 2018; DOI: https://doi.org/10.4178/epih.e2018043

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The 2017 guideline for the prevention of travelers’ diarrhea (TD) by the International Society of Travel Medicine suggested that ‘there is insufficient evidence to recommend the use of commercially available prebiotics or probiotics to prevent or treat TD.’ However, a meta-analysis published in 2007 reported significant efficacy of probiotics in the prevention of TD (summary relative risk [sRR], 0.85, 95% confidence interval [CI], 0.79 to 0.91). This study aimed to synthesize the efficacy of probiotics on TD by updating the meta-analysis of double-blind, placebo-controlled, randomized human trials.

METHODS

The search process was conducted by the adaptive meta-analysis method using the ‘cited by’ and ‘similar articles’ options provided by PubMed. The inclusion criteria were double-blind, placebo-controlled, randomized human trials with hypotheses of probiotics as intervention and TD as an outcome. The adaptive meta-analysis was conducted using Stata software using the csi, metan, metafunnel, and metabias options.

RESULTS

Eleven articles were selected for the meta-analysis. The sRR was 0.85 (95% CI, 0.79 to 0.91) and showed statistical significance. There was no heterogeneity (I-squared=28.4%) and no publication bias.

CONCLUSIONS

Probiotics showed statistically significant efficacy in the prevention of TD.

Summary

Korean summary
활생제가 여행자설사를 예방하는 효과가 있는가에 대한 기존 메타분석결과들과 지침간의 괴리가 확인되어서 갱신용 메타분석을 수행하였다. 총 11편의 무작위배정, 위약대조비교 임상시험결과에 대한 메타분석결과 통계적으로 유의한 효과가 있는 것으로 산출되었다 (summary relative risk =0.85; 95% confidence interval: 0.77-0.91).

Citations

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Perspective

Vitamin D supplementation as a control program against latent tuberculosis infection in Korean high school students: Eun Hee Kim, Jong-Myon Bae; Epidemiol Health. 2018;40:e2018035. Published online July 27, 2018; DOI: https://doi.org/10.4178/epih.e2018035

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Abstract

The prevalence of latnet Mycobacterium tuberculosis infection (LTBI) in the first-grade high school students in South Korea was 2.1%, which was the lowest level at congregated settings in 2017. For LTBI cases refusing anti-tuberculosis (TB) medication or having poor compliance, additional support should be considered. Eight systematic reviews concluded that vitamin D (VD) deficiency is a risk factor for TB. While three of four South Korean adolescents were VD deficiency, VD supplementation could be a practical remedy to protect LTBI students of refusing anti-TB medication or having poor compliance.

Summary

Korean summary
잠복결핵검진 검사 양성자이면서 항결핵제 복용을 거부하는 고1학생에 대한 사후 조치가 필요하다. 그동안의 연구결과들에 근거할 때, 잠복결핵이 활동성결핵으로의 전환을 억제하기 위해서 비타민 D 보충제의 투여를 검토해 볼 수 있다.

Citations

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Vitamin D and the risk of latent tuberculosis infection: a systematic review and meta-analysis
Yan Cao, Xinjing Wang, Ping Liu, Yue Su, Haotian Yu, Jingli Du
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Original Article

Infectious disease-related laws: prevention and control measures: Mijeong Park; Epidemiol Health. 2017;39:e2017033. Published online July 25, 2017; DOI: https://doi.org/10.4178/epih.e2017033

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study examines recently revised Korean government legislation addressing global infectious disease control for public health emergency situations, with the aim of proposing more rational, effective and realistic interpretations and applications for improvement of law.

METHODS

The Korea reported its first laboratory-confirmed case of Middle East Respiratory Syndrome (MERS) coronavirus on May 20, 2015. Since the first indexed case, Korean public health authorities enforced many public health measures that were not authorized in the law; the scope of the current law was too limited to cover MERS. Korea has three levels of government: the central government, special self-governing provinces, and si/gun/gu. Unfortunately, the Infectious Disease Control and Prevention Act does not designate the specific roles of each level of government, and does not state how these governmental branches should be vertically integrated in a state of emergency.

RESULTS

When thinking about these policy questions, we should be especially concerned about introducing a new act that deals with all matters relevant to emerging infectious diseases. The aim would be to develop a structure that specifies the roles of each level of government, and facilitates the close collaboration among them, then enacting this in law for the prevention and response of infectious disease.

CONCLUSIONS

To address this problem, after analyzing the national healthcare infrastructure along with the characteristics of emerging infectious diseases, we propose the revision of the relevant law(s) in terms of governance aspects, emergency medical countermeasure aspects, and the human rights aspect.

Summary

Korean summary
본 연구의 목적은 2015년 메르스 발생 후, 감염병의 예방 및 관리에 관한 법률의 입법경과를 검토하여 감염병으로 인한 공중보건위기 대응과 관련된 법률의 보다 구체적인 개선방안을 제시하는 것이다. 중앙정부와 지자체의 협력을 위한 거버넌스, 응급상황에서의 긴급의약품 제공을 위한 절차, 격리 대상자의 인권보장과 관련된 부분의 충분한 법적 상당성을 갖추기 위해 국가 보건의료체계 하부구조 측면에서 문제점을 분석한 후 법률 개정방안을 제언하였다.

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Editorial

Current status of hepatitis C virus infection and countermeasures in South Korea: Sook-Hyang Jeong, Eun Sun Jang, Hwa Young Choi, Kyung-Ah Kim, Wankyo Chung, Moran Ki; Epidemiol Health. 2017;39:e2017017. Published online April 13, 2017; DOI: https://doi.org/10.4178/epih.e2017017

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Abstract Summary PDF Supplementary Material

Abstract

Hepatitis C virus (HCV) infection is a major cause of liver cirrhosis, hepatocellular carcinoma, and liver-related mortality. The new antiviral drugs against HCV, direct acting antivirals, result in >90% cure rate. This review aimed to summarize the current prevalence, clinical characteristics, outcomes, and treatment response associated with HCV infection, and countermeasures for optimal HCV control in South Korea. Based on a literature review, the current anti-HCV prevalence in the Korean population is 0.6 to 0.8%, with increasing prevalence according to age. The major HCV genotypes in Korean patients were genotype 1b and genotype 2. Successful antiviral treatment leads to significantly reduced liver related complications and mortality. However, only about one third of the individuals with HCV infection seem to be managed under the current national health insurance system, suggesting a remarkable rate of underdiagnoses and subsequent loss of opportunity to cure. A recent study in South Korea showed that targeted population screening for HCV infection is cost-effective. To prevent recently developed clusters of HCV infection in some clinics, mandatory surveillance rather than sentinel surveillance for HCV infection is required and governmental countermeasures to prevent reuse of syringes or other medical devises, and public education should be maintained. Moreover, one-time screening for a targeted population should be considered and a cost-effectiveness study supporting an optimal screening strategy is warranted.

Summary

Korean summary
우리나라 C형간염 유병률은 1% 미만(0.6-0.8%)이며, 수혈에 의한 C형간염은 더 이상 발생하지 않을 것으로 보인다. 그러나 최근 의료기관에서 C형간염 집단감염이 발생하여 국가적 대응이 필요한 공중보건의 문제로 떠올랐다. 2016년 부터는 C형간염을 완치할 수 있는 효과적이고 안전한 약제가 건강보험급여로 인정되어 이미 진단된 환자들에서는 효과적인 치료가 시작되었다. 그러나 진단되지 않은 상태에서 간질환이 진행되고 있는 환자들을 발굴하기 위해 국가 검진체계와 연계하여 선별검사를 시행한다면, 단기적으로는 진단과 치료비용 부담이 커지겠지만 장기적으로 사망률을 감소시키고, 삶의 질을 높이는 비용효과적인 C형간염 퇴치 전략이 될 것이다.

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Epidemiologic Investigation

Epidemiologic research on lung damage caused by humidifier disinfectants: Moo-Song Lee, Hwa Jung Kim; Epidemiol Health. 2016;38:e2016031. Published online July 20, 2016; DOI: https://doi.org/10.4178/epih.e2016031

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Abstract

In April 2011 a tertiary hospital located in Seoul, Korea reported several cases of severe respiratory distress of unknown origin in young adults. To find the route of transmission, causative agent and patient risk factors of the outbreak, an investigation of the epidemic was initiated. A hospital based case-control study was conducted to indicate that humidifier detergent use was the cause of the outbreak. This information led the Ministry of Health and Welfare of Korea issued an order that humidifier detergents should be withdrawn from the market. Here, we describe the major events of planning, execution, and interpretation of the study, and discussions between researchers and public authorities following the decision to perform an epidemiologic study, chronologically.

Summary

Korean summary
본 역학조사는 일개 병원에서 신고한 질병 유행에 대해 다학제적 연구 결과로써, 질병의 임상적 특성과 역학적 원인 파악 후 정책적 대책으로 이어진 사례이다. 향후 가습기 살균제 이외에도 일반국민의 건강에 영향을 미칠 수 있는 다양한 생활환경요인에 관심을 가지고, 필요 시 적극적인 조사와 대응이 필요할 것이다.

Citations

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Prenatal and Childhood Exposure to Humidifier Disinfectants and Attention-Deficit/Hyperactivity Disorder (ADHD): Insights from a Retrospective Cohort Design
Hyowon Choi, Hunju Lee, Yeon-Soon Ahn
Toxics.2025; 13(2): 78. CrossRef
Evaluating Metabolic Signatures in the Serum of South Korean Patients with Humidifier Disinfectant–Associated Lung Injury Identified through Untargeted Metabolomics
Jinwoo Kim, Mi-Jin Kang, So-Yeon Lee, Sang-Bum Hong, Ho Cheol Kim, Myung Hee Nam, Soo-Jong Hong
Environmental Health Perspectives.2025;[Epub] CrossRef
Seropositive Rheumatoid Arthritis and Polyhexamethylene Guanidine/Oligo(2‐(2‐Ethoxy)ethoxyethyl)guanidinium Chloride Exposure Are Associated With a Synergistic Effect on the Risk of Developing Interstitial Lung Disease: Registry Based Cohort‐Study
Hyowon Choi, Seungjun Ryu, Yeon‐Soon Ahn
International Journal of Rheumatic Diseases.2025;[Epub] CrossRef
Is Polyhexamethylene Guanidine and Oligo(2-(2-Ethoxy) Ethoxyethyl Guanidium Chloride Exposure Related to Gestational Diabetes?
Hyowon Choi, Nam-Yun Kim, Nalai Kim, Yeon-Soon Ahn
Toxics.2024; 12(12): 841. CrossRef
Evaluation of polyhexamethylene guanidine-induced lung injuries by chest CT, pathologic examination, and RNA sequencing in a rat model
Cherry Kim, Sang Hoon Jeong, Jaeyoung Kim, Ki Yeol Lee, Jaehyung Cha, Chang Hyun Lee, Eun-Kee Park, Ju-Han Lee
Scientific Reports.2021;[Epub] CrossRef
Comparison of Long Term Follow-up Chest CT Imaging in Adult and Pediatric Patients with Humidifier Disinfectant-related Lung Injury
Soyeoun Lim, Jong Han Leem, Young-Seoub Hong, Jungwon Kim, Soyoung Park, Joon-Sung Joh, Woon-Jung Kwon, Yangho Kim
Journal of Korean Medical Science.2020;[Epub] CrossRef
Guanidine-based disinfectants, polyhexamethylene guanidine-phosphate (PHMG-P), polyhexamethylene biguanide (PHMB), and oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH) induced epithelial-mesenchymal transition in A549 alveolar epithelial cells
Yong Joo Park, Mi Ho Jeong, In Jae Bang, Ha Ryong Kim, Kyu Hyuck Chung
Inhalation Toxicology.2019; 31(4): 161. CrossRef
Development of QSAR Model for Subchronic Inhalation Toxicity Using Random Forest Regression Method
Jae Hong Shin, Byeong Hun Lee, Sung Kwang Lee
Bulletin of the Korean Chemical Society.2019; 40(8): 819. CrossRef

Original Articles

The incidence of congenital hypothyroidism and its determinants from 2012 to 2014 in Shadegan, Iran: a case-control study: Ehsan Keshavarzian, Ali Asghar Valipoor, Mohammad Reza Maracy; Epidemiol Health. 2016;38:e2016021. Published online May 26, 2016; DOI: https://doi.org/10.4178/epih.e2016021

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Abstract PDF

Abstract

OBJECTIVES
Congenital hypothyroidism (CH) is one of the major causes of preventable mental retardation in infants. The aim of this study was to determine the incidence of CH in Shadegan, Khuzestan Province, Iran from 2012 to 2014 and to identify the risk factors associated with CH.

METHODS

A total of 203 cases were confirmed from 2012 to 2014 in Shadegan, with 66, 86, and 51 patients reported in 2012, 2013, and 2014, respectively. A total of 3,900, 3,991, and 4,050 live births occurred in 2012, 2013, and 2014, respectively. The controls (n=657) were selected using a random number table, and a case-control study was carried out to determine the risk factors for neonatal CH, including demographic, environmental, and medical factors.

RESULTS

The incidence of CH was 17.0 per 1,000 live births in 2012, 21.5 per 1,000 live births in 2013, and 12.6 per 1,000 live births in 2014. This study showed that the likelihood of CH in children born to parents with a history of consanguineous marriage was 2.41 times greater than in children born to parents with no such history (odds ratio, 2.41; 95% confidence interval [CI], 1.65 to 3.53). This study also found that CH was 3.4 times more likely (95% CI, 2.29 to 5.20) in infants born in urban settings than in infants born in rural areas.

CONCLUSIONS

The incidence of CH in Shadegan from 2012 to 2014 was approximately 17 times greater than the expected incidence in Iran. CH was associated with a history of consanguineous marriage and urbanization.

Summary

Citations

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Prevalence of Congenital Hypothyroidism in Iranian Neonates: A Systematic Review and Meta-Analysis
Saeed Khorramnia, Babak Shekarchi, Mojgan Mohajeri Iravani, Mohammad Teymurizadeh, Romina Golpayegani, Ali Sarkoohi, Hamid Pakzad Moghadam, Akbar Haji Ghasemalian, Ebadallah Shiri Malekabad, Zia Navidi
Studies in Medical Sciences.2025; 36(2): 96. CrossRef
Increasing prevalence of congenital hypothyroidism emerges as a growing concern in Jordan
Manar Al-Lawama, Rasha Odeh, Abeer AlAssaf, Jumana Albaramki, Nour Ghanem, Dina Abu Assab, Aseel Al-Dmour, Esraa Arabiat, Arwa Kiswani, Salam Al-Kayed, Hadeel Alzoubi, Saleh Al Jbour
World Journal of Clinical Pediatrics.2025;[Epub] CrossRef
The prevalence of Congenital Hypothyroidism in Rafsanjan in Southeast Iran During 2017-2019
Hajar Vatankhah, Hassan Ahmadinia, Mina Asadikaram, Batool Rezaei, Mohsen Rezaeian, Zahra Jamali
Journal of Occupational Health and Epidemiology.2024; 13(4): 247. CrossRef
Risk factors for transient and permanent congenital hypothyroidism: a population-based case-control study
Fariba Abbasi, Leila Janani, Malihe Talebi, Hosein Azizi, Lotfali Hagiri, Shahnaz Rimaz
Thyroid Research.2021;[Epub] CrossRef
Mapping the Relative Risk of Congenital Hypothyroidism Incidence via Spatial Zero-Inflated Poisson Model in Guilan Province, Iran
Bahare Gholami Chaboki, Manijeh Tabrizi, Maryam Heydarpour Meymeh, Hojjat Alaei, Alireza Akbarzadeh Baghban
International Journal of Preventive Medicine.2021;[Epub] CrossRef
Pediatric Quality of Life in Congenital Hypothyroidism: an Indonesian Study
Nur Rochmah, Muhammad Faizi, Carrina Dewanti, Ahmad Suryawan
International Journal of Thyroidology.2020; 13(2): 150. CrossRef
Congenital Hypothyroidism and its Related Factors in an Iranian Population: A Retrospective Study in Semnan (2011–2016)
Soraya Doustmohamadian, Sahar Mehrizi, Mohammad Naser Rahbar, Majid Mirmohammadkhani
International Journal of Preventive Medicine.2020;[Epub] CrossRef
Doğumsal Hipotiroidi ile Ebeveyn Yaşı İlişkisi
Hale Tuhan
Turkish Journal of Pediatric Disease.2019; 13(6): 451. CrossRef
The role of season and climate in the incidence of congenital hypothyroidism in Kerman province, Southeastern Iran
Narges Khanjani, Ahmad Ahmadzadeh, Bahram Bakhtiari, Farzan Madadizadeh
Journal of Pediatric Endocrinology and Metabolism.2017; 30(2): 149. CrossRef

Risk factors for heart failure in a cohort of patients with newly diagnosed myocardial infarction: a matched, case-control study in Iran: Ali Ahmadi, Koorosh Etemad, Arsalan Khaledifar; Epidemiol Health. 2016;38:e2016019. Published online May 17, 2016; DOI: https://doi.org/10.4178/epih.e2016019

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Abstract PDF

Abstract

OBJECTIVES
Risk factors for heart failure (HF) have not yet been studied in myocardial infarction (MI) patients in Iran. This study was conducted to determine these risk factors.

METHODS

In this nationwide, hospital-based, case-control study, the participants were all new MI patients hospitalized from April 2012 to March 2013 in Iran. The data on 1,691 new cases with HF (enrolled by census sampling) were compared with the data of 6,764 patients without HF as controls. We randomly selected four controls per one case, matched on the date at MI and HF diagnosis, according to incidence density sampling. Using conditional logistic regression models, odds ratios (ORs) with a 95% confidence interval (CI) were calculated to identify potential risk factors.

RESULTS

The one-year in-hospital mortality rate was 18.2% in the cases and higher than in the controls (12.1%) (p<0.05). Significant risk factors for HF were: right bundle branch block (RBBB) (OR, 2.86; 95% CI, 1.95 to 4.19), stroke (OR, 2.00; 95% CI, 1.39 to 2.89), and coronary artery bypass grafting (CABG) (OR, 2.03; 95% CI, 1.34 to 3.09). Diabetes, hypertension, percutaneous coronary intervention (PCI), atrial fibrillation, ventricular tachycardia, and age were determined to be the factors significantly associated with HF incidence (p<0.05). The most important factor in women was diabetes (OR, 1.41; 95% CI, 1.05 to 1.88). Age, hypertension, PCI, CABG, and RBBB were the most important factors in men.

CONCLUSIONS

Our findings may help to better identify and monitor the predictive risk factors for HF in MI patients. The pattern of risk factors was different in men and women.

Summary

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Efficacy of a self-monitoring traffic light diary on outcomes of patients with heart failure: A randomized controlled trial
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International Journal of Nursing Studies.2024; 152: 104704. CrossRef
The feasibility and acceptability of an early tele-palliative care intervention to improve quality of life in heart failure patients in Iran: A protocol for a randomized controlled trial
Arvin Mirshahi, Shahrzad Ghiasvandian, Meysam Khoshavi, Seyed Mohammad Riahi, Ali Khanipour-Kencha, Marie Bakitas, J. Nicholas Dionne-Odom, Rachel Wells, Masoumeh Zakerimoghadam
Contemporary Clinical Trials Communications.2023; 33: 101114. CrossRef
Predictions of Adherence to Treatment in Patients Referred to the Heart Failure Clinic of Shahid Rajaee Hospital in Tehran
Asma Shojaee, Amir Vahedian Azimi, Nasim Naderi, Mohammad Mehdi Salaree, Fakhrudin Faizi
Research in Cardiovascular Medicine.2023; 12(1): 8. CrossRef
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Sepideh Omidi, Keivan Kakabaraei, Asadollah Amiripour
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Medication Adherence and Health Literacy in Patients with Heart Failure: A Cross-Sectional Survey in Iran
Soheila Rezaei, Fatemeh Vaezi, Golnaz Afzal, Nasim Naderi, Gholamhossein Mehralian
HLRP: Health Literacy Research and Practice.2022;[Epub] CrossRef
A prospective survey of atrial fibrillation management in Iran: Baseline results of the Iranian Registry of Atrial Fibrillation (IRAF)
Mona Heidarali, Hooman Bakhshandeh, Reza Golpira, Amirfarjam Fazelifar, Abolfath Alizadeh‐Diz, Zahra Emkanjoo, Shabnam Madadi, Farzad Kamali, Majid Maleki, Gregory Y. H. Lip, Majid Haghjoo
International Journal of Clinical Practice.2021;[Epub] CrossRef
Comparing the effects of teach-back method, multimedia and blended training on self-care and social support in patients with heart failure
Maryam Karami Salaheddin Kola, Hedayat Jafari, Jamshid Yazdani Charati, Vida Shafipour
Journal of Education and Health Promotion.2021; 10(1): 248. CrossRef
Gender based survival prediction models for heart failure patients: A case study in Pakistan
Faisal Maqbool Zahid, Shakeela Ramzan, Shahla Faisal, Ijaz Hussain, Olalekan Uthman
PLOS ONE.2019; 14(2): e0210602. CrossRef
Relationship of the ORBIT and HAS-BLED scores with Killip class 3-4 in patients with ST-segment elevation myocardial infarction
Qing Zhang, Lei Zhou, Hong-Li Cai, Hui-He Lu
Medicine.2019; 98(8): e14578. CrossRef
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Mahshid Givi, Davood Shafie, Fatemeh Nouri, Mohammad Garakyaraghi, Ghasem Yadegarfar, Nizal Sarrafzadegan
Postgraduate Medical Journal.2018; 94(1112): 318. CrossRef
Self-Monitoring by Traffic Light Color Coding Versus Usual Care on Outcomes of Patients With Heart Failure Reduced Ejection Fraction: Protocol for a Randomized Controlled Trial
Mahin Nomali, Ramin Mohammadrezaei, Abbas Ali Keshtkar, Gholamreza Roshandel, Shahrzad Ghiyasvandian, Kian Alipasandi, Masoumeh Zakerimoghadam
JMIR Research Protocols.2018; 7(11): e184. CrossRef

A cholera outbreak in Alborz Province, Iran: a matched case-control study: Ghobad Moradi, Mohammad Aziz Rasouli, Parvin Mohammadi, Elham Elahi, Hojatollah Barati; Epidemiol Health. 2016;38:e2016018. Published online May 14, 2016; DOI: https://doi.org/10.4178/epih.e2016018

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Abstract PDF

Abstract

OBJECTIVES
A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks.

METHODS

An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method.

RESULTS

In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72).

CONCLUSIONS

Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

Summary

Citations

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Cholera outbreak and associated risk factors in Dollo Ado district, Ethiopia: un-matched case-control study, 2023
Fitsum Hagos, Habtamu Molla Ayele, Eyob Hailu Kebede, Abdulnasir Abagero, Awgichew Kifle
Frontiers in Epidemiology.2025;[Epub] CrossRef
Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study
Philip Ngere, Elvis Oyugi, Alexis Niyomwungere, Scolastica Wabwire, Adi Dahabo, Daniel Langat, Raphael Muli, Maurice Owiny
Journal of Interventional Epidemiology and Public Health.2022;[Epub] CrossRef
Cholera outbreak investigation report in Mille woreda, Afar region, Ethiopia, 2019
Hana Mekonen, Kefyalew Amene, Dr Samrawit Bisrat, Tesfahun Abye
MOJ Women s Health.2022; 11(2): 63. CrossRef
Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study
Abdulqawi Mohammed Qaserah, Mohammed Abdullah Al Amad, Abdulwahed Abduljabbar Al Serouri, Yousef Saleh Khader
JMIR Public Health and Surveillance.2021; 7(7): e27627. CrossRef
Prevention and control of cholera with household and community water, sanitation and hygiene (WASH) interventions: A scoping review of current international guidelines
Lauren D’Mello-Guyett, Karin Gallandat, Rafael Van den Bergh, Dawn Taylor, Gregory Bulit, Dominique Legros, Peter Maes, Francesco Checchi, Oliver Cumming, Andrew S. Azman
PLOS ONE.2020; 15(1): e0226549. CrossRef
Risk factors associated with the recent cholera outbreak in Yemen: a case-control study
Fekri Dureab, Albrecht Jahn, Johannes Krisam, Asma Dureab, Omer Zain, Sameh Al-Awlaqi, Olaf Müller
Epidemiology and Health.2019; 41: e2019015. CrossRef
Individual and household exposures associated with cholera transmission in case–control studies: a systematic review
Matthew D. Phelps, Lone Simonsen, Peter K. M. Jensen
Tropical Medicine & International Health.2019; 24(10): 1151. CrossRef
Cholera case management in Harare City, 2018: are we doing the right things right?
Govha Emmanuel, Paul Musarurwa, Christine Gabaza, Taurai Masango, Shambira Gerald, Gombe Tafara Notion, Juru Tsitsi Patience, Tshimanga Mufuta
Journal of Interventional Epidemiology and Public Health .2019;[Epub] CrossRef
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Exposure to pistachio pesticides and stillbirth: a case-control study: Saeid Razi, Mohsen Rezaeian, Fatemeh Ghani Dehkordi, Azita Manshoori, Reza Goujani, Reza Vazirinejad; Epidemiol Health. 2016;38:e2016016. Published online April 30, 2016; DOI: https://doi.org/10.4178/epih.e2016016

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Abstract PDF

Abstract

OBJECTIVES
Stillbirth is an undesirable outcome of pregnancy. In light of the increasing use of pesticides and growing concerns about the possible health effects of agricultural pesticides, we investigated the effect of exposure to pistachio pesticides on stillbirth in pregnant mothers.

METHODS

This case-control study was conducted in Rafsanjan, Iran from 2011 to 2012. A total of 125 females who had a recent stillbirth were included as the case group, and 250 controls were selected from females who had a recent live birth. For each case, two controls with the nearest propensity score to the case were selected. Data were collected using a protocol developed by the researcher that involved interviewing respondents and reviewing their medical records. Conditional multivariate and univariate logistic regression analysis were performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

RESULTS

The ORs of stillbirth in mothers living in pistachio gardens and those who were exposed to sprayed pesticides, in comparison to the controls, were 14.1 (95% CI, 3.3 to 63.4) and 5.0 (95% CI, 1.2 to 28.6), respectively. No significant differences were found in stillbirth rates according to the distance between the mother’s residence and a pistachio garden or involvement in agricultural activities.

CONCLUSIONS

The results of our study showed that exposure to pistachio pesticides during pregnancy may increase the likelihood of stillbirth in mothers.

Summary

Citations

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Preconception and first trimester exposure to pesticides and associations with stillbirth
Melissa A Furlong, Kimberly C Paul, Kimberly L Parra, Alfred J Fournier, Peter C Ellsworth, Myles G Cockburn, Avelino F Arellano, Edward J Bedrick, Paloma I Beamer, Beate Ritz
American Journal of Epidemiology.2025; 194(1): 44. CrossRef
Dietary zinc intake and body mass index as modifiers of the association between household pesticide exposure and infertility among US women: a population-level study
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María Mercedes Milesi, Virginia Lorenz, Milena Durando, María Florencia Rossetti, Jorgelina Varayoud
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María M. Milesi, Virginia Lorenz, Guillermina Pacini, María R. Repetti, Luisina D. Demonte, Jorgelina Varayoud, Enrique H. Luque
Archives of Toxicology.2018; 92(8): 2629. CrossRef

Method

A suggestion for quality assessment in systematic reviews of observational studies in nutritional epidemiology: Jong-Myon Bae; Epidemiol Health. 2016;38:e2016014. Published online April 26, 2016; DOI: https://doi.org/10.4178/epih.e2016014

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
It is important to control the quality level of the observational studies in conducting meta-analyses. The Newcastle-Ottawa Scale (NOS) is a representative tool used for this purpose. We investigated the relationship between high-quality (HQ) defined using NOS and the results of subgroup analysis according to study design.

METHODS

We selected systematic review studies with meta-analysis which performed a quality evaluation on observational studies of diet and cancer by NOS. HQ determinations and the distribution of study designs were examined. Subgroup analyses according to quality level as defined by the NOS were also extracted. Equivalence was evaluated based on the summary effect size (sES) and 95% confidence intervals computed in the subgroup analysis.

RESULTS

The meta-analysis results of the HQ and cohort groups were identical. The overall sES, which was obtained by combining the sES when equivalence was observed between the cohort and case-control groups, also showed equivalence.

CONCLUSIONS

The results of this study suggest that it is more reasonable to control for quality level by performing subgroup analysis according to study design rather than by using HQ based on the NOS quality assessment tool.

Summary

Korean summary
관찰연구에 대한 메타분석을 수행할 때, 선정된 논문들의 질적 수준을 통제하기 위해 개발된 Newcastle-Ottawa Scale (NOS)는 평가 항목의 속성상 환자-대조군연구보다는 코호트 연구에서 High quality (HQ) 판정이 될 가능성이 높다. 이에, 식이와 암의 관련성을 연구한 관찰연구에 대한 메타분석에 있어 대부분의 코호트 연구를 HQ로 판정하였기에, HQ 군과 Cohort 군의 메타분석 결과는 동일하였다. 코호트군과 환자-대조군 간의 summary effect size (sES)가 동질성을 보일 경우 이를 합친 Overall sES 또한 동질성을 보였다. 이에, 식이역학에 특화된 질적평가도구가 개발되기 까지는 NOS를 적용하기 보다는 연구설계별로 하부군 분석을 하는 것을 권한다.

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Original Articles

Risk factors for amputation in patients with diabetic foot ulcer in southwest Iran: a matched case-control study: Mohammad Kogani, Mohammad Ali Mansournia, Amin Doosti-Irani, Kourosh Holakouie-Naieni; Epidemiol Health. 2015;37:e2015044. Published online October 5, 2015; DOI: https://doi.org/10.4178/epih/e2015044

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Abstract PDF

Abstract

OBJECTIVES
Amputation is a multifactorial complication in diabetic patients. The aim of this study was to determine the risk factors associated with amputation in patients with diabetic foot ulcers.

METHODS

This matched case-control study was conducted based on new cases of amputation from March 2012 to November 2014. We selected new cases who had undergone amputation, and the control group was chosen from the cities or areas where the cases resided. Each case was matched with two controls based on the duration of diabetes and location. Conditional logistic regression was used to evaluate the associations between potential risk factors and amputation.

RESULTS

A total of 131 cases were compared with 262 controls. The results of the adjusted model showed that sex (odds ratio [OR], 8.66; 95% confidence interval [CI], 2.68 to 27.91), fewer than two hemoglobin A1c (HbA1c) tests per year (OR, 13.97; 95% CI, 4.97 to 39.26), unsuitable shoes (OR, 5.50; 95% CI, 2.20 to 13.77), smoking (OR, 3.44; 95% CI, 1.45 to 8.13), and body mass index (OR, 1.20; 95% CI, 1.03 to 1.41) were associated with amputation in diabetic patients.

CONCLUSIONS

The most important factors associated with amputation were females, irregular monitoring of HbA1c levels, improper footwear, and smoking. Developing educational programs and working to ensure a higher quality of care for diabetic patients are necessary steps to address these issues.

Summary

Citations

Citations to this article as recorded by

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Predictors of miscarriage: a matched case-control study: Jalal Poorolajal, Parvin Cheraghi, Zahra Cheraghi, Masoomeh Ghahramani, Amin Doosti Irani; Epidemiol Health. 2014;36:e2014031. Published online November 20, 2014; DOI: https://doi.org/10.4178/epih/e2014031

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Abstract PDF

Abstract

OBJECTIVES
The risk factors for miscarriage vary across communities and countries. This study was conducted to investigate the predictors of miscarriage in the west of Iran.

METHODS

This matched case-control study was conducted in Hamadan Province from April 2013 to March 2014. Cases were selected from women who had a recent spontaneous abortion and controls were selected from women who had a recent live birth. Two controls were selected for every case and matched for date of pregnancy and area of residence. Multivariate conditional logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

RESULTS

Five hundred fifty cases were compared with 1,091 controls. The OR of miscarriage was 1.58 (95% CI=1.30-1.92) for every five-year increase in age, 0.20 (95% CI=0.14-0.28) for every live birth, and 3.43 (95% CI=2.03-5.79) for a history of previous spontaneous abortion. Compared to nulliparous women, primiparous or multiparous women had an OR of 17.85 (95% CI=6.65-47.91) for miscarriage. There was a strong association between miscarriage and abnormal amniotic status (OR, 2.46; 95% CI, 0.46-13.09) and also abnormal placenta status (OR, 10.44; 95% CI, 0.95-114.92); however, these associations were not statistically significant. No significant associations were observed between miscarriage and body mass index, previous history of stillbirth, low birth weight, congenital anomaly, ectopic pregnancy, impaired thyroid function, or high blood pressure.

CONCLUSIONS

Our study suggests that miscarriage is a multifactorial outcome associated with several modifiable and non-modifiable risk factors that may vary among different communities.

Summary

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Editorial

Korean translation of the CONSORT 2010 Statement: updated guidelines for reporting parallel group randomized trials: Jun Suh Lee, Soyeon Ahn, Kyoung Ho Lee, Jee Hyun Kim; Epidemiol Health. 2014;36:e2014029. Published online November 8, 2014; DOI: https://doi.org/10.4178/epih/e2014029

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Abstract

The Consolidated Standards of Reporting Trials (CONSORT) 2010 Statement, updated in March 2010, includes a 25-item checklist and flow diagram. Adherence to this statement is a minimum requirement for the complete, clear, and transparent reporting of randomized trials. We translated the CONSORT 2010 Statement into Korean to promote the widespread adherence to CONSORT in South Korea and to facilitate the adoption of complete, clear, and transparent reporting. The Korean version of the CONSORT is available at http://www.e-epih.org/.

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Original Articles

Risk factors for maternal mortality in the west of Iran: a nested case-control study: Jalal Poorolajal, Behnaz Alafchi, Roya Najafi Vosoogh, Sahar Hamzeh, Masoomeh Ghahramani; Epidemiol Health. 2014;36:e2014028. Published online November 8, 2014; DOI: https://doi.org/10.4178/epih/e2014028

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Abstract PDF

Abstract

OBJECTIVES
With a gradual decline in maternal mortality in recent years in Iran, this study was conducted to identify the remaining risk factors for maternal death.

METHODS

This 8-year nested case-control study was conducted in Hamadan Province, in the west of Iran, from April 2006 to March 2014. It included 185 women (37 cases and 148 controls). All maternal deaths that occurred during the study period were considered cases. For every case, four women with a live birth were selected as controls from the same area and date. Conditional logistic regression analysis was performed and the odds ratio (OR) and its 95% confidence interval (CI) were obtained for each risk factor.

RESULTS

The majority of cases were aged 20-34 years, died in hospital, and lived in urban areas. The most common causes of death were bleeding, systemic disease, infection, and pre-eclampsia. The OR estimate of maternal death was 8.48 (95% CI=1.26-56.99) for advanced maternal age (≥35 years); 2.10 (95% CI=0.07-65.43) for underweight and 10.99 (95% CI=1.65-73.22) for overweight or obese women compared to those with normal weight; 1.56 (95% CI=1.08-2.25) for every unit increase in gravidity compared to those with one gravidity; 1.73 (95% CI=0.34-8.88) for preterm labors compared to term labors; and 17.54 (95% CI= 2.71-113.42) for women with systemic diseases.

CONCLUSIONS

According to our results, advanced maternal age, abnormal body mass index, multiple gravidity, preterm labor, and systemic disease were the main risk factors for maternal death. However, more evidence based on large cohort studies in different settings is required to confirm our results.

Summary

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Yeşim Yeşil, Leyla Baran
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Sulaiman Salim Al Mashrafi, Laleh Tafakori, Mali Abdollahian
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Epidemiological and Maternal Features of Maternal Mortality in the West of Iran: Hamadan, 2011-2019
Azam Ali Shirzad, Ebrahim Jalili , Fatemeh Shahbazi, Hasan Bahrami, Salman Khazaei, Samereh Ghelichkhani
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Predictors of tuberculosis and human immunodeficiency virus co-infection: a case-control study: Leila Molaeipoor, Jalal Poorolajal, Minoo Mohraz, Nader Esmailnasab; Epidemiol Health. 2014;36:e2014024. Published online October 30, 2014; DOI: https://doi.org/10.4178/epih/e2014024

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Abstract PDF

Abstract

OBJECTIVES
The human immunodeficiency virus (HIV) and Mycobacterium tuberculosis co-infection is a major global challenge. It is not clear why some HIV-positive people are co-infected with tuberculosis (TB) while others are not. This study addressed that question.

METHODS

This case-control study was conducted in Tehran, Iran in June 2004, enrolling 2,388 HIV-positive people. Cases were selected from those who were co-infected with TB and controls from those without TB. Multiple logistic regression analysis was performed to assess the association between M. tuberculosis/HIV co-infection and several predictors. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated.

RESULTS

In this study, 241 cases were compared with 2,147 controls. Sex, age, marital status, educational level, imprisonment, smoking, narcotic use, route of HIV transmission, previous TB infection, isoniazid preventive therapy (IPT), antiretroviral therapy (ART), and low CD4 count (<350 cells/mm3) were independently associated with M. tuberculosis/HIV co-infection (p<0.001). However, after adjusting for all other variables in the model, only the association between M. tuberculosis/HIV co-infection and the following predictors remained statistically significant: imprisonment (odds ratio [OR], 3.82; 95% confidence interval [CI], 2.11-6.90), previous TB infection (OR, 5.54; 95% CI, 1.99-15.39), IPT (OR, 0.13; 95% CI, 0.06-0.31), ART (OR, 1.81; 95% CI, 1.26-2.61), and CD4 count <350 cells/mm3 (OR, 2.34; 95% CI, 1.36-4.02).

CONCLUSIONS

Several predictors are associated with M. tuberculosis/HIV co-infection, but only a few indicators were significantly associated with M. tuberculosis/HIV co-infection. It is estimated that a number of predictors of M. tuberculosis/HIV co-infection remain unknown and require further investigation.

Summary

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Salman Khazaei, Leila Molaeipoor, Shahab Rezaeian, Erfan Ayubi, Mehran Yari, Ali Asghar Valipour, Somayeh Khazaei
Shiraz E-Medical Journal.2016;[Epub] CrossRef
Prisoners co‐infected with tuberculosis and HIV: a systematic review
Chantal L Edge, Emma J King, Kate Dolan, Martin McKee
Journal of the International AIDS Society.2016;[Epub] CrossRef
Predictors of human immunodeficiency virus and tuberculosis co-infection
Venkataramana Kandi
Epidemiology and Health.2015; 37: e2015007. CrossRef

Effects of antibiotic consumption on children 2-8 years of age developing asthma: Hamid Reza Khalkhali, Sima Oshnouei, Shaker Salarilak, Mohammadhossein Rahimi Rad, Mohammad Karamyar, Javad Khashabi; Epidemiol Health. 2014;36:e2014006. Published online July 4, 2014; DOI: https://doi.org/10.4178/epih/e2014006

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Abstract PDF

Abstract

OBJECTIVES
Antibiotic exposure in children is a possible contributor to the increasing asthma prevalence in several countries. The present study aimed to investigate the association between antibiotic exposure and the risk of developing childhood asthma at 2-8 years of age.

METHODS

A case-control study was undertaken among children aged 2-8 years old between March and September 2010 in the Urmia district in the northwest of Iran. The cases were doctor-diagnosed asthmatic children based on Global Initiative for Asthma criteria (n=207), and the controls were children without respiratory symptoms (n=400) selected by frequency matching by age and gender. Clinical data including antibiotic exposure was collected by a validated and reliable questionnaire, which was completed by interviewing parents/guardians.

RESULTS

Antibiotic consumption during the first year of life increased the odds ratio [OR] of asthma symptoms at 2-8 years of age (crude OR, 2.26; 95% confidence interval [CI], 1.53-3.35; p<0.01), and the strength of association was similar after adjusting for a family history of asthma or atopic disorder, preterm delivery, birth order, and delivery method (adjusted OR, 1.91; 95% CI, 1.27-2.88; p=0.03).

CONCLUSIONS

Our study suggests that antibiotic consumption in children was associated with an increased risk of childhood asthma, and an additional confirmative study is needed.

Summary

Citations

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Yaqin Liu, Junjie Dai, Guibao Zhou, Rongchang Chen, Chengwen Bai, Fei Shi
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Advances in Clinical Medicine.2024; 14(04): 909. CrossRef
Antibiotic exposure and adverse long-term health outcomes in children: A systematic review and meta-analysis
Quynh A Duong, Laure F Pittet, Nigel Curtis, Petra Zimmermann
Journal of Infection.2022; 85(3): 213. CrossRef
Analysis of medication patterns for pediatric asthma patients in emergency department: Does the sequence placement of glucocorticoids administration matter?
Hoon Jang, Mustafa Ozkaynak, Claudia R. Amura, Turgay Ayer, Marion R. Sills
Journal of Asthma.2021; 58(2): 180. CrossRef
Factors Associated With First Medication Time for Children Treated in the Emergency Department for Asthma
Hoon Jang, Mustafa Ozkaynak, Turgay Ayer, Marion R. Sills
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Predicting hospitalization of pediatric asthma patients in emergency departments using machine learning
Marion R. Sills, Mustafa Ozkaynak, Hoon Jang
International Journal of Medical Informatics.2021; 151: 104468. CrossRef
Risk factors of asthma in the Asian population: a systematic review and meta-analysis
Yang Yie Sio, Fook Tim Chew
Journal of Physiological Anthropology.2021;[Epub] CrossRef
Association of infant antibiotic exposure and risk of childhood asthma: A meta-analysis
Zeyi Zhang, Jingjing Wang, Haixia Wang, Yizhang Li, Yuanmin Jia, Mo Yi, Ou Chen
World Allergy Organization Journal.2021; 14(11): 100607. CrossRef
Early-Life Exposure to Oral Antibiotics and Lung Function Into Early Adulthood
Karoliny dos Santos, Caroline J. Lodge, Michael J. Abramson, Bircan Erbas, Catherine M. Bennett, Jennie Hui, Shyamali C. Dharmage, Adrian J. Lowe
Chest.2020; 157(2): 334. CrossRef
The relationship of prenatal antibiotic exposure and infant antibiotic administration with childhood allergies: a systematic review
Ruth Baron, Meron Taye, Isolde Besseling-van der Vaart, Joanne Ujčič-Voortman, Hania Szajewska, Jacob C. Seidell, Arnoud Verhoeff
BMC Pediatrics.2020;[Epub] CrossRef
Respiratory morbidity, atopy and asthma at school age in preterm infants aged 32–35 weeks
Júlia Morata-Alba, Maria Teresa Romero-Rubio, Silvia Castillo-Corullón, Amparo Escribano-Montaner
European Journal of Pediatrics.2019; 178(7): 973. CrossRef
Evaluation of Allergic Symptoms Prevalence and Its Relationship with Acetaminophen/Antibiotic Use and Hospitalization Among School-Aged Children in Tehran, Iran
Mohammad Reza Fazlollahi, Javid Morad Abbasi, Vahid Ghobadi Dana, Alireza Yousefzade, Nastaran Sabetkish, Shahpar Haghighat
Iranian Red Crescent Medical Journal.2017;[Epub] CrossRef
Airway Microbiota and the Implications of Dysbiosis in Asthma
Juliana Durack, Homer A. Boushey, Susan V. Lynch
Current Allergy and Asthma Reports.2016;[Epub] CrossRef
Early-life antibiotic use is associated with wheezing among children with high atopic risk: a prospective European study
Wenjie Sun, Erik R. Svendsen, Wilfried J. J. Karmaus, Joachim Kuehr, Johannes Forster
Journal of Asthma.2015; 52(7): 647. CrossRef

Review

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.

Summary

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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

Note

Theory and practice of Case-Crossover Study Design.: Moran Ki; Korean J Epidemiol. 2008;30(1):1-11. Published online June 30, 2008; DOI: https://doi.org/10.4178/kje.2008.30.1.1

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Abstract

A case-crossover study design is a method to assess the effect of transient exposures on the risk of onset of acute events. Which was introduced by Maclure in 1991 for Myocardial Infarction Onset Study. The design has been used to diverse fields of epidemiology such as injury, drug adverse events, air pollution and so on. The most valuable advantage of this design is unnecessary of control selection. To estimate relative risk, the exposure frequency during a window just before outcome onset is compared with exposure frequencies during control times rather than in control persons. One or more control times are supplied by each of the cases themselves. Self-matching of cases eliminates the threat of control-selection bias and increases efficiency. To application of the case-crossover design, we need to make sure several criteria and the possibility of specific bias. This review is designed to help the reader apply a case-crossover study design to their research fields by understanding general ideas, prior conditions and limitations of the design.

Summary

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Inyoung Na, Junyoung Seo, Eunjin Park, Jia Lee
International Journal of Environmental Research and Public Health.2022; 19(14): 8564. CrossRef
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Original Articles

International Cooperation in the Control and Prevention of Emerging and Reemerging Infectious Diseases.: Hae Kwan Cheong; Korean J Epidemiol. 2006;28(1):85-91.

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Abstract PDF: Abstract
This paper discusses the recent increase in the incidence of emerging and reemerging infectious diseases and the role of international cooperation in coping with such public health threats. The historical background and its evolution are reviewed and the need, advantages, and possible areas of international cooperation are presented. A current example and model of international cooperation at various levels is described. Finally, two of the main issues in the process of international cooperation are discussed: the ethical aspect of scientific communication and national interest, and intellectual property issues.; 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 PDF: 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

Epidemiologic Transition of Communicable Diseases in Korea: Academia's Contributions to the National Communicable Disease Prevention and Control Programs.: Joung Soon Kim, Hae Kwan Cheong; Korean J Epidemiol. 2006;28(1):4-21.

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Abstract PDF: Abstract
This paper describes the transition of communicable diseases in Korea since 1970s. Some of Korean's general living background and health indicators are introduced, followed by trends in the changes during the last several decades in socioeconomic, demographic, and living environmental status, which are closely associated with the transition of communicable diseases. The current incidence of classified, notifiable disease, the incidence by year, and the transition of communicable diseases are presented. Governmental responses to prevent and control communicable diseases, including both emerging and re-emerging infectious diseases, which have become recognized as having public health importance are described. Finally, the role played by academia during the last several decades in the successful control of communicable diseases is analyzed.; Summary

Reviews

An epidemiologic review of Japanese Encephalitis with a special focus on incidence and methods of control for South Korea.: Hee choul Ohrr, Sang Wook Lee, Jae Seok Hong; Korean J Epidemiol. 2005;27(1):69-80.

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Abstract PDF: Abstract
Japanese encephalitis(JE) is the leading viral cause of encephalitis and disability in Asia. The disease primarily infects children under the age of 15, leaving up to 70% of these who develop illness either dead or with a long-term neurological disability. We reviewed not only JE disease burden, etiology, vector, mode of transmission, reservoir but also geographic distribution and incidence of the disease in Asia, with a focus on the South Korea. A special comment on the methods of control JE and perspective for South Korea also included.; 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 PDF: 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

Original Articles

The Association of Reproductive and Menstrual Factors and Colon and Rectal Cancer Risk in Korean Women.: Bong Wha Lee, Dong Hyun Kim, Hunjae Lee, Dae Yong Whang, Yoon Ok Ahn; Korean J Epidemiol. 2002;24(1):76-82.

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Abstract PDF: Abstract
Recently, there were several epidemiological studies demonstrating that reproductive and menstrual factors are associated with the risk of colorectal cancer in women. A hospital-based case-control study has been conducted to investigate whether the histories of childbearing, menstruation, and breast-feeding are associated with colorectal cancer risk. The cases were consecutively diagnosed, histologically confirmed, incident patients with cancers of the colon and rectum aged 30-79 who were admitted to three tertiary hospitals in Seoul, Korea between March 1995 and August 1997. Controls were selected in the same hospitals as the cases during the same periods. Finally, a total of 151 cases and 110 controls were selected and interviewed on their reproductive and menstrual characteristics using a structured questionnaire. Earlier age at first birth appears to be related with increased risk of colorectal cancer (multivariate relative risk[RR] of colorectal cancer for <21 vs 25 > or = 2.33; 95% confidence interval[CI] 1.1-5.1, p for trend 0.03). Compared with women who experienced menarche at age 16 or older, women whose menarche occurred at age 14 or less appeared at significantly higher risk of rectal cancer(multivariate RR of colorectal cancer for < or = 14 vs > or =16 = 2.26; 95% CI 1.0-3.4, p for trend 0.03). We found no associations for parity, incomplete pregnancies, menopause, use of oral contraceptives, and hormone replacement therapy. These findings suggest that events of reproductive life may have a bearing on female subsequent risk of colon and rectal cancer; Summary

The Role of Genetic Polymorphism of Cytochrome P450 2E1 in Bladder Cancer in Korea.: Jiyeob Choi, Seungjoon Lee, Kyoungmu Lee, Inmi Choi, Youngju Lee, Hyungjune Im, Sang Yun Lee, Kijung Yoon, Sooung Kim, Moonsoo Park, Hanyong Choi, Whang Choi, Keunyoung Yoo, Soohun Cho, Daehee Kang; Korean J Epidemiol. 2000;22(1):59-67.

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Abstract PDF: Abstract
Although the association of genetic polymorphisms in glutathione S-transferase(GST) and N-acetyltransferase(NAT) with bladder cancer has been reported, limited numbers of studies have been indicated the association of CYP2E1 with bladder cancer, particularly in Asian population. A hospital based case-control study was conducted in South Korean, consisting of 232 histologically confirmed prevalent bladder cancer cases and 165 controls to evaluate the association between genetic polymorphisms of CYP2E1(RsaI) and development of bladder cancer. The frequency of CYP2E1(RsaI) c1/c1 genotype in bladder cancer cases was higher than in controls; 114 of 201(56.7%) vs. 62 of 146(42.5%). Men with CYP2E1(RsaI) c1/c1 genotype had increased risk of development of bladder cancer compared to men with at least one c2 allele(OR=1.7, 95% CI=1.1-2.7). The bladder cancer risk increased as the number of c1 allele increased(p for trend=0.005). The risk increased as the amount of smoking increased(p for trend=0.009). When data were analyzed for the interaction between smoking and CYP2E1 genetic polymorphisms, smokers with c1/c1 genotype have 2.5 greater risk in development of bladder cancer(95% CI=1.0-6.2) compared to nonsmokers with c2 allele(p for interaction=0.008). Our findings suggest that the interaction between genetic polymorphisms of CYP 2E1 (RsaI, c1/c1) and smoking may play an important role for development of bladder cancer among Koreans.; Summary

A Review Study on Confounding Effect: Case-control Study.: Seonwoo Kim, Minji Kim, Soon Young Lee; Korean J Epidemiol. 1999;21(2):248-253.

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Abstract PDF: Abstract
Confounding is the distortion of a disease/exposure association brought about by other factors which are not considered in the study design or the data analysis. These factors are called confounding factors. We should be cautious in data analysis of observational study of association of disease/exposure, since confounding often occurred in observational study. This study examines confounding effect according to data pattern (the ratio of controls to cases, the ratio of exposures to non-exposures for each level of confounding factor), criteria for treating a variable as a confounding variable, and some notes for the analysis in case-control study.; Summary

A Population-Based Case-Control Study on the Risk Factors of Congenital Heart Malformations.: Soon Ho Soh, Byung Chul Chun, Soon Duck Kim, Bae Jung Yoon, Yong Tae Yum; Korean J Epidemiol. 1999;21(2):234-247.

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Abstract PDF: Abstract
The multifactorial hypothesis is proposed as a working hypothesis which encompass both the genetic and environmental factors known to participate in the etiology of congenital heart malformations. So, it is believed that avoidance of suspected environmental factors in early pregnancy is the most certain preventive measure of congenital heart malformations. This study has been undertaken in order to find the possible environmental risk factors for congenital heart malformations in Korea. A total of 114 mothers of first graders of the elementary schools with congenital heart malformations confirmed through the screening program in Kyonggi Province from 1992 to 1995 were included as cases. And 206 mothers of healthy students matched by sex and elementary schools comprised the control group. Environmental risk factors including drug use during the first trimester of pregnancy, and other confounders were collected by telephone interview using standardized questionnaires by well trained interviewers. The result of multivariate logistic regression analysis showed that congenital heart malformation were associated with family history of congenital heart malformations(OR=2.94, 95% CI: 1.08, 7.96), the order of birth(OR=0.49, 95% CI: 0.31, 0.79). And the coffee consumption over 14 cups/week during early pregnancy showed marginal significance(OR=3.52, 95%CI: 0.98, 12.62). The mother's age at the subject birth and father's smoking at home were significant in linear trend test(p<0.05). It is recommended that the genetic counselling and the avoidance of known environmental risk factors in early pregnancy were needed to prevent congenital heart malformations.; Summary

Nested Case-control Study on the Association between Alcohol and the Risk of Proximal Hip Fracture in the Elderly People in Korea.: Byung Joo Park, Kui Oak Jung, Hye Won Koo, Jong Myon Bae; Korean J Epidemiol. 1999;21(1):93-103.

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Abstract PDF: Abstract
OBJECTIVE: To assess the association between alcohol drinking and hip fracture in the elderly people in Korea. BACKGROUND: Hip fracture is known as one of the major health problems because of its high incidence and serious consequences in the elderly people. The association between alcohol consumption and hip fractures has not been directly evaluated yet in Korea. So we conducted a nested case-control study to investigate the relationship between alcohol consumption and hip fracture in the Korean elderly people. DESIGN: Nested case-control study from the Korea Elderly Pharmacoepidemiology Cohort (KEPEC), in Pusan, Korea.
METHODS
Seventy incident cases have been selected since 1993, and 280 controls have been matched with the cases by age and gender among the KEPEC. Average alcohol intake was calculated by multiplying frequency and amount of drinking and unit capacity of each alcohol type. Odds ratios of alcohol intake on the hip fracture and their confidence intervals were computed by using multiple logistic regression with Windows version SAS 6.12.
RESULTS
The elderly people's drinking rate is lower than the young people in Korea. In univariate analysis, crude odds ratio was 0.26 in male and adjusted odds ratio after contolling for age, smoking status, medication history, physical activity and body mass index was 0.36 in male. So current drinking reduces the risk of hip fracture. Adjusted odds ratio after controlling for age, smoking status, medication history, physical activity and body mass index odds ratio was 0.24 in female with moderate drinking.
CONCLUSION
We found that alcohol consumption reduces the risk of hip fracture in the elderly Korean. However, we could not explain the plausible mechanism with our data yet. So, we suggest the further study for elucidating the possible mechanism of the finding including the possible association between nutritional status, alcohol drinking and bone marrow density in the elderly.; Summary

Effect of Non-dietary Factors in the Etiology of Stomach Cancer.: Soo Yong Choi, Hye Sung Park, Hyun Sook Kim, Cha Kwon Chung; Korean J Epidemiol. 1998;20(1):102-112.

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Abstract PDF: Abstract
BACKGROUND
Stomach cancer is the most malignant neoplasm among Koreans. There are some studies on risk factors for cancer prevention. SUBJECTS AND METHODS: A case-control study was conducted at the Korea Cancer Center Hospital in Seoul between April and September in 1996. One hundred twenty-six stomach cancer patients confirmed by the histological diagnosis were compared with 234 control subjects mached by age, sex, and admission date. The questionnaire included information on sociodemographic characteristics, smoking and drinking habits, height, weight, family history of cancer, nutrient supplements intake etc. Associations of stomach cancer with con-dietary factors were evaluated. Multiple logistic regression models were used to estimate relative risks when controlling simultaneously for covariates.
RESULTS
Weight and body mass index(BMI, kg/m2) at diagnosis were significantly low in cases compared with controls. As non-dietary factors, smoking habits, alcoholic beverage, family gistory, physical activity, water supply, stress, vitamin suppliments and the use of functional foods were not associated with stomach cancer risk.
CONCLUSION
Our findings indicated that non-dietary factors were not associated with stomach cancer risk.; Summary

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