Epidemiology and Health

Original Articles

Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses: Hana Kim, Heewon Kang, Sung-il Cho; Epidemiol Health. 2024;46:e2024009. Published online December 13, 2023; DOI: https://doi.org/10.4178/epih.e2024009

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Smoke-free areas have expanded and related campaigns have been implemented since 1995 in Korea. As a result, household secondhand smoke (SHS) exposure has decreased over the past 15 years. We assessed the cohort effect, the effect of a 2008 campaign on household SHS exposure, and the impact of a complete smoking ban in public places along with increased penalties, as implemented in December 2011.
METHODS
Nationally representative cross-sectional 15-wave survey data of Korean adolescents were used. The 810,516 participants were classified into 6 grade groups, 15 period groups, and 20 middle school admission cohorts. An age-period-cohort analysis, conducted with the intrinsic estimator method, was used to assess the cohort effect of household SHS exposure, and interrupted-time series analyses were conducted to evaluate the effects of the smoke-free policy and the campaign.
RESULTS
For cohorts who entered middle school from 2002 to 2008, the risk of household SHS exposure decreased among both boys and girls. Immediately after implementation of the smoke-free policy, the prevalence of household SHS exposure by period decreased significantly for boys (coefficient, -8.96; p<0.05) and non-significantly for girls (coefficient, -6.99; p=0.07). After the campaign, there was a significant decrease in household SHS exposure by cohort among boys, both immediately and post-intervention (coefficient, -4.84; p=0.03; coefficient, -1.22; p=0.02, respectively).
CONCLUSIONS
A school-admission-cohort effect was found on household SHS exposure among adolescents, which was associated with the smoke-free policy and the campaign. Anti-smoking interventions should be implemented consistently and simultaneously.; Summary

Korean summary
지난 15년 동안 한국 청소년의 가정 내 간접흡연 노출은 감소했다. 가정 내 간접흡연 노출에 대하여 중학교 입학 코호트 효과가 존재하였다. 또한, 청소년의 가정 내 간접흡연 노출 감소는 2011년 12월 공공장소에서의 금연구역 규제와 2008년 시행된 캠페인과 연관되어 있었다.

Key Message
Household secondhand smoke (SHS) exposure among Korean adolescents has decreased over the past 15 years. There was a school admission cohort effect on household SHS exposure. A complete smoking ban in public space with increased penalties in December 2011 and a campaign in 2008 to avoid SHS exposure were associated with reduced household SHS exposure among adolescents.

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.

Risk of chronic periodontitis in patients with obstructive sleep apnea in Korea: a nationwide retrospective cohort study: Seon-Rye Kim, Minkook Son, Yu-Rin Kim; Epidemiol Health. 2023;45:e2023032. Published online March 6, 2023; DOI: https://doi.org/10.4178/epih.e2023032

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
The aim of this study was to determine whether the development of chronic periodontitis is more likely among patients who have been newly diagnosed with obstructive sleep apnea (OSA) through an analysis of representative data from the general population.
METHODS
A nationwide, population-based, retrospective cohort study was conducted using patient records from the Korean National Health Insurance Service database. For the period 2004-2019, patient data were categorized into 2 groups: a diagnosis of OSA (747 subjects) and no diagnosis of OSA (1,494 subjects). Subsequently, 1:2 propensity score matching was performed to ensure the homogeneity of the 2 groups. To analyze the risk of incident chronic periodontitis, a Cox proportional-hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs).
RESULTS
In the Kaplan-Meier curve, the disease-free probability was significantly lower in the OSA group than in the non-OSA group (p for log-rank test=0.001). The crude HR for the association between OSA and chronic periodontitis was 1.29 (95% CI, 1.16 to 1.43). The multivariable-adjusted HR was calculated at 1.28 (95% CI, 1.15 to 1.42).
CONCLUSIONS
This study confirmed a relationship between OSA and chronic periodontitis. Therefore, OSA patients require oral care to prevent the progression of chronic periodontitis from mild to severe.; Summary

Korean summary
폐쇄성수면무호흡증 환자의 만성치주염 발생위험 차이를 분석한 결과, 폐쇄성수면무호흡증 그룹에서 만성치주염의 발생위험이 높았다. 따라서 폐쇄성수면무호흡증 환자의 만성치주염 초기치료 및 질환의 진행이 되지 않도록 전문가의 효과적인 구강관리가 필요할 것이다.

Key Message
As a result of analyzing the difference in the risk of chronic periodontitis among patients with obstructive sleep apnea, the risk of chronic periodontitis was higher in the obstructive sleep apnea group. Therefore, effective oral care by experts will be necessary to prevent the initial treatment of chronic periodontitis and progression of the disease in patients with obstructive sleep apnea.

Risk of dementia according to the severity of chronic periodontitis in Korea: a nationwide retrospective cohort study: Seon-Rye Kim, Minkook Son, Yu-Rin Kim, Hyun-Kyung Kang; Epidemiol Health. 2022;44:e2022077. Published online September 21, 2022; DOI: https://doi.org/10.4178/epih.e2022077

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We investigated the risk of dementia in older adults with chronic periodontitis according to the severity of periodontitis.

METHODS

Data on patients with chronic periodontitis were extracted from the National Health Insurance Service-Senior cohort database from 2002 to 2014. Among 52,728 subjects eligible for inclusion, 11,953 subjects had newly diagnosed mild chronic periodontitis (MCP), and 40,775 subjects had newly diagnosed severe chronic periodontitis (SCP). Two 1:1 propensity score matched cohorts were created with 8,624 patients each in the MCP and SCP groups. To analyze the risk of dementia, a Cox proportional-hazard model was used to calculate hazard ratios with 95% confidence intervals (CIs).

RESULTS

In the Kaplan-Meier curve, the disease-free probability was significantly lower in the SCP group than in the MCP group (p for log-rank=0.001). In the multivariable-adjusted model, the HR for the occurrence of dementia in the SCP group compared to the MCP group was 1.15 (95% CI, 1.04 to 1.27; p=0.009). A subgroup analysis revealed a significant association between dementia and the severity of periodontitis, especially in subjects who were male, aged ≥70 years, and had comorbidities.

CONCLUSIONS

Reducing the severity of chronic periodontitis can help to reduce the risk of dementia. Therefore, it is necessary to aggressively conduct early dementia-prevention programs for males under the age of 70 that include dental health to prevent the progression of periodontitis from mild to severe.

Summary

Korean summary
본 연구는 만성치주질환을 가진 노인의 만성치주질환 중등도에 따른 치매 발생위험 차이를 분석하였다. 그 결과, 만성치주질환 중등도가 높은 그룹에서 만성치주질환 중등도가 낮은 그룹에 비해 치매 발생위험이 높았으며, 특히, 남성과 70세 이상 그룹에서 유의한 차이가 있었다. 따라서 70세 이하 남성 노인을 대상으로 만성치주질환이 진행되지 않도록 효과적인 구강관리가 필요할 것이다.

Key Message
In this study, we confirmed that the severity of chronic periodontitis is related to the risk of dementia, so efforts for effective oral care will be needed.

Citations

Citations to this article as recorded by

With Teeth, Broken, or Fixed: The Challenges of Linking Periodontitis, Neuroepidemiology, and Biomarkers of Disease
James M. Noble, Panos N. Papapanou
Journal of Alzheimer's Disease.2023; 93(3): 991. CrossRef
Periodontal Pathogens and Their Links to Neuroinflammation and Neurodegeneration
David Visentin, Ivana Gobin, Željka Maglica
Microorganisms.2023; 11(7): 1832. CrossRef
Association between statin compliance and risk of dementia among patients with chronic periodontitis
Yu‐Rin Kim, Minkook Son, Seon‐Rye Kim
Oral Diseases.2023;[Epub] CrossRef

The risk of stroke according to statin medication compliance in older people with chronic periodontitis: an analysis using the Korea National Health Insurance Service-Senior Cohort Database: Seon-Rye Kim, Minkook Son, Yu-Rin Kim; Epidemiol Health. 2022;44:e2022055. Published online July 5, 2022; DOI: https://doi.org/10.4178/epih.e2022055

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We investigated the risk of stroke according to statin medication compliance in older people with chronic periodontitis.

METHODS

Chronic periodontitis patients were extracted from the National Health Insurance Service-Senior Cohort Database from 2002 to 2014. Among 255,056 chronic periodontitis patients, 41,412 patients with statin prescriptions for 28 days or more were included. The study population was divided into the top 25% of medication compliance group (TSG) and the lower 25% of medication compliance group (BSG). After 1:1 propensity score matching was performed, the final number of patients in the BSG and TSG was 6,172 each. To analyze the risk of stroke, a Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for age, sex, income level, hypertension, diabetes, and Charlson comorbidity index.

RESULTS

In the Kaplan-Meier curve, the disease-free probability was prominently lower in the BSG than in the TSG (p for log-rank= 0.001). The HR in the multivariable-adjusted model for stroke occurrence in the TSG compared to the BSG was 0.79 (95% CI, 0.67 to 0.92; p= 0.002). Subgroup analyses showed significant associations between compliance to statin medication and stroke, especially in female, people 85 years or older, and patients with comorbidities.

CONCLUSIONS

Increasing compliance to statins may reduce stroke risk in older adults with chronic periodontitis. Therefore, in order to increase medication compliance among older people with chronic periodontitis, it is necessary for medical staff to make efforts to provide effective medication guidance.

Summary

Korean summary
만성치주질환을 가진 노인에서 스타틴 복용순응도가 낮은 그룹에 비해 높은 그룹이 뇌졸증 발생위험이 낮았다. 특히 여성과 후기 노인 (85세 이상), 동반 질환을 가진 그룹에서 유의한 차이가 있었다. 따라서 스타틴 복용 순응도를 증대시키기 위한 의료진의 노력이 필요할 것이다.

Key Message
The stroke risk of chronic periodontal disease patients was related to statin medication compliance, and the effect of stroke risk was different in women, the elderly, and comorbidities.

Citations

Citations to this article as recorded by

Association between statin compliance and risk of dementia among patients with chronic periodontitis
Yu‐Rin Kim, Minkook Son, Seon‐Rye Kim
Oral Diseases.2023;[Epub] CrossRef
Impact of statin treatment on cardiovascular events in patients with retinal vein occlusion: a nested case-control study in Korea
Joonsang Yoo, Joo Youn Shin, Jimin Jeon, Jinkwon Kim
Epidemiology and Health.2023; 45: e2023035. CrossRef

COVID-19: Perspective

Maternal mental health in Africa during the COVID-19 pandemic: a neglected global health issue: Kobi V. Ajayi, Elizabeth Wachira, Obasanjo Afolabi Bolarinwa, Beulah D. Suleman; Epidemiol Health. 2021;43:e2021078. Published online October 6, 2021; DOI: https://doi.org/10.4178/epih.e2021078

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Abstract

The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted mental health and well-being around the globe. Public health measures to control the virus’s rapid spread, such as physical distancing, social isolation, lockdown, restricted movements, and quarantine, caused fear and panic in the general population. Although pandemic-related stressors have been reported, changes that occur during the perinatal period compounded by those made to obstetric care guidelines may put pregnant and postpartum mothers at an increased risk of poor mental health. While an abundance of research has examined the impact of the pandemic on maternal mental health in developed nations such as Europe and America, very few studies have done so in the African continent. Considering that Africa has prominently weak health systems, poor mental health policies and infrastructure, high poverty rates, and unreliable maternal care, the pandemic is expected to have dire consequences on maternal mental health in the region. As such, multipronged mental health interventions and strategies that consider the heterogeneity within and between African regions must be developed. Doing so will close existing and widening global health disparities to achieve the United Nations Sustainable Development Goals by 2030.

Summary

Key Message
Despite the adverse psychological impact of the COVID-19 pandemic on maternal mental health globally, little is known about its effect in Africa. As of the time of this study, only four research studies have been conducted in Nigeria, Ethiopia, and Ghana, investigating the psychological sequelae of the pandemic among pregnant and postpartum women in Africa. This study calls for urgent multipronged maternal mental health interventions and psychosocial support that consider the heterogeneity within and between African regions.

Citations

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Poor sleep quality and suicidal ideation among pregnant women during COVID-19 in Ethiopia: systematic review and meta-analysis
Aragaw Asfaw Hasen, Abubeker Alebachew Seid, Ahmed Adem Mohammed
PeerJ.2023; 11: e16038. CrossRef
Experiences of Perinatal Mental Health Care among Minority Ethnic Women during the COVID-19 Pandemic in London: A Qualitative Study
Sabrina Pilav, Abigail Easter, Sergio A. Silverio, Kaat De Backer, Sushma Sundaresh, Sara Roberts, Louise M. Howard
International Journal of Environmental Research and Public Health.2022; 19(4): 1975. CrossRef
Generalized Anxiety Disorder and Its Associated Factors Among Pregnant Women During COVID-19 at Public Health Facilities of East Gojjam Zone, 2020: A Multi-Center Cross-Sectional Study
Keralem Anteneh Bishaw, Addisu Andalem, Haile Amha, Tirusew wondie
Frontiers in Global Women's Health.2022;[Epub] CrossRef

Original Articles

Recent increase in pertussis incidence in Korea: an age-period-cohort analysis: Chanhee Kim, Seonju Yi, Sung-il Cho; Epidemiol Health. 2021;43:e2021053. Published online August 18, 2021; DOI: https://doi.org/10.4178/epih.e2021053

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Pertussis or whooping cough—one of the most contagious diseases—is caused by the Gram-negative bacterium <i>Bordetella pertussis</i>. Despite a high vaccination rate, Korea recently experienced a resurgence of pertussis. This study explores patterns and possible explanations for this resurgence through an age-period-cohort analysis.

METHODS

Using secondary data from the infectious disease portal of the Korea Disease Control and Prevention Agency and the Korea Statistical Information Service of Statistics Korea, this study analyzed the incidence of pertussis in Korea to determine which factors contributed to the recent increase using an age-period-cohort model.

RESULTS

Analysis of the age effect indicated that the age group most vulnerable to pertussis was 0-year to 2-year-olds. Analysis of the period effect showed a sharp increase in the incidence rate after 2016. Analysis of the cohort effect showed a significant decrease in incidence beginning with the 1955 birth cohort, with the risk increasing again with the 2000s birth cohort.

CONCLUSIONS

Previous studies have suggested 3 main possible explanations for our results. First, the increased incidence rate can be attributed to contact rates. Second, the rate of immunity through natural exposure has decreased due to the low number of circulating pathogens, in turn affecting the trend of infection. Lastly, variations in pathogens may have also contributed to the increase in incidence. Given that the most significant increase in incidence was observed among infants younger than 1 year old, sufficient maternal immunity must be prioritized to provide passive immunity to newborns via the placenta.

Summary

Korean summary
본 연구는 연령-기간-코호트 모델을 활용하여 예방접종률이 높은 국가들의 백일해 재출현에 기여하는 요인에 무엇이 있는지 살펴보았다. 연령에 따른 사회적 접촉률(contact rate)의 변화, 자연노출에 의한 면역 강화(natural boosting) 기회의 감소, 그리고 백일해 병원체의 변이가 백일해 재출현의 원인일 수 있다. 분석 결과 영아 집단에서 백일해 발병률이 가장 급격한 증가가 관찰되었으며, 이는 모성면역의 확보가 중요하다는 점을 시사한다.

Key Message
This study examined factors contribute to the re-emergence of pertussis in countries with high vaccination rates using the age-period-cohort model. Changes in social contact rates according to age, reduction in immune boosting opportunities by natural exposure, and variations in pertussis pathogens may be the cause of re-emergence. As a result of the analysis, the sharpest increase in the incidence of pertussis in the infant group was observed, suggesting that securing maternal immunity is important.

Citations

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Epidemiological Characteristics of Notifiable Respiratory Infectious Diseases in Mainland China from 2010 to 2018
Lele Deng, Yajun Han, Jinlong Wang, Haican Liu, Guilian Li, Dayan Wang, Guangxue He
International Journal of Environmental Research and Public Health.2023; 20(5): 3946. CrossRef
Incidence and Healthcare Burden of Pertussis among Older Adults with and without Pre-Existing Chronic Obstructive Pulmonary Disease or Asthma in South Korea
Jing Chen, Ju-Young Shin, Hyungwoo Kim, Ju Hwan Kim, Ahhyung Choi, Hee Jin Cheong, Yeon-Mok Oh, Adrienne Guignard, Sumitra Shantakumar
COPD: Journal of Chronic Obstructive Pulmonary Disease.2023; 20(1): 126. CrossRef
Pre-Pandemic Distribution of Bacterial Species in Nasopharyngeal Swab Specimens from Pediatric and Adult Patients Detected via RT-PCR Using the Allplex Respiratory Panel
Dong-Hyun Lee, Young-Jin Choi, Jieun Kim, Eunhee Han, Mi-Hyun Bae
Life.2023; 13(9): 1840. CrossRef
Bacterial Etiology in Subacute Cough
Ji-Yong Moon, Hyun Lee, Min-Hye Kim, Woo-Jung Song, Sang Min Lee, Sae-Hoon Kim, Sang-Heon Kim, Byung-Jae Lee, Ho Joo Yoon, Sang Hoon Kim
Allergy, Asthma & Immunology Research.2023; 15(5): 673. CrossRef
Post-Marketing Surveillance of Tetravalent Diphtheria-Tetanus-Acellular Pertussis and Inactivated Poliovirus (DTaP-IPV) Vaccine in South Korea, 2009 to 2015
Young June Choe, Emmanuel Vidor, Christine Manson
Infectious Diseases and Therapy.2022; 11(4): 1479. CrossRef
ARIMA and ARIMA-ERNN models for prediction of pertussis incidence in mainland China from 2004 to 2021
Meng Wang, Jinhua Pan, Xinghui Li, Mengying Li, Zhixi Liu, Qi Zhao, Linyun Luo, Haiping Chen, Sirui Chen, Feng Jiang, Liping Zhang, Weibing Wang, Ying Wang
BMC Public Health.2022;[Epub] CrossRef
Evaluation of Whole-Cell and Acellular Pertussis Vaccines in the Context of Long-Term Herd Immunity
Ewa Szwejser-Zawislak, Mieszko M. Wilk, Piotr Piszczek, Justyna Krawczyk, Daria Wilczyńska, Daniela Hozbor
Vaccines.2022; 11(1): 1. CrossRef

Prevalence of sexual experience among Korean adolescent: age-period-cohort analysis: Yongho Jee, Gyuyoung Lee; Epidemiol Health. 2020;42:e2020008. Published online March 3, 2020; DOI: https://doi.org/10.4178/epih.e2020008

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Abstract Summary PDF

Abstract

OBJECTIVES
Since exposure to sexual content and early sexual initiation among adolescents have become serious social issues in Korea, an in-depth analysis of trends in the prevalence of sexual experience among Korean adolescents is necessary to project the trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on the prevalence of sexual experience in Korean adolescents.

METHODS

We analyzed age-specific, period-specific, and birth cohort–specific trends in the prevalence of sexual experience among 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 years to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey. Joinpoint regression analysis was conducted to examine significant changes in the prevalence of sexual experience and to find the optimal number and location of places where trends changed.

RESULTS

The prevalence of sexual experience generally increased with age in all periods in both boys and girls. In boys, the prevalence of sexual experience increased in recent periods, especially in the age group of 12-13 years, while the prevalence of sexual experience decreased in the age group of 16-17 years. In girls, the age group of 12-13 years showed an increased prevalence of sexual experience in recent periods. However, the prevalence showed a decreasing trend in the age group of 16-17 years.

CONCLUSIONS

In boys and girls, sexual experience increased with age, although this tendency has slowed in recent cohorts. Therefore, early sex education is needed.

Summary

Korean summary
성경험 유병률은 일반적으로 남녀 공히 모든 시기에서 연령대에 따라 증가했다. 공통적으로 최근 연도에서 12-13세 연령군의 성 경험 유병률이 증가한 반면 16-17세 연령군에서 성경험 유병률이 감소했다. 전반적으로 2006 년부터 2017 년까지 청소년들의 성경험률은 소폭 감소했지만, 조기 성경험의 빈도는 증가하고 있다. 따라서 피임이나 순결 교육뿐만 아니라 성적자기결정능력같은 보다 실질적인 성교육이 어릴 때부터 강화되어야 할 것으로 보인다.

Citations

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Human Papillomavirus (HPV) Vaccination Intent among Mothers of Adolescent Sons: A National Survey on HPV Knowledge, Attitudes and Beliefs in South Korea
Jihye Choi, Seyoung Kim, Seung-Ju Lee, Sangrak Bae, Sooyoun Kim
The World Journal of Men's Health.2023; 41(2): 413. CrossRef
Association Between School Bullying Victimization and Sexual Risk-Taking among South Korean Adolescents: The Role of Teacher and Parental Relationships
Jihoon Kim, Yeungjeom Lee, Lindsay Leban, Wesley G. Jennings
Archives of Sexual Behavior.2023; 52(7): 2811. CrossRef
Prevalence and Trends of Sexual Behaviors Among Young Adolescents Aged 12 Years to 15 Years in Low and Middle-Income Countries: Population-Based Study
Zhengyue Jing, Jie Li, Yi Wang, Chengchao Zhou
JMIR Public Health and Surveillance.2023; 9: e45236. CrossRef
Association between early sexual initiation and sexually transmitted infections among Peruvian reproductive-age women
Jhosuny Perez-Fernandez, Diego O. Arroyo-Velasco, Mariella R. Huaman, Sarai G. Chavez-Bustamante, Anita P. Llamo-Vilcherrez, Carolina J. Delgado-Flores, Carlos J. Toro-Huamanchumo
Frontiers in Public Health.2023;[Epub] CrossRef
Sexual-Related Knowledge, School and Family Sexuality Education and Its Association with Experience of Sexual Intercourse among Vocational Secondary School Students in China
Yuhang Fang, Yujia Zheng, Yan Jin, Chunyan Yu, Xiayun Zuo, Qiguo Lian, Chaohua Lou, Lihe Li, Ping Hong, Xiaowen Tu
Children.2022; 9(8): 1206. CrossRef
Factors associated with adolescents’ sexual experience based on the biopsychosocial model: a cross-sectional study using the Korea Youth Risk Behavior Web-based Survey (KYRBS)
Ka Young Kim, Hye Young Shin
BMJ Open.2022; 12(11): e066307. CrossRef

Seasonality of tuberculosis in the Republic of Korea, 2006-2016: Eun Hee Kim, Jong-Myon Bae; Epidemiol Health. 2018;40:e2018051. Published online October 20, 2018; DOI: https://doi.org/10.4178/epih.e2018051

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
While the seasonality of notified tuberculosis has been identified in several populations, there is not a descriptive epidemiological study on the seasonality of tuberculosis in Korea. This study aimed to evaluate the seasonality of tuberculosis in Korea from 2006 to 2016.

METHODS

Data regarding notified cases of tuberculosis by year and month was obtained from the Infectious Diseases Surveillance Yearbook, 2017 published by the Korea Centers for Disease Control and Prevention. Seasonal decomposition was conducted using the method of structural model of time series analysis with simple moving averages.

RESULTS

While the trough season was winter from 2006 to 2016, the peak season was summer between 2006 and 2012, but shifted to spring between 2013 and 2016.

CONCLUSIONS

Notified tuberculosis in Korea also showed seasonality. It is necessary to evaluate factors related to the seasonality of tuberculosis for controlling tuberculosis.

Summary

Korean summary
2006-2016년 신고된 신환자의 연보를 근거로 결핵발생의 계절성 여부를 분석한 결과, 2006-2012년까지는 여름, 2013년이후는 봄에 발생 신고율이 높은 계절성을 확인하였다. 계절성을 야기하는 이유들을 찾아서 향후 결핵 예방에 활용할 필요가 있다.

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Methods

The unrealized potential: cohort effects and age-period-cohort analysis: Jongho Heo, Sun-Young Jeon, Chang-Mo Oh, Jongnam Hwang, Juhwan Oh, Youngtae Cho; Epidemiol Health. 2017;39:e2017056. Published online December 5, 2017; DOI: https://doi.org/10.4178/epih.e2017056

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Abstract

This study aims to provide a systematical introduction of age-period-cohort (APC) analysis to South Korean readers who are unfamiliar with this method (we provide an extended version of this study in Korean). As health data in South Korea has substantially accumulated, population-level studies that explore long-term trends of health status and health inequalities and identify macrosocial determinants of the trends are needed. Analyzing long-term trends requires to discern independent effects of age, period, and cohort using APC analysis. Most existing health and aging literature have used cross-sectional or short-term available panel data to identify age or period effects ignoring cohort effects. This under-use of APC analysis may be attributed to the identification (ID) problem caused by the perfect linear dependency across age, period, and cohort. This study explores recently developed three APC models to address the ID problem and adequately estimate the effects of A-P-C: intrinsic estimator-APC models for tabular age by period data; hierarchical cross-classified random effects models for repeated cross-sectional data; and hierarchical APC-growth curve models for accelerated longitudinal panel data. An analytic exemplar for each model was provided. APC analysis may contribute to identifying biological, historical, and socioeconomic determinants in long-term trends of health status and health inequalities as well as examining Korean’s aging trajectories and temporal trends of period and cohort effects. For designing effective health policies that improve Korean population’s health and reduce health inequalities, it is essential to understand independent effects of the three temporal factors by using the innovative APC models.

Summary

Korean summary
-건강수준 및 건강불평등의 장기적인 추이에 미치는 연령, 기간, 출생 코호트의 독립적인 영향을 분해하는 방법인 연령-기간-코호트 분석법(Age-Period-Cohort analysis)을 국내 보건의료 연구자들에게 체계적으로 소개함 -APC 분석법은 건강수준 및 건강행태, 건강불평등의 추세 분석 및 고령화, 만성질환, 생애주기 연구 등에 있어서 널리 활용될 수 있음 -APC 연구 결과를 바탕으로 향후 보건의료 정책에 있어서도 기간 또는 연령에 따른 정책뿐 아니라 코호트에 특정한 정책들도 고려되어야 할 필요가 있음

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Original Articles

Postpartum modern contraceptive use in northern Ethiopia: prevalence and associated factors: Teklehaymanot Huluf Abraha, Alemayehu Shimeka Teferra, Abebaw Addis Gelagay; Epidemiol Health. 2017;39:e2017012. Published online March 20, 2017; DOI: https://doi.org/10.4178/epih.e2017012

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Abstract PDF

Abstract

OBJECTIVES
The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, contraception during the extended postpartum period has been underemphasized in Ethiopia. Therefore, this study aimed to assess postpartum modern contraceptive use among women in northern Ethiopia and to identify factors associated with modern contraceptive use in the postpartum period.

METHODS

A community based cross-sectional study was conducted from March to April, 2015. Data were entered using Epi Info version 7 and then exported into Stata version 12 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and p-values <0.05 were considered to indicate statistical significance.

RESULTS

Nearly half (48.0%) of women used modern contraceptives during the extended postpartum period. Postpartum modern contraceptive use was significantly associated with secondary and tertiary education levels (aOR, 4.25; 95% CI, 1.29 to 14.00; aOR, 5.36 ; 95% CI, 1.14 to 25.45, respectively), family planning counseling during prenatal and postnatal care (aOR, 5.72 ; 95% CI, 2.67, 12.28), having postnatal care (aOR, 2.36; 95% CI, 1.15 to 4.87), resuming sexual activity (aOR, 9.53; 95% CI, 3.74 to 24.27), and menses returning after birth (aOR, 6.35; 95% CI, 3.14 to 13.39). In addition, experiencing problems with previous contraceptive use was negatively associated with modern contraceptive use (aOR, 0.34; 95% CI, 0.16 to 0.72).

CONCLUSIONS

Low rate of postpartum modern contraceptive use were found in the study area. Therefore, strengthening family planning counseling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women’s educational status are crucial steps for to enhance modern contraceptive use among postpartum women.

Summary

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Estimation of the size of the iatrogenic Creutzfeldt-Jakob disease outbreak associated with cadaveric dura mater grafts in Korea: Byoung-Hak Jeon, Jinseob Kim, Ganghyun Kim, Soochul Park, SangYun Kim, Hae-Kwan Cheong; Epidemiol Health. 2016;38:e2016059. Published online December 19, 2016; DOI: https://doi.org/10.4178/epih.e2016059

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Abstract Summary PDF

Abstract

OBJECTIVES
This study estimated the overall incidence of iatrogenic Creutzfeldt-Jakob disease (iCJD) based on dura graft cases in Korea using a mathematical model.

METHODS

We estimated the number of annual dura grafts performed between 1980 and 1995 by applying the proportion of dura grafts recorded by the Health Insurance Review Agency claim dataset in Korea to the number of nationwide neurosurgery cases. The distribution of the incubation period was assumed to fall under a Weibull distribution with density function or a log-logistic distribution with density function.

RESULTS

The total number of neurosurgery procedures performed from 1980 to 1995 was estimated to be 263,945, and among those operations, 37% used dura graft products. Between the years of 1980 and 2020, our model predicted that the total number of iCJD cases would be between 14.9 and 33.2 (95% confidence interval [CI], 13.4 to 50.9). Notably, we estimated that the cumulative number of iCJD cases caused by dura grafts between 1980 and 2011 was approximately 13.3 to 27.3 (95% CI, 12.2 to 40.6).

CONCLUSIONS

Based on our model, we postulate that the incidence of iCJD will sharply decline from 2012 to 2020. However, additional new cases are still expected, which necessitates a strong national surveillance system.

Summary

Korean summary
국내 경막유래 의인성 크로이츠펠트-증후군 환자의 발생규모 추정 본 연구는 국내 가용한 모든 자료원을 활용하여 국내 의인성 CJD 위험인구를 추산하고 이를기반으로 발생 가능한 의인성 CJD 환자의 규모를 수학적 모형을 통해 추산하는 것을 목적으로 시행하였으며, 예측모형 결과 2020년까지 가파르게 감소할것으로 보이나, 추가 발생에 대비한 국가감시체계의 강화가 필요할것으로 사료된다.

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Interventions to reduce the risk of surgically transmitted Creutzfeldt–Jakob disease: a cost-effective modelling review
Matt Stevenson, Lesley Uttley, Jeremy E Oakley, Christopher Carroll, Stephen E Chick, Ruth Wong
Health Technology Assessment.2020; 24(11): 1. CrossRef

Age-period-cohort analysis of smoking prevalence among young adults in Korea: Yong Ho Jee, Sung-il Cho; Epidemiol Health. 2016;38:e2016010. Published online March 19, 2016; DOI: https://doi.org/10.4178/epih.e2016010; Correction in: Epidemiol Health 2016;38(0):e2016029

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Abstract

OBJECTIVES
Smoking prevalence among Korean men in their thirties is substantially high (approximately 50%). An in-depth analysis of smoking trends among young adults in their twenties is necessary to devise antismoking policies for the next 10 years. This study aimed to identify the contributions of age, period, and birth cohort effects on smoking prevalence in young adults.

METHODS

Subjects comprised 181,136 adults (83,947 men: 46.3%; 97,189 women: 53.7%) aged 19 to 30 years from the 2008-2013 Korea Community Health Survey. Smoking prevalence adjusted with reference to the 2008 population was applied to the age-period-cohort (APC) model to identify the independent effects of each factor.

RESULTS

For men, smoking prevalence rapidly escalated among subjects aged 19 to 22 years and slowed down among those aged 23 to 30 years, declined during 2008 to 2010 but stabilized during 2011 to 2013, and declined in birth cohorts prior to 1988 but stabilized in subjects born after 1988. However, in APC models, smoking prevalence increased with age in the 1988 to 1991 birth cohort. In this birth cohort, smoking prevalence at age 19 to 20 years was approximately 24% but increased to 40% when the subjects turned 23 to 24 years. For women, smoking prevalence was too low to generate consistent results.

CONCLUSIONS

Over the past six years and in recent birth cohorts, smoking prevalence in adults aged 19 to 30 years has declined and is stable. Smoking prevalence should be more closely followed as it remains susceptible to an increase depending on antismoking policies or social conditions.

Summary

Korean summary
우리나라 남자의 30대와 40대의 흡연율은 약 50% 수준으로 매우 높다. 앞으로 10년 뒤에 이들 연령대로 진입하는 20대와 30대 젊은 청년층의 흡연율의 추이를 심층 분석하는 것은 10년 뒤 금연정책 준비에 필요한 기초자료가 될 것이다. 이 연구의 목적은 젊은 청년의 흡연율의 변화추이에 영향을 주는 연령, 연도, 출생코호트 효과를 파악하고자 하였다. 지난 6년 동안 19-30세의 흡연율은 전체적으로 연도가 증가하고 최근 출생코호트로 올수록 감소하는 경향을 보였다. 그러나 최근 출생코호트의 흡연율은 앞으로 금연정책이나 사회적인 상황에 따라 여전히 증가할 여지가 있으므로 주의 깊은 관찰이 필요할 것으로 생각된다.

Citations

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