Epidemiology and Health

Epidemiologic Investigation

An outbreak of hepatitis A associated with salted clams in Busan, Korea: Hyunjin Son, Miyoung Lee, Youngduck Eun, Wonseo Park, Kyounghee Park, Sora Kwon, Seungjin Kim, Changhoon Kim; Epidemiol Health. 2022;44:e2022003. Published online December 29, 2021; DOI: https://doi.org/10.4178/epih.e2022003

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Abstract

OBJECTIVES
In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Busan. The current study presents the results of an epidemiological investigation and outlines the supplementary measures that would help with hepatitis A control.

METHODS

A cohort study was conducted for all 2,865 customers who visited restaurant A from June to July. Using a standardized questionnaire, participants reported the presence of hepatitis A symptoms and whether they had consumed any of 19 food items. As for participants who had visited public health centers, their specimens were collected.

RESULTS

From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The epidemic curve was unimodal, and the median number of days from the restaurant visit to symptom onset was 31 days. A genotype analysis indicated that 89 of 90 tested patients had hepatitis A virus (HAV) genotype 1A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times (95% confidence interval [CI], 9.22 to 510.87). In an unopened package of salted clams found and secured through traceback investigation, HAV genotype 1A was detected.

CONCLUSIONS

To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams; the food sampling test standards for salted clams should also be expanded. Furthermore, a laboratory surveillance system based on molecular genetics should be established to detect outbreaks earlier.

Summary

Korean summary
2019년 7월, 부산시의 한 식당을 방문한 사람에서 다수의 A형간염 환자가 신고되었다. 2019년 6월 1일부터 7월 28일까지 해당 식당을 방문하여 카드 결제를 한 사람과 동반자 2,865명 전체를 대상으로 코호트 조사를 수행하였다. A형간염에 확진 된 사람은 총 155명으로 발병률은 5.4%였다. 다변량 로지스틱 회귀분석 결과 조개젓 섭취는 A형간염 발병 위험을 68.62배(95% CI, 9.22 to 510.87) 증가시키는 것으로 나타났다. 익히지 않은 조개류를 섭취하지 않도록 더욱 홍보를 강화해야 한다.

Key Message
In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Bu¬san. A cohort study was conducted for all 2,865 customers who visited the restaurant from June to July. From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times. To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams.

Citations

Citations to this article as recorded by

Investigating the spatio-temporal variation of hepatitis A in Korea using a Bayesian model
Jaehong Jeong, Mijeong Kim, Jungsoon Choi
Frontiers in Public Health.2023;[Epub] CrossRef
Influence of temperature and precipitation on the incidence of hepatitis A in Seoul, Republic of Korea: a time series analysis using distributed lag linear and non-linear model
Kiook Baek, Jonghyuk Choi, Jong-Tae Park, Kyeongmin Kwak
International Journal of Biometeorology.2022; 66(9): 1725. CrossRef

Original Article

Age-specific effects of ozone on pneumonia in Korean children and adolescents: a nationwide time-series study: Kyoung-Nam Kim, Youn-Hee Lim, Sanghyuk Bae, In Gyu Song, Soontae Kim, Yun-Chul Hong; Epidemiol Health. 2022;44:e2022002. Published online December 28, 2021; DOI: https://doi.org/10.4178/epih.e2022002

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
The aim of this study was to estimate the age-specific effects of 8-hour maximum ozone levels on pneumonia in children and adolescents.
METHODS
We performed quasi-Poisson regression analyses for individuals of 0-4 years, 5-9 years, 10-14 years, and 15-19 years of age using nationwide time-series data from the Korea (2011-2015). We constructed distributed lag linear models employing a generalized difference-in-differences method and controlling for other air pollutants.
RESULTS
A 10.0-parts per billion increase in 8-hour maximum ozone levels was associated with a higher risk of hospital admissions due to pneumonia at 0-4 (relative risk [RR], 1.02; 95% confidence interval [CI], 1.01 to 1.03) and 5-9 years of age (RR, 1.06; 95% CI, 1.04 to 1.08), but not at 10-14 (RR, 1.01; 95% CI, 0.98 to 1.04) or 15-19 years of age (RR, 1.01; 95% CI, 0.97 to 1.06). The association between ozone and hospital admissions due to pneumonia was stronger in cool seasons (from November to April) than in warm seasons (from May to October), but was similar between boys and girls.
CONCLUSIONS
Short-term exposure to ozone was associated with a higher risk of pneumonia at 0-4 years and 5-9 years of age, but not at 10-14 years or 15-19 years of age. Our findings can help identify vulnerable periods, determine the target populations for public health interventions, and establish air pollution standards.; Summary

Korean summary
-어린이와 청소년에서 대기오염물질인 오존에 단기 노출되었을 때 폐렴으로 인한 입원 위험이 증가하는지를 건강보험공단 청구자료를 이용하여 구축한 시계열자료로 분석하였다. -0-4세, 5-9세 군에서는 오존 단기 노출 시 폐렴으로 인한 입원 위험이 증가하였으나 10-14세, 15-19세 군에서는 입원 위험 증가가 관찰되지 않았다.

Key Message
• The effects of ozone levels on hospital admissions for pneumonia were evaluated. • We used quasi-Poisson time-series models and a difference-in-differences method. • Ozone levels increased hospital admissions for pneumonia at ages 0–4 and 5–9 years. • Evidence for the effects of ozone levels on pneumonia was not found at older ages.

Editorial

Happy New Year 2022 from Epidemiology and Health (epiH): Hyeon Chang Kim; Epidemiol Health. 2022;44:e2022001. Published online December 28, 2021; DOI: https://doi.org/10.4178/epih.e2022001

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Korean summary

Key Message

Original Article

Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis: Hwa Jeong Seo, Hyun Sook Oh; Epidemiol Health. 2021;43:e2021103. Published online December 17, 2021; DOI: https://doi.org/10.4178/epih.e2021103

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study investigated the effectiveness of early medication treatment and metformin use for cancer prevention in type 2 diabetes patients.
METHODS
Population-based cohort data were used from the Korean National Health Insurance Service-National Sample Cohort database (KNHIS-NSC) for 2002-2013. Patient-specific medication prescription status was defined by the landmark time (LMT; a fixed time after cohort entry), considering both pre- and post-LMT prescriptions to control methodological biases in observational research. The LMT was set to 2 years. Logistic regression analysis with multivariable adjustment was conducted to analyze cancer incidence by patient-specific medication prescription status.
RESULTS
Only 33.4% of the subjects were prescribed medication early (before the LMT) with compliance. Cancer incidence in individuals with early prescription and compliance was 25% lower (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.67 to 0.84) than in those without. As early-prescribed medications, metformin monotherapy and metformin combination therapy were associated with 34% (OR, 0.66; 95% CI, 0.51 to 0.83) and 25% (OR, 0.75; 95% CI, 0.64 to 0.88) lower cancer risk than non-use, respectively. Patients who were prescribed late (post-LMT) but did not comply with the prescription had a 24% (OR, 1.24; 95% CI, 0.97 to 1.58) higher cancer incidence than non-users. Among patients who started monotherapy early without changes throughout the entire follow-up period, those who started on metformin had a 37% (OR, 0.63; 95% CI, 0.41 to 0.99) lower risk of cancer than non-metformin users.
CONCLUSIONS
Doctors must prescribe antidiabetic medication early, and patient compliance is required, regardless of the prescription time, to prevent cancer. Metformin monotherapy or combination therapy is recommended as an early prescription.; Summary

Korean summary
당뇨 환자는 암 발병 위험이 높으며 암은 주요 사망 원인이다. 당뇨환자의 암발생 예방을 위한 관리로서, 당뇨병 진단 후 약물 치료 시기에 대한 연구는 부족하다. 또한, 전 세계적으로 가장 흔히 처방되는 당뇨병 치료제인 메트포민은 암 예방 효과가 있다고 알려져 왔으나 관측연구에서 발생하는 선택 편향의 문제가 제기되었고, 최근 일부 연구에서 기존의 암 예방 효과와 상충되는 결과가 나오고 있어 논쟁이 이어지고 있다. 본 연구는 선택 편향을 통제한 코호트 연구에서 조기 약물 치료와 메트포민 사용이 당뇨환자의 암 예방에 효과적임을 밝혔다. 따라서 의사들은 처음 당뇨 진단을 받은 환자에게 조기에 약물 처방을 하고, 환자들은 처방에 잘 따라야 한다. 조기 처방 약물로서 메트포민이 권장된다.

Key Message
Diabetic patients have a high risk of developing cancer, and cancer is the leading cause of death. There are few studies on the timing of medication treatment after diagnosis of diabetes. In addition, metformin, the most commonly prescribed diabetes treatment worldwide, is known to have cancer-preventive effects, but the problem of selection bias that occurs in observational studies has been raised, and some studies have recently been contradicting the existing cancer-preventing effects of metformin. This study, in a cohort study controlled for selection bias, demonstrated that early medication treatment and metformin use were effective in preventing cancer in diabetic patients.

Editorial

Spatiotemporal analyses of the epidemiological characteristics of diabetes mellitus: Sang Youl Rhee; Epidemiol Health. 2021;43:e2021102. Published online December 16, 2021; DOI: https://doi.org/10.4178/epih.e2021102

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Abstract Summary PDF: Abstract
Research based on spatiotemporal analysis has been conducted to identify various factors that can affect an individual’s or community’s degree of health and disease. These spatiotemporal studies can effectively illustrate patterns in disease frequency, features, and temporal flow in different parts of a country. Furthermore, identifying these regional characteristics can aid in the development of disease prevention or intervention strategies.; Summary

Korean summary
1. 시공간 분석은 국가 혹은 지역의 질병 빈도, 특징 및 시간 흐름의 패턴을 효과적으로 설명할 수 있다. 2. 시공간 분석은 질병의 예방 또는 중재 전략 개발에 도움이 될 수 있다.

Key Message
1. Spatiotemporal analyses can effectively illustrate patterns in disease frequency, features, and temporal flow in different parts of a country. 2. Spatiotemporal analysis can aid in disease prevention or development of intervention strategies.

Original Article

Late eating, blood pressure control, and cardiometabolic risk factors among adults with hypertension: results from the Korea National Health and Nutrition Examination Survey 2010-2018: Jee-Seon Shim, Hyeon Chang Kim; Epidemiol Health. 2021;43:e2021101. Published online November 24, 2021; DOI: https://doi.org/10.4178/epih.e2021101

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Despite growing concerns regarding the timing of eating, little is known about the association between late eating and health. This study aimed to investigate whether late eating is associated with blood pressure (BP) control and cardiometabolic risk factors among Korean adults with hypertension.
METHODS
Data from the Korea National Health and Nutrition Examination Survey 2010-2018 were used. Adults with hypertension aged 30-79 years (n=13,361) were included in this study. Dietary intake and information on meal timing were assessed using 1-day 24-hour recall. Late eating was defined as after the median midpoint between the times of the first and the last eating episode during the recall day. Logistic and linear regression models were used to estimate the associations of late eating with BP control and cardiometabolic risk factors.
RESULTS
Among late eaters, there were more men than women. Compared to early eaters, late eaters were younger, had a higher body mass index (BMI) and unhealthier habits, and their overall dietary quality score was lower. A negative association between late eating and BP control was found in a univariate model (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.94 to 1.12), but this association disappeared after adjustment for confounders (OR, 1.03; 95% CI, 0.94 to 1.12). Late eating was independently associated with higher BMI (p=0.03) and blood triglyceride concentration (p<0.01).
CONCLUSIONS
Our results do not support a link between late eating and BP control among adults with hypertension, but suggest that late eating is associated with cardiometabolic risk factors.; Summary

Korean summary
식사시간이 건강에 미치는 영향에 대한 관심이 증가하고 있지만, 이에 대한 근거는 많지 않다. 이 연구는 국민건강영양조사 자료를 활용하여 고혈압이 있는 성인의 늦은 식사와 혈압 조절, 심장대사 위험인자의 연관성을 분석하였다. 늦은 식사와 혈압 조절의 독립적 연관성은 찾지 못했지만, 늦은 식사는 높은 체질량지수, 혈중 지질 농도와 연관성을 보여 식사 시간 조정이 고혈압 환자의 예후 개선을 위한 유용한 대책이 될 수 있으리라는 근거를 지지한다.

Key Message
This study investigated whether late eating is associated with blood pressure (BP) control and cardiometabolic risk factors among Korean adults with hypertension using data from the Korea National Health and Nutrition Examination Survey 2010–2018. We did not find an independent association between late eating and BP control among Korean adults with hypertension, but found that late eating was significantly associated with higher BMI and a higher blood concentration of triglycerides, independent of potential confounders. Our findings support the suggestion that a time-based dietary approach can be used as a useful strategy to improve the prognosis of adults with hypertension.

COVID-19: Correspondence

Authors’ Reply: Vaccination, payment, and COVID-19: Jelena Dotlic, Vida Jeremic Stojkovic, Paul Cummins, Marija Milic, Tatjana Gazibara; Epidemiol Health. 2021;43:e2021100. Published online November 23, 2021; DOI: https://doi.org/10.4178/epih.e2021100

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Key Message

Original Articles

Gender differences in under-reporting hiring discrimination in Korea: a machine learning approach: Jaehong Yoon, Ji-Hwan Kim, Yeonseung Chung, Jinsu Park, Glorian Sorensen, Seung-Sup Kim; Epidemiol Health. 2021;43:e2021099. Published online November 17, 2021; DOI: https://doi.org/10.4178/epih.e2021099

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study was conducted to examine gender differences in under-reporting hiring discrimination by building a prediction model for workers who responded “not applicable (NA)” to a question about hiring discrimination despite being eligible to answer.
METHODS
Using data from 3,576 wage workers in the seventh wave (2004) of the Korea Labor and Income Panel Study, we trained and tested 9 machine learning algorithms using “yes” or “no” responses regarding the lifetime experience of hiring discrimination. We then applied the best-performing model to estimate the prevalence of experiencing hiring discrimination among those who answered “NA.” Under-reporting of hiring discrimination was calculated by comparing the prevalence of hiring discrimination between the “yes” or “no” group and the “NA” group.
RESULTS
Based on the predictions from the random forest model, we found that 58.8% of the “NA” group were predicted to have experienced hiring discrimination, while 19.7% of the “yes” or “no” group reported hiring discrimination. Among the “NA” group, the predicted prevalence of hiring discrimination for men and women was 45.3% and 84.8%, respectively.
CONCLUSIONS
This study introduces a methodological strategy for epidemiologic studies to address the under-reporting of discrimination by applying machine learning algorithms.; Summary

Korean summary
본 연구는 한국노동패널조사(7차년도)에 포함된 3576명의 임금근로자의 자료를 이용해 성별에 따른 구직 과정 경험한 차별에 대한 과소보고의 규모를 확인하고자 하였다. 질문에 “예” 또는 “아니요”라고 응답한 임금근로자 3479명 데이터를 이용하여 고용 시 차별경험을 예측하는 머신러닝 모형을 구축하였고, 이를 활용해 이미 직장에서 일하고 있는 상태임에도 “해당사항 없음”이라고 응답한 임금근로자 97명이 차별을 경험했는지 여부를 예측하였다. 분석결과, “해당사항 없음”이라고 답한남성 근로자 64명 중 29명(45.3%), 여성 근로자 33명 중 28명(84.8%)가 실제로 차별을 경험한 것으로 추정되었다.

Key Message
We examined gender differences in under-reporting hiring discrimination for wage workers who responded “not applicable(NA)” to a question about hiring discrimination despite being eligible to answer “yes” or “no.” Using data from 3,576 wage workers of the Korea Labor and Income Panel Study, we estimated the prevalence of hiring discrimination among those who answered “NA,” based on the best-performing machine learning prediction model for “yes” or “no” group. Among the “NA” group, the predicted prevalence of hiring discrimination for men and women was 45.3% and 84.8%, respectively.

Spatiotemporal trends in diabetes-related mortality by school district in the state of Michigan, United States: Nurjannah Nurjannah, Kathleen M. Baker, Duduzile Phindi Mashinini; Epidemiol Health. 2021;43:e2021098. Published online November 9, 2021; DOI: https://doi.org/10.4178/epih.e2021098

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Abstract PDF

Abstract

OBJECTIVES
This study examined the spatiotemporal epidemiological status of diabetes-related death in relation to school district boundaries in the state of Michigan, United States.

METHODS

A retrospective observational study was conducted using death records spanning the years 2007-2014 in Michigan, with school districts as the geographic unit of analysis. Geocoding was performed for each death record. Cluster analysis used spatial autocorrelation with local Moran’s I, and spatiotemporal analysis used the Space Time Pattern Mining tool in ArcGIS Pro 2.1.

RESULTS

The study revealed spatial clusters of high-high locations of diabetes-related mortality rate by school district in Michigan from 2007 to 2014. Spatiotemporal analysis showed grids with intensifying, consecutive, sporadic, and persistent hotspots of diabetes-related death in the Lansing, Royal Oak, Flint City, Berkley, Detroit City, East Lansing, South Lake, and Holt public school districts. These school districts should be prioritized for school-based diabetes prevention programs

CONCLUSIONS

The study demonstrated the presence of various hotspots of diabetes-related deaths within the state of Michigan across the 8-year period of analysis. Understanding spatial and temporal hotspots could further improve our ability to evaluate diabetes burden across both time and space.

Summary

Korean summary

Key Message
Using existing secondary data with spatio-temporal analysis, the study identified diabetes-related death varies across space and time within the state of Michigan, USA at the school district level. This approach provided policy-relevant information to target high-risk school-district when having limited resources to prevent diabetes at schools.

Citations

Citations to this article as recorded by

Spatiotemporal analyses of the epidemiological characteristics of diabetes mellitus
Sang Youl Rhee
Epidemiology and Health.2021; 43: e2021102. CrossRef

Real-world incidence of endopthalmitis after intravitreal anti-VEGF injections in Korea: findings from the Common Data Model in ophthalmology: Yongseok Mun, Seng Chan You, Da Yun Lee, Seok Kim, Yoo-Ri Chung, Kihwang Lee, Ji Hun Song, Young Gun Park, Young Hoon Park, Young-Jung Roh, Se Joon Woo, Kyu Hyung Park, Rae Woong Park, Sooyoung Yoo, Dong-Jin Chang, Sang Jun Park; Epidemiol Health. 2021;43:e2021097. Published online November 9, 2021; DOI: https://doi.org/10.4178/epih.e2021097

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The aim of this study was to evaluate the real-world incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (VEGF) injections using data from the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM).

METHODS

Patients with endophthalmitis that developed within 6 weeks after intravitreal anti-VEGF injections were identified in 3 large OMOP CDM databases.

RESULTS

We identified 23,490 patients who received 128,123 intravitreal anti-VEGF injections. The incidence rates of endophthalmitis were 15.75 per 10,000 patients and 2.97 per 10,000 injections. The incidence rates of endophthalmitis for bevacizumab, ranibizumab, and aflibercept (per 10,000 injections) were 3.64, 1.39, and 0.76, respectively. The annual incidence has remained below 5.00 per 10,000 injections since 2011 despite the increasing number of intravitreal anti-VEGF injections. Bevacizumab presented a higher incidence rate for endophthalmitis than ranibizumab and aflibercept (incidence rate ratio, 3.17; p=0.021).

CONCLUSIONS

The incidence of endophthalmitis after intravitreal anti-VEGF injections has stabilized since 2011 despite the explosive increase in anti-VEGF injections. The off-label use of bevacizumab accounted for its disproportionately high incidence of endophthalmitis. The OMOP CDM, which includes off-label uses, laboratory data, and a scalable standardized database, could provide a novel strategy to reveal real-world evidence, especially in ophthalmology.

Summary

Korean summary
- 공통데이터모델 (Observational Medical Outcomes Partnership Common Data Model, OMOP CDM)을 통해 유리체강내 항혈관내피성장인자 주입술 후 발생한 안내염의 실세계 발생률 (Real-world incidence)은 1만명 당 15.75명, 주사 1만회 당 2.97회였음을 알 수 있었다. - 베바시주맙에서 다른 항혈관내피성장인자에 비해 유리체강내 주사 후 안내염 발생 비율이 높았으며, 이는 약제의 분주로 인한 오염과 관련이 있을 것이다. - 공통데이터모델은 건강보험 청구자료가 포함하지 않는 유리체강내 베바시주맙 사용과 같은 오프라벨 의약품 사용 자료까지 포함하기 때문에, 유리체강내 항혈관내피성장인자 주입 후 발생한 안내염의 인구기반 발생률 추정을 가능케 했다.

Key Message
- The real-world incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (VEGF) injections was 15.75 per 10,000 patients and 2.97 per 10,000 injections based on data from the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). - Patients treated with bevacizumab showed a significantly higher incidence rate of post-injection endophthalmitis, which might have resulted from contamination related to the division of bevacizumab. - OMOP CDM provides insights into the population-based incidence rate of endophthalmitis since it covers off-label prescriptions including intravitreal bevacizumab, which the national claims database does not cover.

Citations

Citations to this article as recorded by

Real-world treatment intensities and pathways of macular edema following retinal vein occlusion in Korea from Common Data Model in ophthalmology
Yongseok Mun, ChulHyoung Park, Da Yun Lee, Tong Min Kim, Ki Won Jin, Seok Kim, Yoo-Ri Chung, Kihwang Lee, Ji Hun Song, Young-Jung Roh, Donghyun Jee, Jin-Woo Kwon, Se Joon Woo, Kyu Hyung Park, Rae Woong Park, Sooyoung Yoo, Dong-Jin Chang, Sang Jun Park
Scientific Reports.2022;[Epub] CrossRef
Blueprint for harmonising unstandardised disease registries to allow federated data analysis: prepare for the future
Johannes A. Kroes, Aruna T. Bansal, Emmanuelle Berret, Nils Christian, Andreas Kremer, Anna Alloni, Matteo Gabetta, Chris Marshall, Scott Wagers, Ratko Djukanovic, Celeste Porsbjerg, Dominique Hamerlijnck, Olivia Fulton, Anneke ten Brinke, Elisabeth H. Be
ERJ Open Research.2022; 8(4): 00168-2022. CrossRef
Towards effective data sharing in ophthalmology: data standardization and data privacy
William Halfpenny, Sally L. Baxter
Current Opinion in Ophthalmology.2022; 33(5): 418. CrossRef

Joint association of aerobic physical activity and muscle-strengthening activities with metabolic syndrome : the Korean National Health and Nutrition Examination Survey 2014-2015: Jungjun Lim, Soyoung Park, Joon-Sik Kim; Epidemiol Health. 2021;43:e2021096. Published online November 6, 2021; DOI: https://doi.org/10.4178/epih.e2021096

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Abstract Summary PDF

Abstract

OBJECTIVES
The study aimed to examine whether simultaneously meeting the combined guidelines of accelerometer-assessed moderate to vigorous physical activity (MVPA) and self-reported muscle-strengthening activity (MSA) was associated with lower odds of metabolic syndrome (MetS) than meeting neither or 1 of the guidelines among the Koreans.

METHODS

This cross-sectional analysis included 1,355 participants from the Korea National Health and Nutrition Examination Survey (2014-2015). Logistic regression was used to analyze the associations across groups of MVPA-MSA guideline adherence (meeting neither [reference]; meeting MVPA only; meeting MSA only; meeting both MVPS and MSA) with MetS components (abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol [HDL-C], hypertension, and hyperglycemia). The odds ratios (ORs) were adjusted for covariates (e.g., sex, age, body mass index, and accelerometer wearing time).

RESULTS

MSA only significantly reduced the OR for abdominal obesity (OR, 0.34; 95% confidence interval [CI], 0.13 to 0.91). Meeting both MVPA and MSA reduced the OR for hypertriglyceridemia (OR, 0.59; 95% CI, 0.39 to 0.88) and low HDL-C (OR, 0.46; 95% CI, 0.31 to 0.68). Compared to meeting neither, MVPA only (OR, 0.63; 95% CI, 0.44 to 0.89) and both MVPA and MSA (OR, 0.46; 95% CI, 0.28 to 0.76) significantly reduced the OR for MetS.

CONCLUSIONS

Combined MVPA-MSA was more beneficially associated with MetS prevalence than MVPA only and MSA only. Considering that more than 85% of Korean adults do not meet both the MVPA and MSA guidelines, public health actions to promote adherence should be supported.

Summary

Korean summary
본 연구는 2014-2015 국민건강영양조사 자료의 가속도계 자료와 신체활동 설문지를 활용하여 한국 성인의 유산소 신체활동과 근력강화운동 지침 충족 여부에 따른 대사증후군의 오즈비를 확인하였다. 그 결과, 유산소 신체활동과 근력강화운동 지침을 모두 충족한 한국 성인은 둘 중 하나의 지침만을 충족하거나, 모두 충족하지 않는 성인에 비해 더 낮은 오즈비를 나타내었다.

Key Message
In this study, the 2014-2015 Korean National Health and Nutrition Examination Survey data, the odds ratio of metabolic syndrome was confirmed according to the guidelines for aerobic physical activities and muscle-strengthening activities were met in Korean adults. As a result, Korean adults who met both the guidelines for aerobic physical activity and muscle-strengthening activities showed a lower odds ratio than adults who met only one of the guidelines or did not meet both guidelines.

Citations

Citations to this article as recorded by

The effect of Tabata-style functional high-intensity interval training on cardiometabolic health and physical activity in female university students
Yining Lu, Huw D. Wiltshire, Julien Steven Baker, Qiaojun Wang, Shanshan Ying
Frontiers in Physiology.2023;[Epub] CrossRef
Association of Aerobic and Muscle-strengthening Activities with AIP in Korean Adults: Korea National Health and Nutrition Examination Survey 2014-2019
Jungjun Lim, Yang Hei, Yeonsoo Kim
Journal of Korean Association of Physical Education and Sport for Girls and Women.2022; 36(3): 245. CrossRef
Current status of health promotion in Korea
Soo Young Kim
Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef
Aerobic or Muscle-Strengthening Physical Activity: Which Is Better for Health?
Angelique G. Brellenthin, Jason A. Bennie, Duck-chul Lee
Current Sports Medicine Reports.2022; 21(8): 272. CrossRef

COVID-19: Perspective

Magnifying the importance of collecting race, ethnicity, industry, and occupation data during the COVID-19 pandemic: Sai Krishna Gudi, Sophia M. George, Komal Krishna Tiwari; Epidemiol Health. 2021;43:e2021095. Published online November 6, 2021; DOI: https://doi.org/10.4178/epih.e2021095

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Abstract PDF: Abstract
The contagiousness of coronavirus disease-2019 (COVID-19) led to the imposition of historical lockdowns in various countries. No scientific mind could have made accurate projections of the tremendous impact that COVID-19 would have on nations, communities, and the global-wide economy. Meanwhile, millions of workers have lost their jobs, while healthcare workers are overwhelmed and are reaching a state of mental and physical exhaustion. With the uncontrollable spread, researchers have been working to identify factors associated with COVID-19. In this regard, race, ethnicity, industry, and occupation have been found to be predominant factors of interest. However, unfortunately, the unavailability of such information has been a difficult reality. Since race, ethnicity, and employment are essential social determinants of health and could serve as potential risk-factors for COVID-19, collecting such information may offer important context for prioritising vulnerable groups. Thus, this perspective aims to highlight the importance and need for collecting race, ethnicity, and occupation-related data to track and treat the racial/ethnic groups that have been most strongly affected by the COVID-19 pandemic. Collecting such data will provide valuable insights and help public health officials recognise workplace-related outbreaks and evaluate the odds of various ethnic groups and professions contracting COVID-19.; Summary

Korean summary

Key Message
As essential social determinants of health, collecting and recording the race/ethnicity, occupation and industry information will provide valuable insights and help public health officials identify workplace-related outbreaks and evaluate the odds of various ethnic groups and professions contracting COVID-19.

Original Articles

Misconceptions and stigma against people living with HIV/AIDS: a cross-sectional study from the 2017 Indonesia Demographic and Health Survey: Desi Suantari; Epidemiol Health. 2021;43:e2021094. Published online November 6, 2021; DOI: https://doi.org/10.4178/epih.e2021094

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Abstract PDF

Abstract

OBJECTIVES
Data are not available in Indonesia to measure the main indicators of zero new infections, zero acquired immune deficiency syndrome (AIDS)-related deaths and zero discrimination. This study aimed to determine factors related to misconceptions about human immunodeficiency virus (HIV) transmission and the stigma against people living with HIV/AIDS (PLWHA) in Indonesia

METHODS

This cross-sectional study used secondary data from the 2017 Indonesia Demographic and Health Survey (IDHS). The sample was women and men aged 17-45 years and married (n=3,023).

RESULTS

Education and wealth index quintile were significantly related to misconceptions about HIV transmission. Respondents with low levels of education were more likely to have misconceptions about HIV transmission. Respondents who were in the poorest, poorer, middle, and richer quintiles of the wealth index were more likely to have misconceptions about HIV transmission than those in the richest quintile. Educational level, employment status, and wealth index quintile were predictors of stigma against PLWHA.

CONCLUSIONS

There are still many Indonesian people with misconceptions about HIV transmission and stigma against PLWHA. Future studies should focus on educational programs or interventions aimed at increasing public knowledge and awareness, promoting compassion towards PLWHA, and emphasizing respect for the rights of PLWHA. These interventions are particularly important for populations who are uneducated and living in poverty.

Summary

Korean summary

Key Message
Many Indonesians still experience misconceptions about HIV transmission and stigmatize PLWHA. Educational programs or interventions are needed to increase public knowledge and awareness, promoting compassion towards PLWHA, and emphasizing respect for the rights of PLWHA, particularly among the poor and uneducated.

Citations

Citations to this article as recorded by

Stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among general adult population: the results from the 6th Thai National Health Examination Survey (NHES VI)
Sineenart Chautrakarn, Parichat Ong-Artborirak, Warangkana Naksen, Aksara Thongprachum, Jukkrit Wungrath, Suwat Chariyalertsak, Scott Stonington, Surasak Taneepanichskul, Sawitri Assanangkornchai, Pattapong Kessomboon, Nareemarn Neelapaichit, Wichai Aekpl
Journal of Global Health.2023;[Epub] CrossRef
Factor Associated with HIV/AIDS knowledge among males: Findings from 2017-18 Pakistan Demographic and Health Survey
Jamal Abdul Nasir, Muhammad Danish Khan, Syed Arif Ahmed Zaidi
Journal of Biosocial Science.2023; : 1. CrossRef

Effect of chemotherapy and radiotherapy on cognitive impairment in colorectal cancer: evidence from Korean National Health Insurance Database Cohort: Kwanghyun Kim, Chang Woo Kim, Aesun Shin, Hyunseok Kang, Sun Jae Jung; Epidemiol Health. 2021;43:e2021093. Published online November 2, 2021; DOI: https://doi.org/10.4178/epih.e2021093

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2 Citations

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We investigated the risk of chemotherapy-related and radiotherapy-related cognitive impairment in colorectal cancer patients.

METHODS

Medical use data of colorectal cancer patients were obtained from the Korean National Health Insurance Database from 2004 to 2018. We randomly selected 40% of all colorectal cancer patients (n=148,848). Cognitive impairment was defined as having 1 or more International Classification of Diseases, 10th revision diagnostic codes for dementia or mild cognitive impairment. Patients aged 18 years or younger, patients diagnosed with cognitive impairment before colorectal cancer diagnosis (n=8,225), and patients who did not receive primary resection (n=45,320) were excluded. The effects of individual chemotherapy regimens on cognitive impairment were estimated. We additionally estimated the effect of radiotherapy in rectal cancer patients. Time-dependent competing risk Cox regression was conducted to estimate the overall and age-specific hazard ratios (HR) separately for colon and rectal cancer. Landmark analyses with different lag times were conducted as sensitivity analyses.

RESULTS

Chemotherapy did not increase the risk of cognitive impairment in colorectal cancer patients (colon cancer: HR, 0.92; 95% confidence interval [CI], 0.83 to 1.03; rectal cancer: HR, 0.88; 95% CI, 0.75 to 1.04), while radiotherapy was negatively associated with cognitive impairment in rectal cancer patients (HR, 0.01; 95% CI, 0.84 to 0.99). Varying directions of the associations between regimens and cognitive impairment were detected. The adverse effect of certain chemotherapy regimens on cognition was more prominent in older adults.

CONCLUSIONS

Chemotherapy and radiotherapy did not increase the risk of cognitive impairment. Older patients with low cognitive reserve could be affected by the adverse cognitive effects of chemotherapy.

Summary

Korean summary
- 대장암 환자를 대상으로 한 항암화학요법 및 방사선요법은 인지기능저하의 위험을 높이지 않았다 - 일부 항암화학요법의 경우 고령의 대장암 환자에서 인지기능저하의 위험을 증가시킬 수 있다

Key Message
Results from nationwide cohort of Korea showed that chemotherapy and radiotherapy did not increase the risk of cognitive impairment in colorectal cancer patients.

Citations

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Chemotherapy-induced functional brain abnormality in colorectal cancer patients: a resting‐state functional magnetic resonance imaging study
Siwen Liu, Yesong Guo, Jie Ni, Na Yin, Chenchen Li, Xuan Pan, Rong Ma, Jianzhong Wu, Shengwei Li, Xiaoyou Li
Frontiers in Oncology.2022;[Epub] CrossRef
Association between multimorbidity status and incident dementia: a prospective cohort study of 245,483 participants
He-Ying Hu, Ya-Ru Zhang, Qiaolifan Aerqin, Ya-Nan Ou, Zuo-Teng Wang, Wei Cheng, Jian-Feng Feng, Lan Tan, Jin-Tai Yu
Translational Psychiatry.2022;[Epub] CrossRef

Association between early antenatal care and antenatal care contacts across low-and middle-income countries: effect modification by place of residence: Paschal Awingura Apanga, Maxwell Tii Kumbeni; Epidemiol Health. 2021;43:e2021092. Published online November 2, 2021; DOI: https://doi.org/10.4178/epih.e2021092

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1 Citations

Abstract PDF Supplementary Material

Abstract

OBJECTIVES
The relationship between receiving early antenatal care (ANC) and 8 or more antenatal contacts (ANC8+) has not been well characterised across low-and middle-income countries (LMICs). It is also unclear whether the association between early ANC and ANC8+ is modified by a woman’s place of residence. Our primary aim was to assess the relationship between early ANC and ANC8+ and to investigate whether this relationship was modified by place of residence. We also estimated the coverage of ANC8+ across LMICs.

METHODS

We analysed data on 207,388 mothers with a recent live birth using multiple indicator cluster surveys conducted between 2017 and 2020 in 30 LMICS. Modified Poisson regression with robust variance was used to evaluate the relationship between early ANC and ANC8+, whilst adjusting for country, clustering, stratification, and sampling weights. Effect modification by place of residence was assessed on additive and multiplicative scales. A meta-analysis was conducted to pool prevalence estimates of ANC8+ across all countries.

RESULTS

The overall prevalence of ANC8+ was 35.6%, ranging from 1.7% in Madagascar to 99.4% in Belarus. Early ANC was positively associated with ANC8+ (adjusted prevalence ratio [aPR], 2.61; 95% confidence interval [CI], 1.82 to 3.74). There was evidence of positive effect modification on additive (relative excess risk due to interaction, 0.39; 95% CI, 0.35 to 0.44) and multiplicative (aPR, 1.78; 95% CI, 1.08 to 2.95) scales.

CONCLUSIONS

Many LMICs may not have adopted the 2016 World Health Organization guidelines on ANC8+. Receiving early ANC was associated with a higher likelihood of ANC8+, particularly for women in rural areas.

Summary

Korean summary

Key Message
Our findings suggest that early antenatal care (ANC) was associated with the likelihood of receiving eight or more ANC contacts (ANC8+) among all mothers across low-and middle-income countries. This association was modified by a woman’s place of residence such that mothers living in rural areas who received early ANC had a higher prevalence of ANC8+. Public health programs, which focus on increasing the coverage of ANC8+ should encourage all pregnant women to receive early ANC, particularly those living rural areas.

Citations

Citations to this article as recorded by

The moderating role of partners’ education on early antenatal care in northern Ghana
Paschal Awingura Apanga, Maxwell Tii Kumbeni, James Kotuah Sakeah, Ayokunle A. Olagoke, Olufemi Ajumobi
BMC Pregnancy and Childbirth.2022;[Epub] CrossRef

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