Most-read articles are from the articles published in 2021 during the last three month.
COVID-19: Special Article
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Changes in health behaviors and obesity of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
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Chang-Mo Oh
, Yangha Kim
, Jieun Yang
, Sunhye Choi
, Kyungwon Oh
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Epidemiol Health. 2023;45:e2023018. Published online February 14, 2023
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DOI: https://doi.org/10.4178/epih.e2023018
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
This study aimed to investigate changes in health behaviors, including cigarette smoking, alcohol drinking, physical activity, dietary behaviors, and obesity, before and during the coronavirus disease 2019 (COVID-19) pandemic using the Korea Youth Risk Behavior Survey (KYRBS) database.
METHODS
KYRBS data from 2015 to 2021 were used in this study. Differences in health behaviors between before (pre-pandemic period: 2018-2019) and during (pandemic period: 2020-2021) the pandemic were examined. Differences were compared using linear regression and the chi-square test considering the complex survey design after adjusting for grade level.
RESULTS
The prevalence of current cigarette smoking and current alcohol drinking significantly decreased in both male and female students during the pandemic compared to the pre-pandemic period. However, the prevalence of obesity significantly increased in both male and female students during the same period. When examining physical activity and dietary behaviors closely related to obesity, fast food consumption increased and fruit consumption decreased during the pandemic in both male and female students, whereas no significant changes in physical activity were observed in either male or female students.
CONCLUSIONS
The deterioration of adolescent dietary behaviors and an increase in the prevalence of obesity can increase the future disease burden, and concerted efforts at the individual and national levels are needed to reduce obesity and promote healthy dietary behaviors.
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Summary
Korean summary
이 연구는 한국 청소년건강행태조사자료(KYRBS)를 사용하여 코로나19 유행 전후의 우리나라 청소년들의 흡연, 음주, 신체활동, 식습관, 비만 등의 건강행태의 변화에 대하여 살펴보고자 하였다. 이 연구에서는 2015년부터 2021년까지의 청소년건강행태조사자료를 사용하여, 코로나19 유행 이전 (2018-2019년)과 코로나 유행 이후 (2020-2021년) 기간의 건강행태의 변화에 대하여 조사하였다. 학년레벨을 보정한 후, 복합표본설계를 고려하여 로지스틱 회귀분석과 카이제곱검정을 이용하여 코로나19 유행 이전 (2018-2019년)과 비교하여, 코로나 유행 이후 (2020-2021년) 기간의 건강행태의 변화가 있었는지에 대하여 확인하였다. 그 결과, 코로나19 유행 이전 (2018-2019년)과 비교하여, 코로나19 유행 기간(2020-2021년) 동안에 현재흡연율과 현재음주율이 유의하게 감소하였다. 그러나 동일한 기간 동안에 남학생과 여학생 모두에서 비만율이 유의하게 증가하였는데, 비만율과 관련된 신체활동 및 식습관에 대하여 살펴보았을 때, 신체활동에서는 유의한 변화가 없었던 반면, 남학생과 여학생 모두에서 패스트푸드 섭취는 증가하고 과일섭취가 감소한 것으로 나타났다. 따라서 코로나19 유행기간 동안 흡연율 및 음주율 등의 청소년 건강에 유익한 변화도 있었으나, 비만율도 같이 증가한 것을 확인할 수 있었다. 청소년기의 식습관의 악화 및 비만율의 증가는 미래 우리나라의 질병부담을 증가시킬 수 있기 때문에, 청소년의 비만율을 낮추고 건강한 식습관을 증진시키기 위한 개인 및 사회 차원의 노력이 필요하다.
Key Message
-The current cigarette smoking and current alcohol drinking rates significantly decreased among Korean adolescents during the pandemic period compared to the pre-pandemic period.
-On the other hand, the obesity rate increased significantly especially among Korean male adolescents, which is accompanied by changes in dietary habits such as an increase in fast food intake and a decrease in fruit intake.
Methods
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Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions
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Kyungwon Oh
, Yoonjung Kim
, Sanghui Kweon
, Soyeon Kim
, Sungha Yun
, Suyeon Park
, Yeon-Kyeng Lee
, Youngtaek Kim
, Ok Park
, Eun Kyeong Jeong
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Epidemiol Health. 2021;43:e2021025. Published online April 19, 2021
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DOI: https://doi.org/10.4178/epih.e2021025
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13,506
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511
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31
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Abstract
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Supplementary Material
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Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.
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Summary
Korean summary
국민건강영양조사는 국민건강증진법제16조에 근거하여 1998년부터 우리 국민의 건강수준, 건강행태, 식품 및 영양소 섭취 실태에 대한 국가단위 통계를 산출하는 조사사업이다. 본 연구에서는 건강지표 생산 확대, 조사 자료 활용도 향상 등 20년간의 성과를 요약하고 사회환경과 조사여건 변화를 반영한 건강통계 생산의 발전 방안을 제시하였다.
Key Message
The Korea National Health and Nutrition Examination Survey (KNHANES) is an ongoing surveillance system that was initiated in 1998 based on Ar¬ticle 16 of the National Health Promotion Act to produce nationwide statistics regarding the health status, health behaviors, and food and nutrient consumption of the Korean population. In this study, the 20-year accomplishments of the KNHANES including vigorous production of health indicators and improvement of data utilization are summarized, and future plans are presented to improve the health statistics to reflect changes in the social and survey environments.
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Citations
Citations to this article as recorded by

- Impact of the COVID-19 Pandemic on Gender Differences in Depression Based on National Representative Data
Hyunsuk Jeong, Hyeon Woo Yim, Seung-Yup Lee, Da Young Jung
Journal of Korean Medical Science.2023;[Epub] CrossRef - Identifying the Group Vulnerable to Unmet Medical Needs Due to Food Security: According to Children in the Household
Min-Soo Kim, Hyeon-Ji Lee, Jae-Hyun Kim
Healthcare.2023; 11(3): 423. CrossRef - Food Insecurity Is Associated with Dietary Consumption during the COVID-19 Pandemic: Data from the Korea National Health and Nutrition Examination Survey 2019–2020
Jeong-Hwa Choi
Nutrients.2023; 15(3): 772. CrossRef - Metabolically unhealthy phenotype in adults with normal weight: Is cardiometabolic health worse off when compared to adults with obesity?
Myong-Won Seo, Joon Young Kim
Obesity Research & Clinical Practice.2023; 17(2): 116. CrossRef - Sleep duration, weekend catch-up sleep, and risk of obstructive sleep apnea in relation to handgrip strength
Kayoung Lee
Archives of Gerontology and Geriatrics.2023; 110: 104987. CrossRef - Prevalence and trends in obesity and severe obesity in Korean children and adolescents, 2007–2020: A population‐based study
Hong Kyu Park, Ji‐Young Seo, Hae Woon Jung, Jung Sub Lim
Pediatrics International.2023;[Epub] CrossRef - Evaluation of weekend catch-up sleep and weekday sleep duration in relation to metabolic syndrome in Korean adults
Kayoung Lee
Sleep and Breathing.2023;[Epub] CrossRef - Self-Reported Reasons for Activity Limitations According to Age and Sex in Community-Dwelling Stroke Survivors
Young-Ah Choi, Yeo Hyung Kim
Healthcare.2023; 11(10): 1420. CrossRef - Sex-Specific Trends in the Prevalence of Hypertension and the Number of People With Hypertension: Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 1998–2018
Eunsun Seo, Sunjae Jung, Hokyou Lee, Hyeon Chang Kim
Korean Circulation Journal.2022; 52(5): 382. CrossRef - Inverse Association of Serum Folate Level with Metabolic Syndrome and Its Components in Korean Premenopausal Women: Findings of the 2016–2018 Korean National Health Nutrition Examination Survey
Ye-Seul Koo, Yong-Jae Lee, Jae-Min Park
Nutrients.2022; 14(4): 880. CrossRef - Lower Dietary Calcium Intake is Associated with a Higher Risk of Mortality in Korean Adults
Jin Young Yoo, Hyun Jeong Cho, Jung Eun Lee
Journal of the Academy of Nutrition and Dietetics.2022; 122(11): 2072. CrossRef - Association between exposure to fine particulate matter and kidney function: Results from the Korea National Health and Nutrition Examination Survey
Jongmin Oh, Shinhee Ye, Duk-Hee Kang, Eunhee Ha
Environmental Research.2022; 212: 113080. CrossRef - Cardiovascular Implications of the 2021 KDIGO Blood Pressure Guideline for Adults With Chronic Kidney Disease
Hyeok-Hee Lee, Hokyou Lee, Raymond R. Townsend, Dong-Wook Kim, Sungha Park, Hyeon Chang Kim
Journal of the American College of Cardiology.2022; 79(17): 1675. CrossRef - The Korea National Health and Nutrition Examination Survey data linked Cause of Death data
Sungha Yun, Kyungwon Oh
Epidemiology and Health.2022; 44: e2022021. CrossRef - Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Ga Bin Lee, Yoonjung Kim, Suyeon Park, Hyeon Chang Kim, Kyungwon Oh
Epidemiology and Health.2022; 44: e2022041. CrossRef - Mental health of Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Hyunsuk Jeong, Suyeon Park, Jihee Kim, Kyungwon Oh, Hyeon Woo Yim
Epidemiology and Health.2022; 44: e2022042. CrossRef - Diabetes Fact Sheet in Korea 2021
Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won
Diabetes & Metabolism Journal.2022; 46(3): 417. CrossRef - Serum folate levels and hypertension
Yoonkyung Lee, Sangshin Park
Scientific Reports.2022;[Epub] CrossRef - The Relationship between Lipid Accumulation Product, Insulin Resistance and Obesity in Korean Adults
Hyun Yoon
Korean Journal of Clinical Laboratory Science.2022; 54(2): 149. CrossRef - Relationship between Anemia and Falls among Postmenopausal Women in Korea
Yunmi Kim, Jiyun Kim
International Journal of Environmental Research and Public Health.2022; 19(14): 8242. CrossRef - Smoking in the workplace: A study of female call center employees in South Korea
Hyunjin Oh, Sunjoo Boo, Petri Böckerman
PLOS ONE.2022; 17(7): e0267685. CrossRef - Alterations in Glomerular Filtration Rates Using Different Algorithms in the Korean Population Visiting Local Clinics and Hospitals
Rihwa Choi, Sang Gon Lee, Eun Hee Lee
Journal of Clinical Medicine.2022; 11(18): 5339. CrossRef - Prevalence Trends of Metabolic Syndrome among Korean Children and Adolescents from a Population-Based Cross-Sectional Survey
Ji Hyun Kim, Jung Sub Lim
Life.2022; 12(9): 1404. CrossRef - The Association of Mercury and ALT with Obesity in Korean Adults: Using Data from the Korea National Health and Nutrition Examination Survey for 11 Years (KNHANES 2005, 2008~2017)
Sang Shin Pyo
Korean Journal of Clinical Laboratory Science.2022; 54(3): 192. CrossRef - Low relative hand grip strength is associated with a higher risk for diabetes and impaired fasting glucose among the Korean population
Min Jin Lee, Ah Reum Khang, Dongwon Yi, Yang Ho Kang, Giacomo Pucci
PLOS ONE.2022; 17(10): e0275746. CrossRef - Menstrual and Reproductive Factors for Gastric Cancer in Postmenopausal Women: The 2007–2020 Korea National Health and Nutrition Examination Survey
Heekyoung Song, Jung Yoon Park, Ju Myung Song, Youngjae Yoon, Yong-Wook Kim
International Journal of Environmental Research and Public Health.2022; 19(21): 14468. CrossRef - Prevalence and management of hypertension in Korean adults
Hyeon Chang Kim
Journal of the Korean Medical Association.2022; 65(10): 633. CrossRef - One-year prevalence and clinical characteristics in chronic dizziness: The 2019–2020 Korean National Health and Nutrition Examination Survey
Eun Ji Kim, Hee-Jung Song, Hak In Lee, Eunjin Kwon, Seong-Hae Jeong
Frontiers in Neurology.2022;[Epub] CrossRef - Spousal concordance of ideal cardiovascular health metrics: findings from the 2014–2019 Korea National Health and Nutrition Examination Survey
Manh Thang Hoang, Hokyou Lee, Hyeon Chang Kim
Clinical Hypertension.2022;[Epub] CrossRef - The Interaction of High Sensitivity C-Reactive Protein and Uric Acid on Obesity in Koreans: Based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII, 2016∼2018)
Sang Shin Pyo
Korean Journal of Clinical Laboratory Science.2021; 53(4): 342. CrossRef - Non-cancer disease prevalence and association with occupational radiation exposure among Korean radiation workers
Soojin Park, Dal Nim Lee, Young Woo Jin, Eun Shil Cha, Won-Il Jang, Sunhoo Park, Songwon Seo
Scientific Reports.2021;[Epub] CrossRef
Data Profile
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The Korea National Health and Nutrition Examination Survey data linked Cause of Death data
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Sungha Yun
, Kyungwon Oh
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Epidemiol Health. 2022;44:e2022021. Published online February 9, 2022
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DOI: https://doi.org/10.4178/epih.e2022021
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7,670
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495
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6
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Abstract
Summary
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Supplementary Material
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Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey that is conducted annually to assess the health and and health-related behaviors of Korean population. To utilize KNHANES data to studies of mortality risk factors, the Korea Disease Control and Prevention Agency (KDCA) constructed a database linking KNHANES data to cause-of-death statistics in Statistics Korea, made available to researchers since 2020. The KNHANES data were linked to the Cause of Death Statistics based on resident registration numbers for subjects aged 19 years or older who agreed to link the data. The linkage rate between 2007-2015 National Health and Nutrition Examination Survey and 2007-2019 Cause of Death Statistics was 97.1%. In the linked dataset, the total death rate was 6.6%, of which neoplasms accounted for the highest death rate (32.1%), followed by circulatory system disease (22.7%) and respiratory system disease (11.5%). The linked dataset was made available through the Research Data Center of the KDCA after a review of the research proposal, and will be made available after periodical updates.
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Summary
Korean summary
1. 국민건강영양조사 자료가 사망 위험요인 규명 연구에 활용되도록 통계청의 사망원인통계와 연계자료 구축함
2. 2007~2015년 국민건강영양조사와 2007~2019년 사망원인통계의 연계율은 97.1%이었음
3. 국민건강영양조사-사망원인통계 연계자료는 2020년부터 연구자에게 질병관리청 내 학술연구자료처리실를 통해 제공되고 있음
Key Message
1. To utilize the Korea National Health and Nutrition Examination Survey (KNHANES) data to studies of mortality risk factors, the data were linked to the Cause of Death Statistics in the Statistics Korea.
2. The linkage rate between the 2007-2015 KNHANES and the 2007-2019 Cause of Death Statistics was 97.1%.
3. The Korea National Health and Nutrition Examination Survey data linked Cause of Death data have been provided to researchers through the Research Data Center in the Korea Disease Control and Prevention Agency (KDCA) since 2020.
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Citations
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Scientific Reports.2023;[Epub] CrossRef - The Association between Advanced Liver Fibrosis and Mortality Is Modified by Dietary Quality among Korean Adults: Results from the Korea National Health and Nutrition Examination Survey with Mortality Data
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COVID-19: Original Article
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The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies
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Mehmet Onur Kaya
, Esra Pamukçu
, Burkay Yakar
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Epidemiol Health. 2021;43:e2021074. Published online September 23, 2021
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DOI: https://doi.org/10.4178/epih.e2021074
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11,097
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580
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
Although vaccination has started, coronavirus disease 2019 (COVID-19) poses a continuing threat to public health. Therefore, in addition to vaccination, the use of supplements to support the immune system may be important. The purpose of this study was to synthesize evidence on the possible effect of low serum vitamin D levels (25[OH]D<20 ng/mL or 50 nmol/L) on COVID-19 infection and outcomes.
METHODS
We searched Google Scholar, PubMed, Scopus, Web of Science, and ScienceDirect without any language restrictions for articles published between January 1 and December 15, 2020. We performed 3 meta-analyses (called vitamin D and COVID-19 infection meta-analysis [D-CIMA], vitamin D and COVID-19 severity meta-analysis [D-CSMA], and vitamin D and COV ID-19 mortality meta-analysis [D-CMMA] for COVID-19 infection, severity, and mortality, respectively) to combine odds ratio values according to laboratory measurement units for vitamin D and the measured serum 25(OH)D level.
RESULTS
Twenty-one eligible studies were found to be relevant to the relationship between vitamin D and COVID-19 infection/outcomes (n=205,869). The D-CIMA meta-analysis showed that individuals with low serum vitamin D levels were 1.64 times (95% confidence interval [CI], 1.32 to 2.04; p<0.001) more likely to contract COVID-19. The D-CSMA meta-analysis showed that people with serum 25(OH)D levels below 20 ng/mL or 50 nmol/L were 2.42 times (95% CI, 1.13 to 5.18; p=0.022) more likely to have severe COVID-19. The D-CMMA meta-analysis showed that low vitamin D levels had no effect on COVID-19 mortality (OR, 1.64; 95% CI, 0.53 to 5.06, p=0.390).
CONCLUSIONS
According to our results, vitamin D deficiency may increase the risk of COVID-19 infection and the likelihood of severe disease. Therefore, we recommend vitamin D supplementation to prevent COVID-19 and its negative outcomes.
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Summary
Korean summary
Key Message
Although vaccination has started, it seems that Covid-19 will continue to threaten public health for a long time. In addition to the vaccine, the use of supplements to support the immune system may also be important. The purpose of this study is to indicate the possible effect of low serum vitamin D (25(OH)D<20 ng/mL or 50nmol/L) on the Covid-19 infection and outcomes. According to our remarkable results, vitamin D deficiency increases the risk of Covid-19 infection and the potential for the severity of the disease. Therefore, vitamin D supplements should be added to prevention and treatment protocols for Covid-19 disease.
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Citations
Citations to this article as recorded by

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Nutrients.2023; 15(7): 1769. CrossRef - The Role of Diet and Specific Nutrients during the COVID-19 Pandemic: What Have We Learned over the Last Three Years?
Petra Rust, Cem Ekmekcioglu
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Tatiana L. Karonova, Ksenia A. Golovatyuk, Igor V. Kudryavtsev, Alena T. Chernikova, Arina A. Mikhaylova, Arthur D. Aquino, Daria I. Lagutina, Ekaterina K. Zaikova, Olga V. Kalinina, Alexey S. Golovkin, William B. Grant, Evgeny V. Shlyakhto
Nutrients.2022; 14(13): 2602. CrossRef - Vitamin D Endocrine System and COVID-19: Treatment with Calcifediol
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Viruses.2022; 14(8): 1700. CrossRef - Serum vitamin D levels and COVID-19 during pregnancy: A systematic review and meta-analysis
Sadegh Mazaheri-Tehrani, Mohammad Hossein Mirzapour, Maryam Yazdi, Mohammad Fakhrolmobasheri, Amir Parsa Abhari
Clinical Nutrition ESPEN.2022; 51: 120. CrossRef - Administration of vitamin D and its metabolites in critically ill adult patients: an updated systematic review with meta-analysis of randomized controlled trials
Johannes Menger, Zheng-Yii Lee, Quirin Notz, Julia Wallqvist, M. Shahnaz Hasan, Gunnar Elke, Martin Dworschak, Patrick Meybohm, Daren K. Heyland, Christian Stoppe
Critical Care.2022;[Epub] CrossRef - Prevention of covid-19 and other acute respiratory infections with cod liver oil supplementation, a low dose vitamin D supplement: quadruple blinded, randomised placebo controlled trial
Sonja H Brunvoll, Anders B Nygaard, Merete Ellingjord-Dale, Petter Holland, Mette Stausland Istre, Karl Trygve Kalleberg, Camilla L Søraas, Kirsten B Holven, Stine M Ulven, Anette Hjartåker, Trond Haider, Fridtjof Lund-Johansen, John Arne Dahl, Haakon E M
BMJ.2022; : e071245. CrossRef - Adipokines, and not vitamin D, associate with antibody immune responses following dual BNT162b2 vaccination within individuals younger than 60 years
Mariana Pavel-Tanasa, Daniela Constantinescu, Corina Maria Cianga, Ecaterina Anisie, Ana Irina Mereuta, Cristina Gabriela Tuchilus, Petru Cianga
Frontiers in Immunology.2022;[Epub] CrossRef - Vitamin D intoxication induced severe hypercalcemia from self-medication for COVID-19 infection: a public health problem?
Stefano PINI, Giuseppe SCAPARROTTA, Valentina DI VICO, Antonio FRAGASSO, Lucia F. STEFANELLI, Federico NALESSO, Lorenzo A. CALÒ
Minerva Endocrinology.2022;[Epub] CrossRef - Novel CYP11A1-Derived Vitamin D and Lumisterol Biometabolites for the Management of COVID-19
Shariq Qayyum, Radomir M. Slominski, Chander Raman, Andrzej T. Slominski
Nutrients.2022; 14(22): 4779. CrossRef - COVID-19 Prevention: Vitamin D Is Still a Valid Remedy
Rachel Nicoll, Michael Y. Henein
Journal of Clinical Medicine.2022; 11(22): 6818. CrossRef - Integrated bioinformatics and in silico approaches reveal the biological targets and molecular mechanisms of 1,25-dihydroxyvitamin D against COVID-19 and diabetes mellitus
Fanqiang Zeng, Yongli Xu, Chaoling Tang, Zhigang Yan, Chaohe Wei
Frontiers in Nutrition.2022;[Epub] CrossRef - Can vitamin D status influence seroconversion to SARS-COV2 vaccines?
Endrit Shahini, Francesco Pesce, Antonella Argentiero, Antonio Giovanni Solimando
Frontiers in Immunology.2022;[Epub] CrossRef - Cholecalciferol as part of complex therapy for acute COVID-19
K.A. Golovatyuk, T.L. Karonova, A.A. Mikhailova, D.I. Lagutina, A.T. Chernikova, E.Yu. Vasilieva, E.V. Shlyakhto
Profilakticheskaya meditsina.2022; 25(12): 106. CrossRef - Vitamin D Metabolism Gene Polymorphisms and Their Associated Disorders: A
Literature Review
Mohamed Abouzid, Franciszek Główka, Leonid Kagan, Marta Karaźniewicz-Łada
Current Drug Metabolism.2022; 23(8): 630. CrossRef - The role of serum vitamin 25(OH)D concentration in the Covid-19 pandemic in children
Chrysoula Kosmeri, Foteini Balomenou, Dimitrios Rallis, Maria Baltogianni, Vasileios Giapros
British Journal of Nutrition.2022; : 1. CrossRef - Nutraceuticals in prevention and management of COVID-19
Ivana Đuričić, Milica Zrnić-Ćirić, Bojana Vidović, Vanja Todorović, Nevena Dabetić, Nevena Ivanović
Hrana i ishrana.2021; 62(2): 7. CrossRef
Original Article
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The association between occupational stress level and health-related productivity loss among Korean employees
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Jonghee Chung
, Jin-Hyo Kim
, Jae Yoon Lee
, Hee Seok Kang
, Dong-wook Lee
, Yun-Chul Hong
, Mo-Yeol Kang
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Epidemiol Health. 2023;45:e2023009. Published online December 28, 2022
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DOI: https://doi.org/10.4178/epih.e2023009
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Abstract
Summary
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Abstract
OBJECTIVES
Occupational stress management is particularly important for successful business operations, since occupational stress adversely affects workers’ health, eventually lowering their productivity. Therefore, this study aimed to investigate the correlation between occupational stress and health-related productivity loss (HRPL) among Korean workers.
METHODS
In 2021, 1,078 workers participated in a web-based questionnaire survey. HRPL was measured using the Work Productivity and Activity Impairment Questionnaire, and occupational stress was measured using the Korean Occupational Stress Scale-Short Form. The occupational stress level was divided into tertiles (low, intermediate, and high), and the low occupational stress group was used as the reference group. Using a generalised linear model, differences in labour productivity loss according to the level of occupational stress were tested after adjusting for demographic characteristics such as age, gender, education level, household income, occupation, and underlying medical conditions.
RESULTS
Non-parametric regression analysis of HRPL according to occupational stress showed a direct association between occupational stress and HRPL. A statistically significant difference was observed in HRPL between participants with intermediate and high occupational stress and those with low occupational stress.
CONCLUSIONS
Our results support the hypothesis that high occupational stress is associated with decreased labour productivity.
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Summary
Korean summary
직무스트레스가 건강에 미치는 영향은 잘 알려져 있으나, 노동생산성에 대해 분석한 결과는 그동안 부족하였다.
한국 노동자 1078명을 분석한 결과, 직무스트레스가 낮은 군에 비해서 중등도이거나 높은 경우, 결근이나 프리젠티즘과 같은 건강관련 노동생산성 손실이 약 20%p 정도 높은 것으로 분석되었다.
Key Message
As a result of analyzing 1078 Korean workers, it was revealed that health-related labor productivity losses such as absenteeism and presenteeism were about 20%p higher when occupational stress was moderate or high compared to the low occupational stress group.
COVID-19: Perspective
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Neglecting the neglected during the COVID-19 pandemic: the case of leptospirosis in Sri Lanka
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Janith Warnasekara
, Suneth Agampodi
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Epidemiol Health. 2022;44:e2022015. Published online January 10, 2022
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DOI: https://doi.org/10.4178/epih.e2022015
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7,301
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4
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic has disrupted global health systems and affected the transmission dynamics as well as the surveillance of other infectious diseases. This study described the probable effect of the COVID-19 pandemic on the surveillance and control of leptospirosis in Sri Lanka. With 8,579 reported cases and more than 800 estimated deaths, the Sri Lankan public health surveillance system documented the largest outbreak of leptospirosis in Sri Lankan history in 2020. This was the worst infectious disease outbreak Sri Lanka experienced in 2020, but it was neglected, primarily due to the COVID-19 pandemic.
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Summary
Korean summary
Key Message
The largest reported outbreak of leptospirosis in Sri Lankan history was not given proper attention; probably due to COVID pandemic.
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Citations
Citations to this article as recorded by

- Coinfection of leptospirosis and coronavirus disease 2019: A retrospective case series from a coastal region in South India
Nitin Gupta, William Wilson, Prithvishree Ravindra, Roshini Raghu, Kavitha Saravu
Journal of Medical Virology.2022; 94(9): 4508. CrossRef - A global one health perspective on leptospirosis in humans and animals
Jane E. Sykes, David A. Haake, Chandika D. Gamage, W. Zach Mills, Jarlath E. Nally
Journal of the American Veterinary Medical Association.2022; 260(13): 1589. CrossRef - Ocular leptospirosis: lack of awareness among ophthalmologists and challenges in diagnosis
Rathinam R. Sivakumar
Current Opinion in Ophthalmology.2022; 33(6): 532. CrossRef - SARIMA and ARDL models for predicting leptospirosis in Anuradhapura district Sri Lanka
Janith Warnasekara, Suneth Agampodi, Abeynayake NR, Manjula Manoji Weerasekera
PLOS ONE.2022; 17(10): e0275447. CrossRef
Original Articles
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Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity:
an analysis of data from the community-based KoGES cohort study
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Ju-Yeun Lee
, Kyungsik Kim
, Sangjun Lee
, Woo Ju An
, Sue K. Park
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Epidemiol Health. 2023;45:e2023029. Published online February 23, 2023
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DOI: https://doi.org/10.4178/epih.e2023029
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Summary
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Supplementary Material
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Abstract
OBJECTIVES
The aim of this study was to clarify the clinical trait of familial diabetes mellitus (DM) by analyzing participants’ risk of DM according to the age of DM onset in parents and siblings, and to evaluate individuals’ risk of DM-associated cardiometabolic diseases.
METHODS
Altogether, 211,173 participants aged ≥40 years from the Korean Genome and Epidemiology Study were included in this study. The participants were divided into groups based on the number (1 or 2 relatives) and age of onset (no DM and early, common, or late onset) of familial DM. Participants’ risk of DM was assessed using a Cox regression model with hazard ratios and 95% confidence intervals (CIs). A logistic regression model with odds ratios was used to evaluate associations among the participants’ likelihood of acquiring cardiometabolic diseases such as hypertension, chronic kidney disease (CKD), and cardiovascular disease.
RESULTS
The risk of developing DM was 2.02-fold (95% CI, 1.88 to 2.18) and 2.88-fold (95% CI, 2.50 to 3.33) higher, respectively, in participants with 1 and 2 family members diagnosed with familial DM. It was 2.72-fold (95% CI, 2.03 to 3.66) higher in those with early-onset familial DM. In the early-onset group, the respective risks of hypertension and CKD were 1.87-fold (95% CI, 1.37 to 2.55) and 4.31-fold (95% CI, 2.55 to 7.27) higher than in the control group.
CONCLUSIONS
The risk of DM and related cardiometabolic diseases was positively associated with the number of family members diagnosed with DM and an early diagnosis in family members with DM.
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Summary
Korean summary
본 연구는 한국인유전체역학조사사업 역학자료를 이용하여, 당뇨병을 진단받은 가족 구성원 (부모 및 형제)의 수가 많고 당뇨병이 조기에 발생할수록 개인의 당뇨발생 위험도가 높아짐을 보고하였습니다. 또한 당뇨병이 조기에 발생한 가족구성원이 있을 경우 개인의 일부 심대사질환과의 연관성이 있을 수 있음을 설명하였습니다.
Key Message
This study demonstrated that the risk of diabetes in individuals was significantly associated with the quantity and the onset of family members diagnosed with diabetes. We also explained that having a family member with early-onset diabetes can be associated with some cardiometabolic diseases in individuals.
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Changes in mental health service utilization before and during the COVID-19 pandemic: a nationwide database analysis in Korea
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Kyoung Hoon Kim
, Sang Min Lee
, Minha Hong
, Kyu-Man Han
, Jong-Woo Paik
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Epidemiol Health. 2023;45:e2023022. Published online February 14, 2023
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DOI: https://doi.org/10.4178/epih.e2023022
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Summary
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Supplementary Material
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Abstract
OBJECTIVES
The present study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health service utilization through a comparative analysis of nationwide data regarding inpatient care users, outpatient visits, emergency department (ED) visits, and admissions via the ED before and during the pandemic.
METHODS
Data from approximately 350,000 Koreans diagnosed with mental illness were analyzed in terms of hospitalization, outpatient visits, and ED visits between January 2018 and June 2021. An interrupted time series analysis was conducted to determine the significance of changes in mental health service utilization indicators.
RESULTS
The number of hospital admissions per patient decreased by 1.2% at the start of the pandemic and 0.7% afterward. The length of hospital stay increased by 1.8% at the outbreak of the pandemic, and then decreased by 20.2%. Although the number of outpatients increased, the number of outpatient visits per patient decreased; the number of outpatient visits for schizophrenia (3.4%) and bipolar disorder (3.5%) significantly decreased immediately post-outbreak. The number of ED visits per patient decreased both immediately post-outbreak and afterward, and ED visits for schizophrenia (19.2%), bipolar disorder (22.3%), and depression (17.4%) decreased significantly immediately post-outbreak. Admissions via the ED did not show a significant change immediately post-outbreak.
CONCLUSIONS
Mental health service utilization increased during the pandemic, but medical service use decreased overall, with a particularly significant decrease in ED utilization. As the pandemic worsened, the decline in outpatient visits became more pronounced among those with severe mental illness.
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Summary
Korean summary
이 연구는 COVID-19 전후 정신질환 의료서비스 이용 변화를 분석하였다. 팬데믹 기간 중에 정신질환 의료서비스는 전반적으로 감소하였고, 특히 중증 정신질환의 외래 방문이 감소하였다. 따라서, 정신질환자의 진료 연속성을 보장하기 위한 조치가 요구된다.
Key Message
This study examined the impact of the COVID-19 pandemic on mental health service utilization. The mental health service utilization decreased overall after the outbreak of COVID-19, especially outpatient visits for severe mental illness significantly decreased. Therefore, countermeasures are needed to maintain the continuity of care.
COVID-19: Special Article
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Changes in mental health of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
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Bomi Park
, Jihee Kim
, Jieun Yang
, Sunhye Choi
, Kyungwon Oh
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Epidemiol Health. 2023;45:e2023019. Published online February 14, 2023
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DOI: https://doi.org/10.4178/epih.e2023019
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Abstract
Summary
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Supplementary Material
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Abstract
OBJECTIVES
We aimed to study the effects of the coronavirus disease 2019 (COVID-19) pandemic on adolescents’ mental health in Korea.
METHODS
We used data from the Korea Youth Risk Behavior Survey 2018-2021 with 227,139 students aged 12-18 years. We estimated the differences in depressive symptoms, suicidal ideation, and stress perception before (2018-2019) and during (2020-2021) the pandemic, as well as before (2019), the first year (2020) of, and the second year (2021) of the pandemic. We also examined whether COVID-19 is statistically associated with mental health.
RESULTS
In both male and female adolescents, the prevalence of depressive symptoms, suicidal ideation, and stress perception was higher in the “not living with family,” “low household economic status,” and “self-rated unhealthy status” subgroups. The prevalence of depressive symptoms and stress perception was higher in middle school students. Adolescents were less likely to experience depressive symptoms (adjusted odds ratio [aOR], 0.86; 95% confidence interval [CI], 0.83 to 0.89), suicidal ideation (aOR, 0.80; 95% CI, 0.76 to 0.83), and stress perception (aOR, 0.76; 95% CI, 0.74 to 0.79) in 2020 than in 2019. However, there were more depressive symptoms (aOR, 1.06; 95% CI, 1.02 to 1.09), suicidal ideation (aOR, 1.15; 95% CI, 1.10 to 1.21), and stress perception (aOR, 1.19; 95% CI, 1.16 to 1.23) in 2021 than in 2020.
CONCLUSIONS
The COVID-19 pandemic had positive impacts on mental health of adolescents in its early stages but has had negative impacts as the pandemic continues. Attention should be paid to adolescents who are particularly vulnerable to the mental health effects of the pandemic.
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Summary
Korean summary
The results from a nationally representative data showed that mental health in adolescents was improved in the first year of the COVID-19 pandemic compared to before the COVID-19 pandemic, but it was deteriorated in the second year of the pandemic compared to the first year.
Key Message
본 연구에서는 대규모 건강조사를 이용하여 코로나19가 장기화됨에 따른 영향을 평가하고자 하였다. 2018년-2021년 청소년건강행태조사에 참여한 만 12-18세 청소년 227,139 명을 대상으로 분석한 결과, 코로나19 유행 첫번째 해(2020년)에는 코로나19 유행 이전에 비해 정신건강이 개선되었으나, 코로나19 유행 두 번째 해(2021년)에는 코로나19 유행 첫 번째 해에 비해 청소년 정신건강이 나빠졌다. 또한 가족과 함께 거주하지 않는 경우, 가정 경제 수준이 낮은 경우, 본인이 건강하지 않다고 인지하는 경우에 더 취약하였다.
Systematic Review
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Prevalence of high-risk HPV genotypes in sub-Saharan Africa according to HIV status: a 20-year systematic review
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Jude Ogechukwu Okoye
, Chukwudi Amaechi Ofodile
, Oluwaseun Kelechi Adeleke
, Okechi Obioma
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Epidemiol Health. 2021;43:e2021039. Published online May 25, 2021
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DOI: https://doi.org/10.4178/epih.e2021039
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8,199
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14
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Abstract
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Abstract
OBJECTIVES
This review assessed the rate of high-risk human papillomavirus (HPV) infection among women living in sub-Saharan Africa. It also determined the prevalence of high-risk HPV (hrHPV) among human immunodeficiency virus (HIV) seropositive (HIV+) and seronegative (HIV-) women in sub-Saharan Africa, pre-2010 and post-2010.
METHODS
In this systematic review, Google Scholar, PubMed Central, and Embase were searched to identify cohort and case-control studies that investigated the relationship between HIV and HPV infection. The database searches yielded 17 studies published between 1999 and 2018.
RESULTS
In the general population, the prevalence of any HPV/multiple HPV infections was higher among HIV+ (53.6/22.6%) than among HIV- women (26.5/7.3%) with odds ratios of 3.22 and 3.71, respectively (95% confidence interval, 3.00 to 3.42 and 2.39 to 5.75, p< 0.001). The prevalent HPV genotypes among HIV+ and HIV- women diagnosed with invasive cervical cancer (ICC) were HPV-16/18 and HPV-45. The prevalence of HPV-16, HPV-18, and HPV-45 was lower in 1999-2010 (3.8, 1.7, and 0.8%, respectively) than in 2011-2018 (19.1, 6.0, and 3.6%, respectively). Among women diagnosed with ICC, HIV+ women had a higher prevalence of HPV-56, HPV-31, and HPV-51 (7.3, 5.3, and 3.3%, respectively) than HIV- women (1.3, 2.2, and 0.4%, p< 0.001, p= 0.050, and p= 0.013, respectively).
CONCLUSIONS
The prevalence of HPV infection, multiple HPV infections, and non-vaccine HPV types were higher among HIV+ women than among HIV- women in sub-Saharan Africa. Although HIV infection influences the distribution of HPV types, this study suggests that cervical cancer incidence in sub-Saharan Africa is primarily driven by the prevalence of vaccine hrHPVs, especially HPV-16 and HPV-18.
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Summary
Korean summary
Key Message
Despite increasing awareness of Human papillomavirus (HPV) among women and availability of HPV vaccines, mounting evidence shows that the age-standardized incidence rate of cervical cancer is increasing in sub-Saharan Africa. This review revealed the influences of some viruses on the trends of the disease between 1999-2010 and 2011-2018.
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Citations
Citations to this article as recorded by

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Comparison of human papillomavirus‐based cervical cancer screening strategies in Tanzania among women with and without
HIV
Crispin Kahesa, Louise T. Thomsen, Ditte S. Linde, Bariki Mchome, Johnson Katanga, Patricia Swai, Rachel Manongi, Myassa Kjaerem, Thomas Iftner, Marianne Waldstrøm, Julius Mwaiselage, Vibeke Rasch, Susanne K. Kjær
International Journal of Cancer.2023; 152(4): 686. CrossRef - Human papillomavirus testing using existing nucleic acid testing platforms to screen women for cervical cancer: implementation studies from five sub-Saharan African countries
Jessica Joseph, Owen Demke, Lola Ameyan, Joseph Bitilinyu-Bango, Blandine Bourgoin, Mamadou Diop, Babacar Guèye, Jibrin Kama, Marvin Lubega, Bernard Madzima, Tatenda Maparo, Tasimba Mhizha, Andrew Musoke, Susan Nabadda, Twambilire Phiri, Timothy Tchereni,
BMJ Open.2023; 13(1): e065074. CrossRef - Utilizing first void urine for high-risk HPV testing for cervical cancer screening in HIV-positive women in Katete, Zambia
Marian Kaoma, Oladapo Olayemi, Mwila Hilton Mwaba, Kapembwa Sikwewa
BMC Women's Health.2023;[Epub] CrossRef - High-risk human papillomavirus genotype distribution among women living with and at risk for HIV in Africa
Mkunde Chachage, Ajay P. Parikh, Anifrid Mahenge, Emmanuel Bahemana, Jonathan Mnkai, Wilbert Mbuya, Ruby Mcharo, Lucas Maganga, Jaqueline Mwamwaja, Reginald Gervas, Hannah Kibuuka, Jonah Maswai, Valentine Singoei, Michael Iroezindu, Abiola Fasina, Allahna
AIDS.2023; 37(4): 625. CrossRef - The state of human papillomavirus research in Africa
Kehinde Kazeem Kanmodi, Eyinade Adeduntan Egbedina, Jimoh Amzat, Kafayat Aminu, Lawrence Achilles Nnyanzi
Public Health Challenges.2023;[Epub] CrossRef - Measuring the impact of COVID-19 social distancing measures on sexual health behaviours and access to HIV and sexual and reproductive health services for people living with HIV in Botswana
Samuel Ensor, Imogen Mechie, Rebecca Ryan, Aamirah Mussa, Bame Bame, Lefhela Tamuthiba, Neo Moshashane, Chelsea Morroni
Frontiers in Global Women's Health.2023;[Epub] CrossRef - Malignancy and viral infections in Sub-Saharan Africa: A review
Mahamadou Diakite, Kathryn Shaw-Saliba, Chuen-Yen Lau
Frontiers in Virology.2023;[Epub] CrossRef - Cervicovaginal Microbiota Profiles in Precancerous Lesions and Cervical Cancer among Ethiopian Women
Brhanu Teka, Kyoko Yoshida-Court, Ededia Firdawoke, Zewditu Chanyalew, Muluken Gizaw, Adamu Addissie, Adane Mihret, Lauren E. Colbert, Tatiana Cisneros Napravnik, Molly B. El Alam, Erica J. Lynn, Melissa Mezzari, Jhingran Anuja, Eva Johanna Kantelhardt, A
Microorganisms.2023; 11(4): 833. CrossRef - High-risk human papillomavirus genotype distribution among women living with HIV; implication for cervical cancer prevention in a resource limited setting
Patrick Kafui Akakpo, Sebastian Ken-Amoah, Nancy Innocentia Ebu Enyan, Elizabeth Agyare, Emmanuel Salia, Ibrahim Baidoo, Leonard Derkyi-Kwarteng, Matthew Asare, George Adjei, Stephen Ayisi Addo, Dorcas Obiri-Yeboah
Infectious Agents and Cancer.2023;[Epub] CrossRef - HPV prevalence among young adult women living with and without HIV in Botswana for future HPV vaccine impact monitoring
Nancy McClung, Anikie Mathoma, Julia W. Gargano, Naledi Gape Nyepetsi, Troy D. Querec, Juanita Onyekwuluje, Madisa Mine, Chelsea Morroni, Rebecca Luckett, Lauri E. Markowitz, Doreen Ramogola-Masire
BMC Infectious Diseases.2022;[Epub] CrossRef - Acting on the call for cervical cancer elimination: Planning tools for low- and middle- income countries to increase the coverage and effectiveness of screening and treatment
Tara Herrick, Kerry A. Thomson, Michelle Shin, Sarah Gannon, Vivien Tsu, Silvia de Sanjosé
BMC Health Services Research.2022;[Epub] CrossRef - The preference of women living with HIV for the HPV self-sampling of urine at a rural HIV clinic in Uganda
Agnes Nyabigambo, Roy W. Mayega, Hilbert Mendoza, Aslam Shiraz, John Doorbar, Lynn Atuyambe, Themba G. Ginindza
Southern African Journal of Infectious Diseases.2022;[Epub] CrossRef - Cervical cancer prevention and control in women living with human immunodeficiency virus
Philip E. Castle, Mark H. Einstein, Vikrant V. Sahasrabuddhe
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Original Articles
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Age at first childbirth and the risk of hypertriglyceridemia among Korean women
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Hye Rin Choi
, Hyeon Chang Kim
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Epidemiol Health. 2023;45:e2023010. Published online December 29, 2022
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DOI: https://doi.org/10.4178/epih.e2023010
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Abstract
Summary
PDF
Supplementary Material
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Abstract
OBJECTIVES
We aimed to investigate the association of age at first childbirth with the risk of hypertriglyceridemia among Korean women.
METHODS
This study used data from the Korean Genome and Epidemiology Study–Cardiovascular Disease Association Study. In total, 16,747 women were included in the cross-sectional analysis, and 6,250 women were included in the longitudinal analysis. The participants were divided based on their age at first childbirth (<20, 20-24, 25-29, and ≥30 years). Hypertriglyceridemia was defined as triglyceride levels of ≥150 mg/dL.
RESULTS
The multivariable-adjusted odds ratio for prevalent hypertriglyceridemia was 1.19 (95% confidence interval [CI], 1.01 to 1.40) in women whose first childbirth was before 20 years of age, compared to those whose first childbirth was at 25-29 years of age, after adjustment for age, study site, body mass index, blood pressure, diabetes, alcohol consumption, carbohydrate intake, income, marital status, education, parity, usage of oral contraceptives, and hormone replacement status. During a median follow-up of 5.2 years, 1,770 women developed hypertriglyceridemia. Compared with women who gave birth to their first child between 25 years and 29 years of age, those giving birth to their first child before 20 years of age had a higher risk for incident hypertriglyceridemia in later life (adjusted hazard ratio, 1.25; 95% CI, 0.99 to 1.57).
CONCLUSIONS
Giving birth to one’s first child before the age of 20 years was associated with an increased risk of hypertriglyceridemia among Korean women.
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Summary
Korean summary
한국인유전체역학조사사업의 농촌기반 코호트 자료를 분석한 결과, 20세 이전에 초산을 경험한 한국 여성에서 25-29세에 경험한 군에 비해 고중성지방혈증에 걸릴 위험이 증가하였음
폐경 후 여성을 한정하여 보았을 때도 20세 이전 초산과 고중성지방혈증 간의 유의한 관련성을 보였음
여성의 출산 등 여성력이 심혈관계 질환 발생의 위험요인으로 작용할 수 있으며, 출산력에 따른 혈중 중성지방수치 관리 전략 마련이 필요함
Key Message
Among Korean women, having their first child before the age of 20 was associated with an increased risk of hypertriglyceridemia. Targeted preventive actions should be developed for those women who give birth at an early age in order to manage their blood triglyceride levels.
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Decreased birth weight after prenatal exposure to wildfires on the eastern coast of Korea in 2000
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En-Joo Jung
, Ah-Young Lim
, Jong-Hun Kim
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Epidemiol Health. 2023;45:e2023003. Published online December 9, 2022
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DOI: https://doi.org/10.4178/epih.e2023003
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Abstract
Summary
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Supplementary Material
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Abstract
OBJECTIVES
In April 2000, a series of wildfires occurred simultaneously in five adjacent small cities located on the eastern coast of Korea. These wildfires burned approximately 23,794 hectares of forestland over several days. We investigated the effects of prenatal exposure to the by-products generated by wildfire disasters on birth weight.
METHODS
Birth weight data were obtained for 1999-2001 from the birth registration database of the Korean National Statistical Office and matched with the zip code and exposed/unexposed pregnancy week for days of the wildfires. Generalized linear models were then used to assess the associations between birth weight and exposure to wildfires after adjusting for fetal sex, gestational age, parity, maternal age, maternal education, paternal education, and average exposed atmospheric temperature.
RESULTS
Compared with unexposed pregnancies before and after the wildfires, mean birth weight decreased by 41.4 g (95% confidence interval [CI], -72.4 to -10.4) after wildfire exposure during the first trimester, 23.2 g (95% CI, -59.3 to 13.0) for exposure during the second trimester, and 27.0 g (95% CI, -63.8 to 9.8) during the third trimester. In the adjusted model for infants exposed in utero during any trimester, the mean birth weight decreased by 32.5 g (95% CI, -53.2 to -11.7).
CONCLUSIONS
We observed a 1% reduction in birth weight after wildfire exposure. Thus, exposure to by-products generated during a wildfire disaster during pregnancy may slow fetal growth and cause developmental delays.
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Summary
Korean summary
산불로 인한 연소 부산물에 대한 태아기 노출이 출생 체중에 미치는 영향을 조사하였다.
산불 발생 전후로 연소 부산물에 노출되지 않았던 신생아와 비교하였을 때, 노출된 신생아의 평균 출생 체중은 32.5g (-53.2~-11.7g) 감소하였다.
임신 중 산불로 인한 연소 부산물에 대한 노출은 태아 성장을 느리게 하거나 발달 지연을 일으킬 수 있다.
Key Message
The study investigated the effects of prenatal exposure to by-products generated by wildfire disasters on birth weight.
Compared to newborns who were not prenatally exposed to wildfire byproducts, exposed newborns had a 32.5 g (-53.2 to -11.7 g) reduction in birth weight.
Exposure to wildfire by-products during pregnancy can slow fetal growth or cause developmental delays.
Systematic Reviews
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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
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Akhmad Azmiardi
, Bhisma Murti
, Ratih Puspita Febrinasari
, Didik Gunawan Tamtomo
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Epidemiol Health. 2021;43:e2021090. Published online October 22, 2021
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DOI: https://doi.org/10.4178/epih.e2021090
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6,176
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190
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4
Citations
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Abstract
PDF
Supplementary Material
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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.
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Summary
Korean 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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Citations
Citations to this article as recorded by

- The current diabetes education experience: Findings of a cross-sectional survey of adults with type 2 diabetes
Kelley M. Baker, Carine M. Nassar, Neelam Baral, Michelle F. Magee
Patient Education and Counseling.2023; 108: 107615. CrossRef - 2023 update on Italian guidelines for the treatment of type 2 diabetes
Edoardo Mannucci, Riccardo Candido, Lina delle Monache, Marco Gallo, Andrea Giaccari, Maria Luisa Masini, Angela Mazzone, Gerardo Medea, Basilio Pintaudi, Giovanni Targher, Marina Trento, Giuseppe Turchetti, Valentina Lorenzoni, Matteo Monami
Acta Diabetologica.2023;[Epub] CrossRef - Family doctors’ attitudes toward peer support programs for type 2 diabetes and/or coronary artery disease: an exploratory survey among German practitioners
K. Majjouti, L. Küppers, A. Thielmann, M. Redaélli, F. Vitinius, C. Funke, I. van der Arend, L. Pilic, M. Hessbrügge, S. Stock, B. Weltermann, D. Wild
BMC Primary Care.2022;[Epub] CrossRef - From clinic to community: A randomized controlled trial of a peer support model for adults with type 2 diabetes from specialty care settings in British Columbia
Tricia S. Tang, Rowshanak Afshar, Thomas Elliott, Jason Kong, Sabrina Gill
Diabetic Medicine.2022;[Epub] CrossRef
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The prevalence of Q fever in the Eastern Mediterranean region: a systematic review and meta-analysis
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Mozhgan Ahmadinezhad
, Leila Mounesan
, Amin Doosti-Irani
, Manijeh Yousefi Behzadi
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Epidemiol Health. 2022;44:e2022097. Published online October 28, 2022
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DOI: https://doi.org/10.4178/epih.e2022097
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Abstract
PDF
Supplementary Material
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Abstract
OBJECTIVES
Q fever, caused by the bacterium, is a major zoonotic disease around the world. This disease is common in the Eastern Mediterranean region; therefore, we conducted the first systematic review and meta-analysis on its prevalence in humans, animals, and ticks in the Eastern Mediterranean region.
METHODS
Major Iranian and international databases were searched from 2000 to 2021. We extracted the prevalence of Q fever in blood samples from animals and milk samples from animals, ticks, and humans as the main outcome. We reported the prevalence of seropositivity and molecular positivity as point estimates and 95% confidence intervals (CIs).
RESULTS
In this review, 112 papers were identified. The overall seroprevalence of Q fever was 22.4% (95% CI, 19.8 to 25.1). The pooled prevalence of Q fever in ticks was 17.5% (95% CI, -1.3 to 36.4). The prevalence was 25.5% (95% CI, 16.1 to 34.9) in humans. The prevalence of Q fever in animal blood samples from goats, sheep, camels, cattle, cats, dogs, horses, and buffalo were 28.1%, 25.1%, 25.0%, 20.1%, 9.8%, 8.4%, 6.5%, and 6.3%, respectively. Furthermore, the prevalence of Q fever in milk samples of animals was higher in cattle (20.3%) than in sheep (20.0%), goats (16.4%), and camels (3.3%).
CONCLUSIONS
Coxiella burnetii infections are common in humans and in a wide range of animal species, but they are still not recognized in many countries in the Eastern Mediterranean region, thus presenting a significant threat to human and animal health in the region.
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Summary
Korean summary
Key Message
COVID-19: Special Article
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Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
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Ga Bin Lee
, Yoonjung Kim
, Suyeon Park
, Hyeon Chang Kim
, Kyungwon Oh
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Epidemiol Health. 2022;44:e2022041. Published online April 25, 2022
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DOI: https://doi.org/10.4178/epih.e2022041
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7,174
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524
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10
Citations
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Abstract
Summary
PDF
Supplementary Material
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Abstract
OBJECTIVES
We investigated trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the coronavirus disease 2019 (COVID-19) pandemic in the Korean adult population.
METHODS
Data from 60,098 participants in the Korea National Health and Nutritional Examination Survey between 2011 and 2020 aged ≥19 were used. The age-standardized prevalence and annual percent changes (APCs) were calculated for obesity (body mass index ≥25 kg/m2), hypertension (systolic/diastolic blood pressure ≥140/90 mmHg or under treatment), diabetes (hemoglobin A1c ≥6.5%, fasting glucose ≥126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol ≥240 mg/dL or under treatment).
RESULTS
Over the past decade (2011-2020), the age-standardized APCs (95% confidence intervals) for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8), 0.1% (-1.3 to 1.5), 1.5% (-1.0 to 4.0) and 8.0% (5.7 to 10.3), respectively, in men; and -0.2% (-1.5 to 1.2), -0.5% (-1.9 to 0.9), -0.1% (-2.3 to 2.2) and 5.9% (3.9 to 8.0), respectively, in women. In 2020 compared to the previous 3 years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (6.0, 1.8, 1.9, and 2.8%p, respectively), but an increase was not apparent in women (2.5, -1.1, 0.8, and 0.7%p, respectively).
CONCLUSIONS
An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 pandemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.
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Summary
Korean summary
한국인의 비만, 고혈압, 당뇨 및 고지혈증 유병률은 지난 10년간 전반적으로 증가하는 경향을 보였다. 특히, 코로나 19가 유행한 2020년에 남성의 주요 만성질환 유병률은 지난 3년 평균치와 비교하였을 때 모두 유의하게 증가하였다. 반면, 여성에서 만성질환 유병률의 뚜렷한 증가는 관찰되지 않았다.
Key Message
During COVID-19 pandemic, the overall increase in major chronic diseases was observed in Korean adults, and this trend was prominent in men. Accordingly, target-specific intervention strategies need to be developed to reduce the burden of cardiovascular and metabolic diseases in the future.
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Citations
Citations to this article as recorded by

- Sleep Deficit as a Risk Factor for Hypertension in Korean Adults
Mi-Joon Lee, Bum-Jeun Seo, Inmyung Song
Sustainability.2023; 15(3): 2586. CrossRef - Gene–Nutrient Interactions in Obesity: COBLL1 Genetic Variants Interact with Dietary Fat Intake to Modulate the Incidence of Obesity
Junkyung Kwak, Dayeon Shin
International Journal of Molecular Sciences.2023; 24(4): 3758. CrossRef - Identifying the Associations of Nightly Fasting Duration and Meal Timing with Type 2 Diabetes Mellitus Using Data from the 2016–2020 Korea National Health and Nutrition Survey
Junkyung Kwak, Kyeong-A Jang, Haeng-Ran Kim, Min-Sook Kang, Kyung Won Lee, Dayeon Shin
Nutrients.2023; 15(6): 1385. CrossRef - Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak
Kyungchul Song, Juyeon Yang, Hye Sun Lee, Su Jin Kim, Myeongseob Lee, Junghwan Suh, Ahreum Kwon, Ho-Seong Kim, Hyun Wook Chae
Yonsei Medical Journal.2023; 64(4): 269. CrossRef - Revisiting the Diabetes Crisis in Korea: Call for Urgent Action
Jun Sung Moon
The Journal of Korean Diabetes.2023; 24(1): 1. CrossRef - Changes in dietary habits and chronic diseases before and after COVID-19 by regions using data from the 2018-2020 Korea Community Health Survey and Consumer Behavior Survey for Foods: a cross-sectional study
Surim Park, Eun-hee Jang, Seungmin Lee
Korean Journal of Community Nutrition.2023; 28(2): 124. CrossRef - Trends in socioeconomic inequalities in obesity among Korean adolescents: the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2006 to 2020
Eunji Kim, Ga Bin Lee, Dong Keon Yon, Hyeon Chang Kim
Epidemiology and Health.2023;[Epub] CrossRef - Changes in food and nutrient intakes in Korean adults before and during the coronavirus disease 2019 pandemic : data from the 2011-2020 Korea National Health and Nutrition Examination Survey
Kyungwon Oh, Suyeon Park, Sihyun Park, Sungha Yun, Hongseok Choi, Eun Kyeong Jeong
Epidemiology and Health.2023;[Epub] CrossRef - Prevalence and management of hypertension in Korean adults
Hyeon Chang Kim
Journal of the Korean Medical Association.2022; 65(10): 633. CrossRef - Association between Mental Health and Hand Hygiene Practices in Adults with Hypertension and Diabetes during the COVID-19 Pandemic: The 2020 Korea Community Health Survey
Pius Kim, Hae Ran Kim
Healthcare.2022; 10(10): 1912. CrossRef