Epidemiology and Health

Moran Ki

39 Articles

Increasing trends in mortality and costs of infectious diseases in Korea: trends in mortality and costs of infectious diseases: Dahye Baik, Byung-Woo Kim, Moran Ki; Epidemiol Health. 2022;44:e2022010. Published online January 3, 2022; DOI: https://doi.org/10.4178/epih.e2022010

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Abstract

OBJECTIVES
In an era when the average life expectancy and overall mortality rate have improved, Korea remains at risk for infectious disease outbreaks that place substantial burdens on the healthcare system. This study investigated trends in mortality and the economic burden of infectious diseases.

METHODS

Healthcare data from the Health Insurance Review and Assessment Service (2009-2019) and the Korean Statistics Information Service (1997-2019) were used. We selected 10 infectious disease groups (intestinal infections, tuberculosis, vaccine- preventable diseases, sepsis, viral hepatitis, HIV-related diseases, central nervous system infections, rheumatic heart diseases, respiratory tract infections, and arthropod-borne viral diseases).

RESULTS

The age-standardized mortality rate for infectious diseases increased from 27.2 per 100,000 population in 1997 to 37.1 per 100,000 population in 2019 and has had an upward trend since 2004. During this same period, significant increases were seen in respiratory tract infections and among elderly persons, especially those aged ≥85 years. The costs for infectious diseases increased from 4.126 billion US dollar (USD) in 2009 to 6.612 billion USD in 2019, with respiratory tract infections accounting for 3.699 billion USD (69%). The annual cost per patient for visits for medical care due to infectious diseases increased from 131 USD in 2009 to 204 USD in 2019.

CONCLUSIONS

Mortality among elderly persons and those with respiratory tract infections increased during the study period. The economic burden of infectious diseases has consistently increased, especially for respiratory tract infections. It is therefore essential to establish effective management policies that considers specific infectious diseases and patient groups.

Summary

Korean summary
우리나라의 감염병으로 인한 사망률과 의료비용은 증가하고 있다. 특히 고령층에서의 높은 사망률과 과다한 의료비용 지출을 고려하면, 호흡기 감염 관리에 집중하는 것이 중요하며 각 감염병 그룹별로 효과적인 정책과 효율적인 관리가 필요하다. 본 연구는 COVID-19 발생 이전의 우리나라 감염병의 사망률과 발생, 의료비 부담의 장기적인 추세를 분석한 중요한 레퍼런스가 될 것이다.

Key Message
In Republic of Korea, the mortality trends (1997-2019) and costs (2009-2019) of infectious disease have increased and this study is particularly important reference for identifying the long-term trends including mortality, outbreak, financial burden of infectious disease in Korea before COVID-19 outbreak.

Citations

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Validation of operational definitions of mortality in a nationwide hemodialysis population using the Health Insurance Review and Assessment Service databases of Korea
Dong Hee Lee, Ye-Jee Kim, Hyangkyoung Kim, Hyung Seok Lee
Kidney Research and Clinical Practice.2024; 43(2): 156. CrossRef
Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea
Jongmin Oh, Youn-Hee Lim, Changwoo Han, Dong-Wook Lee, Jisun Myung, Yun-Chul Hong, Soontae Kim, Hyun-Joo Bae
Journal of Preventive Medicine and Public Health.2024; 57(2): 185. CrossRef
Glycaemic status, insulin resistance, and risk of infection-related mortality: a cohort study
Hae Suk Cheong, Yoosoo Chang, Yejin Kim, Eun-Jeong Joo, Min-Jung Kwon, Sarah H Wild, Christopher D Byrne, Seungho Ryu
European Journal of Endocrinology.2023; 188(2): 197. CrossRef
Bacterial biofilm inhibitors: An overview
Vipin Chandra Kalia, Sanjay K.S. Patel, Jung-Kul Lee
Ecotoxicology and Environmental Safety.2023; 264: 115389. CrossRef
Determination of Volatile Compounds of Mentha piperita and Lavandula multifida and Investigation of Their Antibacterial, Antioxidant, and Antidiabetic Properties
Samiah Hamad Al-Mijalli, Eman R. ELsharkawy, Emad M. Abdallah, Munerah Hamed, Nasreddine El Omari, Shafi Mahmud, Mohammed Merae Alshahrani, Hanae Naceiri Mrabti, Abdelhakim Bouyahya, Fernanda Tonelli
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef

Association between levels of physical activity and low handgrip strength: Korea National Health and Nutrition Examination Survey 2014-2019: Hyungsoon Ahn, Hwa Young Choi, Moran Ki; Epidemiol Health. 2022;44:e2022027. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022027

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to investigate the association between levels of physical activity (PA) and low handgrip strength in Korean adults.

METHODS

Our cross-sectional study design included 24,109 Korean adults older than 19 years of age who participated in the Korea National Health and Nutrition Examination Survey 2014–2019. Low handgrip strength is described as hand strength less than the cut-off value of the 20th percentile of handgrip strength from a healthy population in each gender and age group. PA was categorized into three levels (inactive, active, and highly active) according to the World Health Organization’s global recommendations on PA for health. Multivariable logistic regression analysis was used to examine the association between levels of PA and low handgrip strength.

RESULTS

Odds ratios (ORs) for low handgrip strength were significantly higher in middle-aged women who were active (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI], 1.15 to 1.69) and inactive (aOR, 1.47; 95% CI, 1.23 to 1.76) than in those highly active in walking exercise. Most of older people had significantly higher ORs for low handgrip strength in active compared to highly active in the context of aerobic, muscle strengthening, and walking exercise.

CONCLUSIONS

Walking exercise was associated with a lower risk of sarcopenia in middle-aged women and older individuals. However, further studies are necessary to confirm the causal relationship between levels of PA and low handgrip strength.

Summary

Korean summary
본 연구는 국민건강영양조사 2014-2019년도 자료를 활용하여 한국인 만 19세 이상 건강한 성인을 대상으로 낮은 악력의 기준값을 성별 및 연령그룹별로 도출하고 유산소 운동, 근력 운동, 걷기 운동 수준과 낮은 악력의 연관성을 분석하였다. 분석 결과, 중년 여성과 노년층에서 걷기 운동이 근감소증 발생의 예방과 연관성이 있음을 알 수 있었다.

Key Message
The association between levels of physical activity and low handgrip strength was different by sex and age groups. For women, walking exercise was associated with low handgrip strength, but not for men. By age groups, muscle strengthening exercise could help prevent sarcopenia in the young population, aerobic exercise has the potential to prevent sarcopenia in middle-aged individuals, and walking exercise could reduce sarcopenia risk in older individuals.

Citations

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A cross-sectional study on the effects of physical activity on hand grip strength in type 2 diabetes mellitus patients
Praveena Meyyazhagan, Thamaraiselvi Kanagaraj, Nachal Annamalai
Journal of Basic and Clinical Physiology and Pharmacology.2025; 36(1): 27. CrossRef
Back-leg-chest test as an alternative to the handgrip testing for measuring body strength in adults
M.J.S. Bortolini, L.A.R. Oliveira, R.O. Resende, M.B. Gerrero, B.K.S. Maia, E.A. Taketomi, M.B. Lanza
Journal of Bodywork and Movement Therapies.2025; 42: 1085. CrossRef
The Effect of Differences in Activity Levels according to Types of Physical Leisure Activities in Elderly Measured by an Accelerometer on Muscle Strength, Body Composition and Lipid Metabolism
Sae-Sook Oh
Korean Journal of Lesure, Recreation & Park.2025; 49(1): 15. CrossRef
Nonregular Physical Activity and Handgrip Strength as Indicators of Fatigue and Psychological Distress in Cancer Survivors
Ilaria Pepe, Alessandro Petrelli, Francesco Fischetti, Carla Minoia, Stefania Morsanuto, Livica Talaba, Stefania Cataldi, Gianpiero Greco
Current Oncology.2025; 32(5): 289. CrossRef
The association of dietary branched-chain amino acid intake with hand grip strength and muscular viscoelastic properties in sedentary young women: a cross-sectional study
Ramazan Mert Atan, Derya Azim
Irish Journal of Medical Science (1971 -).2025;[Epub] CrossRef
Association Between Serum High Sensitivity C-Reactive Protein Levels and Low Muscle Strength Among Korean Adults
Bo-Hyun Choi, Sunhye Shin
Nutrients.2025; 17(16): 2698. CrossRef
Examining factors contributing to the socioeconomic inequalities in handgrip strength among older adults in India: a decomposition analysis
Manacy Pai, T. Muhammad
Scientific Reports.2024;[Epub] CrossRef
Relationship between Handgrip Strength and Incident Diabetes in Korean Adults According to Gender: A Population-Based Prospective Cohort Study
Sung-Bum Lee, Min-Kyeung Jo, Ji-Eun Moon, Hui-Jeong Lee, Jong-Koo Kim
Journal of Clinical Medicine.2024; 13(2): 627. CrossRef
Association Between Dietary Fiber Intake and Low Muscle Strength Among Korean Adults
Sunhye Shin
Clinical Nutrition Research.2024; 13(1): 33. CrossRef
Do age, gender, and subjective health-related factors influence health-related life satisfaction in people with disabilities who are physically active?: a secondary analysis
Hyunseok Cho, Sukhee Ahn
Women's Health Nursing.2024; 30(1): 56. CrossRef
Association of adipose tissue inflammation and physical fitness in older adults
Anna Tylutka, Barbara Morawin, Natalia Torz, Joanna Osmólska, Kacper Łuszczki, Paweł Jarmużek, Agnieszka Zembron-Lacny
Immunity & Ageing.2024;[Epub] CrossRef
Physical activity and nutrient intake levels according to grip strength among single-household elderly in Korea: data from 2014 and 2019 Korea National Health and Nutrition Examination Survey (KNHANES)
Mi-Young Park, Nana Chung
Physical Activity and Nutrition.2024; 28(3): 027. CrossRef
Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)
Dongzhe Wu, Hao Wang, Wendi Wang, Chang Qing, Weiqiang Zhang, Xiaolin Gao, Yongjin Shi, Yanbin Li, Zicheng Zheng
Frontiers in Nutrition.2023;[Epub] CrossRef
Assessment of dynapenia and undernutrition in primary care, a systematic screening study in community medicine
Marie Treuil, Meliha Mahmutovic, Paolo Di Patrizio, Phi-Linh Nguyen-Thi, Didier Quilliot
Clinical Nutrition ESPEN.2023; 57: 561. CrossRef
Water Intake and Handgrip Strength in US Adults: A Cross-Sectional Study Based on NHANES 2011–2014 Data
Dongzhe Wu, Chaoyi Qu, Peng Huang, Xue Geng, Jianhong Zhang, Yulin Shen, Zhijian Rao, Jiexiu Zhao
Nutrients.2023; 15(20): 4477. CrossRef
Hand Grip Strength, Osteoporosis, and Quality of Life in Middle-Aged and Older Adults
Hyo Jin Park, Byoungduck Han, So-youn Chang, Seung Ho Kang, Dae Wook Lee, Seok Kang
Medicina.2023; 59(12): 2148. CrossRef
Lower grip strength and insufficient physical activity can increase depressive symptoms among middle-aged and older European adults: a longitudinal study
Han Zheng, Qingwen He, Hongyan Xu, Xiaowei Zheng, Yanfang Gu
BMC Geriatrics.2022;[Epub] CrossRef

Estimated incidence of juvenile-onset recurrent respiratory papillomatosis in Korea: Jin-Kyoung Oh, Hwa Young Choi, Minji Han, Yuh-Seog Jung, Sang Joon Lee, Moran Ki; Epidemiol Health. 2021;43:e2021019. Published online March 10, 2021; DOI: https://doi.org/10.4178/epih.e2021019

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Abstract Summary PDF

Abstract

OBJECTIVES
Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV) types 6 and 11 and is potentially preventable through vaccination. This study estimated the incidence of juvenile-onset RRP before the implementation of the national HPV vaccination program in Korea.

METHODS

We conducted a cohort study using claims data provided by a mandatory insurance program to estimate the incidence of RRP and associated healthcare use. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits during which they received the International Classification of Diseases, 10th revision code for benign neoplasms of the larynx (D14.1).

RESULTS

During 2002-2014, 123 children (74 boys and 49 girls) were diagnosed with RRP. The patients had a mean of 6.5 person-years of follow-up. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years (mean, 4.3). Thirty-six (29.3%) patients underwent surgery, including 23 patients (18.7%) who underwent 2 or more surgical procedures. Severe disease, measured by more frequent surgical procedures and shorter time intervals between consecutive operations, was associated with a younger age at diagnosis.

CONCLUSIONS

The estimated incidence of juvenile-onset RRP in Korea was similar to that reported in other countries. The RRP burden should continue to be monitored using National Health Insurance Service claims data.

Summary

Korean summary
재발성호흡기유두종증은 사람유두종바이러스에 의해 발현되는 희귀 질환이다. 건강보험 청구자료를 활용하여 2002년 이후 출생아 전수 중 2014년까지 후두양성종양으로 2회이상 입원 또는 2회이상 외래진료를 받은 어린이 코호트를 관찰하여 재발성호흡기유두종증 발생률을 추정하였다. 총 123명의 재발성호흡기유두종증 환자가 발생하였으며 (발생률 10만인년당 0.30명), 평균 첫 진단시기는 4세인 것으로 나타났다. 2회 이상 수술적 치료를 받은 경우는 18.7%였다.

Key Message
Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV). We conducted a cohort study using claims data to estimate the incidence of RRP. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits with diagnosis for benign neoplasms of the larynx. During 2002-2014, 123 children were diagnosed with RRP. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years. Twenty three patients (18.7%) underwent 2 or more surgical procedures.

Citations

Citations to this article as recorded by

Characteristics of juvenile-onset recurrent respiratory papillomatosis in China, 2011-2021: A hospital-based nationwide study
Changchang Dun, Yutong Li, Wenbin Lei, Yun Li, Hui Yang, Yalikun Yasen, Nilipaer Alimu, Dapeng Lei, Dongyan Chen, Qingquan Hua, Zhen Xu, Zhe Zhang, Guangke Wang, Weiwei Wang, Li Shi, Xin Wang, Xuelian Zhao, Shangying Hu, Xiaoguang Ni, Jie Zhang, Jun Wang,
International Journal of Infectious Diseases.2025; 158: 107972. CrossRef
"A systematic literature review of the epidemiology, clinical, economic and humanistic burden in recurrent respiratory papillomatosis”
Olga Ovcinnikova, Kayla Engelbrecht, Meenu Verma, Rishabh Pandey, Edith Morais
Respiratory Research.2024;[Epub] CrossRef
Global Epidemiology of HPV-Associated Recurrent Respiratory Papillomatosis and Effect of Vaccination
RY Seedat, FG Dikkers
Future Virology.2022; 17(5): 265. CrossRef

Epidemiology and treatment status of hepatitis C virus infection among people who have ever injected drugs in Korea: a prospective multicenter cohort study from 2007 to 2019 in comparison with non-PWID: Kyung-Ah Kim, Gwang Hyun Choi, Eun Sun Jang, Young Seok Kim, Youn Jae Lee, In Hee Kim, Sung Bum Cho, Moran Ki, Hwa Young Choi, Dahye Paik, Sook-Hyang Jeong; Epidemiol Health. 2021;43:e2021077. Published online October 6, 2021; DOI: https://doi.org/10.4178/epih.e2021077

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Abstract Summary PDF

Abstract

OBJECTIVES
Injection drug use is a major risk factor for hepatitis C virus (HCV) infection; however, limited data on this topic are available in Korea. Thus, this study aimed to investigate the epidemiological and clinical characteristics, treatment uptake, and outcomes of HCV infection among people who inject drugs (PWID).

METHODS

We used the data from the Korea HCV cohort, which prospectively enrolled patients with HCV infection between 2007 and 2019. Clinical data and results of a questionnaire survey on lifetime risk factors for HCV infection were analyzed according to a self-reported history of injection drug use (PWID vs. non-PWID group).

RESULTS

Among the 2,468 patients, 166 (6.7%) were in the PWID group, which contained younger patients (50.6±8.2 vs. 58.2±13.1 years) and a higher proportion of male (81.9 vs. 48.8%) than the non-PWID group. The distribution of PWID showed significant regional variations. Exposure to other risk factors for HCV infection was different between the groups. The proportion of patients with genotype non-2 infection was higher in the PWID group. Treatment uptake was higher in the PWID group in the interferon era; however, it was comparable between the groups in the direct-acting antiviral era. The rate of sustained virological response did not significantly differ between the groups.

CONCLUSIONS

As of 2019, PWID constituted a minority of HCV-infected people in Korea. The epidemiological characteristics, but not treatment uptake and outcomes, were different between the PWID and non-PWID groups. Therefore, active HCV screening and treatment should be offered to PWID in Korea.

Summary

Korean summary
1. 국내 C형간염 환자 중 정맥주사 사용자의 비율은 6.7%로 서구에 비하면 낮은 편이며, 지역별로 차이가 있다. 2. C형간염 환자 중 정맥주사 사용자는 비사용자에 비하여 연령, 성별 및 C형간염 위험 요인 노출 등에서 상이한 역학적 특성을 보인다. 3. 정맥주사 사용자의 C형간염 치료 수용률이나 치료 성공률은 비사용자와 비슷하다.

Key Message
As of 2019, PWID comprised a minority (6.7%) of all HCV-infected people in South Korea. The epidemiological features of the PWID group were different from those of the non-PWID group in terms of age, sex and exposure to risk factors of HCV infection. However, the treatment uptake and outcomes were not significantly different between these 2 groups in DAA era. Therefore, considering the global and national increase in the number of PWID and the contribution of PWID to new cases of HCV infection, active screening and treatment should be offered to PWID in Korea.

Citations

Citations to this article as recorded by

Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
Hwa Young Choi, Kyung-Ah Kim, Bo Young Park, Bo Youl Choi, Moran Ki
Journal of Infection and Public Health.2025; 18(3): 102662. CrossRef
Universal self-testing as a cost-effective weapon to eliminate hepatitis C virus in the Republic of Korea: Editorial on “Self-testing strategy to eliminate hepatitis C as per World Health Organization’s goal: Analysis of disease burden and cost-effectiven
Eun Sun Jang
Clinical and Molecular Hepatology.2025; 31(2): 596. CrossRef
Prevalence and factors associated with hepatitis C among pregnant women in China: a cross-sectional study
Sun He, Gao Shuang, Wu Yinglan, Wang Lan, Wang Wei, Wang Ailing, Wang Changhe, Wang Xiaoyan, Gao Qun, Lu Zechun, Huang Dongxu, Wang Yu, Mo Phoenix Kit Han, Chen Zhongdan, Polin Chan, Wang Qian
Scientific Reports.2023;[Epub] CrossRef
Hepatitis C Virus Seroprevalence in Persons Who Inject Drugs in Korea, 2012–2022: A Multicenter, Retrospective Study
Jihye Kim, Gwang Hyeon Choi, Og-Jin Jang, Younghoon Chon, Sung Nam Cho, Dohoon Kwon, Sook-Hyang Jeong
Journal of Korean Medical Science.2023;[Epub] CrossRef

Epidemiologic characteristics of early cases with 2019 novel coronavirus (2019-nCoV) disease in Korea: Moran Ki, Task Force for 2019-nCoV; Epidemiol Health. 2020;42:e2020007. Published online February 9, 2020; DOI: https://doi.org/10.4178/epih.e2020007

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Abstract Summary PDF Supplementary Material

Abstract

In about 20 days since the diagnosis of the first case of the 2019 novel coronavirus (2019-nCoV) in Korea on January 20, 2020, 28 cases have been confirmed. Fifteen patients (53.6%) of them were male and median age of was 42 years (range, 20-73). Of the confirmed cases, 16, 9, and 3 were index (57.2%), first-generation (32.1%), and second-generation (10.7%) cases, respectively. All first-generation and second-generation patients were family members or intimate acquaintances of the index cases with close contacts. Fifteen among 16 index patients had entered Korea from January 19 to 24, 2020 while 1 patient had entered Korea on January 31, 2020. The average incubation period was 3.9 days (median, 3.0), and the reproduction number was estimated as 0.48. Three of the confirmed patients were asymptomatic when they were diagnosed. Epidemiological indicators will be revised with the availability of additional data in the future. Sharing epidemiological information among researchers worldwide is essential for efficient preparation and response in tackling this new infectious disease.

Summary

Korean summary
2020년 1월 20일 한국의 신종코로나바이러스 감염자가 확진된 이후 약 20일만에 28명이 확진되었다. 확진자중 지표환자가 16명(57.2%), 1세대환자 9명(32.1%), 2세대환자가 3명(10.7%)이다. 지표환자 16명중 15명은 1월 19일-24일에, 1명은 1월 31일에 국내에 입국하였다. 환자들의 잠복기는 평균 3.9일 (중위값 3일), 감염재생산수(R)는 0.48로 추정되었다. 확진자 중 3명은 증상이 없는 상태에서 확진이 되었다. 향후 새로운 정보가 나오면 역학 지표들이 수정될 것이다.

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Estimating the reproductive number and the outbreak size of COVID-19 in Korea: Sunhwa Choi, Moran Ki; Epidemiol Health. 2020;42:e2020011. Published online March 12, 2020; DOI: https://doi.org/10.4178/epih.e2020011

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Since the first novel coronavirus disease 2019 (COVID-19) patient in Korea was diagnosed on January 20, 2020, 30 patients were diagnosed until February 17, 2020. However, 5,298 additional patients were confirmed until March 4, 2020. Therefore, our objective was to estimate the reproduction number (R) and evaluate the effectiveness of preventive measures.

METHODS

A COVID-19 transmission model (SEIHR) was established to suit the Korean outbreak. The number of daily confirmed cases in Daegu and North Gyeongsang Province (NGP), the main area of outbreak, was used. The first patient’ symptom onset date in the Daegu/NGP outbreak was assumed as January 22, 2020. The R according to the start date of the effect of preventive measures was estimated.

RESULTS

The estimated R in Hubei Province, China, was 4.0281, whereas the estimated initial R in Korea was 0.555, but later in Daegu/NGP, the value was between 3.472 and 3.543. When the transmission period decreases from 4-day to 2-day, the outbreak ends early, but the peak of the epidemic increases, and the total number of patients does not change greatly. It was found that, if transmission rate decreases, the outbreak ends early, and the size of the peak and the total number of patients also decreases.

CONCLUSIONS

To end the COVID-19 epidemic, efforts to reduce the spread of the virus, such as social distancing and wearing masks, are absolutely crucial with the participation of the public, along with the policy of reducing the transmission period by finding and isolating patients as quickly as possible through the efforts of the quarantine authorities.

Summary

Korean summary
수학적 모델링을 통하여 코로나-19 감염재생산수( R )와 대구, 경북의 유행 규모와 유행 종료 시점 등을 예측해보았다. 그 결과 중국 후베이성의 R=4, 한국 초기 30일간의 유행은 R=0.5, 대구/경북의 3월 4일까지의 유행은 R=3.5 수준으로 나타났다. 하지만 방역당국의 적극적인 코로나-19검사로 환자들의 감염전파기간이 짧아지고, 국민들의 마스크 쓰기, 사회적 거리두기 등의 감염 예방조치 적극 참여로 전파율이 낮아져 5월 1일경에 하루 환자 1명 수준으로 예측되었다.

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Analyzing the effects of social distancing on the COVID-19 pandemic in Korea using mathematical modeling: Sunhwa Choi, Moran Ki; Epidemiol Health. 2020;42:e2020064. Published online September 7, 2020; DOI: https://doi.org/10.4178/epih.e2020064

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
During the 6 months since the first coronavirus disease 2019 (COVID-19) patient was diagnosed in Korea on January 20, 2020, various prevention and control measures have been implemented according to the COVID-19 epidemic pattern. Therefore, this study aimed to estimate the reproductive numbers (R) for each epidemic stage to analyze the effects of the preventive measures and to predict the COVID-19 transmission trends.

METHODS

We estimated the transmission rates for each epidemic stage by fitting a COVID-19 transmission model, based on a deterministic mathematical model, to the data on confirmed cases. The effects of preventive measures such as social distancing by time period were analyzed, and the size and trends of future COVID-19 outbreaks were estimated.

RESULTS

The value of R was 3.53 from February18, 2020 to February 28, 2020, and the mean R reduced to 0.45 from March 14, 2020 to April 29, 2020, but it significantly increased to 2.69 from April 30, 2020 to May13, 2020 and it was maintained at 1.03 from May 14, 2020 to July 23, 2020.

CONCLUSIONS

According to the estimated R, it had fallen to below 1 and was maintained at that level owing to the isolation of infected persons by the public health authorities and social distancing measures followed by the general public. Then, the estimated R increased rapidly as the contact among individuals increased during the long holiday period from April 30, 2020 to May 5, 2020. Thereafter, the value of R dropped, with the continued use of preventive measures but remained higher than 1.00, indicating that the COVID-19 outbreak can be prolonged and develop into a severe outbreak at any time.

Summary

Korean summary
수학적 모델링을 통하여 코로나-19 유행양상에 따른 시기별 감염재생산수(reproductive number)를 추정하고, 시기별 방역정책의 효과를 분석하여 향후 유행의 규모와 유행 종료 시점 등을 예측하였다. 그 결과, 4월30일부터 5월5일까지의 긴 연휴 기간을 통해 사람들 간의 접촉이 증가하면서 감염재생산수가 급격히 증가하였고(4월 30일 - 5월 13일까지 평균 R=2.69), 그 후, 지속적인 방역조치로 인해 5월 14일-7월 23일까지 평균 R=1.03로 감소하였으나, 여전히 1보다 큰 값으로 나타나, 코로나-19유행이 지속되고 있으며 언제라도 다시 큰 유행으로 커질 수 있다고 예측되었다.

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국내 코로나바이러스감염증-19 예측 연구 현황 분석
현경 김, 보영 류, 민규 유, 재훈 김, 경덕 민
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International Journal of Environmental Research and Public Health.2022; 19(11): 6763. CrossRef
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Incidence and mortality of cervical cancer in Vietnam and Korea (1999-2017): Kim Ngoc Tran, Yoon Park, Byung-Woo Kim, Jin-Kyoung Oh, Moran Ki; Epidemiol Health. 2020;42:e2020075. Published online December 16, 2020; DOI: https://doi.org/10.4178/epih.e2020075

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Abstract Summary PDF

Abstract

OBJECTIVES
Cervical cancer is a major disease burden in Vietnam. This study aimed to estimate the incidence and mortality rates of cervical cancer in Vietnam (1999-2017) in comparison to those in Korea, where a population-based cancer registry and national cervical cancer screening program have been implemented.

METHODS

The estimated incidence and mortality of cervical cancer in Vietnam and Korea (1999-2017) were collected from Global Burden of Disease 2017 study. Estimated age-standardized rates (ASRs) in both countries were calculated utilizing the 1999-2017 population of each country and the World Health Organization standard population. The reported ASRs in Korea were also computed using data on incidence and mortality (1999-2017) and the Korean population from the Korea Statistical Information Service.

RESULTS

In Vietnam, the estimated incidence and mortality of cervical cancer decreased annually by 0.84% and 1.01%. In Korea, the trend of reported incidence showed a dramatic drop (1999-2007 annual percent change [APC], -4.53%) before stably declining (2007-2017 APC, -2.71%). Reported mortality also significantly decreased (2003-2008 APC, -6.63%), and then maintained a stable decline (2008-2017 APC, -3.78%). The incidence and mortality rates were higher in Vietnam than in Korea. The declining trend of incidence and mortality in Vietnam was slower than the corresponding trends in Korea.

CONCLUSIONS

A national screening program should be implemented for Vietnamese women aged over 30 to maintain, or even hasten, the decline in cervical cancer incidence and mortality. A population-based cancer registry may help monitor the effectiveness of a cervical cancer screening program.

Summary

Korean summary
국가 암 등록 체계와 국가 암 검진 프로그램이 아직 마련되지 않은 베트남에서 자궁경부암에 대한 질병부담을 줄일 수 있는 방향성을 제시하고자, 한국의 암 관리 현황과 질병부담을 비교한 연구입니다. 국가 암 등록자료를 구축하고 자궁경부암에 대한 국가 암 검진 프로그램을 도입한 한국과 베트남의 자궁경부암 발생률과 사망률 추이를 비교함으로 베트남에서도 체계적인 암 관리와 예방의 필요성을 강조하고자 한 연구입니다.

Citations

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Cervical cancer screening by cotesting method for Vietnamese women 25–55 years old: a cost-effectiveness analysis
Hien Thu Bui, Van Nu Hanh Pham, Thang Hong Vu
BMJ Open.2025; 15(1): e082145. CrossRef
Socioeconomic inequalities in cervical cancer screening practices in Vietnam: a decomposition analysis
Thi Bich-Van Nguyen, Kim-Duy Vu, Lam Tung Ngoc Cu, Minh Hai Nguyen Ngoc, Hoang-Dung Ho
BMC Public Health.2025;[Epub] CrossRef
Trends in cervical cancer incidence and mortality in the United States, 1975–2018: a population-based study
Xianying Cheng, Ping Wang, Li Cheng, Feng Zhao, Jiangang Liu
Frontiers in Medicine.2025;[Epub] CrossRef
Trends of cervical tumours amongst women from perspectives of demographic, socioeconomic and geographic indicators: retrospective ecological study in Czechia
Ondrej Holy, Ondrej Machaczka, Tereza Schovankova, Daniela Navratilova, Jarmila Zimmermannova, Romana Klasterecka, Jiri Vevoda
Frontiers in Public Health.2024;[Epub] CrossRef
Analysis of the global burden of cervical cancer in young women aged 15–44 years old
Min Zhang, Jiayi Chen, Meimei Cui, Jingjing Jia, Ming Zhao, Dan Zhou, Liling Zhu, Limei Luo
European Journal of Public Health.2024; 34(4): 839. CrossRef
Transcriptomic era of cancers in females: new epigenetic perspectives and therapeutic prospects
Runhe Zhu, Jiawei Ni, Jiayin Ren, Dongye Li, Jiawei Xu, Xinru Yu, Ying Jie Ma, Luan Kou
Frontiers in Oncology.2024;[Epub] CrossRef
A questionnaire study on disparity of cervical cancer prevention programs in Asia‐Oceania
Ka Yu Tse, Kimio Ushijima, Ai Ling Tan, Perapong Intasorn, Jitendra Pariyar, Chih‐Long Chang, Efren J. Domingo, Hiralal Konar, Suresh Kumarasamy, Brahmana Askandar Tjokroprawiro, Sarikapan Wilailak
Journal of Obstetrics and Gynaecology Research.2023; 49(4): 1230. CrossRef
N-Acetyl-L-Cysteine Reduces Cervical Carcinogenesis by Promoting Apoptosis
Wenping Guo, Wang Jing
Drugs in R&D.2023; 23(2): 165. CrossRef
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Sangnim Lee, Nhan Huu Thanh Nguyen, Shori Takaoka, An Dang Do, Yoshihisa Shirayama, Quy Pham Nguyen, Yusuke Akutsu, Jin Takasaki, Akihiro Ohkado
International Journal of Environmental Research and Public Health.2023; 20(12): 6150. CrossRef
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Dong Hyeok Kim, Kyung Eun Lee
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Oncology Letters.2021;[Epub] CrossRef

Causes and countermeasures for repeated outbreaks of hepatitis A among adults in Korea: Moran Ki, Hyunjin Son, Bo Youl Choi; Epidemiol Health. 2019;41:e2019038. Published online September 22, 2019; DOI: https://doi.org/10.4178/epih.e2019038

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Abstract Summary PDF Supplementary Material

Abstract

The 2019 hepatitis A outbreak has become increasingly prevalent among adults in Korea and is the largest outbreak since that in 2009-2010. The incidence in the current outbreak is highest among adults aged 35-44 years, corresponding to the peak incidence among those aged 25-34 years 10 years ago. This may indicate a cohort effect in the corresponding age group. Causes of these repeated outbreaks of hepatitis A in Korea are low level of immunity among adults, Korean food culture that consumes raw seafood such as salted clam and inadequate public health system. Among countermeasures, along with general infectious disease control measures including control of the infectious agent, infection spread, and host, urgent actions are needed to review the vaccination policy and establish an adequate public health system.

Summary

Korean summary
2019년 한국 성인의 A형 간염 유행은 10년전 대규모 유행 이후 가장 큰 규모로발생하고 있다. 주 발생 연령이 10년전 유행보다 10세가 증가한 35-44세로 나타나 연령 코호트 효과라 볼 수 있다. 우리나라의 A형 간염 반복 유행의 원인은 성인의 낮은 집단면역수준, 어패류 생식문화, 공중보건의료체계 미비 등으로 보인다. 이에 대한 대책은 일반적인 감염관리대책인 감염원관리, 전파관리, 숙주관리와 함께 효율적인 백신접종정책, 공고한 공중보건관리체계 마련 등의 근본적 대책이 시급하다.

Citations

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From Outbreak to Action: The Need for Policy Change Based on Epidemiological Investigation of Hepatitis A in a Special Care Setting in Central Kerala
Sangeetha Merrin Varghese, C. S. Nandini, Amar Fettle, Abey Sushan, Libu Gnanaseelan Kanakamma, A. L. Sheeja, Betsy A. Jose, P. B. Boban, Prince Alexander
Archives of Medicine and Health Sciences.2025; 13(1): 23. CrossRef
Comparative evaluation of four commercial analyzers for the serological screening of hepatitis A
Junhyup Song, Jiyeon Kim, Sinyoung Kim, Younhee Park
Virology Journal.2025;[Epub] CrossRef
A Bayesian spatially-clustered coefficient model with temporal structures for hepatitis A data in South Korea*
Jaeseon Lee, Jungsoon Choi
Journal of Applied Statistics.2025; : 1. CrossRef
Gender differences in hepatitis A seropositivity rates according to the Republic of Korea’s vaccination policy
Hyunjin Son, Sunhyun Ahn, Wonseo Park, Gayoung Chun, Unyeong Go, Sang Gon Lee, Eun Hee Lee
Osong Public Health and Research Perspectives.2024; 15(2): 168. CrossRef
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
Antiviral Efficacy of Dielectric Barrier Discharge Plasma against Hepatitis A Virus in Fresh Oyster Using PMA/RT-qPCR
Min Gyu Song, Ji Yoon Kim, Eun Bi Jeon, So Hee Kim, Min Soo Heu, Jung-Suck Lee, Jin-Soo Kim, Shin Young Park
Applied Sciences.2023; 13(6): 3513. 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
A case-control study of acute hepatitis A in South Korea, 2019
Jung Hee Hyun, Ju Young Yoon, Sang Hyuk Lee
Osong Public Health and Research Perspectives.2022; 13(5): 352. CrossRef
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
Epidemiology and Health.2021; 44: e2022003. CrossRef
Hepatitis A vaccination
Li Zhang
Human Vaccines & Immunotherapeutics.2020; 16(7): 1565. CrossRef
A Study on Seroprevalence of Hepatitis A Virus among Healthcare Workers at a University-Affiliated Hospital in Deajeon, Korea
Seul Ki Ji, So Hee Jang, Min Hee Park, Ji Eun Lee, Hye Sook Jeong, Joonhong Park, Seung Beom Han, Yunmi Yi, Sun Hee Park
The Korean Journal of Healthcare-Associated Infection Control and Prevention.2020; 25(1): 54. CrossRef
Epidemiology of viral disease outbreaks in Odisha, India (2010–2019)
J.S. Kshatri, J. Turuk, J. Sabat, S. Subhadra, L.M. Ho, S. Rath, S.K. Palo, D. Bhattacharya, B. Dwibedi, S. Pati
Epidemiology and Infection.2020;[Epub] CrossRef
Current State and Problems of Hepatitis A and E in Japan
Jun Inoue, Atsushi Masamune
Nihon Naika Gakkai Zasshi.2020; 109(7): 1439. CrossRef

Ebola virus disease outbreak in Korea: use of a mathematical model and stochastic simulation to estimate risk: Youngsuk Ko, Seok-Min Lee, Soyoung Kim, Moran Ki, Eunok Jung; Epidemiol Health. 2019;41:e2019048. Published online November 24, 2019; DOI: https://doi.org/10.4178/epih.e2019048

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
According to the World Health Organization, there have been frequent reports of Ebola virus disease (EVD) since the 2014 EVD pandemic in West Africa. We aim to estimate the outbreak scale when an EVD infected person arrives in Korea.

METHODS

Western Africa EVD epidemic mathematical model SEIJR or SEIJQR was modified to create a Korean EVD outbreak model. The expected number of EVD patients and outbreak duration were calculated by stochastic simulation under the scenarios of Best case, Diagnosis delay, and Case missing.

RESULTS

The 2,000 trials of stochastic simulation for each scenario demonstrated the following results: The possible median number of patients is 2 and the estimated maximum number is 11 when the government intervention is proceeded immediately right after the first EVD case is confirmed. With a 6-day delay in diagnosis of the first case, the median number of patients becomes 7, and the maximum, 20. If the first case is missed and the government intervention is not activated until 2 cases of secondary infection occur, the median number of patients is estimated at 15, and the maximum, at 35.

CONCLUSIONS

Timely and rigorous diagnosis is important to reduce the spreading scale of infection when a new communicable disease is inflowed into Korea. Moreover, it is imperative to strengthen the local surveillance system and diagnostic protocols to avoid missing cases of secondary infection.

Summary

Korean summary
본 연구는 수학적 모델과 확률 시뮬레이션 기법을 이용하여 국내에 유입되지 않았던 에볼라바이러스병(EVD)의 확산 위험도를 정량적으로 예측하는 첫 번째 연구이다. 또한 이 연구를 통해 에볼라바이러스병 환자의 유입 시 발생 가능한 진단 지연 혹은 유입 미인지 상황을 가정하여 발생할 수 있는 2차 감염자 수 및 감염 종식까지의 기간을 계산했고 에볼라바이러스 유입 대비 실시간모니터링의 중요성과 확산 시 상황에 따른 최대 일일 환자수를 합리적으로 제시할 수 있다.

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Estimating the Transmission Risk of COVID-19 in Nigeria: A Mathematical Modelling Approach
Irany FA, Akwafuo SE, Abah T, Mikler AR
Journal of Health Care and Research.2020; 1(3): 135. CrossRef

Asymptomatic Middle East Respiratory Syndrome coronavirus infection using a serologic survey in Korea: Yeong-jun Song, Jeong-Sun Yang, Hee Jung Yoon, Hae-Sung Nam, Soon Young Lee, Hae-Kwan Cheong, Woo-Jung Park, Sung Han Park, Bo Youl Choi, Sung Soon Kim, Moran Ki; Epidemiol Health. 2018;40:e2018014. Published online April 15, 2018; DOI: https://doi.org/10.4178/epih.e2018014

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Abstract Summary PDF

Abstract

OBJECTIVES
The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status.

METHODS

Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results.

RESULTS

The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis.

CONCLUSIONS

The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.

Summary

Korean summary
2015년 국내 MERS 유행시에 자가격리를 시행하였던 접촉자 약 15,000명 (의료인과 비의료인 포함) 중에서 주요 유행지역, 노출 강도 등을 고려하여 선별된 3,291명을 대상으로 무증상 감염여부를 확인하기 위한 혈청 역학조사를 수행하였다. 최종 검사에 참여한 1,610명 중에서 7명이 ELISA 양성 반응을 보였고, 그 중 1명이 IFA와 PRNT에서도 양성 반응을 보여 무증상 감염률은 0.060%(95% CI: 0.002-0.346)로 기존 연구에 비하여 낮았다. 최종 양성을 보인 1명은 노출 당시 1번환자와 가까운 병실에 입원하였던 환자였다.

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Seongmin Jo, Jinkwan Hong, Sang-Eun Lee, Moran Ki, Bo Youl Choi, Minki Sung
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Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017
Sibylle Bernard-Stoecklin, Birgit Nikolay, Abdullah Assiri, Abdul Aziz Bin Saeed, Peter Karim Ben Embarek, Hassan El Bushra, Moran Ki, Mamunur Rahman Malik, Arnaud Fontanet, Simon Cauchemez, Maria D. Van Kerkhove
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Airflow as a Possible Transmission Route of Middle East Respiratory Syndrome at an Initial Outbreak Hospital in Korea
Minki Sung, Seongmin Jo, Sang-Eun Lee, Moran Ki, Bo Youl Choi, JinKwan Hong
International Journal of Environmental Research and Public Health.2018; 15(12): 2757. CrossRef
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Current status of hepatitis C virus infection and countermeasures in South Korea: Sook-Hyang Jeong, Eun Sun Jang, Hwa Young Choi, Kyung-Ah Kim, Wankyo Chung, Moran Ki; Epidemiol Health. 2017;39:e2017017. Published online April 13, 2017; DOI: https://doi.org/10.4178/epih.e2017017

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Abstract Summary PDF Supplementary Material

Abstract

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

Summary

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

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Next-generation sequencing analysis of hepatitis C virus resistance–associated substitutions in direct-acting antiviral failure in South Korea
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The current status of health data on Korean children and adolescents: Eunyoung Lee, Dahye Baik, Yoon Park, Moran Ki; Epidemiol Health. 2017;39:e2017059. Published online December 26, 2017; DOI: https://doi.org/10.4178/epih.e2017059

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Abstract Summary PDF Supplementary Material

Abstract

Childhood and adolescence are critical periods that affect adults’ health status. Therefore, the factors influencing the health of children and adolescents should be analyzed. In Korea, a wide range of youth-related health data has been obtained, both on the regional level and on the national level. This report summarizes the current status of studies related to the health of Korean children and adolescents. Data for which open access is offered include the Korea Youth Risk Behavior Web-based Study, the Panel Study on Korean Children, the Korean Youth Panel Survey, the Korean Children and Youth Panel Survey, and the Student Health Examination. In addition, the Health Examination of Korean Youth Outside of School, the Korean Children and Adolescents Obesity Cohort Study, the Korean Children’s Environmental Health Study, the Korea Youth Media Use and Harmful Environment Survey, the Comprehensive Survey of Korean Youth, and the Multicultural Adolescents Panel Study are summarized.

Summary

Korean summary
청소년시기는 성인의 건강상태에 영향을 미치는 중요한 시기이다. 따라서 청소년의 건강에 영향을 미치는 여러 가지 요소들에 대한 분석이 필요하다. 한국에서 청소년건강과 관련한 데이터는 지역 단위에서뿐 아니라 국가 단위에서도 수집되고 있다. 해당 데이터가 공개되고 있는 것으로는 청소년건강행태온라인조사, 한국아동패널, 한국청소년패널조사, 한국아동ㆍ청소년패널조사, 학교건강검사가 있다. 이외에도 학교 밖 청소년 건강검진조사, 소아비만 및 대사질환 코호트, 어린이 환경 보건 출생코호트, 청소년 매체이용 및 유해환경 실태조사, 청소년 종합실태조사, 다문화청소년패널조사를 요약하였다.

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Relevance of self-rated health level and mental health in Korean adolescents
Yunjeong Kim, Joohee Shim
Frontiers in Public Health.2025;[Epub] CrossRef
Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data
Minji Kang, So Yoon Choi, Minyoung Jung
Clinical and Experimental Pediatrics.2021; 64(9): 443. CrossRef
Benefits of cooperation among large-scale cohort studies and human biomonitoring projects in environmental health research: An exercise in blood lead analysis of the Environment and Child Health International Birth Cohort Group
Shoji F. Nakayama, Carolina Espina, Michihiro Kamijima, Per Magnus, Marie-Aline Charles, Jun Zhang, Birgit Wolz, André Conrad, Aline Murawski, Miyuki Iwai-Shimada, Cécile Zaros, Ida Henriette Caspersen, Marike Kolossa-Gehring, Helle Margrete Meltzer, Sjur
International Journal of Hygiene and Environmental Health.2019; 222(8): 1059. CrossRef

Age-period-cohort analysis of hepatitis A incidence rates in Korea from 2002 to 2012: Joo Yeon Seo, Sungyong Choi, BoYoul Choi, Moran Ki; Epidemiol Health. 2016;38:e2016040. Published online September 30, 2016; DOI: https://doi.org/10.4178/epih.e2016040

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Abstract Summary PDF

Abstract

OBJECTIVES
This study aimed to evaluate the epidemiology of hepatitis A in Korea from 2002 to 2012 using age-period-cohort analyses.

METHODS

We used claims data from the Korean National Health Insurance Corporation for the entire population. Census data from 2010 were used as the standard population. The incidence of hepatitis A was assumed to have a Poisson distribution, and the models and effects were evaluated using the intrinsic estimator method, the likelihood ratio, and the Akaike information criterion.

RESULTS

The incidence of hepatitis A gradually increased until 2007 (from 17.55 to 35.72 per 100,000 population) and peaked in 2009 (177.47 per 100,000 population). The highest incidence was observed among 27-29-year-old individuals when we omitted data from 2005 to 2007. From 2005 to 2007, the peak incidence was observed among 24-26-year-old individuals, followed by 27-29-year-olds. The best model fits were observed when the age-period-cohort variables were all considered at the same time for males, females, and the whole population.

CONCLUSIONS

The incidence of hepatitis A exhibited significant age-period-cohort effects; its incidence peaked in 2009 and was especially high among Koreans 20-39 years of age. These epidemiological patterns may help predict when high incidence rates of hepatitis A may occur in developing countries during their socioeconomic development.

Summary

Korean summary
A형 간염 발생률은 서서히 증가하는 추세였으나 2009년 가파르게 증가하여 최고조에 이르렀으며, (177 명 100,000 명당) 1978–1986 년 생 (발생 당시25–35세) 사이에서 가장 높았다. 남성, 여성, 전체 인구를 통틀어 가장 적합한 모형은 연령, 기간, 코호트 변수를 모두 고려한 모형이었다. 한국의 A형 간염 발생은 고위험 양상에서 중등도 위험양상으로 변해가고 있으며, 이는 역학적 변화를 겪는 여러 나라의 향후 양상을 예측하는데 도움이 될 것이다.

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Hepatitis A vaccination
Li Zhang
Human Vaccines & Immunotherapeutics.2020; 16(7): 1565. CrossRef
Causes and countermeasures for repeated outbreaks of hepatitis A among adults in Korea
Moran Ki, Hyunjin Son, Bo Youl Choi
Epidemiology and Health.2019; 41: e2019038. CrossRef
The unrealized potential: cohort effects and age-period-cohort analysis
Jongho Heo, Sun-Young Jeon, Chang-Mo Oh, Jongnam Hwang, Juhwan Oh, Youngtae Cho
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Viral Hepatitis in South Korea
Stella C Pak, Yaseen Alastal, Zubair Khan, Umar Darr
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Mental health status of people isolated due to Middle East Respiratory Syndrome: Hyunsuk Jeong, Hyeon Woo Yim, Yeong-Jun Song, Moran Ki, Jung-Ah Min, Juhee Cho, Jeong-Ho Chae; Epidemiol Health. 2016;38:e2016048. Published online November 5, 2016; DOI: https://doi.org/10.4178/epih.e2016048

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1,193 Download
692 Web of Science
720 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Isolation due to the management of infectious diseases is thought to affect mental health, but the effects are still unknown. We examined the prevalence of anxiety symptoms and anger in persons isolated during the Middle East Respiratory Syndrome (MERS) epidemic both at isolation period and at four to six months after release from isolation. We also determined risk factors associated with these symptoms at four to six months.

METHODS

Of 14,992 individuals isolated for 2-week due to having contact with MERS patients in 2015, when MERS was introduced to Korea, 1,692 individuals were included in this study. Anxiety symptoms were evaluated with the Generalized Anxiety Disorder 7-item scale and anger was assessed with the State-Trait Anger Expression Inventory at four to six months after release from isolation for MERS.

RESULTS

Of 1,692 who came in contact with MERS patients, 1,656 were not diagnosed with MERS. Among 1,656, anxiety symptoms showed 7.6% (95% confidence interval [CI], 6.3 to 8.9%) and feelings of anger were present in 16.6% (95% CI, 14.8 to 18.4%) during the isolation period. At four to six months after release from isolation, anxiety symptoms were observed in 3.0% (95%CI, 2.2 to 3.9%). Feelings of anger were present in 6.4% (95% CI, 5.2 to 7.6%). Risk factors for experiencing anxiety symptoms and anger at four to six months after release included symptoms related to MERS during isolation, inadequate supplies (food, clothes, accommodation), social networking activities (email, text, Internet), history of psychiatric illnesses, and financial loss.

CONCLUSIONS

Mental health problems at four to six month after release from isolation might be prevented by providing mental health support to individuals with vulnerable mental health, and providing accurate information as well as appropriate supplies, including food, clothes, and accommodation.

Summary

Korean summary
메르스 환자와의 밀착접촉으로 격리되었던 1,692명을 대상으로 격리 당시와 격리해제 후 4-6개월 시점의 불안증상과 분노감 유병율을 파악하고 격리 해제 후 4-6개월 시점에 불안증상과 분노감 유병과 연관된 격리기간 동안의 위험요인을 알아보고자 하였다. 메르스 격리자에서 격리시점의 불안증상 유병율은 7.6% (95%CI: 6.3-8.9%), 분노감 유병율은 16.6% (95%CI: 14.8-18.4%) 였고, 4-6개월 시점이 불안증상 유병율은 3.0% (95%CI: 2.2-3.9%), 분노감 유병율은 6.4% (95%CI: 5.2-7.6%) 이였다. 성별과 연령을 보정한 후 격리해제 4-6개월 지난 시점에서 불안증상 및 분노감 유병의 위험요인은 격리 당시 메르스 증상이 있었거나 구호품 보급이 충분하지 않았거나, 정신과 질환의 과거력이 있었던 경우, 재정 손실이 있었던 사람이었다.

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Changing trends in the incidence (1999-2011) and mortality (1983-2013) of cervical cancer in the Republic of Korea: Yoon Park, Champadeng Vongdala, Jeongseon Kim, Moran Ki; Epidemiol Health. 2015;37:e2015024. Published online May 29, 2015; DOI: https://doi.org/10.4178/epih/e2015024

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Abstract

Cervical cancer is a well-known preventable cancer worldwide. Many countries including Korea have pursued the positive endpoint of a reduction in mortality from cervical cancer. Our aim is to examine changing trends in cervical cancer incidence and mortality after the implementation of a national preventive effort in Korea. Cervical cancer incidence data from 1999 to 2011 and mortality data from 1983 to 2013 were collected from the Korean Statistical Information Service. Yearly age-standardized rates (ASR) per 100,000 were compared using two standards: the 2005 Korean population and the world standard population, based on Segi’s world standard for incidence and the World Health Organization for mortality. In Korea, the age-standardized incidence of cervical cancer per 100,000 persons declined from 17.2 in 2000 to 11.8 in 2011. However, the group aged 25 to 29 showed a higher rate in 2011 (ASR, 6.5) than in 2000 (ASR, 3.6). The age-standardized mortality rate per 100,000 persons dropped from 2.81 in 2000 to 1.95 in 2013. In the worldwide comparison, the incidence rates remained close to the average incidence estimate of more developed regions (ASR, 9.9). The decreasing mortality trend in Korea approached the lower rate observed in Australia (ASR, 1.4) in 2010. Although the incidence rate of cervical cancer is continuously declining in Korea, it is still high relative to other countries. Moreover, incidence and mortality rates in females aged 30 years or under have recently increased. It is necessary to develop effective policy to reduce both incidence and mortality, particularly in younger age groups.

Summary

Korean summary
한국의 자궁경부암 발생률과 사망률은 꾸준히 감소하고 있는 추세이다. 그러나 한국의 발생률은 여러 선진국에 비해 여전히 높은 수준에 머무르고 있다. 또한, 지난 10년 동안 자궁경부암 사망률은 상대적으로 큰 감소를 보이지 않았다. 특히 35세 미만에서는 자궁경부암 발생률이 감소하지 않았고, 사망률은 오히려 높아진 것으로 나타났다. 젊은 연령층의 자궁경부암 예방과 관리가 필요하다.

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Income-based disparities in the risk of distant-stage cervical cancer and 5-year mortality after the introduction of a National Cancer Screening Program in Korea
Erdenetuya Bolormaa, Seung-Ah Choe, Mia Son, Myung Ki, Domyung Paek
Epidemiology and Health.2022; 44: e2022066. CrossRef
Effect of Pap smears on the long-term survival of cervical cancer patients: a nationwide population-based cohort study in Korea
Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, kyu-won Jung, Myong Cheol Lim, Kui Son Choi
Epidemiology and Health.2022; 44: e2022072. CrossRef
The Effects of Age, Period, and Cohort on the Mortality of Cervical Cancer in Three High‐Income Countries: Canada, Korea, and Italy
Jinyao Wang, Zhiqiang Bai, Xudong Gao, Nianping Zhang, Zhenkun Wang, Zhongjie Shi
BioMed Research International.2021;[Epub] CrossRef
Performance Indicators of Cervical Cancer Screening Program Based on The Guidelines of Iran Ministry of Health and Medical Education
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Effect of Pap smear screening on cervical cancer stage at diagnosis: results from the Korean National Cancer Screening Program
Cam Nhung Bui, Seri Hong, Mina Suh, Jae Kwan Jun, Kyu Won Jung, Myong Cheol Lim, Kui Son Choi
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Screening Plasma Exosomal RNAs as Diagnostic Markers for Cervical Cancer: An Analysis of Patients Who Underwent Primary Chemoradiotherapy
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Kallikrein 5 overexpression is associated with poor prognosis in uterine cervical cancer
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Trends of liver cancer and its major risk factors in Korea: Eun-Young Lee, Tran Thi Xuan Mai, Yoonjung Chang, Moran Ki; Epidemiol Health. 2015;37:e2015016. Published online March 11, 2015; DOI: https://doi.org/10.4178/epih/e2015016

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Abstract

The Republic of Korea (hereafter Korea) is one of the countries with high incidence of liver cancer and there is great difference in incidence of liver cancer between male and female. We investigated the sex-specific trends of three major risk factors of liver cancer, which are hepatitis B virus(HBV) infection, hepatitis C virus(HCV) infection, and alcoholic liver cirrhosis. The incidence of liver cancer was obtained from the Cancer Registration Statistics of the National Cancer Center of Korea. Hepatitis B surface antigen (HBsAg) seropositivity was based on data from the 2011 Korea National Health and Nutrition Examination Survey. Disease statistics from the Health Insurance Review and Assessment Service of Korea were used to evaluate trends in HCV infection and alcoholic liver cirrhosis. The prevalence of these risk factors were compared with the incidence of liver cancer. Males had a three to four times higher incidence of liver cancer than females did from 1999 to 2011. This gap between the incidence for males and females increased with age and males aged 50 to 59 showed a five times higher incidence than females of the same age did. In general, HBsAg seropositivity decreased from 1998 to 2011. The prevalence of HCV infections was 96.2 and 90.3 per 100,000 females and males, respectively in 2013. The prevalences of HCV infections from 2009 to 2013 did not substantially differ. The annual average prevalence of alcoholic liver cirrhosis from 2009 to 2013 was 77.22 and 8.90 per 100,000 males and females, respectively; the prevalence among males was 8.7 times higher than that among females. The prevalence rapidly increased with age in males, and males aged 60 to 69 peaked with a 19.2 times higher prevalence than that among females of the same age group. We found that the incidence of alcoholic liver cirrhosis, a major risk factor of liver cancer, exhibited a trend similar to that of liver cancer incidence in males, and this trend also differed remarkably by sex.

Summary

Korean summary
한국의 간암 발생 추세에서 나타나는 큰 남녀차이와 관련하여 간암의 주요 위험요소로 평가되는 만성 간염, 음주, 간경변과 관련한 B형간염, C형간염, 알코올성 간경변의 유병률 추세를 살펴본 결과 알코올성 간경변의 유병률 추세에서 간암발생에서와 유사한 큰 남녀차이가 발견되었다.

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Hepatocellular carcinoma incidence is decreasing in Korea but increasing in the very elderly
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Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011: Yeerae Kim, Jinju Park, Byung-Ho Nam, Moran Ki; Epidemiol Health. 2015;37:e2015006. Published online February 16, 2015; DOI: https://doi.org/10.4178/epih/e2015006

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Abstract PDF

Abstract

Stomach cancer is the second most common cancer in Eastern Asia, accounting for approximately 50% of all new cases of stomach cancer worldwide. Our objective was to compare the stomach cancer incidence rates of Asian Americans in Los Angeles with those of native Asians to assess the etiology of stomach cancer from 1988 to 2011. To examine these differences, Asian Americans (Korean, Japanese, Chinese, and Filipino Americans living in Los Angeles, California, USA) and native Asians (from Korea, Japan, China, and the Philippines) were selected for this study. Using the Cancer Incidence in Five Continents database, stomach cancer incidence rates were examined. Data from the National Cancer Registry of Korea were used for native Koreans. Between native countries, the incidence rates in Japan, China, the Philippines, and the US declined over time, but the incidence in Korea has remained constant. The incidences among Asian immigrants were lower than those among native Asians. The incidence rates of males were approximately 2 times higher than those among females in Asian countries were. The effect of immigration on stomach cancer incidence suggests that lifestyle factors are a significant determinant of stomach cancer risk. However, the incidence in Korea remains the highest of these countries

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2015 MERS outbreak in Korea: hospital-to-hospital transmission: Moran Ki; Epidemiol Health. 2015;37:e2015033. Published online July 21, 2015; DOI: https://doi.org/10.4178/epih/e2015033

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Abstract Summary PDF Supplementary Material

Abstract

The distinct characteristic of the Middle East Respiratory Syndrome (MERS) outbreak in South Korea is that it not only involves intra-hospital transmission, but it also involves hospital-to-hospital transmission. It has been the largest MERS outbreak outside the Middle East, with 186 confirmed cases and, among them, 36 fatal cases as of July 26, 2015. All confirmed cases are suspected to be hospital-acquired infections except one case of household transmission and two cases still undergoing examination. The Korean health care system has been the major factor shaping the unique characteristics of the outbreak. Taking this as an opportunity, the Korean government should carefully assess the fundamental problems of the vulnerability to hospital infection and make short- as well as long-term plans for countermeasures. In addition, it is hoped that this journal, Epidemiology and Health, becomes a place where various topics regarding MERS can be discussed and shared.

Summary

Korean summary
한국의 메르스 유행은 병원내 감염뿐 아니라 병원에서 병원으로 전파되는 양상을 보인 것이 특징이다. 사우디아라비아 다음으로 가장 많은 환자가 발생하였는데 전체 확진자는 186명이고, 이중에 사망자는 36명이다. 확진자 대부분이 병원에서 감염된 것으로 추정된다. 가족간 감염이 의심되는 경우는 1명정도이며, 2명은 경로를 조사중인데 이중에 한명은 지역사회 감염이 의심된다. 한국의 의료체계 특성이 이번 유행에 중요한 요인이 되었다. 이 기회에 한국은 병원감염관리에 취약한 우리의 근본적인 문제점을 살펴서 장단기적인 대책을 마련하여야 할 것이다. 또한 역학회지가 메르스와 관련된 다양한 주제가 논의되는 장이 되기를 바란다.

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MERS epidemiological investigation to detect potential mode of transmission in the 178th MERS confirmed case in Pyeongtaek, Korea: Kyujin Chang, Moran Ki, Eun Gyu Lee, Soon Young Lee, Byoungin Yoo, Jong Hyuk Choi; Epidemiol Health. 2015;37:e2015036. Published online August 15, 2015; DOI: https://doi.org/10.4178/epih/e2015036

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Abstract Summary PDF Supplementary Material

Abstract

Most cases of Middle East Respiratory Syndrome (MERS) infection in Korea (outbreak: May 11-July 4, 2015) occurred in hospital settings, with uncertain transmission modes in some cases. We performed an in-depth investigation epidemiological survey on the 178th case to determine the precise mode of transmission. A 29- year-old man living in Pyeongtaek presented on June 16 with a febrile sensation, chills, and myalgia. Upon confirmatory diagnosis on June 23, he was treated in an isolation room and discharged on July 2 after cure. An epidemiological investigation of all possible infection routes indicated two likely modes of transmission: exposure to MERS in Pyeongtaek St. Mary’s Hospital during a visit to his hospitalized father (May 18-29), and infection through frequent contact with his father between the latter’s referral to Pyeongtaek Good Samaritan Bagae Hospital for treatment without confirmatory diagnosis until his death (May 29-June 6). Although lack of clear proof or evidence to the contrary does not allow a definitive conclusion, all other possibilities could be excluded by epidemiological inferences. While it is impossible to trace back the modes of transmission of all cases in a large-scale outbreak, case-by-case tracking and isolation of infected individuals and those in close contact with them is important in preventing the spread. Efforts should be made to establish a methodology for rapid tracking of all possible contacts and elimination-based identification of the precise modes of transmission.

Summary

Korean summary
이 논문은 2015년 한국에서 새롭게 발생한 감염병인 메르스 유행 중, 감염경로가 불분명하였던 178번째 환자에 대한 심층 역학조사 과정과 결과를 기술한 것이며, 조사를 통해 얻은 교훈을 학계 및 관계자들과 공유하고자 한다. 조사 결과, 다른 사례들과 마찬가지로 병원감염으로 볼 수 있음을 밝힌다.

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BMJ Open.2016; 6(2): e009936. CrossRef
Epidemiologic Parameters of the Middle East Respiratory Syndrome Outbreak in Korea, 2015
Sun Hee Park, Woo Joo Kim, Jin-Hong Yoo, Jung-Hyun Choi
Infection & Chemotherapy.2016; 48(2): 108. CrossRef

Changing trends in colorectal cancer in the Republic of Korea: contrast with Japan: Minjoo Yoon, Nicholas Kim, Byungho Nam, Jungnam Joo, Moran Ki; Epidemiol Health. 2015;37:e2015038. Published online August 17, 2015; DOI: https://doi.org/10.4178/epih/e2015038

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Abstract Summary PDF

Abstract

Colorectal cancer has a high worldwide incidence. Japan, a country that is geographically and culturally similar to the Republic of Korea (here after Korea), has recently reported a decreasing trend in the incidence of colorectal cancer. However, Korea had the highest incidence of colorectal cancer among Asian countries in 2012. Our aim was to observe the changing trends in incidence and mortality of colorectal cancer in Korea and to compare them to those in Japan. Incidence data were collected from the Korean Central Cancer Registry and mortality data were collected from Korean Statistical Information Service. Incidence and mortality data on colorectal cancer in Japan were acquired from the National Cancer Center in Japan. Age-standardized incidence and mortality rates were determined based on Segi’s world population. Screening data from both countries were collected from the national cancer center in each country. In Korea, the age-standardized incidence rate of colorectal cancer in both sexes was 20.9 to 38.0 per 100,000 from 1999 to 2012 and the rate in males increased more dramatically than in females. In addition, the increase between 2002 and 2012 was first observed in the age group over 40. In Japan, the incidence of colorectal cancer has been more constant over recent years than in Korea. The age-standardized mortality rate of colorectal cancer in both sexes in Korea was 8.5 to 9.3 per 100,000 from 2000 to 2013, and the trend in mortality was constant during this period. In Japan, the mortality rate decreased slightly during the same period. Crude screening rates were increased overall in both Korea and Japan during the period studied. Since the incidence of colorectal cancer has increased in Korea, the control of this cancer is an important public health issue. As Japan has achieved a reduction in colorectal cancer, adjustment of Korea’s current systems for screening and treatment of colorectal cancer according to those of Japan may contribute to improved colorectal cancer control in Korea.

Summary

Korean summary
우리나라와 지리적, 문화적으로 가까운 일본은 대장암 발생 및 사망이 감소하고 있는 반면, 한국의 대장암 발생은 증가하는 추세이다. 본 연구는 한국의 대장암 발생 및 사망의 경향을 관찰하고, 이를 일본의 경우와 비교하고자 한다

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Statistical methods for measuring trends in colorectal cancer incidence in registries: A systematic review
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Tasuku Okui
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Hyeong Taek Woo, Jin Ah Sim, Jonghoon Mo, Young Ho Yun, Aesun Shin
Journal of Epidemiology.2019; 29(10): 399. CrossRef
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International Journal of Colorectal Disease.2018; 33(6): 799. CrossRef
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Qin Zhou, Yan Li, Hua-Zhang Liu, Ying-Ru Liang, Guo-Zhen Lin
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Strengthening epidemiologic investigation of infectious diseases in Korea: lessons from the Middle East Respiratory Syndrome outbreak: Changhwan Lee, Moran Ki; Epidemiol Health. 2015;37:e2015040. Published online September 16, 2015; DOI: https://doi.org/10.4178/epih/e2015040

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Abstract Summary PDF Supplementary Material

Abstract

The recent outbreak of Middle East Respiratory Syndrome (MERS) coronavirus infection in Korea resulted in large socioeconomic losses. This provoked the Korean government and the general public to recognize the importance of having a well-established system against infectious diseases. Although epidemiologic investigation is one of the most important aspects of prevention, it has been pointed out that much needs to be improved in Korea. We review here the current status of the Korean epidemiologic service and suggest possible supplementation measures. We examine the current national preventive infrastructure, including human resources such as Epidemic Intelligence Service officers, its governmental management, and related policies. In addition, we describe the practical application of these resources to the recent MERS outbreak and the progress in preventive measures. The spread of MERS demonstrated that the general readiness for emerging infectious diseases in Korea is considerably low. We believe that it is essential to increase society’s investment in disease prevention. Fostering public health personnel, legislating management policies, and establishing research centers for emerging infectious diseases are potential solutions. Evaluating international preventive systems, developing cooperative measures, and initiating improvements are necessary. We evaluated the Korean epidemiologic investigation system and the public preventive measures against infectious diseases in light of the recent MERS outbreak. We suggest that governmental authorities in Korea enforce preventive policies, foster the development of highly qualified personnel, and increase investment in the public health domain of infectious disease prevention.

Summary

Korean summary
2015년 한국의 메르스 유행시 실제 시행되었던 역학조사 내용을 기술하고, 단계별로 문제점을 검토하였다. 또한 향후 역학조사 강화방안으로 1)관련 법령 수정, 2)역학조사 전문인력 강화, 3) 신종 감염병 연구센터 필요성 등을 제시하였다. 이번 메르스 위기를 기회로 삼아 한국 감염병 대비대응체계를 굳건히 하여야 할 것이다.

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Ely Zarina Samsudin, Siti Munira Yasin, Nur-Hasanah Ruslan, Nik Nairan Abdullah, Ahmad Faiz Azhari Noor, Ahmad Fitri Abdullah Hair
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Epidemiology and Health.2018; 40: e2018014. CrossRef
Airflow as a Possible Transmission Route of Middle East Respiratory Syndrome at an Initial Outbreak Hospital in Korea
Minki Sung, Seongmin Jo, Sang-Eun Lee, Moran Ki, Bo Youl Choi, JinKwan Hong
International Journal of Environmental Research and Public Health.2018; 15(12): 2757. CrossRef
Surveillance and epidemiologic investigation in public health emergencies caused by infectious diseases
Moran Ki
Journal of the Korean Medical Association.2017; 60(4): 292. CrossRef
Identifying determinants of heterogeneous transmission dynamics of the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea, 2015: a retrospective epidemiological analysis
Hiroshi Nishiura, Akira Endo, Masaya Saitoh, Ryo Kinoshita, Ryo Ueno, Shinji Nakaoka, Yuichiro Miyamatsu, Yueping Dong, Gerardo Chowell, Kenji Mizumoto
BMJ Open.2016; 6(2): e009936. CrossRef
Epidemiologic Parameters of the Middle East Respiratory Syndrome Outbreak in Korea, 2015
Sun Hee Park, Woo Joo Kim, Jin-Hong Yoo, Jung-Hyun Choi
Infection & Chemotherapy.2016; 48(2): 108. CrossRef

Epidemiologic features of the first MERS outbreak in Korea: focus on Pyeongtaek St. Mary’s Hospital: Kyung Min Kim, Moran Ki, Sung-il Cho, Minki Sung, Jin Kwan Hong, Hae-Kwan Cheong, Jong-Hun Kim, Sang-Eun Lee, Changhwan Lee, Keon-Joo Lee, Yong-Shik Park, Seung Woo Kim, Bo Youl Choi; Epidemiol Health. 2015;37:e2015041. Published online September 17, 2015; DOI: https://doi.org/10.4178/epih/e2015041

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated the epidemiologic features of the confirmed cases of Middle East Respiratory Syndrome (MERS) in Pyeongtaek St. Mary’s Hospital, where the outbreak first began, in order to identify lessons relevant for the prevention and control of future outbreaks.

METHODS

The patients’ clinical symptoms and test results were collected from their medical records. The caregivers of patients were identified by phone calls.

RESULTS

After patient zero (case #1) was admitted to Pyeongtaek St. Mary’s Hospital (May 15-May 17), an outbreak occurred, with 36 cases between May 18 and June 4, 2015. Six patients died (fatality rate, 16.7%). Twenty-six cases occurred in the first-generation, and 10 in the second-generation. The median incubation period was five days, while the median period from symptom onset to death was 12.5 days. While the total attack rate was 3.9%, the attack rate among inpatients was 7.6%, and the inpatients on the eighth floor, where patient zero was hospitalized, had an 18.6% attack rate. In contrast, caregivers and medical staff showed attack rates of 3.3% and 1.1%, respectively.

CONCLUSIONS

The attack rates were higher than those of the previous outbreaks in other countries. The outbreak spread beyond Pyeongtaek St. Mary’s Hospital when four of the patients were moved to other hospitals without appropriate quarantine. The best method of preventing future outbreaks is to overcome the vulnerabilities observed in this outbreak, such as ward crowding, patient migration without appropriate data sharing, and the lack of an initial broad quarantine.

Summary

Korean summary
평택성모병원에서는 총 36명의 메르스 환자가 발생하여 이중 6명이 사망하였다. 또한 평택성모병원 유행의 발병률은 기존에 알려진 것보다 높았다. 한국의 메르스 유행이 시작된 평택성모병원에서 나타난 초기 방역 부족, 적절한 정보공유 없이 환자들이 병원간에 이동하는 것, 혼잡한 병동 문제 등의 감염병 전파 취약점을 극복하는 것이 향후 새로운 감염병 유행을 막을 수 있는 최선의 방법이 될 것이다.

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Epidemiology and Health.2015; 37: e2015049. CrossRef

The first case of the 2015 Korean Middle East Respiratory Syndrome outbreak: Yong-Shik Park, Changhwan Lee, Kyung Min Kim, Seung Woo Kim, Keon-Joo Lee, Jungmo Ahn, Moran Ki; Epidemiol Health. 2015;37:e2015049. Published online November 14, 2015; DOI: https://doi.org/10.4178/epih/e2015049

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Abstract Summary PDF Supplementary Material

Abstract

This study reviewed problems in the prevention of outbreak and spread of Middle East Respiratory Syndrome (MERS) and aimed to provide assistance in establishing policies to prevent and manage future outbreaks of novel infectious diseases of foreign origin via in-depth epidemiological investigation of the patient who initiated the MERS outbreak in Korea, 2015. Personal and phone interviews were conducted with the patient and his guardians, and his activities in Saudi Arabia were investigated with the help of the Saudi Arabian Ministry of Health. Clinical courses and test results were confirmed from the medical records. The patient visited 4 medical facilities and contacted 742 people between May 11, 2015, at symptom onset, and May 20, at admission to the National Medical Center; 28 people were infected and diagnosed with MERS thereafter. Valuable lessons learned included: (1) epidemiological knowledge on the MERS transmission pattern and medical knowledge on its clinical course; (2) improvement of epidemiological investigative methods via closed-circuit television, global positioning system tracking, and review of Health Insurance Review and Assessment Service records; (3) problems revealed in the existing preventive techniques, including early determination of the various people contacted; (4) experiences with preventive methods used for the first time in Korea, including cohort quarantine; (5) reconsideration of the management systems for infectious disease outbreaks across the country, such as this case, at the levels of central government, local government, and the public; (6) reconsideration of hospital infectious disease management systems, culture involving patient visitation, and emergency room environments.

Summary

Korean summary
2015년 한국 메르스 유행의 발단이 된 첫 번째 환자의 역학조사를 통해 신종감염병의 국내 유입 경위 및 유행확산을 막기 위한 대응 과정의 문제점을 되짚어 보았다. 이를 통해 향후 신종감염병의 국내유입을 막기 위한 대비, 대응 정책 수립에 도움이 되길 바라며 이번 메르스 유행이 한국의 병원감염 관리 수준이 향상되는 계기가 되어야 할 것이다.

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A new strategy for tuberculosis control in North Korea: Young-jeon Shin, Moran Ki, Nackmoon Sung; Epidemiol Health. 2015;37:e2015053. Published online November 22, 2015; DOI: https://doi.org/10.4178/epih/e2015053

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Abstract

Tuberculosis is one of the most prevalent diseases in North Korea. Despite some positive accomplishments by current aid projects, it is still necessary to investigate the existing aid system. The following are necessary for improvement: sustaining a high degree of expertise, cooperation among various related parties including the international community, mediation to induce this cooperation, a more active role of the South Korean government, and encouragement of North Korea to more actively participate. Achieving these will help solve the issues of current tuberculosis aid projects in North Korea and lead to more successful outcomes.

Summary

Korean summary
결핵은 북한의 주요 질병 중 하나이다. 기존 사업이 이루어낸 일부 긍정적인 성과에도 불구하고 북한 결핵사업의 문제들을 해결하고 성공적인 성과를 거두기 위해서는 기존 지원체계에 대한 반성과 함께 고도 전문성의 지속유지, 국제사회를 포함한 다양한 관련자들간의 협력, 이러한 협력을 이끌어낼 수 있는 조정능력, 남한정부의 보다 적극적인 역할, 북한 당사자의 참여유도가 필요하다.

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Experiences of Nurses Defecting from North Korea Regarding North Korean Nursing Education and Practice
Jung Hee Jeon, Kon Hee Kim
Journal of Korean Public Health Nursing.2024; 38(2): 234. CrossRef
Towards Understanding Tuberculosis-Related Issues in North Korea: A Narrative Review of North Korean Literature
Chang-Jun Lee, Sungwhan Lee, Hee-Jin Kim, Young Ae Kang
Tuberculosis and Respiratory Diseases.2020; 83(3): 201. CrossRef
An Analysis of Infectious Disease Research Trends in Medical Journals From North Korea
Do-Hyeon Park, Min-Ho Choi, Ah-Young Lim, Hee Young Shin
Journal of Preventive Medicine and Public Health.2018; 51(2): 109. CrossRef
Identifying socioeconomic, epidemiological and operational scenarios for tuberculosis control in Brazil: an ecological study
Daniele Maria Pelissari, Marli Souza Rocha, Patricia Bartholomay, Mauro Niskier Sanchez, Elisabeth Carmen Duarte, Denise Arakaki-Sanchez, Cíntia Oliveira Dantas, Marina Gasino Jacobs, Kleydson Bonfim Andrade, Stefano Barbosa Codenotti, Elaine Silva Nascim
BMJ Open.2018; 8(6): e018545. CrossRef

Epidemiological investigation of the 119th confirmed Middle East Respiratory Syndrome coronavirus case with an indefinite mode of transmission during the Pyeongtaek outbreak in Korea: Jong Hyuk Choi, Byoungin Yoo, Soon Young Lee, Eun Gyu Lee, Moran Ki, Woncheol Lee, Jong Rak Jung, Kyujin Chang; Epidemiol Health. 2015;37:e2015054. Published online December 10, 2015; DOI: https://doi.org/10.4178/epih/e2015054

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Abstract

Since the first case was diagnosed on May 20, 2015, there were 186 confirmed cases of Middle East Respiratory Syndrome (MERS) until the end of outbreak in South Korea. Although medical institutions were the most identifiable sources of MERS transmission in South Korea, similar to other countries, in-depth epidemiological investigation was required for some confirmed cases with indefinite contact history or hospital visit records. The subject of epidemiological investigation in the present study was a 35 year-old male patient diagnosed with MERS (#119) who lived in Asan-city and worked in Pyeongtaek-city. Various potential sources of transmission were carefully investigated. While he could have been exposed to MERS through a friend from Saudi Arabia or confirmed MERS cases in his workplace, neighboring areas, and medical institutions, as well as contacts in his home, the chances of transmission were low; however, the potential for transmission through his local community could not be excluded. Practically, it was difficult to determine the modes of transmission for all outbreak cases in communicable disease that occurred in this short period of time. The investigation to identify the mode of transmission in this case was ultimately unsuccessful. However, the various data collected and analyzed to reveal modes of transmission provided detailed information that could not be collected using only interview surveys.

Summary

Korean summary
2015년 한국에서 유행한 메르스 환자들 중, 감염 경로가 불분명한 119번째 환자에 대한 심층 역학조사를 통해 다양한 감염경로의 가능성을 검토하였다. 감염경로를 명확하게 밝혀내지 못한 한계점이 있지만, 지역사회 전파에 대한 가능성을 제시하였다. 감염병 대유행시 효율적인 감염경로 파악을 위해서는 다방면의 자료에 대한 확보체계와 이를 신속히 분석하고 판단할 수 있는 전문 인력 확충이 필요하다.

Citations

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A database of geopositioned Middle East Respiratory Syndrome Coronavirus occurrences
Rebecca E. Ramshaw, Ian D. Letourneau, Amy Y. Hong, Julia Hon, Julia D. Morgan, Joshua C. P. Osborne, Shreya Shirude, Maria D. Van Kerkhove, Simon I. Hay, David M. Pigott
Scientific Data.2019;[Epub] CrossRef

Changes in seroprevalence of hepatitis B surface antigen and epidemiologic characteristics in the Republic of Korea, 1998-2013: Hyerin Lee, Hyungmin Lee, Yumi Cho, Kyungwon Oh, Moran Ki; Epidemiol Health. 2015;37:e2015055. Published online December 23, 2015; DOI: https://doi.org/10.4178/epih/e2015055

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated changes in hepatitis B seroprevalence from 1998 to 2013, and to identify differences in epidemiologic characteristics between hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative people.

METHODS

HBsAg seropositive rates were compared by year, sex, and age using the blood test data from the periods I to VI (1998-2013) of the Korea National Health and Nutrition Examination Survey. Interviews and self-administered surveys were conducted to collect data on health behavior, quality of life, comorbidities, and health care utilization.

RESULTS

HBsAg seropositive rates in the Republic of Korea decreased from 4.6% in 1998 to 2.9% in 2008, and then remained the same for the next five years. While seropositive rates by age were the highest at 35 to 39 years of age in 1998, it peaked at 50 to 54 years of age in 2013. HBsAg-positive people showed high values from two liver function tests, including glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase, and the prevalence rates of liver cirrhosis and liver cancer were also significantly high. Indices for health behavior and quality of life showed no significant differences between HBsAg-positive and HBsAg-negative people.

CONCLUSIONS

While HBsAg seropositive rates tended to decline after 1998, there have been no significant changes over the most recent five years. We should focus on treatment of existing hepatitis B patients along with immunization programmes to prevent new hepatitis B infections. In addition, it may be necessary to encourage HBsAg-positive people to follow healthier life-styles in order to prevent further progression of hepatitis B to liver cirrhosis and liver cancer.

Summary

Korean summary
한국 국민건강영양조사 자료로 본 HBsAg 양성률은 1998 년 4.6%에서 2008 년에 2.9%로 감소한 이후 5 년간 증감없이 2013 년에 2.9%로 나타났다. 한국 HBsAg 양성률을 더욱 감소시키기 위해서는 예방접종사업뿐 아니라 B형 간염 환자 치료를 보다 적극적으로 해야 될 것으로 보인다. 또한 HBsAg 양성자는 간경화나 간암 예방을 위해 건강한 생활습관을 가지도록 노력하는 것이 필요하다.

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Shifting Epidemiology of Hepatocellular Carcinoma in Far Eastern and Southeast Asian Patients: Explanations and Implications
Nguyen H. Tran
Current Oncology Reports.2022; 24(2): 187. CrossRef
Proportion of People Who Are Positive for HBsAg and Anti-HCV Antibody Among Participants in a Community Screening Campaign in Malaysia
Zhuo-Zhi Lim, Jau Shya Teo, Ah Choon Tan, Teck-Onn Lim
Hepatitis Monthly.2022;[Epub] CrossRef
The changing epidemiology of liver diseases in the Asia–Pacific region
Martin C. S. Wong, Jason L. W. Huang, Jacob George, Junjie Huang, Colette Leung, Mohammed Eslam, Henry L. Y. Chan, Siew C. Ng
Nature Reviews Gastroenterology & Hepatology.2019; 16(1): 57. CrossRef
Incidence and Overall Survival of Biliary Tract Cancers in South Korea from 2006 to 2015: Using the National Health Information Database
Byung-Woo Kim, Chang-Mo Oh, Hwa Young Choi, Joong-Won Park, Hyunsoon Cho, Moran Ki
Gut and Liver.2019; 13(1): 104. CrossRef
Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Liver Disease
So-Ryoung Lee, Hyun-Jung Lee, Eue-Keun Choi, Kyung-Do Han, Jin-Hyung Jung, Myung-Jin Cha, Seil Oh, Gregory Y.H. Lip
Journal of the American College of Cardiology.2019; 73(25): 3295. CrossRef
Negative Association of Hepatitis B Virus With Hearing Impairment
SKM Azizul Islam, Jin Wook Chung, Young-Sil Lee, HoChan Cho, Seong-Su Moon
American Journal of Audiology.2018; 27(3): 324. CrossRef
Response to hepatitis B vaccination in patients with inflammatory bowel disease: a prospective observational study in Korea
Ji Young Chang, Sung-Ae Jung, Chang Mo Moon, Seong-Eun Kim, Hye-Kyung Jung, Ki-Nam Shim
Intestinal Research.2018; 16(4): 599. CrossRef
Recognition criteria for occupational cancers in relation to hepatitis B virus and hepatitis C virus in Korea
Hogil Kim, Yun Kyung Chung, Inah Kim
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Identification of Novel A2/C2 Inter-Genotype Recombinants of Hepatitis B Virus from a Korean Chronic Patient Co-Infected with Both Genotype A2 and C2
So-Young Lee, Seung-Hee Lee, Ji-Eun Kim, Hong Kim, Kijeong Kim, Yoon-Hoh Kook, Bum-Joon Kim
International Journal of Molecular Sciences.2017; 18(4): 737. CrossRef

Efflux-mediated resistance identified among norfloxacin resistant clinical strains of group B Streptococcus from South Korea: Trang Nguyen Doan Dang, Usha Srinivasan, Zachary Britt, Carl F. Marrs, Lixin Zhang, Moran Ki, Betsy Foxman; Epidemiol Health. 2014;36:e2014022. Published online October 11, 2014; DOI: https://doi.org/10.4178/epih/e2014022

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Abstract PDF

Abstract

OBJECTIVES
Group B Streptococcus (GBS), a common bowel commensal, is a major cause of neonatal sepsis and an emerging cause of infection in immune-compromised adult populations. Fluoroquinolones are used to treat GBS infections in those allergic to beta-lactams, but GBS are increasingly resistant to fluoroquinolones. Fluoroquinolone resistance has been previously attributed to quinolone resistance determining regions (QRDRs) mutations. We demonstrate that some of fluoroquinolone resistance is due to efflux-mediated resistance.

METHODS

We tested 20 GBS strains resistant only to norfloxacin with no mutations in the QRDRs, for the efflux phenotype using norfloxacin and ethidium bromide as substrates in the presence of the efflux inhibitor reserpine. Also tested were 68 GBS strains resistant only to norfloxacin not screened for QRDRs, and 58 GBS strains resistant to ciprofloxacin, levofloxacin or moxifloxacin. Isolates were randomly selected from 221 pregnant women (35-37 weeks of gestation) asymptomatically carrying GBS, and 838 patients with GBS infection identified in South Korea between 2006 and 2008. The VITEK II automatic system (Biomerieux, Durham, NC, USA) was used to determine fluoroquinolone resistance.

RESULTS

The reserpine associated efflux phenotype was found in more than half of GBS strains resistant only to norfloxacin with no QRDR mutations, and half where QRDR mutations were unknown. No evidence of the efflux phenotype was detected in GBS strains that were resistant to moxifloxacin or levofloxacin or both. The reserpine sensitive efflux phenotype resulted in moderate increases in norfloxacin minimum inhibitory concentration (average=3.6 fold, range=>1-16 fold).

CONCLUSIONS

A substantial portion of GBS strains resistant to norfloxacin have an efflux phenotype.

Summary

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Exploring norfloxacin analogs in combating antimicrobial resistance: design, mechanistic insights and structure activity relationship
Aanchal Khanna, Karanvir Singh, Jyoti, Nitish Kumar, Harmandeep Kaur, Rakshit Badhwar, Jagtar Singh, Preet Mohinder Singh Bedi
Future Medicinal Chemistry.2025; 17(14): 1739. CrossRef
Fluoroquinolones tackling antimicrobial resistance: Rational design, mechanistic insights and comparative analysis of norfloxacin vs ciprofloxacin derivatives
Aanchal Khanna, Nitish Kumar, Rupali Rana, Jyoti, Anchal Sharma, Muskan, Harmandeep Kaur, Preet Mohinder Singh Bedi
Bioorganic Chemistry.2024; 153: 107773. CrossRef
A review of antibiotic resistance in Group B Streptococcus: the story so far
Katherine Hayes, Fiona O’Halloran, Lesley Cotter
Critical Reviews in Microbiology.2020; 46(3): 253. CrossRef
Tackling Multidrug Resistance in Streptococci – From Novel Biotherapeutic Strategies to Nanomedicines
Cinthia Alves-Barroco, Lorenzo Rivas-García, Alexandra R. Fernandes, Pedro Viana Baptista
Frontiers in Microbiology.2020;[Epub] CrossRef
Fluoroquinolone-Resistant Streptococcus agalactiae Invasive Isolates Recovered in Argentina
Bárbara Arias, Verónica Kovacec, Laura Vigliarolo, Mariana Suárez, Carina Tersigni, Loana Müller, Horacio Lopardo, Laura Bonofiglio, Marta Mollerach
Microbial Drug Resistance.2019; 25(5): 739. CrossRef
Multidrug efflux pumps of Gram-positive bacteria
Bryan D. Schindler, Glenn W. Kaatz
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Fluoroquinolone Resistance among Clonal Complex 1 Group BStreptococcusStrains
Alefiya Neemuchwala, Sarah Teatero, Samir N. Patel, Nahuel Fittipaldi
Canadian Journal of Infectious Diseases and Medical Microbiology.2016; 2016: 1. CrossRef
Molecular Analysis of Rising Fluoroquinolone Resistance in Belgian Non-Invasive Streptococcus pneumoniae Isolates (1995-2014)
Pieter-Jan Ceyssens, Françoise Van Bambeke, Wesley Mattheus, Sophie Bertrand, Frédéric Fux, Eddie Van Bossuyt, Sabrina Damée, Henry-Jean Nyssen, Stéphane De Craeye, Jan Verhaegen, Paul M. Tulkens, Raymond Vanhoof, Eliane Namie Miyaji
PLOS ONE.2016; 11(5): e0154816. CrossRef

Prevalence of fungal infections using National Health Insurance data from 2009-2013, South Korea: Hee Jung Yoon, Hwa Young Choi, Young Kwon Kim, Yeong Jun Song, Moran Ki; Epidemiol Health. 2014;36:e2014017. Published online September 11, 2014; DOI: https://doi.org/10.4178/epih/e2014017

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Abstract

OBJECTIVES
The symptoms of fungal infections vary from minor to severe. According to recent reports, fungal infection prevalence is increasing due to increases in the aging population and in patients with compromised immune systems. However, the total prevalence of fungal infections in South Korea is unknown. We investigated the recent 5-year prevalence of each type of fungal infection in South Korea across age, sex, and regional groups.

METHODS

Nationwide data from the National Health Insurance of South Korea were used. The target population included patients who had received treatment for a fungal infection that was listed as the main disease. For each patient, multiple treatments were counted as one case per year in the data analysis.

RESULTS

The annual prevalence of all-type mycoses increased from 6.9% in 2009 to 7.4% in 2013. Among the specific groups, the prevalence of dermatophytosis was highest (5.2%), followed by that of opportunistic mycoses (1.7%) and superficial mycoses (0.2%). The prevalence of subcutaneous mycoses and generalized mycoses was very low (8 cases per 100,000 persons and 3 cases per 1 million persons, respectively).

CONCLUSIONS

Every year, approximately 7.1% of the Korean population receives treatment for fungal diseases. Cases of opportunistic mycoses are assumed to increase each year. Therefore, further research is needed to understand and monitor the prevalence of mycoses to establish management policies to reduce the burden of fungal diseases.

Summary

Korean summary
2009-2013년도 한국의 건강보험자료를 활용하여 진균 종류별로 연령별, 성별, 지역별 유병률을 검토하였다. 그 결과 한국 인구의 약 7.1%가 매년 진균 질환으로 치료를 받고 있는 것으로 나타났다. 특히 기회감염 진균증의 연도별 증가 양상이 관찰되었다. 진균증 유병률에 대한 이해와 관심이 필요하며 이를 토대로 진균 질환 관리 정책 수립이 필요하다.

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The costs of hepatitis A infections in South Korea: Kyohyun Kim, Baek-Geun Jeong, Moran Ki, Mira Park, Jin Kyung Park, Bo Youl Choi, Weon-Seob Yoo; Epidemiol Health. 2014;36:e2014011. Published online August 18, 2014; DOI: https://doi.org/10.4178/epih/e2014011

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Abstract

OBJECTIVES
The incidence of hepatitis A infections among young adults has recently increased in South Korea. Although universal vaccination has often been suggested to mitigate the problem, its rationale has not been well-understood. Estimating the societal costs of hepatitis A infections might support the development of intervention strategies.

METHODS

We classified hepatitis A infections into eight clinical pathways and estimated the number of occurrences and cost per case for each clinical pathway using claim data from National Health Insurance and several national surveys as well as assumptions based on previous studies. To determine the total costs of a hepatitis A infection, both direct and indirect costs were estimated. Indirect costs were estimated using the human-capital approach. All costs are adjusted to the year 2008.

RESULTS

There were 30,240 identified cases of hepatitis A infections in 2008 for a total cost of 80,873 million won (2.7 million won per case). Direct and indirect costs constituted 56.2% and 43.8% of the total costs, respectively. People aged 20-39 accounted for 71.3% of total cases and 74.6% of total costs. Medical costs per capita were the lowest in the 0-4 age group and highest in the 20-29 age group.

CONCLUSIONS

This study could provide evidence for development of cost-effective interventions to control hepatitis A infections. But the true costs including uncaptured and intangible costs of hepatitis A infections might be higher than our results indicate.

Summary

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What do we really fear? The epidemiological characteristics of Ebola and our preparedness: Moran Ki; Epidemiol Health. 2014;36:e2014014. Published online August 18, 2014; DOI: https://doi.org/10.4178/epih/e2014014

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Abstract

Ebola virus disease (hereafter Ebola) has a high fatality rate; currently lacks a treatment or vaccine with proven safety and efficacy, and thus many people fear this infection. As of August 13, 2014, 2,127 patients across four West African countries have been infected with the Ebola virus over the past nine months. Among these patients, approximately 1 in 2 has subsequently died from the disease. In response, the World Health Organization has declared the Ebola outbreak in West Africa to be a Public Health Emergency of International Concern. However, Ebola is only transmitted by patients who already present symptoms of the disease, and infection only occurs upon direct contact with the blood or body fluids of an Ebola patient. Consequently, transmission of the outbreak can be contained through careful monitoring for fever among persons who have visited, or come into contact with persons from, the site of the outbreak. Thus, patients suspected of presenting symptoms characteristic of Ebola should be quarantined. To date, South Korea is not equipped with the special containment clinical units and biosafety level 4 facilities required to contain the outbreak of a fatal virus disease, such as Ebola. Therefore, it is necessary for South Korea to make strategies to the outbreak by using present facilities as quickly as possible. It is also imperative that the government establish suitable communication with its citizens to prevent the spread of uninformed fear and anxiety regarding the Ebola outbreak.

Summary

Korean summary
에볼라 바이러스병은 치명률이 높고 효과와 안전성을 모두 검증받은 치료제나 백신이 없어 많은 사람들이 두려워하고 있는 질환이다. 이번에 서아프리카에서 9개월째 지속된 유행으로 8월 13일까지 4개국에서 2127명의 환자가 발생하였고 1145명이 사망하여 2명중 1명꼴인 높은 치명률을 보이고 있다. 이에 WHO에서는 국제보건긴급상황을 선포하였다. 하지만 에볼라 바이러스는 증상이 나타난 이후에 전염되며 환자의 혈액이나 체액에 접촉한 경우에만 감염이 된다. 따라서 유행지역을 방문하였거나 접촉한 사람을 대상으로 발열감시와 함께 환자 격리를 철저히 시행한다면 유행 전파를 막을 수 있다. 한국은 아직 에볼라 바이러스와 같은 질환에 적합한 격리병상이나 실험실 안전 4등급 시설이 없다. 이에 대한 대비를 빠른 시간에 마련하여 대응하는 것이 필요하며, 국민과의 소통을 통해서 막연한 불안과 두려움을 예방하는 것이 무엇보다 중요하다.

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Greetings from the editor-in-chief: Moran Ki; Epidemiol Health. 2014;36:e2014001. Published online April 30, 2014; DOI: https://doi.org/10.4178/epih/e2014001

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Korean summary
한국역학회지 창간 35주년이 되는 뜻깊은 해에 새로이 편집장을 맡게 되어 인사드립니다. 올해 우리 학회지는 국제학술지로서의 위치를 공고히 하고자 몇가지 변화를 도입하였습니다. 한글 논문도 받기로 하였고, 영문 번역을 포함하여 논문 출판시 저자의 금전전 부담이 전혀 없도록 하였으며, 코호트 프로파일, 데이터 프로파일 등의 연구 설계 논문도 게재하기로 하였습니다. 또한 온라인 논문 투고 시스템을 도입하였고, 창간호부터 현재까지의 역학회지 전체를 업로드 하였습니다. epiH는 여러분의 소중한 논문이 전세계 독자들에게 빠르게 읽히고 인용될 수 있도록 항상 최선을 다할 것입니다. 적극적인 참여 부탁드립니다.

Risk Factors for Group B Streptococcus Colonization Among Pregnant Women in Korea: Eun Ju Kim, Kwan Young Oh, Moon Young Kim, Yong Soo Seo, Jung-Hwan Shin, Young Rae Song, Jae-Hyug Yang, Betsy Foxman, Moran Ki; Epidemiol Health. 2011;33:e2011010. Published online November 11, 2011; DOI: https://doi.org/10.4178/epih/e2011010

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Abstract

<sec><title>OBJECTIVES</title>To identify obstetric and maternal factors related to Group B Streptococcus (GBS) colonization in pregnant women in Korea.</sec><sec><title>METHODS</title>The study was conducted between the years 2006-2008 in four hospitals, Cheil and Eulji hospital in Seoul, and Motae and Eulji hospital in Daejeon. We recruited 2,644 pregnant women between 35 to 37 weeks of gestation who had visited for antenatal care. Participants completed a questionnaire, and urine, vaginal and rectal specimens were obtained and cultured using selective broth media. After delivery, medical records were reviewed.</sec><sec><title>RESULTS</title>GBS colonization was significantly associated with hospital, age group, education, frequency of pregnancy, and premature rupture of membranes (PROM, more than 18 hours). After adjustment for other variables, Cheil hospital (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.20-3.52), and the first pregnancy (OR, 2.32; 95% CI, 1.12-4.81) remained significant. History of vaginitis showed marginal significance (OR, 1.50; 95% CI, 0.98-2.29).</sec><sec><title>CONCLUSION</title>To prevent GBS infection of neonates, clinicians should be alert to the potentially higher risk of GBS colonization in pregnant women in their first pregnancy, and women with premature rupture of membranes (PROM) (18 hours+) or who have a history of vaginitis.</sec>

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Hepatitis A Vaccination Rates and Related Factors in a 2005 Population-based Study in Nonsan, Korea: Eun Young Kim, Baeg Ju Na, Moo Sik Lee, Keon Yeop Kim, Moran Ki; Epidemiol Health. 2009;31:e2009003. Published online October 12, 2009; DOI: https://doi.org/10.4178/epih/e2009003

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Abstract

<sec><title>OBJECTIVES</title>The incidence of clinical hepatitis A has increased in young Korean adults since the mid-1990s. Although hepatitis A vaccinations have been administered in private clinics over the past 10 yr, no data exist on the vaccination rate and relating factors.</sec><sec><title>METHODS</title>In 2005, a population-based survey of 12-35-month-old children was carried out in Nonsan, Korea. An interview survey was completed for 71.3% of the children. All data came from a vaccination card or confirmation from a provider.</sec><sec><title>RESULTS</title>The hepatitis A vaccination rate was 42.3% for ≥1 dose and 24.7% for 2-dose. The results of the multivariate regression analysis for the hepatitis A vaccination showed that the second (OR=1.6) and third and successive children (OR=3.3) were less often immunized than the first child. Low economic status (OR=1.6), rural area (OR=1.5) and employed mother (OR=1.5) were also correlated with a lower vaccination rate. The hepatitis A vaccination rate was significantly lower in children who had no other vaccinations: measlesmumps-rubella (OR=2.8 for ≥1 dose and 7.3 for 2-dose), varicella (OR=20.2 and 22.0, respectively) and <italic>Haemophilus influenza</italic> type b (OR=14.3 and 13.3, respectively).</sec><sec><title>CONCLUSION</title>To prevent outbreaks of clinical hepatitis A by enough herd immunity, a vaccination should be included in the National Immunization Program and a vaccination policy developed and implemented that can overcome the barriers to immunization such as late birth order and a mother's employment.</sec>

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Marissa Gripenberg, Naveena Aloysia D’Cor, Maïna L’Azou, Grenville Marsh, Sophie Druelles, Joshua Nealon
International Journal of Infectious Diseases.2018; 68: 13. CrossRef
Hepatitis A Virus Vaccination Status and Related Factors among College Students
Jae Seong Baek, Mi Ah Han, Jong Park, Na-Ra Yun
Korean Journal of Health Promotion.2014; 14(3): 103. CrossRef
Vaccination rates and related factors among health care workers in South Korea, 2009
Hee Jung Yoon, Jiseun Lim, BoYoul Choi, Jungsoo Kim, Jeonguk Kim, Changhwi Kim, Joon Soo Park, Sang-Bum Hong, Jooyoun Seo, Geun-Ryang Bae, Moran Ki
American Journal of Infection Control.2013; 41(8): 753. CrossRef
Factors Related to Completed Status and Seropositivity of Hepatitis A Immunization Among Children Aged 1–3 Years and 6–8 Years in South Korea
Jee-Young Hong, Mo Ran Ki, Hye-Jung Hwang, Delacroix Sinny, Young-Joon Park, Geun-Ryang Bae, Moo-Sik Lee
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Six year national trend of childhood aseptic meningitis incidence in Korea, 1996-2001.: Hae Kwan Cheong, Sue Kyung Park, Moran Ki, Kwan Lee; Korean J Epidemiol. 2008;30(2):252-262. Published online December 31, 2008; DOI: https://doi.org/10.4178/kje.2008.30.2.252

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Abstract

BACKGROUND
AND OBJECTIVES: Aseptic meningitis is a disease of children with seasonal outbreak in summer. In spite of high morbidity, it is not notifiable without reported nationwide morbidity. The authors estimated incidence of aseptic meningitis and its descriptive characteristics and time- and space-clustering pattern. SUBJECTS AND METHODs: Cases of aseptic meningitis were extracted from National Health Insurance payment request data of National Health Insurance Corporation from January 1996 to December 2001. Cases were classified by region, institution, and hospitalization. Standardized incidence was calculated and compared by the region, month of the year whether there is any clustering.

RESULTS

Nationwide incidence of aseptic meningitis among children under 15 years old over the six year period was 3.48 per 1,000 per year. Incidence was higher in female (2.80/1,000) compared to male (4.02/1,000). Age-specific incidence was highest in 5 years old. Annual incidence was highest in 1997 (8.44/1,000) and lowest in 2000 (0.79 /1,000) with outbreak every 3 or 4 years. Outbreak was mostly confined in summer months, between May and Septe- mber. However, seasonal pattern was variable by year. Southern provinces and metropolitan areas had higher incidences and pattern was more prominent in the years with higher outbreak. Time-dependent pattern of the disease from south to north was not prominent.

DISCUSSIONS

AND CONCLUSIONS: We have calculated the nationwide incidence of the aseptic meningitis over six year period. In terms of aseptic meningitis, using National Health Insurance data for the estimation of the incidence is a plausible method for the surveillance of the disease.

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Young Ki Lee, Kyeong Hye Park, Young Duk Song, Taemi Youk, Joo Young Nam, Sun Ok Song, Dong Yeob Shin, Eun Jig Lee
Cancer Research and Treatment.2019; 51(4): 1430. CrossRef
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Jong-Hun Kim, Hae-Kwan Cheong, Byoung-Hak Jeon
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Impact of Drinking Water Quality on the Development of Enteroviral Diseases in Korea
Yadav P. Joshi, Jong-Hun Kim, Ho Kim, Hae-Kwan Cheong
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Associations between Meteorological Factors and Aseptic Meningitis in Six Metropolitan Provinces of the Republic of Korea
Yadav Joshi, Eun-Hye Kim, Jong-Hun Kim, Ho Kim, Hae-Kwan Cheong
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Is the Tuberculosis Case Reporting Rate of Medical Care Institutions in Private Sector low?: Jong Seon Han, Won Gi Jhang, Young Hwangbo, Sung Soo Lee, Moran Ki; Korean J Epidemiol. 2008;30(2):230-238. Published online December 31, 2008; DOI: https://doi.org/10.4178/kje.2008.30.2.230

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PURPOSE
To estimate the reporting rate of tuberculosis in one medium-sized city in Korea.
METHODS
Data claimed by national health insurance corporationand notification data of KTBS (Korea Tuberculosis Surveillance System) were compared through medical record-linkage method. Regarding the cases that were claimed medical care fee as tuberculosis but not notified to KTBS, we reviewed medical charts of the patients and investigated the reasons of failure to notify.
RESULTS
Number of cases claimed health insurance fee as tuberculosis occurrences in Cheonan was 2,331 in 2007, while 956 cases were matched as notified cases to KTBS after electronic record-linkage by personal identifier. Among remaining 1,375 cases that were not matched, real missed cases through medical record review survey were found to be 104. The reasons of failure to notify were because of 'not tuberculosis patients' (500, 36.4%), 'notified in 2006' (421, 30.6%), 'diseases coding error' (341, 24.8%) and 'notified as other diseases' (9, 0.7%). Therefore, the corrected reporting rate was calculated at 93% (95% CI: 91.6% - 94.2%). Notably, reporting rate of clinics (58.1%) was significantly lower than those of hospitals (93.4%) or general hospitals (96.6%).
CONCLUSIONS
All cases of tuberculosis diagnosis, which were claimed and not notified, were verified, the reporting rate was not as low as that of the data known through media. However, to reach the goal of tuberculosis elimination (reporting rate over 95%), more effort into improvement of the reporting system is necessary.; Summary

Evaluation of Mumps Vaccine Effectiveness by outbreak investigation in one kindergarten in Ulsan city, 2006.: Kyo Hyun Kim, Heran Ki, Bo Youl Choi, Chang Hui Kim, Dong Han Lee, Un Young Ko, Moran Ki; Korean J Epidemiol. 2008;30(1):110-118. Published online June 30, 2008; DOI: https://doi.org/10.4178/kje.2008.30.1.110

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Abstract

PURPOSE
Despite of the high MMR vaccine coverage, the mumps outbreaks is continued in most developed countries including South Korea. To evaluate the effectiveness of MMR vaccine, we carried out mumps outbreak investigation in one kindergarten.

METHODS

In Dec. 2006, a mumps outbreak occurred in a kindergarten. Retrospective study was conducted among 212 respondents (205 children and 7 teachers) in 230 study populations (study participation rate: 92%). To define mumps cases, a questionnaire survey, telephone survey, and mumps antibody test with serum were conducted. MMR vaccination status was verified in 198 children using children's vaccination records, National Immunization Registration System and/or medical records of private clinics or hospitals.

RESULTS

Over 90% children had received one dose of MMR vaccination. However, 2nd dose of MMR vaccination rate was 45.1%. Attack rates of mumps were 22.9%(22/96) for one dose MMR vaccinees and 3.3%(3/92) for two doses vaccinees. MMR vaccine effectiveness of two doses over one dose was 86%. Mumps attack rate in one dose MMR vaccinees increased by the duration after MMR vaccination. Among all mumps cases, asymptomatic mumps infection identified by IgM positive or IgG over 10,000mIU/ml was 58% (26/ 45).

CONCLUSIONS

MMR one dose coverage rate was high(92.1%), but the second dose vaccination rate was very low (45.1%). Mumps attack rate was increased by the duration after the MMR vaccination, and the maximum effectiveness of one dose MMR vaccination was low (77.1%). Therefore, to prevent mumps outbreaks in the kindergarten, second MMR vaccination should be scheduled in 4 years old age, and the coverage rate should be increased over 90%. Further studies for the effectiveness of MMR two doses after 5 and more years are needed.

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

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Abstract

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

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Incidence of complication and societal cost of measles in Korea, 2000.: Weon Young Lee, Moran Ki, Jin Kyoung Oh, Jong Koo Lee, Myung Bin Kim, Bo Youl Choi; Korean J Epidemiol. 2004;26(2):71-80.

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Abstract PDF: Abstract
OBJECTIVES
To estimate the complication rate and the societal cost of measles, a survey was conducted in Seoul, Jeonju city, and Kyonggi province in 2001.
METHODS
A telephone survey was conducted in Jeonju city (175/307) and four local areas of Kyonggi province (793/1,238) to gather information on the complications of measles. To estimate societal cost, the telephone survey was conducted for the sampled subject by complication type and the age group. The response rate was 78% (180/230). Paid bills were examined for direct cost estimation, and the time cost and the transportation expense were analyzed for indirect cost estimation.
RESULTS
The incidence of a complication of measles was 3.1% which found to be higher in younger age group. The incidence of pneumonia, otitis media, and encephalitis were 2.1%, 0.8%, and 0.2% respectively. Direct and indirect costs of in-patients without a complication were $417.00 (US $1.00 = 1,000 won) and $256.00 per case, respectively, and the out-patients who have no complication were $54.00 and $65.00, respectively. The average cost for a patient with measles without complication was $119.00 as the result. The societal cost of encephalitis was high as $6,660. Estimated total societal cost of measles ranges from $14 million to $69 million in the year 2000.
CONCLUSION
Complication rate of measles was fairly low compared to foreign countries. The lower rate could result from the difference in vaccination rate and the age distribution of the measles patients. The cost of measles without complication was not high. However, the cost for the complication and the total disease burden caused by measles shown to be high in the year 2000.; Summary

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