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Original Article

July 19, 2019


The relationship between maternal mental health and communication skills in children in Shiraz, Iran
Najmeh Maharlouei, Hossein Alibeigi, Abbas Rezaianzadeh, Pedram Keshavarz, Hadi Raeisi Shahraki, Hamid Nemati, Kamran B. lankarani
Epidemiol Health. 2019;41:e2019035.

Original Article

July 12, 2019


Bilirubin and risk of ischemic heart disease in Korea: a two-sample Mendelian randomization study
Christina Jeon, Ji-Young Lee, Sun Ju Lee, Keum Ji Jung, Heejin Kimm, Sun Ha Jee
Epidemiol Health. 2019;41:e2019034.

Case Report

July 12, 2019


Two cases of cholera O1 in South Batinah, Oman, April 2019: lessons learned
Zayid K. Al Mayahi, Nasser Al-Shaqsi, Hamid A. Elmutashi, Ali Al-Dhoyani, Azza Al Hattali, Khalid Salim, Issa S. Al Fulaiti, Mahmood S. Al Subhi
Epidemiol Health. 2019;41:e2019033.

Original Article

July 9, 2019


Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data
Fatemeh Sarvi, Abbas Moghimbeigi, Hossein Mahjub, Mahshid Nasehi, Mahmoud Khodadost
Epidemiol Health. 2019;41:e2019032.

Original Article

July 9, 2019


Why do some Korean parents hesitate to vaccinate their children?
Kyujin Chang, Soon Young Lee
Epidemiol Health. 2019;41:e2019031.

Current Issue
Volume 41; 2019
Original Article The relationship between maternal mental health and communication skills in children in Shiraz, Iran
Najmeh Maharlouei, Hossein Alibeigi, Abbas Rezaianzadeh, Pedram Keshavarz, et al. Epidemiol Health. 2019;41:e2019035.
  • Abstract
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Original Article Bilirubin and risk of ischemic heart disease in Korea: a two-sample Mendelian randomization study
Christina Jeon, Ji-Young Lee, Sun Ju Lee, Keum Ji Jung, et al. Epidemiol Health. 2019;41:e2019034.
  • Abstract
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  • Supplementary data
Abstract
OBJECTIVES:
Child development is a significant issue in global public health, and maternal mental health (MMH) can have a remarkable effect on children’s development of communication skills. We aimed to investigate the association between MMH and communication skills in a sample of Iranian children.
METHODS:
This study was conducted in Shiraz, Iran during 2016. In total, 640 mothers who lived in Shiraz and were registered in the Fars Birth Cohort (FBC) study were invited to attend the FBC clinic with their children. A trained physician evaluated MMH using the General Health Questionnaire (GHQ). Additionally, a trained nurse assessed the children’s communication development status using the Ages and Stages Questionnaire for 60-month old children.
RESULTS:
The majority of the mothers were homemakers (82.8%) and had high school diplomas (38.9%). The mothers’ mean age was 33.7±4.6 years. Seventy-nine (12.3%) children had delayed communication skills, but no significant association was found between children’s communication skills and the mothers’ total GHQ score (p=0.43). In total, 493 mothers (77.0%) had abnormal somatic symptoms, 497 (77.7%) had abnormal anxiety/insomnia, 337 (52.7%) had social dysfunction, and 232 (36.3%) suffered from depression. Logistic regression indicated that after adjusting for confounders, the odds of delayed communication skills were 3-fold higher among the children of mothers with abnormal somatic symptoms than among other children (p=0.01).
CONCLUSIONS:
The study results confirmed that MMH had a significant impact on children’s communication skills. Moreover, maternal abnormal somatic symptoms exerted the strongest impact on the development of communication skills in 5-yearold children.
Abstract
OBJECTIVES:
Bilirubin is an endogenous antioxidant that protects cells against oxidative stress. Increased plasma levels of bilirubin have been associated with a reduced risk of ischemic heart disease (IHD) in previous studies. Nonetheless, whether those associations reflect a true protective effect of bilirubin on IHD, rather than confounding or reverse causation, remains unknown. Therefore, we applied two-sample Mendelian randomization to evaluate the causal association between bilirubin levels and IHD risk in a Korean population.
METHODS:
A total of 5 genetic variants—TRPM8 (rs10490012), USP40 (rs12993249), ATG16L1 (rs2119503), SLCO1B1 (rs4149014), and SLCO1B3 (rs73233620)—were selected as genetic instruments for serum bilirubin levels using a communitybased cohort, the Korean Genome and Epidemiology Study, comprising 33,598 subjects. We then evaluated their impact on IHD using the Korean Cancer Prevention Study-II cohort.
RESULTS:
Among the 5 instrumental variables that showed significant associations with serum bilirubin levels, rs12993249 (USP40) showed the most significant association (p<2.36×10-105). However, we found no significant association between serum bilirubin levels and IHD. Sensitivity analyses demonstrated a consistent association, suggesting that our observations were robust.
CONCLUSIONS:
Using two-sample Mendelian randomization, we found no association between serum bilirubin levels and IHD. Further studies that confirm the observed interactions among other ethnicities are warranted.
Case Report Two cases of cholera O1 in South Batinah, Oman, April 2019: lessons learned
Zayid K. Al Mayahi, Nasser Al-Shaqsi, Hamid A. Elmutashi, Ali Al-Dhoyani, et al. Epidemiol Health. 2019;41:e2019033.
  • Abstract
  • View article
Original Article Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data
Fatemeh Sarvi, Abbas Moghimbeigi, Hossein Mahjub, Mahshid Nasehi, et al. Epidemiol Health. 2019;41:e2019032.
  • Abstract
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Abstract
Cholera represents an ongoing threat to many low-income and middle-income countries, but some cases of cholera even occur in high-income countries. Therefore, to prevent or combat cholera outbreaks, it is necessary to maintain the capacity to rapidly detect cholera cases, implement infection control measures, and improve general hygiene in terms of the environment, water, and food. The 2 cases, 1 imported and 1 secondary, described herein are broadly indicative of areas that require improvement. These cases were missed at the primary health care stage, which should be the first detection point even for unusual diseases such as cholera, and the absence of strict infection control practices at the primary care level is believed to contribute to secondary cases of infection. This report also encourages countries to ensure that rapid diagnostic stool tests are available to enable quick detection, as well as to provide information to people travelling to areas where cholera is endemic.
Abstract
OBJECTIVES:
Tuberculosis (TB) is a global public health problem that causes morbidity and mortality in millions of people per year. The purpose of this study was to examine the relationship of potential risk factors with TB mortality in Iran.
METHODS:
This cross-sectional study was performed on 9,151 patients with TB from March 2017 to March 2018 in Iran. Data were gathered from all 429 counties of Iran by the Ministry of Health and Medical Education and Statistical Center of Iran. In this study, a generalized estimating equation-based zero-inflated negative binomial model was used to determine the effect of related factors on TB mortality at the community level. For data analysis, R version 3.4.2 was used with the relevant packages.
RESULTS:
The risk of mortality from TB was found to increase with the unemployment rate (βˆ=0.02), illiteracy (βˆ=0.04), household density per residential unit (βˆ=1.29), distance between the center of the county and the provincial capital (βˆ=0.03), and urbanization (βˆ=0.81). The following other risk factors for TB mortality were identified: diabetes (βˆ=0.02), human immunodeficiency virus infection (βˆ=0.04), infection with TB in the most recent 2 years (βˆ=0.07), injection drug use (βˆ=0.07), long-term corticosteroid use (βˆ=0.09), malignant diseases (βˆ=0.09), chronic kidney disease (βˆ=0.32), gastrectomy (βˆ=0.50), chronic malnutrition (βˆ=0.38), and a body mass index more than 10% under the ideal weight (βˆ=0.01). However, silicosis had no effect.
CONCLUSIONS:
The results of this study provide useful information on risk factors for mortality from TB.
Original Article Why do some Korean parents hesitate to vaccinate their children?
Kyujin Chang, Soon Young Lee Epidemiol Health. 2019;41:e2019031.
  • Abstract
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  • Korean summary
  • Supplementary data
Original Article Trends in the prevalence and management of diabetes in Korea: 2007-2017
Ji-Yeon Shin Epidemiol Health. 2019;41:e2019029.
  • Abstract
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  • Korean summary
  • Supplementary data
Abstract
OBJECTIVES:
Vaccinations for infectious diseases are opposed despite their achievement, and this opposition has recently been revealed in Korea. However, research in Korea has not been vigorous. The authors studied why some Korean parents hesitate to vaccinate their children by applying the health belief model.
METHODS:
Parents who hesitate to vaccinate and parents who do not were surveyed in alternative education preschools and elementary schools. They were classified into four types of hesitancy and statistically compared.
RESULTS:
Among the 129 subjects, 43 vaccinated without hesitancy, 20 vaccinated on time with hesitancy, 32 vaccinated with a deliberate delay of one month or longer, and 34 did not vaccinate. Vaccination increased with an increase in the awareness that severe outcomes can occur when unvaccinated. Concerns about adverse reactions from vaccinations or direct/indirect experiences affected refusal. Furthermore, perceptions of the lack of meaningfulness of vaccinations, distrust of policy and safety management, influence of leaders or activists in joined organizations, and experts of Korean traditional or alternative medicine affected refusal. Explanations by doctors, text messages and mails from institutions, and concerns about disadvantages caused by not complying with government policies increased vaccination.
CONCLUSIONS:
The reasons for vaccine hesitancy and acceptance were similar to the results of international research. Health authorities and professionals should communicate sufficiently and appropriately with hesitant parents and find ways to rationally resolve social conflicts. However, this sample was small and there is little Korean research, so more in-depth and diverse researchs are needed.
Abstract
OBJECTIVES:
This study analyzed Korea National Health and Nutrition Examination Survey data from 2007 to 2017 to assess trends in the prevalence, treatment, and control of diabetes in Korean adults ≥30 years of age.
METHODS:
Prevalent diabetes was defined as a fasting plasma glucose level ≥126 mg/dL, self-reported use of anti-diabetic treatment (insulin or oral anti-diabetic drugs), or diabetes diagnosis by a physician. Target levels were defined as glycosylated hemoglobin <6.5% or <7.0%, blood pressure <130/80 mmHg, and total cholesterol <200 mg/dL. All survey waves were age-standardized to the 2005 Korean census population.
RESULTS:
Diabetes prevalence increased from 9.6% in 2007-2009 to 10.8% in 2016-2017 (p<0.001). Impaired fasting glucose prevalence significantly increased in both genders and almost every age group. Diabetes awareness and glycemic control did not show an increasing trend; however, the treatment rate and proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved from 57.2% to 63.5% (p=0.008), from 41.1% to 53.2% (p<0.001), and from 65.0% to 78.0% (p<0.001), respectively.
CONCLUSIONS:
From 2007 to 2017, the prevalence of diabetes increased moderately in Korea, whereas the diabetes treatment rate and the proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved. However, awareness of diabetes and glycemic control require significant improvements. A national-level action plan is required to raise awareness about diabetes and prediabetes, with the goal of improving glycemic control and minimizing the occurrence of adverse health outcomes.

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