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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.

Original Article

July 4, 2019


Trends in the prevalence and management of diabetes in Korea: 2007-2017
Ji-Yeon Shin
Epidemiol Health. 2019;41:e2019029.

Original Article

June 22, 2019


Incidence and predictors of tuberculosis among HIV-positive children at Adama Referral Hospital and Medical College, Oromia, Ethiopia: a retrospective follow-up study
Masino Tessu Beshir, Aklil Hailu Beyene, Kenean Getaneh Tlaye, Tefera Mulugeta Demelew
Epidemiol Health. 2019;41:e2019028.

Current Issue
Volume 41; 2019
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.
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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.
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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.
Original Article Incidence and predictors of tuberculosis among HIV-positive children at Adama Referral Hospital and Medical College, Oromia, Ethiopia: a retrospective follow-up study
Masino Tessu Beshir, Aklil Hailu Beyene, Kenean Getaneh Tlaye, Tefera Mulugeta Demelew Epidemiol Health. 2019;41:e2019028.
  • Abstract
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Original Article Effects of a cancer prevention education program on elementary school students’ knowledge, attitude, self-efficacy, and intentions in South Korea
Su Yeon Kye, Soon-Yong Hwang, Kyung Hee Oh, Jae Kwan Jun Epidemiol Health. 2019;41:e2019027.
  • Abstract
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  • Korean summary
Abstract
OBJECTIVES:
Tuberculosis (TB) is common in children with human immunodeficiency virus (HIV), but its effect on the survival of HIV-infected children is not well understood. Therefore, the aim of this study was to assess the incidence and predictors of active TB among HIV-positive children at Adama Referral Hospital and Medical College, Oromia, Ethiopia.
METHODS:
A retrospective study was conducted over 5 years using a checklist to gather data from 428 randomly selected pediatric patient charts. The checklist was adapted from the standardized antiretroviral therapy (ART) follow-up form currently used by the institution’s ART clinic. Data were analyzed by bivariate and multivariable analysis using Cox regression proportional hazards models, as appropriate. Survival was calculated and compared using the Kaplan-Meier and log-rank tests.
RESULTS:
Of the 466 charts reviewed, 428 patient records were included in the analysis. A total of 67 new TB cases were observed during the follow-up period. Hence, the incidence rate in this cohort was found to be 6.03 per 100 child-years of observation. A baseline hemoglobin level <10 g/dL (adjusted hazard ratio [aHR], 7.04; 95% confidence interval [CI], 1.03 to 48.15), moderate wasting (aHR, 2.86; 95% CI, 1.02 to 7.99), and not receiving isoniazid preventive therapy (aHR, 8.23; 95% CI, 2.11 to 32.06) were among the independent predictors of TB occurrence.
CONCLUSIONS:
The incidence of TB was high, particularly in pre-ART patients receiving chronic care for HIV. Close followup of HIV-positive children is crucial to protect them against the development of TB. Initiating isoniazid preventive therapy, averting malnutrition, and managing anemia are also of significant importance.
Abstract
OBJECTIVES:
Most children and adolescents have low levels of cancer knowledge and awareness, and infrequently engage in preventive behaviors. This study examined the effects of a short classroom-based intervention for cancer prevention on knowledge, attitude toward cancer preventability, self-efficacy, and behavioral intentions of fifth-grade elementary school students.
METHODS:
The study was based on a pre-post-follow-up, 2-group, quasi-experimental design. Participants in the intervention group attended two 40-minute sessions on cancer prevention education and watched a music video about cancer prevention, while participants in the control group were only exposed to the music video. Self-reported knowledge, attitude toward cancer preventability, self-efficacy, and behavioral intentions were assessed 1 week pre-intervention and post-intervention, as well as 3 months post-intervention.
RESULTS:
The 3-month post-intervention results revealed partial effects, indicating that the education intervention improved knowledge and attitudes toward cancer preventability; however, no effects were observed on self-efficacy and behavioral intentions 3 months after the intervention.
CONCLUSIONS:
Long-term regular booster sessions are required to improve not only social-cognitive factors, but also behavioral intentions, which could result in behavior changes promoting cancer prevention.

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