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Changhoon Kim 3 Articles
Evaluation of the accessibility and its equity of the national public-private mix program for tuberculosis in Korea: a multilevel analysis
Hyunjin Son, Changhoon Kim
Epidemiol Health. 2023;45:e2023002.   Published online December 7, 2022
DOI: https://doi.org/10.4178/epih.e2023002
  • 3,122 View
  • 134 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To examine the effect of individual and area-level characteristics on the probability of public-private mix (PPM) support (PPM coverage) for tuberculosis (TB).
METHODS
This study is a retrospective cohort design using TB reporting and treatment management data in Korea. We analyzed PPM coverage through multilevel logistic regression and empirical Bayesian estimation according to individual and area-level characteristics and their interaction.
RESULTS
Patients aged 0-29 years, women, of Korean nationality, treated at a general hospital, a one-time reporting, urban areas, and the lowest deprivation index (DI) showed higher PPM coverage. Due to the cross-level interaction, PPM coverage in the urban areas (slope=-0.048, p<0.001) had a higher level but a steeper negative deprivation gradient than in rural areas (slope= -0.015, p<0.001). For a general hospital, the PPM coverage in urban is high but more significantly decreased than in rural areas with the higher DI (urban: slope=-0.047, p<0.001; rural: slope=-0.031, p<0.001). For clinics and hospitals, the effect of DI did not appear in urban areas, but in rural areas, the higher the DI, the higher the PPM coverage with a slope of 0.046 (p<0.001) and 0.063 (p<0.001), respectively.
CONCLUSIONS
The PPM program created a significant disparity in PPM coverage between urban-rural areas and type of healthcare provider according to DI. Considering the high risk of TB incidence in areas with higher DI, institutional improvement and program redesign are needed to improve accessibility and equity.
Summary
Korean summary
다수준 분석을 통해 시행하여 PPM(Public-Private Mix) 사업의 주요한 평가 지표인 PPM coverage를 접근성과 형평성 관점에서 검토하였다. PPM 사업은 전반적으로 치료지원 수준을 높이는 효과가 있었지만, 도시화수준, 박탈 수준과 치료지원기관 선택의 3원 교차수준 교호작용의 결과로 지역간 PPM coverage에 지역박탈지수에 따른 큰 기울기를 가진 격차를 만들었다. 지역박탈수준이 큰 지역의 높은 결핵 발생 위험을 고려하면 효율성과 함께 형평성 수준을 향상시킬 수 있는 제도적 개선과 프로그램의 보완이 필요하다.
Key Message
This study analyzed the effect of individual and area-level characteristics on the probability of public-private mix (PPM) coverage for tuberculosis (TB) in Korea. The PPM program created a significant disparity in PPM coverage between urban-rural areas and type of healthcare provider according to deprivation index (DI). Given the high TB risk in areas with high DI, there is a need for institutional improvement and program redesign to improve accessibility and equity.
An outbreak of hepatitis A associated with salted clams in Busan, Korea
Hyunjin Son, Miyoung Lee, Youngduck Eun, Wonseo Park, Kyounghee Park, Sora Kwon, Seungjin Kim, Changhoon Kim
Epidemiol Health. 2022;44:e2022003.   Published online December 29, 2021
DOI: https://doi.org/10.4178/epih.e2022003
  • 11,349 View
  • 568 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Busan. The current study presents the results of an epidemiological investigation and outlines the supplementary measures that would help with hepatitis A control.
METHODS
A cohort study was conducted for all 2,865 customers who visited restaurant A from June to July. Using a standardized questionnaire, participants reported the presence of hepatitis A symptoms and whether they had consumed any of 19 food items. As for participants who had visited public health centers, their specimens were collected.
RESULTS
From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The epidemic curve was unimodal, and the median number of days from the restaurant visit to symptom onset was 31 days. A genotype analysis indicated that 89 of 90 tested patients had hepatitis A virus (HAV) genotype 1A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times (95% confidence interval [CI], 9.22 to 510.87). In an unopened package of salted clams found and secured through traceback investigation, HAV genotype 1A was detected.
CONCLUSIONS
To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams; the food sampling test standards for salted clams should also be expanded. Furthermore, a laboratory surveillance system based on molecular genetics should be established to detect outbreaks earlier.
Summary
Korean summary
2019년 7월, 부산시의 한 식당을 방문한 사람에서 다수의 A형간염 환자가 신고되었다. 2019년 6월 1일부터 7월 28일까지 해당 식당을 방문하여 카드 결제를 한 사람과 동반자 2,865명 전체를 대상으로 코호트 조사를 수행하였다. A형간염에 확진 된 사람은 총 155명으로 발병률은 5.4%였다. 다변량 로지스틱 회귀분석 결과 조개젓 섭취는 A형간염 발병 위험을 68.62배(95% CI, 9.22 to 510.87) 증가시키는 것으로 나타났다. 익히지 않은 조개류를 섭취하지 않도록 더욱 홍보를 강화해야 한다.
Key Message
In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Bu¬san. A cohort study was conducted for all 2,865 customers who visited the restaurant from June to July. From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times. To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams.

Citations

Citations to this article as recorded by  
  • Investigating the spatio-temporal variation of hepatitis A in Korea using a Bayesian model
    Jaehong Jeong, Mijeong Kim, Jungsoon Choi
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • A Study on the Detection Rate of Hepatitis A from Gastroenteritis Patients and the Genotype Analysis of Hepatitis A Virus in Busan
    Sun Hee Park, Chanhee Kim, Summi Lee, Jihye Jeong, Junghye Choi, Seung Ju Lee
    Journal of Bacteriology and Virology.2023; 53(2): 74.     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
Epidemiological characteristics of and containment measures for COVID-19 in Busan, Korea
Hyunjin Son, Hyojung Lee, Miyoung Lee, Youngduck Eun, Kyounghee Park, Seungjin Kim, Wonseo Park, Sora Kwon, Byoungseon Ahn, Dongkeun Kim, Changhoon Kim
Epidemiol Health. 2020;42:e2020035.   Published online June 1, 2020
DOI: https://doi.org/10.4178/epih.e2020035
  • 17,044 View
  • 530 Download
  • 24 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Objectives
To describe and evaluate epidemiological investigation results and containment measures implemented in Busan, where 108 cases were confirmed with coronavirus disease 2019 (COVID-19) between February 21, 2020 and March 24, 2020.
Methods
Any individual who tested positive for COVID-19 was classified as a confirmed case. Measures were taken to identify the source of infection and trace and quarantine contacts. Serial intervals were estimated and the effective reproduction number was computed.
Results
Of the total 18,303 COVID-19 tests performed between January 16, 2020 and March 24, 2020 in Busan, 108 yielded positive results (positive test rate, 0.6%). All confirmed cases were placed in isolation at hospitals. Of the 108 confirmed cases, 59 (54.6%) were female. The most common age group was 20-29 years with 37 cases (34.3%). Regarding symptoms at the time of diagnosis, cough (n=38, 35.2%) and fever (n=34, 31.5%) were most common; 12 cases (11.1%) were asymptomatic. The source of infection was identified in 99 cases (91.7%). A total of 3,223 contacts were identified and quarantined. Household contacts accounted for 196, and the household secondary attack rate was 8.2% (95% confidence interval [CI], 4.7 to 12.9). The mean serial interval was estimated to be 5.54 days (95% CI, 4.08 to 7.01). After February 26, (R<sub>t</sub>) remained below 1 in Busan.
Conclusions
The early containment strategy implemented in Busan shows that control is possible if outbreaks are of limited scope. In preparation for future outbreaks, public health and healthcare systems should be re-examined and put in a ready state.
Summary
Korean summary
2월 21일부터 3월 24일까지 부산시에서 보고된 108명의 코로나바이러스감염증-19 (코로나19) 확진 환자의 역학 조사 결과와 관리 조치를 기술하고 평가하였다. 초기에는 A 교회 클러스터와 다른 지역에서 유입된 사례로 인해 급격한 환자 증가가 있었고 이후 접촉자를 중심으로 2차 유행을 보였다. 2월 26일 이후 부산 지역의 Rt가 1보다 낮은 값을 보여 전파가 통제되고 있음을 알 수 있었다. 부산에서 초기 containment 전략을 시행한 결과 제한된 발생 규모인 경우 통제가 가능하다는 점을 확인하였다. 이후 발생할 유행에 대비해 적극적으로 공중보건 및 보건의료 체계를 정비하고 준비해야 할 것으로 생각된다

Citations

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  • Asymptomatic SARS-CoV-2 Infection by Age: A Global Systematic Review and Meta-analysis
    Bing Wang, Prabha Andraweera, Salenna Elliott, Hassen Mohammed, Zohra Lassi, Ashley Twigger, Chloe Borgas, Shehani Gunasekera, Shamez Ladhani, Helen Siobhan Marshall
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  • Improved time-varying reproduction numbers using the generation interval for COVID-19
    Tobhin Kim, Hyojung Lee, Sungchan Kim, Changhoon Kim, Hyunjin Son, Sunmi Lee
    Frontiers in Public Health.2023;[Epub]     CrossRef
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