Epidemiology and Health

A Statistical Standard for Detecting Epidemic of Notifiable Acute Communicable Diseases in Korea.: Yong Gyu Park, Eui Chul Shin, Kwang Ho Meng; Korean J Epidemiol. 1997;19(1):73-80.

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Many problems have been stated in the surveillance system of notifiable acute communicable diseases in Korea. Lack of objective tools for detecting epidemic is one of the most fundamental. We propose a statistical standard for detecting epidemic of those diseases that could be easily and promptly applicable to the existing data. Suggested standard measure is computed from the median and the spread of upper and lower hinge(spr(H)) which is robust to the assumption of normal distribution, so frequently used in exploratory data analysis as a measure of variation, and the results are compared with those of existing method using recent 3 years from January 1994 to December 1996 of monthly data of 8 notifiable acute communicable diseases in Korea. Monthly pattern of statistical epidemic between the proposed (median) and existing(mean) methods is similar. Therefore, we propose that the statistical epidemic should be defined when the current occurrence exeeds the standards of both methods. When the data collection is made weekly than monthly, the proposed method of determining the time of epidemic will be much helpful for the management of notifiable diseases.; Summary

Sample Size Estimation for Log-Rank Test for Phase III Clinical Trials.: Sin Ho Jung, Jae Hee Choi, Byung Joo Park; Korean J Epidemiol. 1997;19(1):67-72.

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At first, we review a sample size estimation method for log-rank test in survival analysis. Although it is widely used these days, it has a weakness for practical use. We propose a modification method to avoid the weakness.; Summary

A Study on Tracking by Using Random Coefficient Model.: Hyung Gon Kang, Byung Soo Kim, Chung Mo Nam; Korean J Epidemiol. 1997;19(1):58-66.

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There are many epidemiologic studies to find the tracking phenomenon. In repeated measurement data, a population is said to have tracking phenomenon with respect to particular chracteristic if, for each individual, the relative rank of observed value maintained over time. Understanding tracking phenomena in epidemiologic study is quite important. If the risk factors of chronic disease have tracking phenomenon, early detection of these risk factors can lead to the possibility of early treatment. In this study, we defined tracking as relative maintenance and proposed new measure of tracking by using random coefficient model. We compared our measure with McMahan's using simulation study. And we applied ours to real data. We may conclude that our new measure of tracking is adequate in explaining and dectecting the tracking phenomenon.; Summary

Dietary Factors Related to the Chronic Diseases Assessed by Semiquantitaive Food Frequency Questionnaire in Korean Adults Living in Rural Area.: J E Shim, J Y Ryu, H Y Paik, C S Shin, H K Lee, Y S Park; Korean J Epidemiol. 1997;19(1):42-57.

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This study was conducted to assess dietary intake of adults in rural ares and to determine the dietary factors associated with the development of chronic diseases. A cross sectional dietary survey using semiquantitative food frequency questionnaire was conducted together with a health survey including health questionnaire, physical examination and glucose tolerance test. Mean dairy energy intake of subjects was 1872.5kcal and mean percent of RDA for energy intake was 88.4%. Nutrients of average intake below 75% of RDA were vitamine A, vitamin B2, calcium. Older subjects tend to have lower nutrient intake. Intakes of most nutrients and proportion of energy from alcohol were signifi-cantly higher in men than in woman. Newly diagnosed diabetic patients and hypertensives had higher age, BMI, blood pressure, fasting serum glucose levels and serum lipid levels compared with subjects without the diseases, respectively. After adjusted for age and sex, newly-diagnosed hypertencives had more intakes of charbohydrate and niacin, and higher proportion of energy from fat. The odds ratio(OR) for hypertension in higher quartile of subjects compared with subjects in the lowest quartile of intake increased significantly for energy, fat,protein, carbohydrate, vitamin B1, vitamin B2 and niacin after adjusted for age and sex. Also, compared with subjects consumed nutrients in 75-125% of RDA, the OR for hypertension in subjects with intake levels above 125% of RDA were 0.75 for energy, 1.69 for calcium and 0.68 for niacin, and those in below 75% of RDA were 1.33 for energy 1.42 for calcium, 1.23 for vitamin B1, 1.41 for vitamin B2. These inverse associations suggest that the development of hypertension in rural area of Korea is partialey attributed to the intake of several nutrients, generally of undernu-trition. Therefore these results suggests that dietary factors related to chronic diseases in Korea are different from those in the Western society.; Summary

Incidence and Risk Factors of Needle Stick Injury and the Association with HBV Infection in Hospital Personnels.: Jin Hee Park, Byung Yeol Chun, Min Hae Yeh; Korean J Epidemiol. 1997;19(1):29-41.

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To investigate the incidence and risk factors of needle stick injury(NSI) and the association between NSI and hepatitis B infection in hospital personnel, a prospective cohort study was conducted at a university hospital in Pusan city from April 1, 1994 to September 30, 1994. Of five hundred and thirty hospital personnel, 38.7 percent reported one NSI or more. The annual person incidence rate of NSI was 81.3 per 100 person and annual spell incidence rate was 144.3 per 100 persons. The annual incidence rate in registered nurses(192.8 cases per 100) was the highest, followed by physicians(115.4 cases per 100), nurse aids(75.5 cases per 100) and laboratory technicals(51.8 cases per 100) (p<0.05). Risk factors significantly associated with needle stick injuries were being interns higher than residents(p<0.05) for physicians, the incidence rate decreased as length of employment increased (p<0.05) for registered nurses and working in operating room and central supply room higher than working in surgical department(p<0.05) for nurses aids. The most common device related to needle stick injuries was disposable needles(49.7%), the most frequent activity related to needle stick injuries was recapping needle(35.7%), and most of the needle stick injuries occurred in nurse station(40.9%) and patient room (34.1%). The vaccination rate for hepatitis B virus was 40.2 percent. Of the non-vacciness, 4.5 percent were positive for hepatitis B surface antigen and 69.2 percent were serologically positive for hepatitis B viral markers at the beginning of this study. Of 80 negative personnel for for all hepatitis B viral markers, 27 persons experienced needle stick injuries during study period. Three out of 27persons were positive for hepatitis B markers at the end of follow-up. However, all of 53 persons who had no experience of needle stick injuries were negative. Therefore, NSI was significantly associated with HBV infection and the annual incidence for hepatitis B virus infection was as 8.0 per 100 in hospital personnel. These findings suggest that hospital personnels are at a high risk group for needle stick injuries. Particulary interns, novice registered nures (length of employment less than 1 year), and nurse aids who are working at operating room and central supply room are the highest risk group. It is recommended that NSI prevention program for hospital personnel should be developed to minimize the risk of needle stick injuries in the hospital.; Summary

Laboratory Based Surveillance System of Communicable Disease in Korea.: Bok Kwon Lee; Korean J Epidemiol. 1997;19(1):22-28.

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Since the communicable disease trend changes rapidly, many nations have developed communicable disease surveillance system according to their system. Among the surveillance, the laboratory based surveillance system has been particulary important for epidemiological analysis of various communicable diseases. Some communicable diseases, such as salmonellosis and shigellosis can be monitored accurately only through the laboratory based surveillance system because of the nonspecificity of the clinical syndrome. And clinical surveillance data are confirmed with laboratory findings can have substantial impacts of reporting rate and can increase the reliablity of survillance data. The current communicable disease surveillance system in Korea is notitiable disease report system and has problems in representativeness of reports and reporting rate. The object of this study is to find problems of present laboratory based surveillance system in Korea and to suggest implementation strategies.; Summary

Communicable Disease Surveillance System and Sentinel Surveillance.: Eui Chul Shin, Kwang Ho Meng; Korean J Epidemiol. 1997;19(1):14-21.

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Surveillance is the ongoing and systematic collection, analysis of disease related data and dissemination of the information to the people who need it, and application of it to disease prevention and control. So, it is composed of reportable disease; system of data collection, analysis, distribution; coorporation of medical institution with public health organization and effective control. The most dynamic and important part of surveillance is the feedback mechanism. As for positive ways of feedback, there are dissemination of collected and analysed information and reimbursement to the reporters. Legal punishment is the negative way of feedback. The common systems that the developed countries use for communicable disease surveillance are notifiable disease surveillance, sentinel surveillance, and laboratory surveillance systems. Notifiable disease surveillance is for the diseases that their impact is serious to the community when epidemic occurs even though the number of cases is small. Most countries have this type of surveillance, but they suffer from low reporting rate. Sentinel surveillance is for the disease which is mild or whose trend is to be traced for the evaluation of the public health programs. Sampled reporters notifies the disease information voluntarily not by law. Laboratory surveillance is to support the notifiable and sentinel surveillance. It provides laboratory information on the microorganism and antibody level of the disease. Surveillance of communicable diseases in Korea is totally dependent on the notifiable disease reporting system, and there are many problems involved. To improve the surveillance of communicable diseases, it is strongly recommended that the sentinel and laboratory surveillance systems be adopted.; Summary

Communicable disease survillance system in Japan.: Hiroshi Yanagawa; Korean J Epidemiol. 1997;19(1):11-13.

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No abstract available.; Summary

Epidemiological Studies of Colonary Heart Disease in Japan.: Kazunori Kodama, Fumiyoshi Kasagi; Korean J Epidemiol. 1997;19(1):5-10.

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No abstract available.; Summary

Epidemiology of Intestinal and Diffuse Type of Gastric Cancer: Are Etiologic Factors Common?.: Takesumi Yoshimura; Korean J Epidemiol. 1997;19(1):1-4.

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No abstract available.; Summary

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