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Original Article
- Risk factors for Q fever incidence in Korea: a comparative analysis using frequentist and Bayesian methods
- Ji-Hyun Son, Sung-Dae Park
- Epidemiol Health. 2025;47:e2025046. Published online August 20, 2025
- DOI: https://doi.org/10.4178/epih.e2025046
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Abstract
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AbstractOBJECTIVES
This study investigated the principal determinants of human Q fever incidence and explored regional variation between metropolitan cities and provinces in Korea.METHODSPanel data on human Q fever incidence, livestock populations, and facility metrics were collected across 17 metropolitan cities and provinces from 2017 to 2024. Analytical approaches included frequentist models (ordinary least squares [OLS], random effects [RE], fixed effects [FE]) and Bayesian models.RESULTSFrequentist panel analysis indicated that slaughterhouse count was positively associated with Q fever incidence in both pooled OLS (β=1.20, p<0.001) and RE models (β=1.03, p<0.001), but not in the FE model (β=0.14, p=0.65). After correcting for serial correlation using Driscoll-Kraay standard errors, livestock population (β=0.55, p<0.01), livestock market count (β=-2.01, p<0.05), and livestock Q fever cases (β=-0.11, p<0.01) were significantly associated with human incidence. A Bayesian FE model confirmed a significant relationship between slaughterhouses and human Q fever incidence (posterior mean: 0.87; 95% credible interval [CrI], 0.21 to 1.42), providing more stable inference with limited samples and allowing probabilistic uncertainty estimation. A Bayesian hierarchical model revealed a stronger association in metropolitan cities (posterior mean, 1.46; 95% CrI, 0.34 to 2.57) than in provinces (1.22), while livestock population remained significant in provinces (0.94; 95% CrI, 0.15 to 1.74).CONCLUSIONSIn Korea, slaughterhouse density was the main determinant of Q fever in metropolitan cities and livestock density was the primary risk factor in provinces. These findings underscore the need for region-specific preventive strategies and reinforce the value of a One Health approach. -
SummaryKorean summary
본 연구는 대한민국 내 큐열(Q fever) 발생의 주요 위험 요인이 지역별로 다르다는 것을 규명하였다. 광역시(metropolitan cities)에서는 도축장 밀도가, 도(provinces)에서는 가축 사육 밀도가 사람에서 큐열 발생의 주된 위험 요인으로 확인되었다. 이러한 결과는 사람, 동물, 환경의 건강을 통합적으로 고려하는 원헬스(One Health) 접근법에 기반하여 각 지역 특성에 맞는 예방 전략이 필요함을 강조한다.Key Message
This study identified that the primary risk factors for Q fever in Korea vary by region. Slaughterhouse density was the main determinant of human Q fever incidence in metropolitan cities, whereas livestock density was the primary risk factor in provinces. These findings underscore the need for region-specific preventive strategies based on a One Health approach, which integrally considers human, animal, and environmental health.
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