Epidemiology and Health

Original Article

Palivizumab coverage rates among moderate-to-late preterm infants in Korea: a nationwide cross-sectional study: Seungyeon Kim, Saram Lee, Young June Choe, Ju Sun Heo; Epidemiol Health. 2025;47:e2025015. Published online April 1, 2025; DOI: https://doi.org/10.4178/epih.e2025015

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Since October 2016, Korea has implemented a national reimbursement program for palivizumab aimed at moderate-to-late preterm (MLPT) infants born between 32 0/7 weels and 35 6/7 weeks of gestation during the respiratory syncytial virus (RSV) season (October–March). However, large-scale data on coverage rates and associated factors remain limited. This study evaluated palivizumab coverage rates and identified predictive factors influencing its administration in MLPT infants.
METHODS
This nationwide, population-based cross-sectional study utilized data from the Korean National Health Insurance Service collected between October 2016 and March 2019. MLPT infants eligible for palivizumab reimbursement were divided into administration and non-administration groups. Seasonal and overall coverage rates were assessed. A multivariate logistic regression analysis examined factors associated with palivizumab administration, with a focus on infant and maternal characteristics.
RESULTS
Among 2,843 eligible MLPT infants, 1,201 (42.2%) received palivizumab, while 1,642 (57.8%) did not. Although coverage rates increased annually, they remained suboptimal. Lower palivizumab prophylaxis coverage was observed in infants with higher gestational ages, female sex, absence of low birth weight, those born in March, residents of non-capital areas, infants not admitted to a neonatal intensive care unit at birth, and infants of mothers aged <35 years.
CONCLUSIONS
In the initial 3 RSV seasons following the introduction of palivizumab reimbursement for MLPT infants in Korea, the overall coverage rate was low (42.2%). National policies targeting infants with higher gestational ages, those born in March, and those residing in non-capital areas are necessary to improve coverage and ensure equitable RSV prophylaxis.; Summary

Korean summary
- 한국에서 중후기 미숙아를 대상으로 팔리비주맙 예방접종이 도입된 이후, 초기 3개 RSV 유행 시즌 동안 전체 예방접종률은 42.2%로 낮은 수준에 머물렀다. - 재태주수가 높은 영아, 3월 출생 영아, 그리고 비수도권 거주 영아에서 예방접종률이 유의하게 낮았다.

Key Message
- In Korea, following the introduction of palivizumab for MLPT infants, the overall coverage rate during the initial 3 RSV seasons was low (42.2%). - Infants with higher gestational ages, those born in March, and residents of non-capital areas exhibited significantly lower coverage rates.

Cohort Profile

Cohort profile: congenital Zika virus infection and child neurodevelopmental outcomes in the ZEN cohort study in Colombia: Maritza Gonzalez, Van T. Tong, Helena Rodriguez, Diana Valencia, Jacqueline Acosta, Margaret A. Honein, Martha L. Ospina, The ZEN Study Team; Epidemiol Health. 2020;42:e2020060. Published online August 31, 2020; DOI: https://doi.org/10.4178/epih.e2020060

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Abstract

Zika en Embarazadas y Niños (ZEN) is a prospective cohort study designed to identify risk factors and modifiers for Zika virus (ZIKV) infection in pregnant women, partners, and infants, as well as to assess the risk for adverse maternal, fetal, infant, and childhood outcomes of ZIKV and other congenital infections. ZIKV infection during pregnancy may be associated with longterm sequelae. In the ZEN cohort, 1,519 pregnant women and 287 partners were enrolled from 3 departments within Colombia between February 2017 and January 2018, as well as 1,108 infants born to the pregnant women who were followed to 6 months. The data include baseline questionnaires at enrollment; repeated symptoms and study follow-up questionnaires; the results of lab tests to detect ZIKV and other congenital infections; medical record abstractions; infant physical, eye, and hearing exams; and developmental screening tests. Follow-up of 850 mother-child dyads occurred at 9 months, 12 months, and 18 months with developmental screenings, physical exams, and parent questionnaires. The data will be pooled with those from other prospective cohort studies for an individual participant data meta-analysis of ZIKV infection during pregnancy to characterize pregnancy outcomes and sequelae in children.

Summary

Citations

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Building a growing genomic repository for maternal and fetal health through the PING Consortium
Clara M. Abdelmalek, Shriya Singh, Blain Fasil, Allison R. Horvath, Sarah B. Mulkey, Carlos Curé, Maribel Campos, Denise P. Cavalcanti, Van T. Tong, Marcela Mercado, Marcela Daza, Mónica Marcela Benavides, Jacqueline Acosta, Suzanne Gilboa, Diana Valencia
Pediatric Research.2025;[Epub] CrossRef
Neurodevelopmental assessment of normocephalic children born to Zika virus exposed and unexposed pregnant people
Jackeline Alger, María Luisa Cafferata, Raquel López, Lisa D. Wiggins, Allison Callejas, Mario Castillo, Jenny Fúnes, Fátima Rico, Diana Valencia, Douglas Varela, Zulma Alvarez, Mabel Berrueta, Harry Bock, Carolina Bustillo, Alejandra Calderón, Alvaro Cig
Pediatric Research.2024; 95(2): 566. CrossRef
Zika virus prevention behaviors and knowledge among male partners of pregnant people and lack of condom use as a prevention behavior from the Zika en Embarazadas y Niños (ZEN) prospective cohort study, Colombia
Christina L. Sancken, Ayzsa Tannis, Sandra A. Amouzou, Veronica Burkel, Jeffrey M. Carlson, Suzanne Newton, Suzanne M. Gilboa, Maritza Gonzalez, Diana Valencia, Van T. Tong, Martha Ospina
BMC Research Notes.2024;[Epub] CrossRef
Zika virus knowledge, attitudes and prevention behaviors among pregnant women in the ZEN cohort study, Colombia, 2017–2018
Veronica K Burkel, Suzanne M Newton, Jacqueline Acosta, Diana Valencia, Monica Benavides, Van T Tong, Marcela Daza, Christina Sancken, Maritza Gonzalez, Kara Polen, Helena Rodriguez, Milena Borbón, Carol Y Rao, Suzanne M Gilboa, Margaret A Honein, Marta L
Transactions of The Royal Society of Tropical Medicine and Hygiene.2023; 117(7): 496. CrossRef
Epidemiology of cytomegalovirus Infection among mothers and infants in Colombia
Angelica Rico, Sheila C. Dollard, Diana Valencia, Sheryll Corchuelo, Van T. Tong, Katherine Laiton‐Donato, Minal M. Amin, Monica Benavides, Phili Wong, Suzanne Newton, Marcela Daza, Jordan Cates, Maritza Gonzalez, Laura D. Zambrano, Marcela M. Mercado, El
Journal of Medical Virology.2021; 93(11): 6393. CrossRef
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Original Articles

Ecological context of infant mortality in high-focus states of India: Laishram Ladusingh, Ashish Kumar Gupta, Awdhesh Yadav; Epidemiol Health. 2016;38:e2016006. Published online March 5, 2016; DOI: https://doi.org/10.4178/epih.e2016006

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Abstract

OBJECTIVES
This goal of this study was to shed light on the ecological context as a potential determinant of the infant mortality rate in nine high-focus states in India.

METHODS

Data from the Annual Health Survey (2010-2011), the Census of India (2011), and the District Level Household and Facility Survey 3 (2007-08) were used in this study. In multiple regression analysis explanatory variable such as underdevelopment is measured by the non-working population, and income inequality, quantified as the proportion of households in the bottom wealth quintile. While, the trickle-down effect of education is measured by female literacy, and investment in health, as reflected by neonatal care facilities in primary health centres.

RESULTS

A high spatial autocorrelation of district infant mortality rates was observed, and ecological factors were found to have a significant impact on district infant mortality rates. The result also revealed that non-working population and income inequality were found to have a negative effect on the district infant mortality rate. Additionally, female literacy and new-born care facilities were found to have an inverse association with the infant mortality rate.

CONCLUSIONS

Interventions at the community level can reduce district infant mortality rates.

Summary

Citations

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The Synergy Between Undernutrition and Under-five Mortality in India: A Spatially Explicit Structural Equation Modelling Approach
Wahengbam Bigyananda Meitei
Spatial Demography.2025;[Epub] CrossRef
Does club convergence matter in health outcomes? Evidence from Indian states
Ajit Nag, Andrej Privara, Beata Gavurova, Jalandhar Pradhan
BMC Public Health.2023;[Epub] CrossRef
Major Determinants of Infant Mortality: District-level Evidence from Annual Health Survey States of India
Subhanil Banerjee, Souren Koner, Arshleen Kaur, Charvi Sharma
Journal of Health Management.2023;[Epub] CrossRef
Does socio-economic inequality in infant mortality still exists in India? An analysis based on National Family Health Survey 2005–06 and 2015–16
Pradeep Kumar, Ratna Patel, Shekhar Chauhan, Shobhit Srivastava, Ankur Khare, Kamlesh Kumar Patel
Clinical Epidemiology and Global Health.2021; 9: 116. CrossRef
Sociodemographic correlates of infant mortality in India: A review of national family health survey data
Ratan Gupta, ManasPratim Roy
CHRISMED Journal of Health and Research.2020; 7(1): 12. CrossRef
Factors explaining regional variation in under-five mortality in India: An evidence from NFHS-4
Jayanta Kumar Bora
Health & Place.2020; 64: 102363. CrossRef
Spatial heterogeneity of the associations of economic and health care factors with infant mortality in China using geographically weighted regression and spatial clustering
Shaobin Wang, Jun Wu
Social Science & Medicine.2020; 263: 113287. CrossRef
A spatial analysis of childhood stunting and its contextual correlates in India
Rupam Bharti, Preeti Dhillon, Pralip Kumar Narzary
Clinical Epidemiology and Global Health.2019; 7(3): 488. CrossRef
The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states
Jayanta Kumar Bora, Rajesh Raushan, Wolfgang Lutz, William Joe
PLOS ONE.2019; 14(8): e0211086. CrossRef

Modeling and forecasting of the under-five mortality rate in Kermanshah province in Iran: a time series analysis: Mehran Rostami, Abdollah Jalilian, Behrooz Hamzeh, Zahra Laghaei; Epidemiol Health. 2015;37:e2015003. Published online January 22, 2015; DOI: https://doi.org/10.4178/epih/e2015003

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Abstract

OBJECTIVES
The target of the Fourth Millennium Development Goal (MDG-4) is to reduce the rate of under-five mortality by two-thirds between 1990 and 2015. Despite substantial progress towards achieving the target of the MDG-4 in Iran at the national level, differences at the sub-national levels should be taken into consideration.

METHODS

The under-five mortality data available from the Deputy of Public Health, Kermanshah University of Medical Sciences, was used in order to perform a time series analysis of the monthly under-five mortality rate (U5MR) from 2005 to 2012 in Kermanshah province in the west of Iran. After primary analysis, a seasonal auto-regressive integrated moving average model was chosen as the best fitting model based on model selection criteria.

RESULTS

The model was assessed and proved to be adequate in describing variations in the data. However, the unexpected presence of a stochastic increasing trend and a seasonal component with a periodicity of six months in the fitted model are very likely to be consequences of poor quality of data collection and reporting systems.

CONCLUSIONS

The present work is the first attempt at time series modeling of the U5MR in Iran, and reveals that improvement of under-five mortality data collection in health facilities and their corresponding systems is a major challenge to fully achieving the MGD-4 in Iran. Studies similar to the present work can enhance the understanding of the invisible patterns in U5MR, monitor progress towards the MGD-4, and predict the impact of future variations on the U5MR.

Summary

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Vera Gregório, Dinilson Pedroza, Celivane Barbosa, Gilberto Bezerra, Ulisses Montarroyos, Cristine Bonfim, Zulma Medeiros
Indian Journal of Dermatology, Venereology and Leprology.2021; 87: 651. CrossRef
Forecasting Malaysia Under-5 Mortality Using State Space Model
N F Abd Nasir, A N Muzaffar, S N E Rahmat, W Z Wan Husin, N S Zainal Abidin
Journal of Physics: Conference Series.2020; 1496: 012001. CrossRef
Multivariate Long Memory Cohort Mortality Models
Hongxuan Yan, Gareth Peters, Jennifer Chan
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Forecast analysis of any opportunistic infection among HIV positive individuals on antiretroviral therapy in Uganda
John Rubaihayo, Nazarius M. Tumwesigye, Joseph Konde-Lule, Fredrick Makumbi
BMC Public Health.2016;[Epub] CrossRef

Hepatitis A Vaccination Rates and Related Factors in a 2005 Population-based Study in Nonsan, Korea: Eun Young Kim, Baeg Ju Na, Moo Sik Lee, Keon Yeop Kim, Moran Ki; Epidemiol Health. 2009;31:e2009003. Published online October 12, 2009; DOI: https://doi.org/10.4178/epih/e2009003

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Abstract

<sec><title>OBJECTIVES</title>The incidence of clinical hepatitis A has increased in young Korean adults since the mid-1990s. Although hepatitis A vaccinations have been administered in private clinics over the past 10 yr, no data exist on the vaccination rate and relating factors.</sec><sec><title>METHODS</title>In 2005, a population-based survey of 12-35-month-old children was carried out in Nonsan, Korea. An interview survey was completed for 71.3% of the children. All data came from a vaccination card or confirmation from a provider.</sec><sec><title>RESULTS</title>The hepatitis A vaccination rate was 42.3% for ≥1 dose and 24.7% for 2-dose. The results of the multivariate regression analysis for the hepatitis A vaccination showed that the second (OR=1.6) and third and successive children (OR=3.3) were less often immunized than the first child. Low economic status (OR=1.6), rural area (OR=1.5) and employed mother (OR=1.5) were also correlated with a lower vaccination rate. The hepatitis A vaccination rate was significantly lower in children who had no other vaccinations: measlesmumps-rubella (OR=2.8 for ≥1 dose and 7.3 for 2-dose), varicella (OR=20.2 and 22.0, respectively) and <italic>Haemophilus influenza</italic> type b (OR=14.3 and 13.3, respectively).</sec><sec><title>CONCLUSION</title>To prevent outbreaks of clinical hepatitis A by enough herd immunity, a vaccination should be included in the National Immunization Program and a vaccination policy developed and implemented that can overcome the barriers to immunization such as late birth order and a mother's employment.</sec>

Summary

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Very low prevalence of anti-HAV in Japan: high potential for future outbreak
Chikako Yamamoto, Ko Ko, Shintaro Nagashima, Takayuki Harakawa, Toshiko Fujii, Masayuki Ohisa, Keiko Katayama, Kazuaki Takahashi, Hiroaki Okamoto, Junko Tanaka
Scientific Reports.2019;[Epub] CrossRef
Changing sero-epidemiology of hepatitis A in Asia Pacific countries: A systematic review
Marissa Gripenberg, Naveena Aloysia D’Cor, Maïna L’Azou, Grenville Marsh, Sophie Druelles, Joshua Nealon
International Journal of Infectious Diseases.2018; 68: 13. CrossRef
Hepatitis A Virus Vaccination Status and Related Factors among College Students
Jae Seong Baek, Mi Ah Han, Jong Park, Na-Ra Yun
Korean Journal of Health Promotion.2014; 14(3): 103. CrossRef
Vaccination rates and related factors among health care workers in South Korea, 2009
Hee Jung Yoon, Jiseun Lim, BoYoul Choi, Jungsoo Kim, Jeonguk Kim, Changhwi Kim, Joon Soo Park, Sang-Bum Hong, Jooyoun Seo, Geun-Ryang Bae, Moran Ki
American Journal of Infection Control.2013; 41(8): 753. CrossRef
Factors Related to Completed Status and Seropositivity of Hepatitis A Immunization Among Children Aged 1–3 Years and 6–8 Years in South Korea
Jee-Young Hong, Mo Ran Ki, Hye-Jung Hwang, Delacroix Sinny, Young-Joon Park, Geun-Ryang Bae, Moo-Sik Lee
Osong Public Health and Research Perspectives.2013; 4(2): 93. CrossRef
Evaluation on the Accuracy of Vaccination Card for National Immunization Program in a 2005 Population-Based Survey in Nonsan, Korea
Moo-Sik Lee, Jee-Hee Kim, Kwang-Hwan Kim, Jee-Young Hong, Jin-Yong Lee, Keon-Yeop Kim
Journal of agricultural medicine and community health.2011; 36(2): 113. CrossRef

A Trial for Association between Oxidative Stress in Midterm Pregnancy and Postnatal Growth during the First Year of Life.: Hyesook Park, Young Ju Kim, Hwa Young Lee, Eun Ae Park, Nam Soo Chang, Eun Hee Ha, Bo Hyun Park, Bo Eun Lee, Ju Hee Hong; Korean J Epidemiol. 2004;26(1):17-26.

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Abstract PDF: Abstract
OBJECTIVES
We aims to construct Infant Growth Cohort for evaluating whether oxidative stress in midterm pregnancy has an adverse effect on postnatal growth.
METHODS
AND MATERIALS: From September 2001 to April 2004, we constructed an Ewha Infant Growth Cohort connected with the Ewha Pregnant Women Cohort. We excluded mother-and-child pairs in which the mother had experienced hypertension or diabetes during pregnancy and had multiple births for this study, which gave us 233 mother-and-child pairs for analysis. We measured maternal serum homocysteine and urinary 8-hydroxyguanosine (8-OHdG) and malondialdehyde (MDA) at 24~28 weeks of pregnancy, and infant weights at birth and at 6 and 12 months postnatally. We applied repeated measures ANOVA with PROC MIXED to assess the significance of differences.
RESULTS
We followed 64 and 85 infants at 6 and 12 months respectively. The mean body weights were 3146.4 g at birth, 8229.7 g at 6 months, and 1006.47 g at 12 months. The mean birth weight of infants was lower in mothers with higher homocysteine levels (third and fourth quartiles), but body weights from the first- and fourth-quartile groups of maternal homocysteine levels were lower than the others even though it was not statistically significant. Body weights at birth and at 6 months in third- and fourth-quartile groups of 8-OHdG levels were lower than the others. The body weights in the fourth quartile MDA group were significantly lower than the others at all time points.
CONCLUSIONS
Maternal oxidative stress in midterm pregnancy may cause postnatal growth retardation. But, there were high rate of follow up loss and various measurement errors. Therefore, we need to have efforts for compete follow up and valid and reliable measurements.; Summary

Measles Outbreak among Institutional Infants after Hospital Infection.: Hyung Cheol Park, Eun Young Park, Sun Hee Cho, Young Jun Choi, Hyun Kyun Ki, Young Hwa Jung, Kyung Rye Moon, So Yeon Ryu, Ki Soon Kim; Korean J Epidemiol. 2001;23(1):50-58.

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Abstract PDF: Abstract
PURPOSE
S: This study was to investigate the source of infection, mode of transmission and incidence of a measles outbreak among infants living in a Gwangju welfare institution in July 2000.
METHODS
The information about 63 children was collected through the nurses interview and blood sampling and laryngopharyngeal swab were conducted to the children. In addition, an epidemiologic survey was performed to confirm the infection dissemination route.
RESULTS
Before the outbreak, two children living at the institution were admitted to a university hospital for other health problems. These children shared a room with a 5 year old diagnosed with meningitis who was later diagnosed as having measles after rashes appeared. The two children developed measles after returning to their institution and the infection spread to other children in the institution. Among 63 children observed, 14 children(22.2%) developed measles, secondary attack rate of measles due to index cases was 19.7%. And 78.6% of the patients were between 4 and 8 months old. The room where the index case lived showed an attack rate of 81.8%, which is a much higher rate compared to other rooms. The attack rate among boys(26.0%) was higher than that of girls(12.5%), but it was not statistically significant.
CONCLUSIONS
This outbreak was considered to be a nosocomial infection, where the index cases were admitted to a hospital, infected and the infection spread to children. Further studies are necessary to find out the maternal antibody levels of infants of post-vaccinated mothers and the optimal age for measles vaccination.; Summary

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