Epidemiology and Health

Original Article

Bacillus of Calmette and Guérin (BCG) and the risk of leprosy in Ciudad del Este, Paraguay, 2016-2017: Nancy Carolina Cuevas, Victor M. Cardenas; Epidemiol Health. 2021;43:e2021060. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021060

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Abstract

OBJECTIVES
Paraguay has experienced a 35% reduction in the detected incidence of leprosy during the last ten years, as the vaccination coverage against tuberculosis (Bacillus of Calmette and Guérin [BCG] vaccine) reached ≥95% among infants. The objective of this case-control study was to evaluate the protective effect of BCG on the risk of leprosy.

METHODS

We used a population-based case-control study of 20 leprosy confirmed cases reported among residents of Ciudad del Este, Paraguay, diagnosed in 2016-2017. Three controls were selected from a random sample of households from the city. We assessed vaccine effectiveness using 1- odds ratio [OR], and confounding for age, gender, education, occupation, and marital status using stratified and exact logistic regression, and explored if there was effect modification calculating the synergy factor (SF) and relative excess risk due to interaction (RERI).

RESULTS

After controlling for age, gender, education, occupation and marital status, the OR of BCG scar on the risk of leprosy was 0.10 (95% confidence interval [CI], 0.02 to 0.45), for an estimate of vaccine effectiveness of 89.5% reduced risk of leprosy (95% CI, 55.2 to 98.1). There was evidence of heterogeneity by which the effectiveness of BCG seemed stronger among younger persons (Breslow-Day and Z-test of the SF had a p<0.05), and both the RERI and SF indicated a less then multiplicative and additive interaction of BCG and younger age.

CONCLUSIONS

BCG vaccination was associated with a decreased risk of leprosy in the study population, particularly in persons born after 1980.

Summary

Key Message
Paraguay had the second highest reported incidence in the Americas, but no previous study had investigated the topic of BCG for leprosy in Paraguay. We confirmed that BCG protected from leprosy, hence it may have contributed to the observed decline of leprosy.

Citations

Citations to this article as recorded by

BCG and SARS-CoV-2—What Have We Learned?
Jakub Kulesza, Ewelina Kulesza, Piotr Koziński, Wojciech Karpik, Marlena Broncel, Marek Fol
Vaccines.2022; 10(10): 1641. CrossRef

Perspective

Vitamin D supplementation as a control program against latent tuberculosis infection in Korean high school students: Eun Hee Kim, Jong-Myon Bae; Epidemiol Health. 2018;40:e2018035. Published online July 27, 2018; DOI: https://doi.org/10.4178/epih.e2018035

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Abstract Summary PDF Supplementary Material

Abstract

The prevalence of latnet Mycobacterium tuberculosis infection (LTBI) in the first-grade high school students in South Korea was 2.1%, which was the lowest level at congregated settings in 2017. For LTBI cases refusing anti-tuberculosis (TB) medication or having poor compliance, additional support should be considered. Eight systematic reviews concluded that vitamin D (VD) deficiency is a risk factor for TB. While three of four South Korean adolescents were VD deficiency, VD supplementation could be a practical remedy to protect LTBI students of refusing anti-TB medication or having poor compliance.

Summary

Korean summary
잠복결핵검진 검사 양성자이면서 항결핵제 복용을 거부하는 고1학생에 대한 사후 조치가 필요하다. 그동안의 연구결과들에 근거할 때, 잠복결핵이 활동성결핵으로의 전환을 억제하기 위해서 비타민 D 보충제의 투여를 검토해 볼 수 있다.

Citations

Citations to this article as recorded by

Vitamin D and the risk of latent tuberculosis infection: a systematic review and meta-analysis
Yan Cao, Xinjing Wang, Ping Liu, Yue Su, Haotian Yu, Jingli Du
BMC Pulmonary Medicine.2022;[Epub] CrossRef
Association of vitamin D levels and risk of latent tuberculosis in the hemodialysis population
Shang-Yi Lin, Yi-Wen Chiu, Hui-Ru Yang, Tun-Chieh Chen, Min-Han Hsieh, Wen-Hung Wang, Yen-Hsu Chen
Journal of Microbiology, Immunology and Infection.2021; 54(4): 680. CrossRef
A scoping review on climate change and tuberculosis
Bijay Maharjan, Ram Sharan Gopali, Ying Zhang
International Journal of Biometeorology.2021; 65(10): 1579. CrossRef
Tuberculosis risk is associated with genetic polymorphisms in the LRP2, CUBN, and VDR genes
Sung-Soo Kim, Sang In Lee, Hyun-Seok Jin, Sangjung Park
Genes & Genomics.2020; 42(10): 1189. CrossRef

Original Articles

Infectious disease-related laws: prevention and control measures: Mijeong Park; Epidemiol Health. 2017;39:e2017033. Published online July 25, 2017; DOI: https://doi.org/10.4178/epih.e2017033

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study examines recently revised Korean government legislation addressing global infectious disease control for public health emergency situations, with the aim of proposing more rational, effective and realistic interpretations and applications for improvement of law.

METHODS

The Korea reported its first laboratory-confirmed case of Middle East Respiratory Syndrome (MERS) coronavirus on May 20, 2015. Since the first indexed case, Korean public health authorities enforced many public health measures that were not authorized in the law; the scope of the current law was too limited to cover MERS. Korea has three levels of government: the central government, special self-governing provinces, and si/gun/gu. Unfortunately, the Infectious Disease Control and Prevention Act does not designate the specific roles of each level of government, and does not state how these governmental branches should be vertically integrated in a state of emergency.

RESULTS

When thinking about these policy questions, we should be especially concerned about introducing a new act that deals with all matters relevant to emerging infectious diseases. The aim would be to develop a structure that specifies the roles of each level of government, and facilitates the close collaboration among them, then enacting this in law for the prevention and response of infectious disease.

CONCLUSIONS

To address this problem, after analyzing the national healthcare infrastructure along with the characteristics of emerging infectious diseases, we propose the revision of the relevant law(s) in terms of governance aspects, emergency medical countermeasure aspects, and the human rights aspect.

Summary

Korean summary
본 연구의 목적은 2015년 메르스 발생 후, 감염병의 예방 및 관리에 관한 법률의 입법경과를 검토하여 감염병으로 인한 공중보건위기 대응과 관련된 법률의 보다 구체적인 개선방안을 제시하는 것이다. 중앙정부와 지자체의 협력을 위한 거버넌스, 응급상황에서의 긴급의약품 제공을 위한 절차, 격리 대상자의 인권보장과 관련된 부분의 충분한 법적 상당성을 갖추기 위해 국가 보건의료체계 하부구조 측면에서 문제점을 분석한 후 법률 개정방안을 제언하였다.

Citations

Citations to this article as recorded by

Dynamics in a reaction-diffusion epidemic model via environmental driven infection in heterogenous space
Ning Wang, Long Zhang, Zhidong Teng
Journal of Biological Dynamics.2022; 16(1): 373. CrossRef
Trends in gastrointestinal infections before and during non-pharmaceutical interventions in Korea in comparison with the United States
Soyeoun Kim, Jinhyun Kim, Bo Youl Choi, Boyoung Park
Epidemiology and Health.2022; 44: e2022011. CrossRef
Spatial autocorrelation may bias the risk estimation: An application of eigenvector spatial filtering on the risk of air pollutant on asthma
Yujin Park, Su Hwan Kim, Seong Pyo Kim, Jiwon Ryu, Jinyeong Yi, Jin Youp Kim, Hyung-Jin Yoon
Science of The Total Environment.2022; 843: 157053. CrossRef
Impact of national pneumococcal vaccination program on invasive pneumococcal diseases in South Korea
Yeon Haw Jung, Yong June Choe, Chae Young Lee, Sang Oun Jung, Dong Han Lee, Jae Il Yoo
Scientific Reports.2022;[Epub] CrossRef
Interorganizational Coordination and Collaboration During the 2015 MERS-CoV Response in South Korea
Yushim Kim, Seong Soo Oh, Minyoung Ku, Jihyun Byeon
Disaster Medicine and Public Health Preparedness.2021; 15(4): 409. CrossRef
A Mixed-Methods Systematic Review of the Impacts of Coronavirus on Society and Culture
Yeon Jung Yu, Young Su Park, Alison Keller, Jin-Won Noh, Jiho Cha
International Journal of Environmental Research and Public Health.2021; 18(2): 491. CrossRef
Flattening the Curve on COVID-19: South Korea’s Measures in Tackling Initial Outbreak of Coronavirus
Daejoong Lee, Kyungmoo Heo, Yongseok Seo, Hyerim Ahn, Kyungran Jung, Sohyun Lee, Hyeseung Choi
American Journal of Epidemiology.2021; 190(4): 496. CrossRef
Fluctuations in influenza-like illness epidemics and suicide mortality: A time-series regression of 13-year mortality data in South Korea
Sun Jae Jung, Sung-Shil Lim, Jin-Ha Yoon, Mrinmoy Sanyal
PLOS ONE.2021; 16(2): e0244596. CrossRef
Systematic assessment of South Korea’s capabilities to control COVID-19
Katelyn J. Yoo, Soonman Kwon, Yoonjung Choi, David M. Bishai
Health Policy.2021; 125(5): 568. CrossRef
Management of the COVID-19 Pandemic in the Republic of Korea from the Perspective of Governance and Public-Private Partnership
Woojin Kim, Tae Yong Jung, Susann Roth, Woochong Um, Changsoo Kim
Yonsei Medical Journal.2021; 62(9): 777. CrossRef
COVID-19 Responses of South Korea as Hybrids of Governance Modes
Sora Lee, Ryan Wong
Frontiers in Public Health.2021;[Epub] CrossRef
Coronavirus Disease 2019 Cases at Universities and Colleges in Seoul Metropolitan Area
Young June Choe, Yun-Kyung Kim
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Legitimacy and Constitutionality of Contact Tracing in Pandemic in the Republic of Korea
Gyooho Lee
SSRN Electronic Journal .2020;[Epub] CrossRef
Dendrimers and Dendritic Materials: From Laboratory to Medical Practice in Infectious Diseases
Miguel Ángel Ortega, Alberto Guzmán Merino, Oscar Fraile-Martínez, Judith Recio-Ruiz, Leonel Pekarek, Luis G. Guijarro, Natalio García-Honduvilla, Melchor Álvarez-Mon, Julia Buján, Sandra García-Gallego
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Implementation System of a Biosurveillance System in the Republic of Korea and Its Legal Ramifications
Amanda J. Kim, Sangwoo Tak
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Young June Choe, Kwangsuk Park, Eunyoung Park, Insik Kong, Jong-Koo Lee
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International Cooperation in the Control and Prevention of Emerging and Reemerging Infectious Diseases.: Hae Kwan Cheong; Korean J Epidemiol. 2006;28(1):85-91.

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Abstract PDF: Abstract
This paper discusses the recent increase in the incidence of emerging and reemerging infectious diseases and the role of international cooperation in coping with such public health threats. The historical background and its evolution are reviewed and the need, advantages, and possible areas of international cooperation are presented. A current example and model of international cooperation at various levels is described. Finally, two of the main issues in the process of international cooperation are discussed: the ethical aspect of scientific communication and national interest, and intellectual property issues.; Summary

Epidemiologic Transition of Communicable Diseases in Korea: Academia's Contributions to the National Communicable Disease Prevention and Control Programs.: Joung Soon Kim, Hae Kwan Cheong; Korean J Epidemiol. 2006;28(1):4-21.

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Abstract PDF: Abstract
This paper describes the transition of communicable diseases in Korea since 1970s. Some of Korean's general living background and health indicators are introduced, followed by trends in the changes during the last several decades in socioeconomic, demographic, and living environmental status, which are closely associated with the transition of communicable diseases. The current incidence of classified, notifiable disease, the incidence by year, and the transition of communicable diseases are presented. Governmental responses to prevent and control communicable diseases, including both emerging and re-emerging infectious diseases, which have become recognized as having public health importance are described. Finally, the role played by academia during the last several decades in the successful control of communicable diseases is analyzed.; Summary

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