OBJECTIVES: Cervical cancer is a major disease burden in Vietnam. This study aimed to estimate the incidence and mortality rates of cervical cancer in Vietnam (1999-2017) in comparison to those in Korea, where a population-based cancer registry and national cervical cancer screening program have been implemented. METHODS: The estimated incidence and mortality of cervical cancer in Vietnam and Korea (1999-2017) were collected from Global Burden of Disease 2017 study. Estimated age-standardized rates (ASRs) in both countries were calculated utilizing the 1999-2017 population of each country and the World Health Organization standard population. The reported ASRs in Korea were also computed using data on incidence and mortality (1999-2017) and the Korean population from the Korea Statistical Information Service. RESULTS: In Vietnam, the estimated incidence and mortality of cervical cancer decreased annually by 0.84% and 1.01%. In Korea, the trend of reported incidence showed a dramatic drop (1999-2007 annual percent change [APC], -4.53%) before stably declining (2007-2017 APC, -2.71%). Reported mortality also significantly decreased (2003-2008 APC, -6.63%), and then maintained a stable decline (2008-2017 APC, -3.78%). The incidence and mortality rates were higher in Vietnam than in Korea. The declining trend of incidence and mortality in Vietnam was slower than the corresponding trends in Korea. CONCLUSIONS A national screening program should be implemented for Vietnamese women aged over 30 to maintain, or even hasten, the decline in cervical cancer incidence and mortality. A population-based cancer registry may help monitor the effectiveness of a cervical cancer screening program.

OBJECTIVES: The oocysts of the Toxoplasmatinae subfamily (Neospora caninum, Hammondia hammondi and H. heydorni, and Besnoitia besnoiti) are morphologically similar to Toxoplasma gondii, and indistinguishable from each other. This study investigated the prevalence of the Toxoplasmatinae subfamily in dog and cat fecal samples using a nested polymerase chain reaction method. METHODS: Overall, 200 fecal samples from domestic dogs (n=120) and cats (n=80) were collected from 15 farms in northern Iran. The samples were homogenized in 2.5% potassium dichromate solution and subsequently concentrated with sucrose solution. DNA was extracted from samples using a genomic DNA kit. Specific primers and the 18S rDNA gene were used to screen and detect all Toxoplasmatinae oocysts. RESULTS: Overall, 2.5% (3 of 120) and 22.5% (18 of 80) of the fecal samples collected from dogs and cats were infected with Toxoplasmatinae. In dogs, 2 samples were positive for N. caninum and 1 sample was positive for T. gondii. In cats, all 18 positive samples belonged to T. gondii. No contamination with H. heydorni was observed in dog fecal samples or H. hammondi and B. besnoiti in cat fecal samples. A phylogenetic analysis revealed that the T. gondii (cat) and N. caninum (dog) found had similarities with parasites reported from other regions of the world. CONCLUSIONS This is the first study to provide data on the epidemiology of Toxoplasmatinae oocysts in Iran. The findings suggest that public-health monitoring for the effective control of feces from cats and dogs and improved pet hygiene habits are needed.

Brucellosis and tuberculosis are lingering zoonotic infections that are endemic in many developing parts of the world, with considerable economic and health costs. Although guidelines for the control of these diseases exist, we highlight neglected transmission routes of these diseases. We show that informal, door-to-door marketing of unpasteurized milk provides an important route for disease transmission through kitchen cross-contamination. Furthermore, the practice of discarding the first strippings of milk at farms needs adjustment to avoid floor and environmental contamination. Herein, we propose handling guidelines and a design for a milk stripping collection vessel. We believe that taking action to block these hitherto unrecognized transmission routes will complement existing efforts and guidelines.

OBJECTIVES: This study aimed to conduct an age-period-cohort (APC) analysis of smoking prevalence trends in urban and non-urban areas in Japan. METHODS: Data on smoking prevalence from 2004 to 2019 were extracted from the Comprehensive Survey of Living Conditions in Japan. Government ordinance-designated cities and special wards in Tokyo were defined as urban areas. The respondents ranged from 20 years to 79 years old, and were grouped in 5-year intervals. Cohorts were defined for each age group of each year, and those born between 1925-1929 and 1995-1999 were examined. We calculated the estimated smoking prevalence for each age, period, and cohort, as well as the smoking prevalence ratio of non-urban areas compared with urban areas from the APC analysis results. RESULTS: The magnitude of the decrease in the period effect on smoking prevalence was larger in urban areas than in non-urban areas for both men and women. The smoking prevalence ratio for non-urban areas compared with that of urban areas was above 1 for men at most time points, except in the older age groups. In addition, the prevalence ratio between the areas decreased, particularly as age increased. For women, the smoking prevalence ratio in non-urban areas compared to urban areas was below 1 until cohorts born in the 1970s, but the trend reversed thereafter. CONCLUSIONS The results of this study suggest that further smoking control and cessation measures are necessary, particularly for older cohorts in urban women and for younger ages in non-urban men.

OBJECTIVES: West Nile virus (WNV) is a re-emerging mosquito-borne viral infection. This study investigated the pooled prevalence pattern and risk factors of WNV infection among humans and animals in Nigeria. METHODS: A systematic review was conducted of eligible studies published in PubMed, Scopus, Google Scholar, and Web of Science from January 1, 1950 to August 30, 2020. Peer-reviewed cross-sectional studies describing WNV infections in humans and animals were systematically reviewed. Heterogeneity was assessed using the Cochrane Q statistic. RESULTS: Eighteen out of 432 available search output were eligible and included for this study. Of which 13 and 5 were WNV studies on humans and animals, respectively. Although 61.5% of the human studies had a low risk of bias, they all had high heterogeneity. The South West geopolitical zone of Nigeria had the highest pooled prevalence of anti-WNV immunoglobulin M (IgM; 7.8% in humans). The pooled seroprevalence of anti-WNV IgM and immunoglobulin G (IgG) was 7.1% (95% confidence interval [CI], 5.9 to 8.3) and 76.5% (95% CI, 74.0 to 78.8), respectively. The WNV RNA prevalence was 1.9% (95% CI, 1.4 to 2.9), while 14.3% (95% CI, 12.9 to 15.8) had WNV-neutralizing antibodies. In animals, the pooled seroprevalence of anti-WNV IgM and IgG was 90.3% (95% CI, 84.3 to 94.6) and 3.5% (95% CI, 1.9 to 5.8), respectively, while 20.0% (95% CI, 12.9 to 21.4) had WNV-neutralizing antibodies. Age (odds ratio [OR], 3.73; 95% CI, 1.87 to 7.45; p<0.001) and level of education (no formal education: OR, 4.31; 95% CI, 1.08 to 17.2; p<0.05; primary: OR, 7.29; 95% CI, 1.80 to 29.6; p<0.01) were significant risk factors for WNV IgM seropositivity in humans. CONCLUSIONS The findings of this study highlight the endemicity of WNV in animals and humans in Nigeria and underscore the need for the One Health prevention and control approach.

OBJECTIVES: Physical activity (PA) is an established protective factor for many chronic diseases. Numerous studies have established positive relationships between social networks and PA. Accordingly, this study examined the relationship between social network structures (specifically the network size and the number and proportion of same-sex alters) and self-reported PA in Korean middle-age adults, where the term “alter” refers to a respondent’s social network members. METHODS: We analyzed 8,092 participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. We assessed the association between each network structure variable and PA level using a linear regression model. Then, we employed logistic regression to evaluate associations between social network structure and adherence to guideline-recommended exercise levels. Socio-demographic factors and health status measures were used as covariates. RESULTS: In both sexes, the social network size and proportion of same-sex network members showed positive relationships with total and moderate-to-vigorous PA. Notably, female participants with a greater number of kin were more likely to satisfy the recommended amount of total PA. CONCLUSIONS These findings suggest that large scale, same-sex intervention programs can help to achieve recommended PA regimens.

OBJECTIVES: This study investigated differences in the perinatal mortality rate between white-collar and blue-collar workers. METHODS: Data from the “Report of Vital Statistics: Occupational and Industrial Aspects” in Japan covering the period from 1995 to 2015 were used. Five-year maternal age groups from 15-19 years to 45-49 years were analyzed according to work type, and the perinatal mortality rate for each age group and the age-standardized perinatal mortality rate according to maternal age were calculated in each analyzed year. A Bayesian age-period-cohort analysis was used to estimate age, period, and cohort effects for the perinatal mortality rate according to work type. Moreover, the perinatal mortality rate ratios between types of workers were estimated for each age group, period, and cohort. RESULTS: The estimated perinatal mortality rate ratios of blue-collar to white-collar workers were above 1 in most of the age groups and cohorts. The age effect for the perinatal mortality rate among white-collar workers was the largest in the 15-year to 19-year age group, whereas that among blue-collar workers was the largest in the 45-year to 49-year age group. Furthermore, the estimated perinatal rate ratio between white-collar and blue-collar workers tended to increase with maternal age. The magnitude of the decrease of the cohort effects on the perinatal mortality rate was rather larger in blue-collar workers in the cohorts born between 1946-1950 and 1996-2000. CONCLUSIONS The magnitude of the disparity markedly increased with maternal age. Thus, middle-aged blue-collar workers need more prenatal care and preventive measures for perinatal mortality than white-collar workers.

OBJECTIVES: This study aimed to develop hypotheses on trends in malaria incidence in North Korea using malaria incidence among South Korean visitors to North Korea. METHODS: The number of South Korean tourists who visited Mount Kumgang from 2000 to 2008 and the number of South Korean employees at the Kaesong Industrial Complex from 2005 to 2015 were obtained from the Korean Statistical Information Service. The number of malaria cases among South Koreans who visited North Korea was obtained from a previous report. The incidence of malaria per 100,000 person-years was calculated using these data and compared with the malaria incidence in North Korea derived from published articles. RESULTS: A high incidence of malaria in 2001 and a sharp decline in the following years were observed in both South and North Korean data. Since then, North Korean data showed a relatively low and stable incidence, but the incidence among South Koreans visiting North Korea increased in 2006. Considering the trends in mass primaquine preventive treatment, floods, and economic growth rate, the incidence of malaria may have increased in North Korea in 2006. Since 2009, the incidence of malaria decreased gradually according to both South and North Korean data. CONCLUSIONS The trends of malaria incidence in North Korea could be reflected through its incidence among South Koreans who visited North Korea. For future inter-Korean collaboration aiming to eradicate malaria, we propose that a North Korean malaria monitoring system be established applying this method.

OBJECTIVES: Secondhand smoke is an issue that cannot be ignored due to its various negative effects. Especially, secondhand smoke inside the household is an area where health policy must pay attention as it can affect all age groups. This study aims to identify the factors associated with smoking inside the household focusing on socioeconomic status in Korea. METHODS: We used data from the Community Health Survey of 2017 and a total of 33,462 participated in the study. Data were analyzed through IBM SPSS version 25.0 to conduct binary logistic regression analysis. RESULTS: Results indicated that indoor smoking had a significant association with socioeconomic status. This association was more marked in those participants who had low household income or those with elementary school education level or less. Furthermore, the study indicates that when the smoker is a woman, older, has higher stress, and is a heavier smoker, the probability of her smoking inside the house is higher. CONCLUSIONS Based on the results, it is meaningful that this study has found the factors of smoking inside household. The result identify the factors associated with indoor smoking at home, and it can be used as baseline data for developing new smoking cessation policies.

OBJECTIVES: The purpose of this study was to compare moderate-to-vigorous physical activity (MVPA) with walking in terms of associations with metabolic syndrome components in Korean older adults. METHODS: Data on 1,388 older adults (age ≥65 years) from the Korea National Health and Nutrition Examination Survey 2018 were analyzed in this study. MVPA time and walking time per week were used as physical activity variables and blood pressure, waist circumference, glucose, high-density lipoprotein cholesterol, and triglyceride levels were analyzed as metabolic syndrome components. Partial correlations, analysis of covariance, and multinomial logistic regression were used for statistical analysis after adjusting for age, sex, smoking, and alcohol consumption. RESULTS: High-density lipoprotein cholesterol levels were significantly higher in the low MVPA/high walking and high MVPA/ high walking groups than in the low MVPA/low walking group. Triglyceride levels were significantly lower in the high MVPA/ high walking group than in the low MVPA/low walking and low MVPA/high walking groups. Engaging in <150 min/wk of MVPA increased the likelihood of abnormal blood pressure and metabolic syndrome by 1.81 times and 1.89 times, respectively, compared to ≥150 min/wk of MVPA. Engaging in <180 min/wk of walking raised the likelihood of having abnormal highdensity lipoprotein levels by 1.32 times compared to ≥180 min/wk of walking. CONCLUSIONS Not only MVPA but also walking was significantly associated with metabolic syndrome components in Korean older adults. Considering older adults’ preferences and exercise barriers, walking should be considered as an essential component of physical activity guidelines to prevent chronic diseases in older adults.