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Evaluation of Potency on Diphtheria and Tetanus Toxoid for Adult Vaccines by In Vivo Toxin Neutralization Assay Using National Reference Standards.

Chan Woong CHOI ; Jae Hoon MOON ; Jae Ok KIM ; Si Hyung YOO ; Hyeon Guk KIM ; Jung Hwan KIM ; Tae Jun PARK ; Sung Soon KIM

Osong Public Health and Research Perspectives.2018;9(5):278-282. doi:10.24171/j.phrp.2018.9.5.10

OBJECTIVES: Vaccinations against diphtheria and tetanus are essential in providing immunity against these bacterial infections. The potency of diphtheria and tetanus toxoid vaccines can be measured using the in vivo toxin neutralization assay. The limit of potency of this assay was determined only for children. Therefore, we assessed the potency of adult vaccines using this assay to identify the feasibility of limit for adult vaccines. METHODS: Fifteen lots of tetanus-reduced diphtheria and tetanus-diphtheria-acellular pertussis vaccines were used. In vivo toxin neutralization and lethal challenge assays were conducted on each vaccine to calculate the potencies of the toxoids. National reference standards for toxins and antitoxins were used for in vivo toxin neutralization assay. RESULTS: All 15 lots satisfied the limits of potency for lethal challenge assay. The potency of diphtheria and tetanus toxoids exceeded 1 and 8 units/mL, respectively, for in vivo toxin neutralization assay. CONCLUSION: Although additional studies are required for new assays and limits, the current level of potency for adult vaccines as determined by in vivo toxin neutralization assay, was demonstrated in this study. Such efforts to improve assays are expected to promote the development of diphtheria and tetanus vaccines for adults and to contribute to vaccine self-sufficiency.
Adult* ; Antitoxins ; Bacterial Infections ; Child ; Diphtheria Toxoid ; Diphtheria* ; Humans ; Tetanus Toxoid* ; Tetanus* ; Toxoids ; Vaccination ; Vaccines* ; Whooping Cough

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Army Soldiers' Knowledge of, Attitude Towards, and Preventive Behavior Towards Tuberculosis in Korea.

Yun CHOI ; Geum Hee JEONG

Osong Public Health and Research Perspectives.2018;9(5):269-277. doi:10.24171/j.phrp.2018.9.5.09

OBJECTIVES: The aim of this study was to gather information about Korean Army soldiers’ attitude towards tuberculosis to enable the development of an informed educational program and potential intervention plans. METHODS: There were 500 male soldiers serving in the Korean Army who responded to questionnaires regarding knowledge of, attitudes towards, and preventive behavior towards tuberculosis. The questionnaires were collected between September 10 until October 1, 2014. Participants’ characteristic that influenced differences in knowledge, attitudes, and preventive behavior towards tuberculosis were compared by t test. Variables that influenced preventive behavior were identified by multiple regression analysis. RESULTS: The mean scores assessing knowledge of, attitude, and preventive behavior towards tuberculosis were 11.64 (± 4.03) out of 20 points, 3.21 (± 0.38) out of 4 points, and 2.88 (± 0.42) out of 4 points, respectively. Non-smokers were more knowledgeable about tuberculosis than smokers. Participants who had family or friends with tuberculosis had better knowledge and a more productive attitude to tuberculosis. Participants who were educated or obtained information about tuberculosis, received better scores in all areas of knowledge, attitude and preventive behavior compared to other participants. Non-smoking, family or friends who have had tuberculosis, obtaining information about tuberculosis, and positive attitudes towards treatment and preventive education had an explanatory power of 24.6% with regard to preventive behavior against tuberculosis. CONCLUSION: More relatable, systemized education should be provided regularly to improve soldiers’ knowledge of, attitudes towards, and prevention against tuberculosis in the Republic of Korea Army.
Education ; Friends ; Humans ; Korea* ; Male ; Military Personnel ; Republic of Korea ; Tuberculosis*

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Public Awareness of Early and Late Complications of Type 2 Diabetes - Application of Latent Profile Analysis in Determining Questionnaire Cut-Off Points.

Nasrin SHIRMOHAMMADI ; Ali Reza SOLTANIAN ; Shiva BORZOUEI

Osong Public Health and Research Perspectives.2018;9(5):261-268. doi:10.24171/j.phrp.2018.9.5.08

OBJECTIVES: A questionnaire was designed to determine public understanding of early and late complications of Type 2 diabetes mellitus (T2DM). METHODS: A cross-sectional study was performed in participants who were selected using a multi-stage sampling method and a standard questionnaire of 67 questions was proposed. An expert panel selected 53 closed-ended questions for content validity to be included in the questionnaire. The reliability of the questionnaire was tested using Cronbach’s alpha coefficient giving a score of 0.84. RESULTS: Of the 825 participants, 443 (57.6%) were male, and 322 (41.87%) were 40 years or more. The proportion of low-, moderate- and high- awareness about T2DM and its complications was 29.26%, 62.68%, and 8.06%, respectively. Friends (56.31%) and internet and social networks (20.55%) were the 2 major sources of awareness, respectively. The medical staff (e.g., physicians) had the lowest share in the level of public awareness (3.64%) compared to other sources. CONCLUSION: These results present data that shows the general population awareness of T2DM is low. Healthcare policymakers need to be effective at raising awarenes of diabetes and it should be through improved education.
Cross-Sectional Studies ; Delivery of Health Care ; Diabetes Mellitus, Type 2 ; Education ; Friends ; Humans ; Internet ; Male ; Medical Staff ; Methods ; Models, Statistical

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Epidemiological Characterization of Imported Systemic Mycoses Occurred in Korea.

Seung Hak CHO ; Young Bin YU ; Je Seop PARK ; Keun Dol YOOK ; Young Kwon KIM

Osong Public Health and Research Perspectives.2018;9(5):255-260. doi:10.24171/j.phrp.2018.9.5.07

OBJECTIVES: Imported systemic mycoses is a severe fungal infection that can cause diseases in healthy people. However, there is a serious lack of epidemiological data about imported systemic mycoses. Therefore, an epidemiological characterization of imported systemic mycoses in Korea was performed. METHODS: We collected health insurance data between 2008 and 2012 from the Health Insurance Corporation and analyzed the data to determine the prevalence and treatment management of imported systemic mycoses. RESULTS: The prevalence of imported systemic mycoses between 2008 and 2012 increased slowly by 0.49/100,000 to 0.53/100,000 persons. The prevalence of coccidioidomycosis increased from 0.28/100,000 in 2008 to 0.36/100,000 persons in 2012. A mean of 229.6 cases occurred each year. Children and the elderly showed higher prevalence than adults in the 20- to 59-year-old age group. The rate of infection according to region ranged from 0.18/100,000 persons in Ulsan, to 0.59/100,000 persons in Gyeonggi. The prevalence in females was higher than that in males. Inpatient treatment was 3.3% (38 cases), with 96.7% treated as outpatients. Hospitalizations cost 272.7 million won and outpatient treatments cost 111.7 million won. The treatment cost for coccidioidomycosis from 2008 to 2012 was 330.9 million won, with personal charges of 79.2 million won and insurance charges of 251.7 million won. Most of the expenses for the coccidioidomycosis treatment were for inpatient treatment. CONCLUSION: The results in this study may be a useful resource for determining the changes in the trend of imported systemic mycoses.
Adult ; Aged ; Blastomycosis ; Child ; Coccidioidomycosis ; Epidemiology ; Female ; Gyeonggi-do ; Health Care Costs ; Histoplasmosis ; Hospitalization ; Humans ; Inpatients ; Insurance ; Insurance, Health ; Korea* ; Male ; Middle Aged ; Mycoses* ; Outpatients ; Prevalence ; Ulsan

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Changing Disease Trends in the Northern Gyeonggi-do Province of South Korea from 2002 to 2013: A Big Data Study Using National Health Information Database Cohort.

Young Soo KIM ; Dong Hee LEE ; Hiun Suk CHAE ; Kyungdo HAN

Osong Public Health and Research Perspectives.2018;9(5):248-254. doi:10.24171/j.phrp.2018.9.5.06

OBJECTIVES: To investigate the chronological patterns of diseases in Northern Gyeonggi-do province, South Korea, and compare these with national data. METHODS: A National Health Insurance cohort based on the National Health Information Database (NHID Cohort 2002–2013) was used to perform a retrospective, population-based study (46,605,433 of the target population, of which 1,025,340 were randomly sampled) to identify disease patterns from 2002 to 2013. Common diseases including malaria, cancer (uterine cervix, urinary bladder, colon), diabetes mellitus, psychiatric disorders, hypertension, intracranial hemorrhage, bronchitis/bronchiolitis, peptic ulcer, and end stage renal disease were evaluated. RESULTS: Uterine cervix cancer, urinary bladder cancer and colon cancer had the greatest rate of increase in Northern Gyeonggi-do province compared with the rest of the country, but by 2013 the incidence of these cancers had dropped dramatically. Acute myocardial infarction and end stage renal disease also increased over the study period. Psychiatric disorders, diabetes mellitus, hypertension and peptic ulcers showed a gradual increase over time. No obvious differences were found for intracranial hemorrhage or bronchitis/bronchiolitis between the Northern Gyeonggi-do province and the remaining South Korean provinces. Malaria showed a unique time trend, only observed in the Northern Gyeonggi province, peaking in 2004, 2007 and 2009 to 2010. CONCLUSION: This study showed that the Northern Gyeonggi-do province population had a different disease profile over time, compared with collated data for the remaining provinces in South Korea. “Big data” studies using the National Health Insurance cohort database can provide insight into the healthcare environment for healthcare providers, stakeholders and policymakers.
Cervix Uteri ; Cohort Studies* ; Colonic Neoplasms ; Delivery of Health Care ; Diabetes Mellitus ; Female ; Gyeonggi-do* ; Health Personnel ; Health Services Needs and Demand ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Insurance, Health ; Intracranial Hemorrhages ; Intracranial Hypertension ; Kidney Failure, Chronic ; Korea* ; Malaria ; Myocardial Infarction ; National Health Programs ; Peptic Ulcer ; Regional Health Planning ; Retrospective Studies ; Urinary Bladder ; Urinary Bladder Neoplasms

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Factors Affecting Smoking Cessation Success of Heavy Smokers Registered in the Intensive Care Smoking Cessation Camp (Data from the National Tobacco Control Center).

Hansol YEOM ; Hee Sook LIM ; Jihyun MIN ; Seoni LEE ; Yoon Hyung PARK

Osong Public Health and Research Perspectives.2018;9(5):240-247. doi:10.24171/j.phrp.2018.9.5.05

OBJECTIVES: The purpose of this study was to investigate the factors involved in the success of smoking cessation in heavy smokers enrolled in an intensive care smoking cessation camp program. METHODS: Heavy smokers enrolled in the program were classified into a success (n = 69) or failure (n = 29) group, according to whether they maintained smoking cessation for 6 months after the end of the program. Demographics, smoking behaviors, and smoking cessation-related characteristics were analyzed. RESULTS: Statistically significantly more participants in the success group had a spouse (98.6%; p = 0.008) compared with participants in the failure group (82.8%). However, multivariate logistic regression analysis indicated that having a spouse was not an independent factor in smoking cessation (p = 0.349). A significant difference in the frequency of counseling between the success and failure groups was observed (p = 0.001), with 72.5% of those who received counseling on 3–5 occasions for 6 months after the end of program successfully quit smoking, indicating that those who received more counseling had a higher likelihood of smoking cessation success. This was confirmed as an independent factor by multivariate logistic regression (p < 0.005). Furthermore, a graduate school level of education or higher, indicated a statistically greater success rate compared to those that were less well educated (p = 0.043). This was also observed as a significant independent factor using multivariate logistic regression (p = 0.046). CONCLUSION: Education level, marital status, and the number of counseling sessions were significant factors contributing to smoking cessation success.
Counseling ; Critical Care* ; Demography ; Education ; Humans ; Logistic Models ; Marital Status ; Smoke* ; Smoking Cessation* ; Smoking* ; Spouses ; Tobacco*

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Developing the High-Risk Drinking Scorecard Model in Korea.

Jun Tae HAN ; Il Su PARK ; Suk Bok KANG ; Byeong Gyu SEO

Osong Public Health and Research Perspectives.2018;9(5):231-239. doi:10.24171/j.phrp.2018.9.5.04

OBJECTIVES: This study aimed to develop a high-risk drinking scorecard using cross-sectional data from the 2014 Korea Community Health Survey. METHODS: Data were collected from records for 149,592 subjects who had participated in the Korea Community Health Survey conducted from 2014. The scorecard model was developed using data mining, a scorecard and points to double the odds approach for weighted multiple logistic regression. RESULTS: This study found that there were many major influencing factors for high-risk drinkers which included gender, age, educational level, occupation, whether they received health check-ups, depressive symptoms, over-moderate physical activity, mental stress, smoking status, obese status, and regular breakfast. Men in their thirties to fifties had a high risk of being a drinker and the risks in office workers and sales workers were high. Those individuals who were current smokers had a higher risk of drinking. In the scorecard results, the highest score range was observed for gender, age, educational level, and smoking status, suggesting that these were the most important risk factors. CONCLUSION: A credit risk scorecard system can be applied to quantify the scoring method, not only to help the medical service provider to understand the meaning, but also to help the general public to understand the danger of high-risk drinking more easily.
Breakfast ; Commerce ; Data Mining ; Depression ; Drinking* ; Health Surveys ; Humans ; Korea* ; Logistic Models ; Male ; Motor Activity ; Occupations ; Research Design ; Risk Factors ; Smoke ; Smoking

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Corrigendum to “Associations between Social and Physical Environments, and Physical Activity in Adults from Urban and Rural Regions”Osong Public Health Res Perspect 2018;9(1):16–24.

Bongjeong KIM ; Hye Sun HYUN

Osong Public Health and Research Perspectives.2018;9(5):283-285. doi:10.24171/j.phrp.2018.9.5.11

The authors regret to report that in the original paper, the OR and 95% CI values of the individual level variables in Table 4 are missing. Furthermore, the OR values and 95% CI values of individual and community level variables are missing or incorrectly presented in Table 5.
Adult* ; Humans ; Motor Activity* ; Public Health*

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The Effects of Task-Oriented Circuit Training Using Rehabilitation Tools on the Upper-Extremity Functions and Daily Activities of Patients with Acute Stroke: A Randomized Controlled Pilot Trial.

Jong Hoon MOON ; Kyoung Young PARK ; Hee Jin KIM ; Chang Ho NA

Osong Public Health and Research Perspectives.2018;9(5):225-230. doi:10.24171/j.phrp.2018.9.5.03

OBJECTIVES: The purpose of this study was to investigate the effect of task-oriented circuit training (TOCT) using the rehabilitation tools for upper extremity function upon the daily life of patients with acute stroke. METHODS: Eighteen patients with acute stroke were randomly allocated into either the experimental group or the control group. The experimental group performed the TOCT program using rehabilitation tools, whilst the control group had neuro-developmental treatment. Both groups received 30 minutes of treatment per session, 5~6 times per week, for 4 weeks. The assessments conducted were the Fugl-Meyer assessment, motor activity log and stroke impact scale to compare the upper extremity function and activities of daily living. RESULTS: The results showed a significant improvement in the TOCT group compared with the neuro-developmental treatment group in the amount of motor activity use and high stroke impact score, indicating recovery (p < 0.05). CONCLUSION: The TOCT program using rehabilitation tools could have a positive impact on acute stroke patients use of their upper extremity.
Activities of Daily Living ; Circuit-Based Exercise* ; Humans ; Motor Activity ; Rehabilitation* ; Stroke* ; Upper Extremity

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Relationships between Virulence Factors and Antimicrobial Resistance among Escherichia coli Isolated from Urinary Tract Infections and Commensal Isolates in Tehran, Iran.

Mohammad Reza Asadi KARAM ; Mehri HABIBI ; Saeid BOUZARI

Osong Public Health and Research Perspectives.2018;9(5):217-224. doi:10.24171/j.phrp.2018.9.5.02

OBJECTIVES: Uropathogenic Escherichia coli (UPEC) are the major cause of urinary tract infections (UTIs). Here, we determined whether sensitivity to antibiotics was related to the prevalence of iron scavenging genes, or to biofilm and hemolysis formation. METHODS: A total of 110 UPEC and 30 E coli isolates were collected from the urine of UTI patients and feces of healthy individuals without UTI, respectively. The presence of iron receptor genes and phenotypic properties were evaluated by polymerase chain reaction and phenotypic methods, respectively. Susceptibility to routine antibiotics was evaluated using the disc diffusion method. RESULTS: The prevalence of iron scavenging genes ranged from 21.8% (ireA) to 84.5% (chuA) in the UPEC. Resistance to ceftazidime and cefotaxime was significantly correlated with the presence of fyuA and iutA iron genes. Biofilm production was significantly associated with the prevalence of fyuA and hma iron genes. A higher degree of antibiotic resistance was exhibited by isolates that produced biofilms than by their non-biofilm producing counterparts. CONCLUSION: Our study clearly indicates that biofilm production is associated with antibiotic resistance, and that iron receptors and hemolysin production also contribute to reduced antibiotic sensitivity. These results further our understanding of the role that these virulence factors play during UPEC pathogenesis, which in turn may be valuable for the development of novel treatment strategies against UTIs.
Anti-Bacterial Agents ; Biofilms ; Cefotaxime ; Ceftazidime ; Diffusion ; Drug Resistance, Microbial ; Escherichia coli* ; Escherichia* ; Feces ; Hemolysis ; Humans ; Iran* ; Iron ; Methods ; Polymerase Chain Reaction ; Prevalence ; Urinary Tract Infections* ; Urinary Tract* ; Uropathogenic Escherichia coli ; Virulence Factors* ; Virulence*

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