BACKGROUND AND OBJECTIVE

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the causative agent of COVID-19 has significantly challenged the public health landscape in late 2019. After almost 3 years of the first ever SARS-CoV-2 case, the World Health Organization (WHO) declared the end of this global health emergency in May 2023. Although, despite the subsequent drop of COVID-19 cases, the SARS-CoV-2 infection still exhibited multiple waves of infection, primarily attributed to the appearance of new variants. Five of these variants have been classified as Variants of Concern (VOC): Alpha, Beta, Gamma, Delta, and the most recent, Omicron. Therefore, the development of methods for the timely and accurate detection of viral variants remains fundamental, ensuring an ongoing and effective response to the disease. This study aims to evaluate the feasibility of the application of an in-house approach in genomic surveillance for the detection of SARS-CoV-2 variants using in silico designed primers.

METHODS

The primers used for the study were particularly designed based on conserved regions of certain genes in the virus, targeting distinct mutations found in known variants of SARS-CoV-2. Viral RNA extracts from nasopharyngeal samples (n=14) were subjected to quantitative and qualitative tests (Nanodrop and AGE). Selected samples were then analyzed by RT-PCR and amplicons were submitted for sequencing. Sequence alignment analysis was carried out to identify the prevailing COVID-19 variant present in the sample population.

RESULTS

The study findings demonstrated that the in-house method was able to successfully amplify conserved sequences (spike, envelope, membrane, ORF1ab) and enabled identification of the circulating SARS-CoV-2 variant among the samples. Majority of the samples were identified as Omicron variant. Three out of four designed primers effectively bound into the conserved sequence of target genes present in the sample, revealing the specific SARSCoV-2 variant. The detected mutations characterized for Omicron found in the identified lineages included K417N, S477N, and P681H which were also identified as mutations of interest. Furthermore, identification of the B.1.448 lineage which was not classified in any known variant also provided the potential of the developed in-house method in detecting unknown variants of COVID-19.

CONCLUSION

Among the five VOCs, Omicron is the most prevalent and dominant variant. The in-house direct PCR product sequencing surveillance (DPPSS) method provided an alternative platform for SAR-CoV-2 variant analysis which is accessible and affordable than the conventional diagnostic surveillance methods and the whole genome sequencing. Further evaluation and improvements on the oligonucleotide primers may offer significant contribution to the development of a specific and direct PCRbased detection of new emerging COVID-19 variants.

Sars-cov-2 ; Polymerase Chain Reaction ; Dna Primers ; Oligonucleotide Primers ; Computer Simulation ; Conserved Sequence ; Coronavirus ; Covid-19 ; Disease ; Emergencies ; Evaluation Studies As Topic ; Genes ; Genome ; Global Health ; Health ; Identification (psychology) ; Infection ; Infections ; Membranes ; Methods ; Mutation ; Oligonucleotides ; Organizations ; Population ; Public Health ; Rna ; Rna, Viral ; Sars Virus ; Sequence Alignment ; Severe Acute Respiratory Syndrome ; Syndrome ; Viruses ; Whole Genome Sequencing ; World Health Organization

BACKGROUND

Stunting remains a major public health issue in Indonesia, particularly in regions like Pandeglang Regency, where prevalence rates are high. Understanding the contributing factors is essential for targeted interventions.

OBJECTIVE

This study aimed to analyze factors associated with stunting among toddlers using a mixed-methods approach.

METHODS

A cross-sectional mixed-methods study was conducted in two health centers in Banten Province from December 2021 to January 2022. Quantitative data were collected using a structured questionnaire and analyzed using chi-square tests (pRESULTS

There is a relationship between maternal knowledge, history of exclusive breastfeeding, history of supplementary feeding, support from health workers, and socio-economic status with the prevalence of stunting. However, the pattern of exclusive breastfeeding and seeking health services in the working areas of Bangkonol Health Center and Kaduhejo Health Center, Pandeglang Regency, is not good enough and needs to be improved. Health workers need to educate mothers with toddlers about patterns of providing complementary feeding, food preparation, and storage, and basic health practices to prevent stunting.

RESULTS

There is a relationship between maternal knowledge, history of exclusive breastfeeding, history of supplementary feeding, support from health workers, and socio-economic status with the prevalence of stunting. However, the pattern of exclusive breastfeeding and seeking health services in the working areas of Bangkonol Health Center and Kaduhejo Health Center, Pandeglang Regency, is not good enough and needs to be improved. Health workers need to educate mothers with toddlers about patterns of providing complementary feeding, food preparation, and storage, and basic health practices to prevent stunting.

Human ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Public Health ; Prevalence ; Methods ; Indonesia ; Health ; Growth Disorders ; Comprehension

The advances of modern medicine have inadvertently led to a globally ageing population plagued primarily with non-communicable diseases. In addition to traditional medical approaches, nature-based therapy is becoming an increasingly attractive option, with its potential to holistically address physical and mental facets of health and well-being, and to complement 'preventive' and 'population health' strategies, both of which form the bedrock of sustainable healthcare. However, at present, there is vast heterogeneity in the implementation of nature-based therapy, limiting its widespread and sustainable use. The aim of this review is to practically examine and provide a focussed summary of the current evidence with a view to identifying existing gaps and limitations, and to propose directions for future research and implementation within the healthcare setting.
Humans ; Singapore ; Tertiary Care Centers ; Hospitals, Public ; Delivery of Health Care ; Nature ; Complementary Therapies/methods* ; Medicine, Traditional/methods*

PURPOSE: An injury surveillance information system (ISIS) collects, analyzes, and distributes data on injuries to promote health care delivery. The present study aimed to review the data elements and functional requirements of this system. METHOD: This study was conducted in 2019. Studies related to injury surveillance system were searched from January 2000 to September 2019 via the databases of PubMed, Web of Knowledge, ScienceDirect, and Scopus. Articles related to the epidemiology of injury, population survey, and letters to the editor were excluded, while the review and research articles related to ISISs were included in the study. Initially 324 articles were identified, and finally 22 studies were selected for review. Having reviewed the articles, the data needed were extracted and the results were synthesized narratively. RESULTS: The results showed that most of the systems reviewed in this study used the minimum data set suggested by the World Health Organization injury surveillance guidelines along with supplementary data. The main functions considered for the system were injury track, data analysis, report, data linkage, electronic monitoring and data dissemination. CONCLUSION ISISs can help to improve healthcare planning and injury prevention. Since different countries have various technical and organizational infrastructures, it is essential to identify system requirements in different settings.
Datasets as Topic ; Delivery of Health Care ; Health Information Systems ; Health Planning ; Humans ; Public Health Surveillance ; methods ; Wounds and Injuries ; prevention & control

BACKGROUND/AIMS: Public hospitals were established to provide high quality medical services to low socioeconomic status patients. This study examined the effects of public hospitals on the treatment and prognosis of patients with five-major gastrointestinal (GI) cancers (stomach cancer, colon cancer, liver cancer, bile duct cancer, and pancreatic cancer).METHODS: Among the 1,268 patients treated at Seoul National University Boramae Medical Center from January 2010 to December 2017, 164 (13%) were in the medicare group. The data were analyzed to identify and compare the clinical manifestations, treatment modality, and clinical outcomes between the groups.RESULTS: No statistically significant differences in the clinical data (age, sex), treatment method, and five-year survival rate were observed between the health insurance group and medicare group in the five major GI cancer patients. On the other hand, some medicare group patients tended more comorbidities and fewer treatment options than health insurance patients.CONCLUSIONS: Public hospitals have a positive effect on the treatment and prognosis in medicare group patients with the five-major GI cancers.
Bile Duct Neoplasms ; Colonic Neoplasms ; Comorbidity ; Gastrointestinal Neoplasms ; Hand ; Hospitals, Public ; Humans ; Insurance Coverage ; Insurance, Health ; Liver Neoplasms ; Medicare ; Methods ; Prognosis ; Retrospective Studies ; Seoul ; Social Class ; Survival Rate

Through literature review and group discussion, Special Expert Group for Control of the Epidemic of Novel Coronavirus Pneumonia of the Chinese Preventive Medicine Association formulated an update on the epidemiological characteristics of novel coronavirus pneumonia (NCP). The initial source of the 2019 novel coronavirus (2019-nCoV) was the Huanan seafood market in Wuhan, Hubei province, China, with pangolins as a potential animal host. Currently the main source of infection is NCP patients, and asymptomatic carriers may also be infectious. The virus is believed transmitted mostly via droplets or contact. People are all generally susceptible to the virus. The average incubation period was 5.2 days, and the basic reproductive number R(0) was 2.2 at the onset of the outbreak. Most NCP patients were clinically mild cases. The case fatality rate was 2.38%, and elderly men with underlying diseases were at a higher risk of death. Strategies for prevention and control of NCP include improving epidemic surveillance, quarantining the source of infection, speeding up the diagnosis of suspected cases, optimizing the management of close contacts, tightening prevention and control of cluster outbreaks and hospital infection, preventing possible rebound of the epidemic after people return to work from the Chinese Spring Festival holiday, and strengthening community prevention and control.
Aged ; Animals ; Asymptomatic Diseases/epidemiology* ; Betacoronavirus ; COVID-19 ; China/epidemiology* ; Contact Tracing ; Coronavirus ; Coronavirus Infections/epidemiology* ; Humans ; Infectious Disease Incubation Period ; Male ; Pandemics ; Pneumonia, Viral/epidemiology* ; Public Health Surveillance/methods* ; Quarantine ; SARS-CoV-2

This study compared the predictive models for the growth kinetics of Staphylococcus aureus in ham rice balls. In addition, a semi-quantitative risk assessment of S. aureus on ham rice balls was conducted using FDA-iRISK 4.0. The rice was rounded with chopped ham, which was mixed with mayonnaise (SHM), soy sauce (SHS), or gochujang (SHG), and was contaminated artificially with approximately 2.5 log CFU·g⁻¹ of S. aureus. The inoculated rice balls were then stored at 7℃, 15℃, and 25℃, and the number of viable S. aureus was counted. The lag phases duration (LPD) and maximum specific growth rate (SGR) were calculated using a Baranyi model as a primary model. The growth parameters were analyzed using the polynomial equation as a function of temperature. The LPD values of S. aureus decreased with increasing temperature in SHS and SHG. On the other hand, those in SHM did not show any trend with increasing temperature. The SGR positively correlated with temperature. Equations for LPD and SGR were developed and validated using R² values, which ranged from 0.9929 to 0.9999. In addition, the total DALYs (disability adjusted life years) per year in the ham rice balls with soy sauce and gochujang was greater than mayonnaise. These results could be used to calculate the expected number of illnesses, and set the hazard management method taking the DALY value for public health into account.
Hand ; Kinetics ; Methods ; Public Health ; Risk Assessment ; Safety Management ; Soy Foods ; Staphylococcus aureus ; Staphylococcus

The incidence and prevalence of pulmonary tuberculosis (TB) in South Korea remain high despite the fact that South Korea is a high-income country, and pulmonary TB is an important public health issue in terms of both morbidity and mortality. Thus, rapid diagnosis and management of active pulmonary TB are crucial for effective TB control, which can help to prevent the transmission of TB and the occurrence of new TB cases. However, because the clinical and radiological presentations of pulmonary TB may occasionally be nonspecific, identification of causative microorganisms using laboratory tests is the most important diagnostic method. Recently-developed microbiological and molecular techniques are commonly employed in current clinical practice. In particular, advances in liquid culture system, line probe assays, and Xpert MTB/RIF assay have reduced the identification time and facilitate the identification of drug-resistance TB. However, as various tests have both advantages and limitations, physicians should be aware of the principles underpinning the tests when interpreting the results. Thus, the clinical and radiological characteristics of pulmonary TB and several diagnostic laboratory tests that we describe below will aid physicians in diagnosing pulmonary TB efficiently.
Diagnosis ; Drug Resistance ; Incidence ; Korea ; Methods ; Mortality ; Prevalence ; Public Health ; Tuberculosis, Pulmonary

This study aimed to suggest the justification for a self-regulatory body for medical licenses in Korea by reviewing recent cases of physician arrests for medical accidents in Korea. A number of recent cases of medical mistakes have been criminalized by courts in Korea, leading to widespread concern and fear throughout the healthcare community. Without a profession-led self-regulation system ever having been introduced in Korea, there is no alternative method for disciplining doctors other than through criminal tort law. It is expected that the volume of malpractice lawsuits will increase rapidly in Korea as the government ambitiously expands its plans for universal health coverage. Instead of facing criminal charges, however, doctors must put forth an effort to introduce a contemporary form of medical regulation, with more advanced disciplinary measures against substandard practice. The Korean Medical Association has undertaken the challenging mandate of establishing a new professional regulatory body to provide a tribunal and disciplinary system for the medical profession. It has proven difficult to persuade doctors of its purpose and value, as the majority do not yet fully grasp the very foreign concept of self-regulation. Moving forward, however, it will eventually become the responsibility of doctors to persuade society, lawmakers, government, and patient interest groups of the necessity and viability of self-regulation, which may also prove challenging. Despite these predictable challenges, it is imperative that Korean doctors solve the issue of creating a new, modern regulatory body capable of effective self-regulation and acceptable disciplinary measures, within the near future.
Criminals ; Delivery of Health Care ; Hand Strength ; Humans ; Jurisprudence ; Korea ; Liability, Legal ; Licensure ; Malpractice ; Medical Errors ; Methods ; Public Opinion ; Self-Control

PURPOSE: This study aimed to seek agreement on the core components of an e-learning cultural competence program for Korean public health workers (PHWs) while prioritizing educational content areas. METHODS: A two-round Delphi study was performed with 16 Korean experts from five disciplines. Data were collected between August 30 and November 24, 2017. A questionnaire was developed from literature reviews and previous focus group interviews concerning PHWs. The panel members were asked to rate the importance and urgency of educational content areas and the effectiveness of teaching–learning methods and gave opinions on their appropriate frequency, duration, and target audience. Responses were analyzed using descriptive statistics. A median of 4.0 or greater or a rate of agreement of 75% or greater was considered a “consensus” for the purposes of this study. RESULTS: All consenting participants responded to two-round surveys. Participants reached consensus on thirty-one educational content areas. Of these, the highest priorities were “necessity of cultural competence of PHWs,” “health characteristics according to race and ethnicity,” and “establishing trusting relationships with migrants.” The most effective teaching–learning method was case-based learning, with seven to eight sessions of training and duration of fewer than 30 minutes per session. CONCLUSION: Multidisciplinary experts proposed 12 prioritized educational content areas and effective teaching–learning methods as well as their frequency, duration, and target audiences, reflecting Korea-specific multicultural phenomena and the nature of the work of PHWs. These findings can contribute to preparing PHWs to provide culturally competent services to migrants in their communities.
Consensus ; Continental Population Groups ; Cultural Competency ; Delphi Technique ; Education ; Focus Groups ; Health Personnel ; Humans ; Korea ; Learning ; Methods ; Public Health ; Transients and Migrants