Jee-Young Hong

Resurgence of Plasmodium vivax Malaria in the Republic of Korea during 2006-2007

Plasmodium vivax malaria, which re-emerged in the Republic of Korea (ROK) in 1993, had decreased since 2001. However, case numbers began to increase again in 2005. The number of cases rose 54.0% in 2006, but the rate of increase slowed down in 2007. Among the total of 4,206 cases of P. vivax malaria during 2006-2007, 756 cases (18.0%) were ROK military personnel, 891 cases (21.2%) were veterans, and 2,559 cases (60.8%) were civilians. The rapid increase during this period was mostly contributed by the western part of the malaria-risk areas that is under the influence of adjacent North Korea. Local transmission cases in ROK have also increased gradually and the transmission period seemingly became longer. Chemoprophylaxis in the military should be re-assessed in view of chloroquine-resistance. Continuous surveillance and monitoring are warranted to prevent further expansion of P. vivax malaria caused by climate change in ROK.

The Stages of Physical Activity and Exercise Behavior: An Integrated Approach to the Theory of Planned Behavior

This research aims to verify whether it is possible to explain the health-promoting behaviors based on sociodemographic characteristics by integrating the theory of planned behavior (TPB) proposed by Ajzen in 1988 and the transtheoretical model (TTM) proposed by Prochaska and DiClemente in 1983. In particular, the aim was to verify whether the variables of the TPB can properly distinguish the stages of change in exercise in the proposed integrated model and to figure out how attitude, subjective norm, perceived behavior control, influence, and intention-can explain the stages of change in exercise. Investigators who have taken previous training for the survey visited and interviewed 3658 people older than 30 years in the chosen town by multistage sampling method from July 27 to July 31, 2003. After the exclusion of inappropriate data out of 760 participants, only data from 584 participants were used for this research. χ2 test, t test, and 1-way analysis of variance were used to identify the difference between the distribution of the stages of change in exercise and the variables of the means. A discriminant analysis to verify the accuracy of the stages of change in exercise by means of the variables of the TPB and a path analysis to verify the fit of the integrated model were also used. The variables of the TPB were useful to satisfactorily distinguish and predict the stages of change in exercise. But to clarify the validity of this model, more diversified research should be conducted in the future, and the results must be accumulated.

Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation

Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

Factors Related to Completed Status and Seropositivity of Hepatitis A Immunization Among Children Aged 1–3 Years and 6–8 Years in South Korea

This study was designed to identify factors associated with hepatitis A immunization status and seropositivity in Korean children. In-person interviews, reviewing their vaccination cards and testing hepatitis A antibody were conducted with 389 children aged 1–3 years and 544 children aged 6–8 years. In all age groups, earlier birth order was the only significant factor in children receiving either single or both doses of the vaccination. And completion of the second dose of vaccination was a prerequisite for increased seropositivity. Additionally, household income had a positive impact on seropositivity only in children aged 6–8 years. Our findings suggest that presence of an economic barrier is the underlying cause of the decreased hepatitis A vaccination services in Korea. Therefore, hepatitis A vaccine should be included in the essential National Immunization Program.

The Related Factors of Atopic Dermatitis Severity in Elementary School Students

Abstract This study was conducted to provide the basic data for the health management of the primary school, by finding and analyzing the factors affecting the degrees of atopic dermatitis symptoms severeness. The subjects of our study were collected 273 pupils mothers, whose children are undergoing through the atopic symptoms. The investigation process took the entire month of the November in 2006. The result of the older the pupils, the severer their symptoms(p<0.05). The longer the period(p<0.01), the more widely spread over the body, and the severer the symptoms(p<0.01). In the dietary habit, the more meat they eat, the severer the symptom(p<0.05). and in relation to the eating the food outside home, the more frequently they eat the fast-food, the severer the symptom. In the multiple logistic regression analysis, using the degrees of atopic dermatitis symptoms severeness as the dependent variables. it is discovered that the longer infection period they have and the more frequently they have the fast-food, the severer the symptom of the atopic dermatitis. The parents love for the child, the monthly cost for the management of the infection, and the parents feeling toward the child, can have a greate influence on the physical health, the feelings and the relation with the friends of the infected child, when the child shows the symptoms of scratching his skin. The conclusions of When all the results above are put together, the dietary habit of eating the meals mostly prepared with the meat should be corrected, and the education to form the pupils right dietary habit, such as, putting the limit on the fast-food, must be made, in order to prevent the symptom of the atopic dermatitis from getting worse. And by the recognizing the atopic dermatitis as the family health problem, the comprehensive family health management, including the mother should be made. Key Words : Atopic dermatitis, Family health management, Primary school, Pupils

Evaluation on the Accuracy of Vaccination Card for National Immunization Program in a 2005 Population-Based Survey in Nonsan, Korea

목적 : 이 연구는 국가예방접종률 산출 및 조사방법론 개발을 위한 기반을 조성하기 위하여 예방접종률 파악을 위한 자료원 중 영유아 예방접종 수첩기록의 정확도를 평가하기 위하여 수행되었다. 대상 및 방법 : 연구대상은 2005년 1월 31일을 기준으로 충청남도 논산시에 주민등록상 거주하는 생후 12-35개월 영유아 전체로 하였다. 연구대상자가 거주하는 가구를 2005년 2-4월까지 방문하여 보호자의 동의를 얻어 예방접종 수첩기록을 조사하였다. 예방접종 수첩기록의 정확도를 평가하기 위하여 2005년 5-7월까지 예방접종을 시행한 의료기관 및 보건소의 접종관련 기록을 확보하여 예방접종 접종 여부 및 접종 일자의 기록 일치 여부를 확인하였다. 비교 대상 예방접종은 결핵(BCG), B형간염, 디프테리아/파상풍/백일해(DTaP), 홍역/유행성이하선염/풍진(MMR), 폴리오, 일본뇌염, 수두, 인플루엔자, B형 헤모필루스 인플루엔자 뇌수막염(Hib), A형간염, 폐구균으로 총 11종을 대상으로 하였다. 결과 : 예방접종 수첩의 예방접종 여부 및 접종 일시 기록의 정확도는 BCG는 69.5% 및 80.1%였으며, B형 간염은 1차 41.3% 및 89.7%, 2차 76.6% 및 82.1%, 3차 79.7% 및 79.0%였으며, DTaP는 1차 79.9% 및 87.5%, 2차 80.8% 및 87.3%, 3차 82.5% 및 85.1%, 4차 79.9% 및 83.5%였으며, 폴리오는 1차 79.5% 및 88.1%, 2차 79.8% 및 86.2%, 3차 82.1% 및 84.8%였으며, MMR은 83.2% 및 84.0%였으며, 일본뇌염 1차는 80.7% 및 83.1%였으며, 수두는 74.9% 및 83.7%였으며, 인플루엔자는 74.1% 및 55.3%였으며, Hib 1차는 72.7% 및 90.7%였으며, A형 간염 1차는 79.5% 및 88.4%였으며, 폐렴구균 1차는 73.2% 및 90.3%로 나타났다. 결론 : 여러 가지 연구의 제한점에도 불구하고, 예방접종 수첩의 상당한 수준의 신뢰도를 확인하였으나 수첩의 예방접종력 정확도 및 타당도에 대한 추가 연구가 필요할 것으로 판단된다.

A Retrospective Mid- and Long-term Follow-up Study on the Changes in Hematologic Parameters in the Highly Exposed Residents of the Hebei Spirit Oil Spill in Taean, South Korea

Objectives This study aimed to analyze changes in hematologic parameters in the residents of the areas highly contaminated by the Hebei Spirit Oil Spill in 2007 and those who participated in the clean-up activities. Methods According to demographic characteristics, health status and behavior, and level of exposure to oil, we compared the hematologic results in 2009 and 2012 among 701 residents. The hematologic parameters were composed of white blood cell (WBC) count, and levels of hemoglobin, hematocrit (Hct), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glucose, glycosylated hemoglobin (HbA1c), blood urea nitrogen (BUN), creatinine (Cr), total cholesterol (T-chol), high-density lipoprotein (HDL), and triglyceride (TG). Results Paired t-test revealed that the WBC count and levels of Hct, AST, ALT, glucose, and HbA1c significantly increased, whereas the BUN, Cr, HDL, and TG levels significantly decreased. Multiple linear regression modelling showed a relationship between the level of exposure to oil and temporal changes in Hct, glucose, HbA1c, and BUN levels. Conclusion Our results suggest a relationship between level of exposure to oil and changes in hematologic parameters over 3 years. Further studies should be conducted to determine the impact of oil spill on health such as the occurrence of diseases.

The direction of restructuring of a Korea field epidemiology training program through questionnaire survey among communicable disease response staff in Korea

We used a survey about the need for an educational training of infectious disease response staff in Korea Centers for Disease Control and Prevention (KCDC) and officer in metropolitan cities and provincial government to conduct field epidemiological investigation. The survey was conducted from January 25 to March 15, 2016. A total of 173 participants were selected from four different groups as follows: 27 clinical specialists, 22 Epidemic Intelligence Service (EIS) officers, 82 KCDC staff, and 42 local health department officials. Results revealed that 83% of KCDC staff and 95% of local health department officials agreed on the need for educational training to strengthen capability of personnel to conduct epidemic research and investigation. The level of their need for training was relatively high, while self-confidence levels of individuals to conduct epidemic research and investigation was low. It was concluded that there was a need to develop training programs to enhance the ability of public health officials, EIS officers, KCDC staff, and local health department personnel to conduct epidemic research and investigation.

Healthcare worker infected with Middle East Respiratory Syndrome during cardiopulmonary resuscitation in Korea, 2015

OBJECTIVES During the outbreak of the Middle East Respiratory Syndrome (MERS) in Korea in 2015, the Korea Centers for Disease Control and Prevention (KCDC) confirmed a case of MERS in a healthcare worker in Daejeon, South Korea. To verify the precise route of infection for the case, we conducted an in-depth epidemiological investigation in cooperation with the KCDC. METHODS We reviewed the MERS outbreak investigation report of the KCDC, and interviewed the healthcare worker who had recovered from MERS. Using the media interview data, we reaffirmed and supplemented the nature of the exposure. RESULTS The healthcare worker, a nurse, was infected while performing cardiopulmonary resuscitation (CPR) for a MERS patient in an isolation room. During the CPR which lasted for an hour, a large amount of body fluid was splashed. The nurse was presumed to have touched the mask to adjust its position during the CPR. She suggested that she was contaminated with the MERS patient’s body fluids by wiping away the sweat from her face during the CPR. CONCLUSIONS The possible routes of infection may include the following: respiratory invasion of aerosols contaminated with MERS-coronavirus (MERS-CoV) through a gap between the face and mask; mucosal exposure to sweat contaminated with MERS-CoV; and contamination during doffing of personal protective equipment. The MERS guidelines should reflect this case to decrease the risk of infection during CPR.

Actual Analysis of the Interrelationship between Evaluation Indicators of Communicable Disease Control and Prevention Activities and Communicable Disease Incidence Data

This study examined the interrelationship between the evaluation indicators of communicable disease control and prevention activities, and the communicable disease incidence data. This study analyzed the incidence data of communicable disease in local governments of south Korea and evaluated the data of communicable disease control and prevention activities by the Ministry of Health of the central government in South Korea during 2004-2005. Frequency analysis was carried out to understand the character of the participant, t-test to compare the mean value between the two groups and stepwise multiple regression analysis to understand the significance between the dependent and independent variables. In this study, the finance related to communicable diseases (group I diseases in both city and rural center), keep rate of periodic reports on notifiable communicable diseases based on the law for communicable disease control and prevention (group II in city), the level of education on personal hygiene (group II in rural center), level of education on AIDS prevention and the reporting rate of cases of tuberculosis (group III in city), and reporting rate of incident cases of tuberculosis (tuberculosis and Hansen disease in both rural and city) were significant indicators. The level of education on AIDS prevention and the reporting rate of the cases of tuberculosis (in city), and number of adverse reactions after immunization (in rural area), reporting rate of cases of tuberculosis (in total center) were significant indicators in total communicable disease and all types of public health centers. The authors verified core evaluation indicators as actual proof. This study provides useful data for a summative evaluation, standardization, and guidelines on communicable disease control and prevention activities of public health centers and local government.