Journal of Preventive Medicine and Public Health

Perspective

Addressing Public Health Risks: Strategies to Combat Infectious Diseases After the August 2024 Floods in Bangladesh: Fatema Hashem Rupa, Mosharop Hossian; J Prev Med Public Health. 2024;57(6):600-603. Published online November 3, 2024; DOI: https://doi.org/10.3961/jpmph.24.495

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Abstract Summary PDF: The August 2024 floods in Bangladesh have precipitated a major public health crisis, significantly elevating the risk of waterborne and vector-borne diseases and exacerbating existing health vulnerabilities. This disaster has impacted over 5 million people, causing widespread environmental disruption, population displacement, and strained healthcare resources. The flooding of latrines, sewage systems, and agricultural land has led to the contamination of drinking water sources, increasing the risk of cholera, enterotoxigenic Escherichia coli diarrhoea, shigellosis, and hepatitis. Additionally, stagnant floodwaters have created breeding grounds for mosquitoes, thereby increasing the threat of malaria and dengue fever. The disruption of healthcare services has further compounded the crisis, delaying emergency responses and impeding access to care. The psychological impact on affected communities is profound, with mental health issues such as anxiety, depression, and post-traumatic stress disorder emerging as significant concerns. This perspective provides an analysis of these public health threats, supported by data on the impact of floods and a discussion of the underlying risk factors. This underscores the need for immediate and long-term public health interventions, including restoring clean water access, enhancing disease surveillance, repairing healthcare infrastructure, and addressing mental health needs. The response to this disaster must be rapid and comprehensive, with lessons learned to inform preparedness efforts to better manage similar events in the future.; Summary

Key Message
The August 2024 floods in Bangladesh have caused a severe public health crisis, elevating risks of waterborne and vector-borne diseases like cholera, shigellosis, malaria, and dengue. Over 5 million people have been affected, with contaminated water sources, disrupted healthcare services, and mental health issues worsening the impact. This article highlights the urgent need for clean water restoration, disease surveillance, healthcare system repairs, and mental health support, emphasizing the importance of immediate and long-term interventions to manage the crisis and strengthen disaster preparedness for the future.

COVID-19: Perspective

New Obligations of Health Insurance Review and Assessment Service: Taking Full-fledged Action Against the COVID-19 Pandemic: Seung Mi Yoo, Seol Hee Chung, Won Mo Jang, Kyoung Chang Kim, Jin Yong Lee, Sun Min Kim; J Prev Med Public Health. 2021;54(1):17-21. Published online January 26, 2021; DOI: https://doi.org/10.3961/jpmph.20.594

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In 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to global health systems. The Korea has taken full-fledged actions against this novel infectious disease, swiftly implementing a testing-tracing-treatment strategy. New obligations have therefore been given to the Health Insurance Review and Assessment Service (HIRA) to devote the utmost effort towards tackling this global health crisis. Thanks to the universal national health insurance and state-of-the-art information communications technology (ICT) of the Korea, HIRA has conducted far-reaching countermeasures to detect and treat cases early, prevent the spread of COVID-19, respond quickly to surging demand for the healthcare services, and translate evidence into policy. Three main factors have enabled HIRA to undertake pandemic control preemptively and systematically: nationwide data aggregated from all healthcare providers and patients, pre-existing ICT network systems, and real-time data exchanges. HIRA has maximized the use of data and pre-existing network systems to conduct rapid and responsive measures in a centralized way, both of which have been the most critical tactics and strategies used by the Korean healthcare system. In the face of new obligations, our promise is to strive for a more responsive and resilient health system during this prolonged crisis.

Summary

Korean summary
건강보험심사평가원은 전 국민과 전체 요양기관의 축적된 정보, 전체 요양기관과 연결된 네트워크, 실시간 데이터 공유를 통해 이번 코로나19 위기 대응에 기여했다. 건강보험심사평가원은 1) 진단검사∙약제 등재, 2) 요양기관 내 고위험군 감지, 3) 마스크 중복구매 방지 시스템 구축, 4) 주요 보건의료자원 가동현황 모니터링 시스템 구축, 5) 환자관리 정보시스템 구축 및 익명화된 환자 데이터 공개로 국제협력연구 촉진의 다섯 가지 전략을 성공적으로 수행했다. 건강보험심사평가원은 현재의 보건위기 상황을 극복하고, 코로나19 시대 이후로도 새롭게 주어진 위기대응의 역할과 소명을 다할 것이다.

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COVID-19: Special Article

Mainstreaming of Health Equity in Infectious Disease Control Policy During the COVID-19 Pandemic Era: Hongjo Choi, Seong-Yi Kim, Jung-Woo Kim, Yukyung Park, Myoung-Hee Kim; J Prev Med Public Health. 2021;54(1):1-7. Published online January 15, 2021; DOI: https://doi.org/10.3961/jpmph.20.593

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Abstract Summary PDF

The Korean government’s strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.

Summary

Korean summary
"이 연구는 코로나19 대유행이 건강불평등에 미치는 영향을 검토하고, 불평등 완화 방안을 제시하고자 한다. 건강의 사회적 결정요인은 코로나19와 건강불평등을 이해하기 위한 출발점이다. 건강의 사회적 결정요인은 코로나19 감염과 그로 인한 사망 등 직접영향 경로와 코로나19 대응과정의 문제로 건강불평등을 야기하는 간접영향 경로에 모두 관여한다. 공중보건위기로 인한 건강불평등을 줄이기 위해서는 시민참여를 통한 협력적 거버넌스 강화와 모든 건강정책에서 사람중심돌봄의 관점을 견지하는 것이 필요하다."

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COVID-19: Original Article

The Effectiveness of Community-based Social Distancing for Mitigating the Spread of the COVID-19 Pandemic in Turkey: Hasan Durmuş, Mehmet Enes Gökler, Selma Metintaş; J Prev Med Public Health. 2020;53(6):397-404. Published online November 2, 2020; DOI: https://doi.org/10.3961/jpmph.20.381

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Abstract PDF

Objectives
The objective of this study was to demonstrate the effects of community-based social distancing interventions after the first coronavirus disease 2019 (COVID-19) case in Turkey on the course of the pandemic and to determine the number of prevented cases.
Methods
In this ecological study, the interventions implemented in response to the first COVID-19 cases in Turkey were evaluated and the effect of the interventions was demonstrated by calculating the effective reproduction number (Rt) of severe acute respiratory syndrome coro navirus 2 (SARS-CoV-2) when people complied with community-based social distancing rules.
Results
Google mobility scores decreased by an average of 36.33±22.41 points (range, 2.60 to 84.80) and a median of 43.80 points (interquartile range [IQR], 24.90 to 50.25). The interventions caused the calculated Rt to decrease to 1.88 (95% confidence interval, 1.87 to 1.89). The median growth rate was 19.90% (IQR, 10.90 to 53.90). A positive correlation was found between Google mobility data and Rt (r=0.783; p<0.001). The expected number of cases if the growth rate had not changed was predicted according to Google mobility categories, and it was estimated to be 1 381 922 in total. Thus, community-based interventions were estimated to have prevented 1 299 593 people from being infected.
Conclusions
Community-based social distancing interventions significantly decreased the Rt of COVID-19 by reducing human mobility, and thereby prevented many people from becoming infected. Another important result of this study is that it shows health policy-makers that data on human mobility in the community obtained via mobile phones can be a guide for measures to be taken.

Summary

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COVID-19: Perspective

Interpretation of the Basic and Effective Reproduction Number: Jun-Sik Lim, Sung-Il Cho, Sukhyun Ryu, Son-Il Pak; J Prev Med Public Health. 2020;53(6):405-408. Published online October 20, 2020; DOI: https://doi.org/10.3961/jpmph.20.288

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Abstract PDF

In epidemiology, the basic reproduction number (R0) is a term that describes the expected number of infections generated by 1 case in a susceptible population. At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, R0 was frequently referenced by the public health community and the wider public. However, this metric is often misused or misinterpreted. Moreover, the complexity of the process of estimating R0 has caused difficulties for a substantial number of researchers. In this article, in order to increase the accessibility of this concept, we address several misconceptions related to the threshold characteristics of R0 and the effective reproduction number (Rt). Moreover, the appropriate interpretation of the metrics is discussed. R0 should be considered as a population-averaged value that pools the contact structure according to a stochastic transmission process. Furthermore, it is necessary to understand the unavoidable time lag for Rt due to the incubation period of the disease.

Summary

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COVID-19: Brief Report

The Evolving Policy Debate on Border Closure in Korea: Su JIn Kang, Jihyun Moon, Heewon Kang, Heekyoung Nam, Sangwoo Tak, Sung-Il Cho; J Prev Med Public Health. 2020;53(5):302-306. Published online September 11, 2020; DOI: https://doi.org/10.3961/jpmph.20.213

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Abstract PDF Supplementary Material

Objectives
In this paper, we aimed to investigate the evolving debate over border closure in Korea during the coronavirus disease 2019 (COVID-19) pandemic, to address the main themes associated with border closure, and to discuss the factors that need to be considered when making such decisions.
Methods
We collated and reviewed previously conducted review studies on border closures during infectious disease outbreaks to derive relevant themes and factors.
Results
According to our systematic review on border closures and travel restrictions, the effects of such containment efforts are limited. We suggest considering the following factors when determining whether to impose border closure measures: (1) disease characteristics, (2) timeliness of implementation, (3) transmission delay and the basic reproduction number, (4) globalization and pandemics, and (5) social and economic costs.
Conclusions
Our assessment indicates that the effects of border closures are at best temporary and limited. Alternative measures must be contemplated and implemented to suppress the spread of COVID-19 in particular and infectious diseases more broadly.

Summary

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COVID-19: Perspective

A Chinese Case of Coronavirus Disease 2019 (COVID-19) Did Not Show Infectivity During the Incubation Period: Based on an Epidemiological Survey: Jong-Myon Bae; J Prev Med Public Health. 2020;53(2):67-69. Published online March 2, 2020; DOI: https://doi.org/10.3961/jpmph.20.048

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Abstract Summary PDF

Controversy remains over whether the coronavirus disease 2019 (COVID-19) virus may have infectivity during the incubation period before the onset of symptoms. The author had the opportunity to examine the infectivity of COVID-19 during the incubation period by conducting an epidemiological survey on a confirmed patient who had visited Jeju Island during the incubation period. The epidemiological findings support the claim that the COVID-19 virus does not have infectivity during the incubation period.

Summary

Korean summary
잠복기 동안 제주도를 방문했던 중국인 COVID-19 확진자에 대한 역학조사를 수행하였다. 환자와 직접 접촉한 11명을 14일간 격리조치 하였는데, 이들 모두 격리해제까지 COVID-19 감염증상을 보이지 않았다. 이상의 역학조사 결과는 잠복기때는 감염력이 없다는 주장을 뒷받침한다.

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Moira A. Mugglestone, Natasha V. Ratnaraja, Aggie Bak, Jasmin Islam, Jennie A. Wilson, Jennifer Bostock, Samuel E. Moses, James R. Price, Michael Weinbren, Heather P. Loveday, Lucy Rivett, Simon M. Stoneham, A. Peter R. Wilson
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Original Article

The Effects of Socio-demographic Characteristics on Indonesian Women’s Knowledge of HIV/AIDS: A Cross-sectional Study: Putu Erma Pradnyani, Arief Wibowo, Mahmudah; J Prev Med Public Health. 2019;52(2):109-114. Published online February 28, 2019; DOI: https://doi.org/10.3961/jpmph.18.256

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Abstract PDF

Objectives
The purpose of this study was to characterize Indonesian women’s knowledge of HIV/AIDS and to investigate the effects of socio-demographic characteristics thereupon with the goal of supporting the prevention and early detection of HIV/AIDS.
Methods
This cross-sectional study was conducted using secondary data from the standard Indonesian Demographic and Health Survey (IDHS) in 2012. A total of 34 984 subjects ranged in age from 15 years to 49 years. Data were analyzed using the chi-square test and logistic regression to identify the effects of socio-demographic characteristics on Indonesian women’s knowledge of HIV/AIDS.
Results
All socio-demographic characteristics except marital status were related to knowledge of HIV/AIDS among Indonesian women in the univariate analysis (p<0.05). Multivariate analysis revealed that only age group, education level, location of residence, and wealth index were related to Indonesian women’s knowledge of HIV/AIDS (p<0.05).
Conclusions
Indonesian women’s insufficient knowledge related to HIV/AIDS shows that the provision of accurate and comprehensive information related to HIV/AIDS are components of prevention and control interventions that should be improved. With greater knowledge, women are expected to be more likely to determine their own and their partners’ human immunodeficiency virus status and to take appropriate preventive steps.

Summary

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Sources of HIV information and women’s HIV knowledge in Southwest Sumba Indonesia: a cross-sectional study with mediation analysis
Angela Kurniadi, Judith A. Levy, Timothy P. Johnson
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Perspective

Introduction of Phylodynamics for Controlling the HIV/AIDS Epidemic in Korea: Jong-Myon Bae; J Prev Med Public Health. 2018;51(6):326-328. Published online October 22, 2018; DOI: https://doi.org/10.3961/jpmph.18.150

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Abstract Summary PDF Supplementary Material: As over 1000 new cases of HIV/AIDS occur in Korea annually, preventive health programs against HIV/AIDS are urgently needed. Since phylodynamic studies have been suggested as a way to understand how infectious diseases are transmitted and evolve, phylodynamic inferences can be a useful tool for HIV/AIDS research. In particular, phylodynamic models are helpful for dating the origins of an epidemic and estimating its basic reproduction number. Thus, the introduction of phylodynamics would be a highly valuable step towards controlling the HIV/AIDS epidemic in Korea.; Summary

Korean summary
국내 HIV/AIDS 신환자가 지속적으로 발생하고 있는 상황에서, 다른 나라에서는 HIV 감염관리에 계통역동학을 적용하고 있다. 이는 감염원과 감염경로를 알아내고, 기본재생산지수를 산출하도록 해주기 때문이다. 따라서 국내 HIV/AIDS 관리를 위해 계통역동학 적용을 적극 제안한다.”

Original Article

An Analysis of Infectious Disease Research Trends in Medical Journals From North Korea: Do-Hyeon Park, Min-Ho Choi, Ah-Young Lim, Hee Young Shin; J Prev Med Public Health. 2018;51(2):109-120. Published online March 30, 2018; DOI: https://doi.org/10.3961/jpmph.17.145

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Abstract PDF

Objectives
This study aimed to investigate the current status of infectious disease research in North Korea by analyzing recent trends in medical journals from North Korea in comparison with research from South Korea. Methods: Three medical journals (Preventive Medicine, Basic Medicine, and Chosun Medicine) were analyzed from 2012 to 2016. Articles on tuberculosis (TB), malaria, and parasitic diseases were selected and classified by their subtopics and study areas. Two medical journals published in the South Korea were selected for a comparative analysis of research trends. Results: Of the 2792 articles that were reviewed, 93 were extracted from North Korea journals. TB research in North Korea was largely focused on multi-drug resistant TB and extrapulmonary TB, whereas research in South Korea more frequently investigated non-tuberculous mycobacteria. Research on parasitic diseases in North Korea was focused on protozoan and intestinal nematodes, while the corresponding South Korea research investigated various species of parasites. Additionally, the studies conducted in North Korea were more likely to investigate the application of traditional medicine to diagnosis and treatment than those conducted in South Korea. Conclusions: This study presents an analysis of research trends in preventive medicine in North Korea focusing on infectious diseases, in which clear differences were observed between South and North Korea. Trends in research topics suggest a high prevalence of certain parasitic diseases in North Korea that are no longer widespread in South Korea. The large proportion of studies examining traditional medicine implies a lack of affordable medicine in North Korea.

Summary

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Perspective

One Health Perspectives on Emerging Public Health Threats: Sukhyun Ryu, Bryan Inho Kim, Jun-Sik Lim, Cheng Siang Tan, Byung Chul Chun; J Prev Med Public Health. 2017;50(6):411-414. Published online November 2, 2017; DOI: https://doi.org/10.3961/jpmph.17.097

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Abstract PDF

Antimicrobial resistance and emerging infectious diseases, including avian influenza, Ebola virus disease, and Zika virus disease have significantly affected humankind in recent years. In the premodern era, no distinction was made between animal and human medicine. However, as medical science developed, the gap between human and animal science grew deeper. Cooperation among human, animal, and environmental sciences to combat emerging public health threats has become an important issue under the One Health Initiative. Herein, we presented the history of One Health, reviewed current public health threats, and suggested opportunities for the field of public health through better understanding of the One Health paradigm.

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Special Articles

Legal Issues in Quarantine and Isolation for Control of Emerging Infectious Diseases: Cheonsoo Kim; J Prev Med Public Health. 2016;49(1):1-17. Published online January 29, 2016; DOI: https://doi.org/10.3961/jpmph.16.009

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Abstract PDF Supplementary Material

The Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea in 2015 has drawn public attention regarding the legal regulation of infectious disease control in Korea. This paper discusses the interpretive and legislative concerns regarding the Infectious Disease Prevention and Control Act, its ordinance and enforcement regulations, as well as public statements from the relevant administrative agency. Future improvements are also proposed.

Summary

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Structural Factors of the Middle East Respiratory Syndrome Coronavirus Outbreak as a Public Health Crisis in Korea and Future Response Strategies: Dong-Hyun Kim; J Prev Med Public Health. 2015;48(6):265-270. Published online November 30, 2015; DOI: https://doi.org/10.3961/jpmph.15.066

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Abstract PDF

The recent Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system’s weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of “control tower” in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.

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Original Articles

Correlations Between the Incidence of National Notifiable Infectious Diseases and Public Open Data, Including Meteorological Factors and Medical Facility Resources: Jin-Hwa Jang, Ji-Hae Lee, Mi-Kyung Je, Myeong-Ji Cho, Young Mee Bae, Hyeon Seok Son, Insung Ahn; J Prev Med Public Health. 2015;48(4):203-215. Published online July 27, 2015; DOI: https://doi.org/10.3961/jpmph.14.057

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Abstract PDF Supplementary Material

Objectives
This study was performed to investigate the relationship between the incidence of national notifiable infectious diseases (NNIDs) and meteorological factors, air pollution levels, and hospital resources in Korea.
Methods
We collected and stored 660 000 pieces of publicly available data associated with infectious diseases from public data portals and the Diseases Web Statistics System of Korea. We analyzed correlations between the monthly incidence of these diseases and monthly average temperatures and monthly average relative humidity, as well as vaccination rates, number of hospitals, and number of hospital beds by district in Seoul.
Results
Of the 34 NNIDs, malaria showed the most significant correlation with temperature (r=0.949, p<0.01) and concentration of nitrogen dioxide (r=-0.884, p<0.01). We also found a strong correlation between the incidence of NNIDs and the number of hospital beds in 25 districts in Seoul (r=0.606, p<0.01). In particular, Geumcheon-gu was found to have the lowest incidence rate of NNIDs and the highest number of hospital beds per patient.
Conclusions
In this study, we conducted a correlational analysis of public data from Korean government portals that can be used as parameters to forecast the spread of outbreaks.

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The amendment tendency analysis of the Korean Infectious Disease Prevention Act and a recommendation for the next amendment.: Chang Yong Whang, Hee Choul Ohr, Duk Hyoung Lee, Ki Dong Park, Jong Koo Lee; Korean J Prev Med. 1998;31(3):540-563.

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Abstract PDF: This Study has been carried out to make a recommendation for the next amendment of the Infectious Disease Prevention Act with a specific focus on the kind of notifiable disease. Korean, Japanese, German, U.S, English and French acts on infectious diseases prevention were reviewed, compared with and analyzed in regards of numbers and kinds of notifiable infectious diseases and their tendency of amendments. An criteria was designed to assess the level of validity of diseases to be designated in the act. Four items, the fatality (greater than 10% or not), the possibility to make a big epidemic, the availability of efficient vaccination and the usefulness of isolation, are used in the assessment. This index is applied to the diseases in Korean and other countries' Infectious Disease Prevention Acts. Results are as follows : 1. The Korean Infectious Disease Prevention Act has a unique way of classifying the notifiable infectious disease, that is, the first, the second and the third class. But the author cannot find the basis of classification. No other countries reviewed have the similar classification. 2. The ten diseases, cholera, plague, yellow fever, diphtheria, typhoid fever, poliomyelitis, rabies, tetanus, malaria, and meningococcal meningitis are designated as the notifiable diseases not only in Korea but also in Japan, Germany, United States, England and France. 3. Thirty seven diseases including small pox, Lassa fever, anthrax, influenza, German measles, Legionellosis, infection with E. coli O157:H7, Q-fever, brucellosis, Lyme disease are designated as legal disease at least one of the above mentioned countries. 4. The Korea has been coped with the change of the infectious disease occurrence for last fifty years in amendment of the Infectious Disease Prevention Act. 5. Japan has a special infectious surveillance system composed of 3,880 clinics throughout the whole country. 6. Germany has classified infectious diseases in five categories which are based on seriousness of disease. Any confirmed death, cases and suspected cases in class I should be reported within 24 hours. But only confirmed death and cases in class II, but not suspected cases, are repotable in Germany. 7. Plague, bacillary dysentery, pertussis, mumps, Japanese encephaltis and Korean hemorrhagic fevers are diseases with high credits validity index among Korean legal disease. 8. German measles, anthrax, E. coli O157:H7 infection, Lassa fever, Q-fever, brucellosis are high in validity index among those which are not designated in Korea but designated in other countries. In conclusion, the Korean Infectious Disease Prevention Act has well been coped with the changes of infectious disease occurrence for last fifty years, but the classification basis and the validity of diseases to be designated as legal diseases is worth reevaluating.; Summary

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