Journal of Preventive Medicine and Public Health

Original Articles

Factors Associated With Long-term Retention in Antiretroviral Therapy Among People Living With HIV: Evidence From a Tertiary Hospital in Jakarta, Indonesia: Ifael Yerosias Mauleti, Krishna Adi Wibisana, Djati Prasetio Syamsuridzal, Sri Mulyati, Vivi Lisdawati, Ika Saptarini, Nurhayati , Armedy Ronny Hasugian, Harimat Hendarwan; J Prev Med Public Health. 2024;57(3):252-259. Published online April 30, 2024; DOI: https://doi.org/10.3961/jpmph.23.512

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Abstract Summary PDF Supplementary Material

Objectives
This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment.
Methods
A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years.
Results
In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72).
Conclusions
Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.

Summary

Key Message
The administration of antiretroviral therapy to HIV patients has resulted in increased rates of survival, enhanced quality of life, and less transmission of the virus. Nevertheless, a negative correlation exists between the length of antiretroviral therapy and patient retention in care. Our study used data from a tertiary hospital and indicated a decrease in the retention rate of antiretroviral therapy over the third year. Retention was associated with the CD4 count, year of enrollment, and the use of an efavirenz-based treatment. Emphasizing patient engagement has been a longstanding focus in HIV programs, with initiatives being implemented to tackle this matter.

Citations

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Prevalence and trends of cigarette smoking among adults with HIV infection compared with the general population in Korea
Boyoung Park, Yoonyoung Jang, Taehwa Kim, Yunsu Choi, Kyoung Hwan Ahn, Jung Ho Kim, Hye Seong, Jun Yong Choi, Hyo Youl Kim, Joon Young Song, Shin-Woo Kim, Hee Jung Choi, Dae Won Park, Young Kyung Yoon, Sang Il Kim
Epidemiology and Health.2024; 46: e2024097. CrossRef

Clinical Features and Risk Factors of Post-COVID-19 Condition in Korea: Myungwon Jang, Dongkwon Choi, Jonghyuk Choi, Ho-Jang Kwon; J Prev Med Public Health. 2023;56(5):431-439. Published online September 8, 2023; DOI: https://doi.org/10.3961/jpmph.23.124

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Abstract Summary PDF Supplementary Material: Objectives
Numerous studies have explored the causes and spread of outbreaks, yet there is a lack of research on post-coronavirus disease 2019 condition (PCC) in Korea. The goal of this study was to identify the various types of PCC and associated factors in discharged patients and to provide directions for the ongoing health management of confirmed patients.
Methods
A telephone survey was conducted among 680 coronavirus disease 2019 (COVID-19) patients diagnosed between July 7, 2021 and August 26, 2021, in Dangjin, Chungnam, Korea. A descriptive analysis of characteristics, univariate analysis, and regression were performed using data from basic epidemiological surveys conducted at the time of diagnosis and post-discharge questionnaires.
Results
Of the 585 patients who responded, 159 (27.2%) developed PCC. Of the 211 patients with no initial symptoms, 27 (12.8%) developed PCC, versus 132 (35.3%) of the 374 patients with initial symptoms. Among the initial symptoms, fever or chills, cough or sputum, loss of smell, and sore throat were associated with PCC. Compared to patients with less than 10 days of hospitalization, those with a hospitalization period of 21 days to 30 days (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.0 to 5.2) and 31 days or more (OR, 5.8; 95% CI, 1.9 to 18.1) had a higher risk of PCC.
Conclusions
More than a quarter of COVID-19 patients, including those who had no initial symptoms, experienced PCC in Korea. People with the initial symptoms of fever, chills, and respiratory symptoms and those who had prolonged hospital stays had a high risk of PCC.; Summary

Korean summary
코로나19 후유증은 진단 시 초기증상과 연관되며, 입원기간이 길어질수록 후유증 발병 위험이 높았다. 코로나19 후유증의 위험인자에 대한 추가적인 연구가 필요하며, 이러한 특징을 갖는 확진환자를 대상으로 퇴원 후 지속직인 환자관리가 필요하다.

Key Message
Post-coronavirus disease 2019 condition (PCC) are associated with initial symptoms at diagnosis, and the risk of this increases with longer hospital stays. Further research on the risk factors for PCC is needed, and continued patient care is necessary for confirmed patients with these characteristics after discharge.

A Peer-support Mini-counseling Model to Improve Treatment in HIV-positive Pregnant Women in Kupang City, East Nusa Tenggara, Indonesia: Artha Camellia, Plamularsih Swandari, Gusni Rahma, Tuti Parwati Merati, I Made Bakta, Dyah Pradnyaparamita Duarsa; J Prev Med Public Health. 2023;56(3):238-247. Published online April 11, 2023; DOI: https://doi.org/10.3961/jpmph.22.516

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Abstract PDF

Objectives
Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers’ knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services.
Methods
This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants.
Results
Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs’ side effects; and the quality of health workers and HIV services.
Conclusions
There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.

Summary

Citations

Citations to this article as recorded by

The Childbirth Experience of Pregnant Women Living with HIV Virus
Andréa Paula de Azevedo, Luisa Castro, Cristina Barroso Hofer, Francisca Rego
Journal of Clinical Medicine.2025; 14(6): 1975. CrossRef
Manifestation and Markings of HIV Stigma in Indonesia: A Scoping Review
Ni Kadek Sudastri, Luh Putu Lila Wulandari, Pande Putu Januraga
International Journal of Environmental Research and Public Health.2025; 22(6): 840. CrossRef
Letter to the Editor: Supporting the Sick and the Vulnerable
Fides A. del Castillo
Journal of Preventive Medicine and Public Health.2023; 56(4): 392. CrossRef
Author Response: Supporting the Sick and the Vulnerable
Artha Camellia, Gusni Rahma
Journal of Preventive Medicine and Public Health.2023; 56(4): 394. CrossRef

Measurement and Decomposition of Socioeconomic Inequality in Metabolic Syndrome: A Cross-sectional Analysis of the RaNCD Cohort Study in the West of Iran: Moslem Soofi, Farid Najafi, Shahin Soltani, Behzad Karamimatin; J Prev Med Public Health. 2023;56(1):50-58. Published online January 6, 2023; DOI: https://doi.org/10.3961/jpmph.22.373

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Abstract PDF

Objectives
Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran.
Methods
This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middle-aged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CI_n) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants.
Results
The proportion of MetS in the sample was 41.1%. The CI_n of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%).
Conclusions
Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.

Summary

Citations

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Prevalence of metabolic syndrome and its components in Iran: an updated meta-analysis
Asra Moradkhani, Pardis Mohammadzadeh, Srwa Assadi, Lotfolah Saed, Hamid Reza Baradaran, Yousef Moradi
BMC Endocrine Disorders.2025;[Epub] CrossRef
Sleep Quality, Nutrient Intake, and Social Development Index Predict Metabolic Syndrome in the Tlalpan 2020 Cohort: A Machine Learning and Synthetic Data Study
Guadalupe Gutiérrez-Esparza, Mireya Martinez-Garcia, Tania Ramírez-delReal, Lucero Elizabeth Groves-Miralrio, Manlio F. Marquez, Tomás Pulido, Luis M. Amezcua-Guerra, Enrique Hernández-Lemus
Nutrients.2024; 16(5): 612. CrossRef
Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults
Pardis Mohammadzadeh, Farhad Moradpour, Bijan Nouri, Farideh Mostafavi, Farid Najafi, Ghobad Moradi
Epidemiology and Health.2023; 45: e2023083. CrossRef

The Association Between Metabolic Syndrome and Colorectal Cancer Risk by Obesity Status in Korean Women: A Nationwide Cohort Study: Seong-geun Moon, Boyoung Park; J Prev Med Public Health. 2022;55(5):475-484. Published online September 21, 2022; DOI: https://doi.org/10.3961/jpmph.22.286

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to determine the association between metabolic syndrome (MetS) and the incidence of colorectal cancer (CRC) in Korean women with obesity.
Methods
Cancer-free women (n=6 142 486) aged 40-79 years, who underwent National Health Insurance Service health examinations in 2009 and 2010 were included. The incidence of CRC was followed until 2018. The hazard ratio (HR) of MetS for the incidence of colon and rectal cancer was analyzed according to body mass index (BMI) categories, adjusting for confounders such as women’s reproductive factors. In addition, the heterogeneity of associations across BMI categories was assessed.
Results
Women with MetS were at increased risk of colon and rectal cancer compared to women without MetS (HR, 1.20; 95% confidence interval [CI], 1.16 to 1.23 and HR,1.15; 95% CI, 1.11 to 1.20), respectively. The HR of MetS for colon cancer across BMI categories was 1.12 (95% CI, 1.06 to 1.19), 1.14 (95% CI, 1.08 to 1.20), and 1.16 (95% CI, 1.12 to 1.21) in women with BMIs <23.0 kg/m², 23.0-24.9 kg/m², and ≥25.0 kg/m², respectively. The HR of MetS for rectal cancer across corresponding BMI categories was 1.16 (95% CI, 1.06 to 1.26), 1.14 (95% CI, 1.05 to 1.23), and 1.13 (95% CI, 1.06 to 1.20). The heterogeneity of associations across BMI categories was not significant in either colon or rectal cancer (p=0.587 for colon cancer and p=0.927 for rectal cancer).
Conclusions
Women with MetS were at increased risk of colon and rectal cancer. Clinical and public health strategies should be considered for primary CRC prevention with an emphasis on improving women’s metabolic health across all BMI groups.

Summary

Korean summary
한국 여성에서 대사증후군은 대장암 발생과 직장암 발생에 유의한 위험요인으로 보인다. 이는 체질량지수를 층화하고 여성력과 관련된 요인들을 보정하더라도 유의했다. 한국 여성의 대장암 및 직장암 예방을 위해 비만도에 관계 없이 대사증후군 요소를 관리하는 것이 필요하다.

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The Association of Urinary Zinc with Metabolic Syndrome and the Mediating Role of Liver Enzymes in the Bouyei Ethnic Group in China
Fei Xiao, Yuxin Hu, Yuan Wang, Yuxin Zhang, Enhui Zhou, Tingting Yang, Feng Hong
Cardiovascular Toxicology.2025;[Epub] CrossRef
Age-Related Differences in Anthropometric and Lifestyle Factors Linked to Metabolic Syndrome in Women with Overweight and Obesity: A Cross-Sectional Study
Edyta Łuszczki, Magdalena Zielińska, Łukasz Oleksy, Artur Stolarczyk, Katarzyna Dereń
Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 1765. CrossRef
Association of metabolic obesity phenotypes with risk of overall and site-specific cancers: a systematic review and meta-analysis of cohort studies
Yahya Mahamat-saleh, Dagfinn Aune, Heinz Freisling, Sheetal Hardikar, Rola Jaafar, Sabina Rinaldi, Marc J. Gunter, Laure Dossus
British Journal of Cancer.2024; 131(9): 1480. CrossRef
Overweight and obesity significantly increase colorectal cancer risk: a meta-analysis of 66 studies revealing a 25–57% elevation in risk
Zoltan Ungvari, Mónika Fekete, Peter Varga, Andrea Lehoczki, János Tibor Fekete, Anna Ungvari, Balázs Győrffy
GeroScience.2024; 47(3): 3343. CrossRef
Increased risk of cancer and cancer-related mortality in middle-aged Korean women with prediabetes and diabetes: a population-based study
Thi Xuan Mai Tran, Soyeoun Kim, Huiyeon Song, Boyoung Park
Epidemiology and Health.2023; 45: e2023080. CrossRef

COVID-19: Original Articles

Associations Between General Perceptions of COVID-19 and Posttraumatic Stress Disorder in Korean Hospital Workers: Effect Modification by Previous Middle East Respiratory Syndrome Coronavirus Experience and Occupational Type: Youngrong Lee, Kwanghyun Kim, Sungjin Park, Sun Jae Jung; J Prev Med Public Health. 2021;54(2):86-95. Published online January 19, 2021; DOI: https://doi.org/10.3961/jpmph.20.540

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Abstract Summary PDF Supplementary Material

Objectives
This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience.
Methods
The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience.
Results
Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38).
Conclusions
During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.

Summary

Korean summary
본 연구는 COVID-19관련 인식과 COVID-19 안심 병원 근로자들의 외상 후 스트레스 장애 (PTSD) 유병률 사이의 연관성에서 직업 유형과 이전 중동 호흡기 증후군 (MERS-CoV) 방역 경험 여부로 인한 연관성의 크기 차이를 조사하였다. 비의료인이 의료인보다 PTSD유병에 더 강한 연관성을 보였고, 이전 메르스 방역 경험이 있는 근로자들이 COVID-19에 대한 "일반적 공포", "물품 부족 공포" 및 "특정 문제에 따른 공포"로 구분한 인식의 크기가 클 수록 방역 경험이 없는 근로자들보다 PTSD유병과의 관련성이 더 컸다. 결론적으로 COVID-19 대유행 기간 중 비의료 인력은 PTSD유병 확률이 더 높은 경향이 있었다. 이전 MERS-CoV 경험이 있는 근로자는 그러한 경험이 없는 근로자보다 더 취약했다.

Citations

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Association between social networks and symptoms of post-traumatic stress during the pandemic: Cohort study in South Korea
Ji Su Yang, Yu Jin Lee, Hyeon Chang Kim, Chul-Hyun Cho, Alexander C. Tsai, Sun Jae Jung
Comprehensive Psychiatry.2023; 127: 152432. CrossRef
Development and Validation of COVID-19 Stress Scale (CSS) in an Iranian Non-clinical Population
Roghieh Nooripour, Nikzad Ghanbari, Laurel E. Radwin, Simin Hosseinian, Peyman Hassani-Abharian, Mohsen Hosseinbor, Keyvan Kakabraee, Mojtaba Amiri Majd, Serge Brand, Esmaeil Soleimani, Hossein Ilanloo
Zahedan Journal of Research in Medical Sciences.2022;[Epub] CrossRef

Association of Comorbidities With Pneumonia and Death Among COVID-19 Patients in Mexico: A Nationwide Cross-sectional Study: Akram Hernández-Vásquez, Diego Azañedo, Rodrigo Vargas-Fernández, Guido Bendezu-Quispe; J Prev Med Public Health. 2020;53(4):211-219. Published online May 28, 2020; DOI: https://doi.org/10.3961/jpmph.20.186

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Abstract PDF

Objectives
The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death.
Methods
This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age.
Results
Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions.
Conclusions
Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.

Summary

Citations

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Special Article

Introduction of Vaccinomics to Develop Personalized Vaccines in Light of Changes in the Usage of Hantaan Virus Vaccine (Hantavax^®) in Korea: Jong-Myon Bae; J Prev Med Public Health. 2019;52(5):277-280. Published online August 7, 2019; DOI: https://doi.org/10.3961/jpmph.19.018

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Abstract Summary PDF Supplementary Material

The Ministry of Food and Drug Safety of Korea made an official announcement in March 2018 that the total number of inoculations of Hantaan virus vaccine (Hantavax^®) would change from 3 to 4. Some aspects of this decision remain controversial. Based on the characteristics of Hantaan virus (HTNV) and its role in the pathogenesis of hemorrhagic fever with renal syndrome, it might be difficult to develop an effective and safe HTNV vaccine through the isolate-inactivate-inject paradigm. With the development of high-throughput ‘omics’ technologies in the 21st century, vaccinomics has been introduced. While the goal of vaccinomics is to develop equations to describe and predict the immune response, it could also serve as a tool for developing new vaccine candidates and individualized approaches to vaccinology. Thus, the possibility of applying the innovative field of vaccinomics to develop a more effective and safer HTNV vaccine should be considered.

Summary

Korean summary
신증후출혈열 (Hemorrhagic fever with renal syndrome, HFRS)를 예방하기 위한 백신들이 여러 가지로 개발 중에 있지만, 한탄 바이러스 (Hantaan virus) 의 병원체 특성과 HFRS의 임상적 특성으로 효과적이고 안전한 백신 개발을 어렵게 하고 있다. 투여할 백신에 대한 ‘면역과정을 이해하고 백신효능을 예측하여’ 백신개발에 활용하는 백신체학의 적용을 적극 강구할 필요가 있다.

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Grant C Paulsen, Robert Frenck, Kay M Tomashek, Rodolfo M Alarcon, Elizabeth Hensel, Ashley Lowe, Rebecca L Brocato, Steve A Kwilas, Matthew D Josleyn, Jay W Hooper
The Journal of Infectious Diseases.2024; 229(1): 30. CrossRef
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Current Challenges in Vaccinology
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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 Articles

Areca Nut Chewing and the Risk of Re-hospitalization and Mortality Among Patients With Acute Coronary Syndrome in Pakistan: Muhammad Tariq Karim, Sumera Inam, Tariq Ashraf, Nadia Shah, Syed Omair Adil, Kashif Shafique; J Prev Med Public Health. 2018;51(2):71-82. Published online February 19, 2018; DOI: https://doi.org/10.3961/jpmph.17.189

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Abstract PDF

Objectives
Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events.

Summary

Citations

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Association between habitual betel quid chewing and risk of adverse cardiovascular outcomes: A systematic review
Rodney Itaki, Shalon Taufa
Tropical Medicine & International Health.2024; 29(6): 447. CrossRef

Are Serum Vitamin D Levels Associated With Dry Eye Disease? Results From the Study Group for Environmental Eye Disease: Da-Hye Jeon, Hyungseon Yeom, Jaewon Yang, Jong Suk Song, Hyung Keun Lee, Hyeon Chang Kim; J Prev Med Public Health. 2017;50(6):369-376. Published online November 2, 2017; DOI: https://doi.org/10.3961/jpmph.17.089

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Abstract PDF

Objectives
Dry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI).
Methods
The present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI.
Results
Higher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations.
Conclusions
The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.

Summary

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R. Selimoğlu, A. Mete, S.A. Seyyar, S. Kimyon
Journal Français d'Ophtalmologie.2025; 48(4): 104467. CrossRef
The efficacy of vitamin D supplementation in dry eye disease: A systematic review and meta-analysis
Zeying Chen, Chengxiao Zhang, Jiaxuan Jiang, Junwen Ouyang, Di Zhang, Taige Chen, Yiran Chu, Kai Hu
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Dry Eye Disease: What Is the Role of Vitamin D?
Maurizio Rolando, Stefano Barabino
International Journal of Molecular Sciences.2023; 24(2): 1458. CrossRef
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Youngsam Kim, Seonmi Kang, Kangmoon Seo
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Bhavya Gorimanipalli, Rohit Shetty, Swaminathan Sethu, Pooja Khamar
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Serum Vitamin D Levels and Dry Eye Disease in Postmenopausal Women: A Case–Control Study at a Tertiary Care Center in Rural Haryana
Diksha Malik, Renu Garg, Sumita Sethi, Rajiv Mahendru, Sanjeet Singh
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Vitamin D and Ocular Diseases: A Systematic Review
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Miłosz Caban, Urszula Lewandowska
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Busayanut Puangsricharoen, Kavin Vanikieti, Panitha Jindahra, Tanyatuth Padungkiatsagul
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Lei Shi, Ting-Yu Li, Liang-Yu Li, Bao-Ke Hou
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Shireen M. Shousha, Nehal EL-Ghobashy, Maha Alhelf, Dalia Abd El-kareem, Pavly Moawad
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Trailokyanath Panigrahi, Sharon D’Souza, Rohit Shetty, Archana Padmanabhan Nair, Anuprita Ghosh, Everette Jacob Remington Nelson, Arkasubhra Ghosh, Swaminathan Sethu
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Hye Rin Choi, Jung Hyun Lee, Hyung Keun Lee, Jong Suk Song, Hyeon Chang Kim
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Gholamreza Askari, Nahid Rafie, Maryam Miraghajani, Zahra Heidari, Arman Arab
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Effects of Antiretroviral Therapy on the Survival of Human Immunodeficiency Virus-positive Adult Patients in Andhra Pradesh, India: A Retrospective Cohort Study, 2007-2013: Ram Bajpai, Himanshu Chaturvedi, Lakshmanan Jayaseelan, Pauline Harvey, Nicole Seguy, Laxmikant Chavan, Pinnamaneni Raj, Arvind Pandey; J Prev Med Public Health. 2016;49(6):394-405. Published online October 28, 2016; DOI: https://doi.org/10.3961/jpmph.16.073

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Abstract PDF

Objectives
The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India.
Methods
The present study used data from 139 679 HIV patients aged ≥15 years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival.
Results
The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for <100 cells/mm³ vs. >350 cells/mm³), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients.
Conclusions
The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.

Summary

Citations

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Highly active antiretroviral therapy is necessary but not sufficient. A systematic review and meta-analysis of mortality incidence rates and predictors among HIV-infected adults receiving treatment in Ethiopia, a surrogate study for resource-poor settings
Beshada Zerfu Woldegeorgis, Yordanos Sisay Asgedom, Aklilu Habte, Gizachew Ambaw Kassie, Abebe Sorsa Badacho
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Association Between Body Mass Index Variation and Early Mortality Among 834 Ethiopian Adults Living with HIV on ART: A Joint Modelling Approach
Animut Alebel, David Sibbritt, Pammla Petrucka, Daniel Demant
Infectious Diseases and Therapy.2023; 12(1): 227. CrossRef
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Ramón E. R. González, Pedro Hugo de Figueirêdo, Sergio Galvao Coutinho
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Rate and Predictors of Mortality Among Adults on Antiretroviral Therapy at Debre Markos Referral Hospital, North West Ethiopia
Haddis Birhanu, Atsede Alle, Molla Yigzaw Birhanu
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Predictors of Mortality Among Adult HIV-Infected Patients Taking Antiretroviral Therapy (ART) in Harari Hospitals, Ethiopia
Abdi Birhanu, Tariku Dingeta, Moti Tolera
HIV/AIDS - Research and Palliative Care.2021; Volume 13: 727. CrossRef
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S. Shankar, Santosh Karade, Rajul K. Gupta, M.V. Singh
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How varying CD4 criteria for treatment initiation was associated with mortality of HIV-patients? A retrospective analysis of electronic health records from Andhra Pradesh, India
Ram Bajpai, Himanshu K Chaturvedi, Josip Car
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Rimke Bijker, Sasisopin Kiertiburanakul, Nagalingeswaran Kumarasamy, Sanjay Pujari, Ly P Sun, Oon T Ng, Man P Lee, Jun Y Choi, Kinh V Nguyen, Yu J Chan, Tuti P Merati, Do D Cuong, Jeremy Ross, Awachana Jiamsakul
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International Journal of Infectious Diseases.2019; 80: 10. CrossRef

The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study: Venetia Notara, Demosthenes B. Panagiotakos, Yannis Kogias, Petros Stravopodis, Antonis Antonoulas, Spyros Zombolos, Yannis Mantas, Christos Pitsavos; J Prev Med Public Health. 2016;49(4):220-229. Published online June 24, 2016; DOI: https://doi.org/10.3961/jpmph.16.005

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Abstract PDF

Objectives
The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated.
Methods
From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient’s educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years).
Results
Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed.
Conclusions
A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

Summary

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Metabolic Risk Profile and Cancer in Korean Men and Women: Seulki Ko, Seok-Jun Yoon, Dongwoo Kim, A-Rim Kim, Eun-Jung Kim, Hye-Young Seo; J Prev Med Public Health. 2016;49(3):143-152. Published online May 18, 2016; DOI: https://doi.org/10.3961/jpmph.16.021

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Abstract PDF

Objectives
Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented.
Methods
We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise.
Results
A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer.
Conclusions
The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.

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Special Article

Ethical Perspectives on the Middle East Respiratory Syndrome Coronavirus Epidemic in Korea: Ock-Joo Kim; J Prev Med Public Health. 2016;49(1):18-22. Published online January 29, 2016; DOI: https://doi.org/10.3961/jpmph.16.013

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Abstract PDF

Ethical considerations are essential in planning for and responding to outbreaks of infectious diseases. During the outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea in 2015, serious challenges emerged regarding important ethical issues, such as transparency and the protection of privacy. The development of bioethics in Korea has been influenced by individualistic perspectives applied in clinical contexts, leading to a paucity of ethical perspectives relevant to population-level phenomena such as outbreaks. Alternative theories of public health ethics include the perspectives of relational autonomy and the patient as victim and vector. Public health actions need to incorporate clear and systematic procedures founded upon ethical principles. The MERS-CoV epidemic in Korea created significant public support for more aggressive early interventions in future outbreaks. This trend makes it all the more imperative for ethical principles and procedures to be implemented in future planning and responses to outbreaks in order to promote perceptions of legitimacy and civic participation.

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