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Most-download articles are from the articles published in 2022 during the last three month.

Original Article
Risk factors for SARS-CoV-2 transmission during a movie theater outbreak in Incheon in the Republic of Korea, November 2021: a retrospective study
Hye Young Lee, Young-Joon Park, Sang-Eun Lee, Han-Na Yoo, Il-Hwan Kim, Jin Sun No, Eun-Jin Kim, Jungyeon Yu, Sanghwan Bae, Mi Yu
Osong Public Health Res Perspect. 2024;15(1):45-55.   Published online January 31, 2024
DOI: https://doi.org/10.24171/j.phrp.2023.0269
  • 8,360 View
  • 291 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
We examined factors contributing to the transmission of an acute respiratory virus within multi-use facilities, focusing on an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a movie theater in the Republic of Korea. Methods: This retrospective cohort study involved a descriptive analysis of 48 confirmed cases. Logistic regression was applied to a cohort of 80 theater attendees to identify risk factors for infection. The infection source and transmission route were determined through gene sequencing data analysis. Results: Of the 48 confirmed cases, 35 were theater attendees (72.9%), 10 were family members of attendees (20.8%), 2 were friends (4.2%), and 1 was an employee (2.1%). Among the 80 individuals who attended the 3rd to 5th screenings of the day, 35 became infected, representing a 43.8% attack rate. Specifically, 28 of the 33 third-screening attendees developed confirmed SARSCoV-2, constituting an 84.8% attack rate. Furthermore, 11 of the 12 cases epidemiologically linked to the theater outbreak were clustered monophyletically within the AY.69 lineage. At the time of the screening, 35 individuals (72.9%) had received 2 vaccine doses. However, vaccination status did not significantly influence infection risk. Multivariate analysis revealed that close contacts had a 15.9-fold higher risk of infection (95% confidence interval, 4.37–78.39) than casual contacts. Conclusion: SARS-CoV-2 transmission occurred within the theater, and extended into the community, via a moviegoer who attended the 3rd screening during the viral incubation period after contracting the virus from a family member. This study emphasizes the importance of adequate ventilation in theaters.
Editorial
How to transform the medical care system after the COVID-19 pandemic
Jong-Koo Lee
Osong Public Health Res Perspect. 2023;14(6):439-440.   Published online December 28, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0382
  • 500 View
  • 150 Download
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Review Article
Strategies to combat Gram-negative bacterial resistance to conventional antibacterial drugs: a review
Priyanka Bhowmik, Barkha Modi, Parijat Roy, Antarika Chowdhury
Osong Public Health Res Perspect. 2023;14(5):333-346.   Published online October 18, 2023
DOI: https://doi.org/10.24171/j.phrp.2022.0323
  • 1,778 View
  • 152 Download
  • 2 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDF
The emergence of antimicrobial resistance raises the fear of untreatable diseases. Antimicrobial resistance is a multifaceted and dynamic phenomenon that is the cumulative result of different factors. While Gram-positive pathogens, such as methicillin-resistant Staphylococcus aureus and Clostridium difficile, were previously the most concerning issues in the field of public health, Gram-negative pathogens are now of prime importance. The World Health Organization’s priority list of pathogens mostly includes multidrug-resistant Gram-negative organisms particularly carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa, and extensively drug-resistant Acinetobacter baumannii. The spread of Gram-negative bacterial resistance is a global issue, involving a variety of mechanisms. Several strategies have been proposed to control resistant Gram-negative bacteria, such as the development of antimicrobial auxiliary agents and research into chemical compounds with new modes of action. Another emerging trend is the development of naturally derived antibacterial compounds that aim for targets novel areas, including engineered bacteriophages, probiotics, metal-based antibacterial agents, odilorhabdins, quorum sensing inhibitors, and microbiome-modifying agents. This review focuses on the current status of alternative treatment regimens against multidrug-resistant Gram-negative bacteria, aiming to provide a snapshot of the situation and some information on the broader context.

Citations

Citations to this article as recorded by  
  • Efficacy of new generation biosorbents for the sustainable treatment of antibiotic residues and antibiotic resistance genes from polluted waste effluent
    Barkha Madhogaria, Sangeeta Banerjee, Atreyee Kundu, Prasanta Dhak
    Infectious Medicine.2024; : 100092.     CrossRef
  • Evaluation of Plant-Based Silver Nanoparticles for Antioxidant Activity and Promising Wound-Healing Applications
    Maria Qubtia, Shazia Akram Ghumman, Sobia Noreen, Huma Hameed, Shazia Noureen, Rizwana Kausar, Ali Irfan, Pervaiz Akhtar Shah, Hafsa Afzal, Misbah Hameed, Mohammad Raish, Maria Rana, Ajaz Ahmad, Katarzyna Kotwica-Mojzych, Yousef A. Bin Jardan
    ACS Omega.2024;[Epub]     CrossRef
Editorial
What are the strategies for national health security in preparation for the next pandemic?
Jong-Koo Lee
Osong Public Health Res Perspect. 2024;15(1):1-2.   Published online February 28, 2024
DOI: https://doi.org/10.24171/j.phrp.2024.0056
  • 218 View
  • 55 Download
PDF
Commentary
Activities of the Republic of Korea in the Global Health Security Agenda
Gang Lip Kim, Sookhyun Lee, So Yoon Kim
Osong Public Health Res Perspect. 2024;15(1):90-93.   Published online February 19, 2024
DOI: https://doi.org/10.24171/j.phrp.2023.0157
  • 262 View
  • 51 Download
Graphical AbstractGraphical Abstract PDF
Review Article
Global prevalence of enterobiasis in young children over the past 20 years: a systematic review and meta-analysis
Elham Kia Lashaki, Azadeh Mizani, Seyed Abdollah Hosseini, Bentolhoda Habibi, Khadijeh Taherkhani, Amir Javadi, AliReza Taremiha, Samira Dodangeh
Osong Public Health Res Perspect. 2023;14(6):441-450.   Published online December 28, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0204
  • 733 View
  • 48 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Parasitic infections are the most common diseases worldwide, and enterobiasis is a common parasitic infection in children. Various studies have reported on the prevalence of Enterobius vermicularis in different regions of the world. However, no study has gathered and analyzed this data systematically. Our systematic review and meta-analysis investigated the overall prevalence of E. vermicularis among children globally. Data were extracted from 4 available databases for studies published from January 2002 to April 2022. The quality of the included studies was scored based on the standard Strengthening the Reporting of Observational Studies in Epidemiology. A random-effect model was chosen to calculate the pooled prevalence and corresponding 95% confidence interval (CI) according to the degree of heterogeneity in the included studies. Thus, 40 publications (42 data sets) that included 3,279 children with enterobiasis met all criteria and were included in the analysis. The meta-analysis showed that heterogeneity among the included studies was high (Q=4,399.35, I2=99.96%; df=41; p<0.001). The pooled global prevalence of enterobiasis among the studied children was 12.9% (95% CI, 8.2%–17.7%). Our systematic review and meta-analysis estimated that, for the past 20 years, 12.9% of children around the world have been infected with E. vermicularis.
Original Articles
Chronic kidney disease in Indonesia: evidence from a national health survey
Puti Sari Hidayangsih, Dwi Hapsari Tjandrarini, Noor Edi Widya Sukoco, Nikson Sitorus, Ika Dharmayanti, Feri Ahmadi
Osong Public Health Res Perspect. 2023;14(1):23-30.   Published online February 14, 2023
DOI: https://doi.org/10.24171/j.phrp.2022.0290
  • 2,868 View
  • 217 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
Several previous studies have stated that consuming certain foods and beverages might increase the risk of chronic kidney disease (CKD). This study aimed to examine the relationships of food and beverage consumption with other risk factors for CKD. Methods: Data sources included the 2018 Basic Health Research (Riskesdas) and the National Socio-Economic Survey (Susenas), which were analyzed using a cross-sectional design. The study samples were households from 34 provinces in Indonesia, and the analysis was performed with provincial aggregates. Data were analyzed using risk factor analysis followed by linear regression to identify relationships with CKD. Results: The prevalence of CKD in Indonesia was 0.38%. The province with the highest prevalence was North Kalimantan (0.64%), while the lowest was found in West Sulawesi (0.18%). Five major groups were formed from 15 identified risk factors using factor analysis. A linear regression model presented 1 significant selected factor (p=0.006, R2 =31%). The final model of risk factors included water quality, consumption of fatty foods, and a history of diabetes. Conclusion: Drinking water quality, fatty food consumption, and diabetes are associated with CKD. There is a need to monitor drinking water, as well as to promote health education and provide comprehensive services for people with diabetes, to prevent CKD.
Menstrual hygiene management and its determinants among adolescent girls in low-income urban areas of Delhi, India: a community-based study
Suneela Garg, Nidhi Bhatnagar, Mongjam Meghachandra Singh, Saurav Basu, Amod Borle, Yamini Marimuthu, Falak Azmi, Yomri Dabi, Indu Bala
Osong Public Health Res Perspect. 2022;13(4):273-281.   Published online August 31, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0127
  • 3,247 View
  • 238 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Objectives
Menstrual hygiene management (MHM) in developing countries is linked to human rights, social justice, and the education and empowerment of young girls. The objective of this study was to assess menstrual hygiene practices and their determinants among adolescent girls, including school dropouts, and the effects of pad distribution programs in urban resettlement areas of Delhi, India.
Methods
A cross-sectional study was conducted from March 2019 to February 2020 in urban resettlement colonies and 2 villages of Delhi among 1,130 adolescent girls aged 10 to 19 years, who were interviewed face to face.
Results
In total, 954 participants (84.4%) used only disposable sanitary pads, 150 (13.3%) used both sanitary pads and cloths, and 26 (2.3%) used only cloths (n=1,130). Most school-going girls utilized the scheme for pad distribution, but only two-thirds of the girls who were out of school utilized the scheme. In the adjusted analysis, girls with lower educational status, those who had dropped out of school, and those from the Muslim religious community were more likely to use cloths for MHM.
Conclusion
More than 4 out of 5 adolescent girls in Delhi in low-income neighborhoods preferred sanitary pads for MHM. The government free pad scheme reached near-universal utilization among school-going girls (97%), but the subsidized pad scheme for girls who did not attend school was insufficiently utilized (75%).

Citations

Citations to this article as recorded by  
  • Menstrual Hygiene Problems and Challenges Faced by Adolescent Females in Rural Areas: A Narrative Review
    Vijiya Kashyap, Sonali G Choudhari
    Cureus.2023;[Epub]     CrossRef
  • Perceived difficulties in maintaining menstrual hygiene practices among indigenous adolescents during seasonal water scarcity periods in Bandarban hill district of Bangladesh: A cross-sectional study
    Imdadul Haque Talukdar, M.A. Rifat, Plabon Sarkar, Nobonita Saha, Mesfin Kassaye Tessma, Md. Ibrahim Miah
    International Journal of Hygiene and Environmental.2023; 254: 114268.     CrossRef
  • Menstrual hygiene practices among adolescent women in rural India: a cross-sectional study
    Aditya Singh, Mahashweta Chakrabarty, Shivani Singh, Rakesh Chandra, Sourav Chowdhury, Anshika Singh
    BMC Public Health.2022;[Epub]     CrossRef
Review Article
Predictors of outcomes 3 to 12 months after traumatic brain injury: a systematic review and meta-analysis
Younes Iderdar, Maryem Arraji, Nadia Al Wachami, Morad Guennouni, Karima Boumendil, Yassmine Mourajid, Noureddine Elkhoudri, Elmadani Saad, Mohamed Chahboune
Osong Public Health Res Perspect. 2024;15(1):3-17.   Published online February 5, 2024
DOI: https://doi.org/10.24171/j.phrp.2023.0288
  • 467 View
  • 34 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
The exact factors predicting outcomes following traumatic brain injury (TBI) remain elusive. In this systematic review and meta-analysis, we examined factors influencing outcomes in adult patients with TBI, from 3 months to 1 year after injury. A search of four electronic databases—PubMed, Scopus, Web of Science, and ScienceDirect—yielded 29 studies for review and 16 for meta-analysis, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. In patients with TBI of any severity, mean differences were observed in age (8.72 years; 95% confidence interval [CI], 4.77–12.66 years), lymphocyte count (−0.15 109/L; 95% CI, −0.18 to −0.11), glucose levels (1.20 mmol/L; 95% CI, 0.73–1.68), and haemoglobin levels (−0.91 g/dL; 95% CI, −1.49 to −0.33) between those with favourable and unfavourable outcomes. The prevalence rates of unfavourable outcomes were as follows: abnormal cisterns, 65.7%; intracranial pressure above 20 mmHg, 52.9%; midline shift of 5 mm or more, 63%; hypotension, 71%; hypoxia, 86.8%; blood transfusion, 70.3%; and mechanical ventilation, 90%. Several predictors were strongly associated with outcome. Specifically, age, lymphocyte count, glucose level, haemoglobin level, severity of TBI, pupillary reaction, and type of injury were identified as potential predictors of long-term outcomes.
Original Articles
Characteristics and related factors of waterborne and foodborne infectious disease outbreaks before and after the onset of the COVID-19 pandemic (2017–2021) in the Republic of Korea: a descriptive study
Eunkyoung Kim, Bryan Inho Kim
Osong Public Health Res Perspect. 2023;14(6):483-493.   Published online December 14, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0221
  • 646 View
  • 36 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
The incidence of waterborne and foodborne infectious diseases (WFIDs) continues to increase annually, attracting significant global attention. This study examined trends in WFID outbreaks in the Republic of Korea over the 5-year period before and during the coronavirus disease 2019 (COVID-19) pandemic and provided foundational data to establish measures for the prevention and control of WFID outbreaks. Methods: We analyzed 2,541 WFID outbreaks from 2017 to 2021 (42,805 cases) that were reported through the Integrated Disease Surveillance System of the Korea Disease Control and Prevention Agency. Outbreaks were defined as the occurrence of gastrointestinal symptoms in ≥2 individuals within a group with temporal and regional epidemiological associations. The related factors associated with WFID outbreaks during the observation period were statistically analyzed. Results: The total number of WFID outbreaks significantly decreased in 2020 during the COVID-19 pandemic and increased to the pre-pandemic level in 2021. Different patterns were observed for each pathogen. The incidence of Salmonella outbreaks more than doubled, while norovirus outbreaks decreased significantly. Conclusion: WFID outbreaks in the Republic of Korea showed different patterns before and during the COVID-19 pandemic, influenced by infection control measures and changes in dietary consumption patterns. Outbreaks of some diseases increased, but the infection control measures applied during the pandemic resulted in a significant decrease in the overall number of WFID outbreaks. This highlights the importance of strengthening the management strategies for outbreak prevention through hygiene inspections, long-term monitoring, education, and promotion by conducting multidimensional analyses to understand the complex related factors.
Estimation of the onset time of diabetic complications in type 2 diabetes patients in Thailand: a survival analysis
Natthanicha Sauenram, Jutatip Sillabutra, Chukiat Viwatwongkasem, Pratana Satitvipawee
Osong Public Health Res Perspect. 2023;14(6):508-519.   Published online November 23, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0084
  • 860 View
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
This study aimed to identify factors associated with the onset time of diabetic complications in patients with type 2 diabetes mellitus (T2DM) and determine the best-fitted survival model. Methods: A retrospective cohort study was conducted among T2DM patients enrolled from October 1, 2016 to July 15, 2020 at the National Health Security Office (NHSO). In total, 388 T2DM patients were included. Cox proportional-hazard and parametric models were used to identify factors related to the onset time of diabetic complications. The Akaike information criterion, Bayesian information criterion, and Cox-Snell residual were compared to determine the best-fitted survival model. Results: Thirty diabetic complication events were detected among the 388 patients (7.7%). A 90% survival rate for the onset time of diabetic complications was found at 33 months after the first T2DM diagnosis. According to multivariate analysis, a duration of T2DM ≥42 months (time ratio [TR], 0.56; 95% confidence interval [CI], 0.33–0.96; p=0.034), comorbid hypertension (TR, 0.30; 95% CI, 0.15–0.60; p=0.001), mildly to moderately reduced levels of the estimated glomerular filtration rate (eGFR) (TR, 0.43; 95% CI, 0.24–0.75; p=0.003) and an eGFR that was severely reduced or indicative of kidney failure (TR, 0.38; 95% CI, 0.16–0.88; p=0.025) were significantly associated with the onset time of diabetic complications (p<0.05). Conclusion: Patients with T2DM durations of more than 42 months, comorbid hypertension, and decreased eGFR were at risk of developing diabetic complications. The NHSO should be aware of these factors to establish a policy to prevent diabetic complications after the diagnosis of T2DM.
The value of CDC42 effector protein 2 as a novel prognostic biomarker in liver hepatocellular carcinoma: a comprehensive data analysis
Hye-Ran Kim, Choong Won Seo, Jongwan Kim
Osong Public Health Res Perspect. 2023;14(6):451-467.   Published online December 15, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0229
  • 643 View
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
The prognostic significance of CDC42 effector protein 2 (CDC42EP2) and its association with tumor-infiltrating immune cells (TIICs) have not been explored in liver hepatocellular carcinoma (LIHC). This study aims to assess the potential prognostic value of CDC42EP2 by conducting a comprehensive analysis of online databases pertaining to LIHC. Methods: We evaluated the potential of CDC42EP2 as a prognostic biomarker by utilizing online databases such as TIMER, GEPIA2, KM, OSlihc, HPA, and LinkedOmics. Results: In LIHC, we observed that the mRNA and protein expression of CDC42EP2 were upregulated compared to normal tissues. Upregulated CDC42EP2 expression was associated with a worse prognosis based on the clinicopathological characteristics of patients with LIHC. Furthermore, CDC42EP2 was positively associated with TIICs. In the co-expression and functional enrichment analyses of CDC42EP2, 11,416 genes showed positive associations with CDC42EP2 while 8,008 genes showed negative associations. CDC42EP2-related co-expression genes were involved in protein localization to the endoplasmic reticulum, translational initiation, and RNA catabolic processes in gene set enrichment analysis-Gene Ontology (GSEAGO), and regulated the ribosome, spliceosome, and primary immune deficiency in the GSEAKyoto Encyclopedia of Genes and Genomes (KEGG) pathway. In a survival map, 23 and 17 genes that exhibited positive associations with CDC42EP2 showed a significant hazard ratio (HR) for overall survival and disease-free survival, respectively. Conclusion: Our findings demonstrated that CDC42EP2 is a novel prognostic biomarker and a potential tumor immune therapeutic target in patients with LIHC.
Estimating the prevalence of oral manifestations in COVID-19 patients: a systematic review
Ankita Gupta, Kriti Shrivastav, Amit Agrawal, Abhishek Purohit, Roshan Chanchlani
Osong Public Health Res Perspect. 2023;14(5):388-417.   Published online September 19, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0033
  • 2,078 View
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
Patients with coronavirus disease 2019 (COVID-19) present with a variety of oral manifestations. Therefore, we conducted a systematic review to estimate the prevalence of oral lesions among COVID-19 patients. Methods: An extensive literature search of several electronic bibliographic databases (PubMed, Scopus, Science Direct, Litcovid) was conducted to retrieve all articles published in the English language from January 1, 2020 to March 31, 2023 that reported the prevalence of oral manifestations among COVID-19 patients. A meta-analysis of pooled prevalence was performed using Jamovi ver. 2.3 (2022). The I2 and Q statistics were used to assess heterogeneity between studies, and p-values <0.01 were considered statistically significant. Results: In total, 79 studies with data from 13,252 patients were included. The articles were predominantly published in 2020 (n=33), and Italy was the most common country (n=14). Most of the affected patients more than 50 years old and women (56.6%). The most common sites of involvement were the tongue (n=65), followed by the oral mucosa (n=37) and lips (n=19). High heterogeneity was found between studies. The most common oral manifestation was taste alteration, followed by xerostomia and ulceration, showing pooled prevalence rates of 48%, 35%, and 21%, respectively. Conclusion: COVID-19 patients show various oral manifestations that may help clinicians identify the disease promptly. Recognition of the signs and symptoms of COVID-19 is critical for an early diagnosis and better prognosis.
Epidemiological analysis and prevention strategies in response to a shigellosis cluster outbreak: a retrospective case series in an alternative school in the Republic of Korea, 2023
Yeongseo Ahn, Sunmi Jin, Gemma Park, Hye Young Lee, Hyungyong Lee, Eunkyung Shin, Junyoung Kim, Jaeil Yoo, Yuna Kim
Osong Public Health Res Perspect. 2024;15(1):68-76.   Published online February 7, 2024
DOI: https://doi.org/10.24171/j.phrp.2023.0298
  • 427 View
  • 28 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
In March 2023, an alternative school in the Republic of Korea reported 12 cases of shigellosis. This study aims to analyze the epidemiological characteristics in order to determine the cause of the cluster outbreak of shigellosis and to develop prevention strategies. Methods: This study focused on 12 patients with confirmed Shigella infection and investigated their demographics, clinical features, epidemiology, diagnostics, and antimicrobial susceptibility. Following the identification of Shigella, we conducted follow-up rectal smear cultures to manage patients, implementing isolation and control measures. Results: This study investigated the emergence of multidrug-resistant Shigella following missionary activities in Cambodia, documenting a cluster infection within an alternative school in Daejeon, the Republic of Korea. The outbreak affected 56 participants, resulting in the confirmation of 12 cases. The incidence rates varied by gender and occupation, with higher rates among males and teachers. All 12 cases demonstrated multidrug resistance. Challenges included delayed pathogen confirmation and suboptimal adherence to isolation criteria. The incident prompted revisions in the criteria for isolation release, focusing on symptom resolution. The study underscores the necessity for strengthened surveillance, educational initiatives focusing on prevention in endemic areas, and improved oversight of unlicensed educational establishments. Conclusion: Successful response strategies included swift situation assessment, collaborative efforts, effective infection control measures, and modified criteria for isolation release. Continued surveillance of multidrug-resistant strains is recommended, especially in regions with a high prevalence.
Genetic diversity and evolutionary patterns of SARS-CoV-2 among the Bhutanese population during the pandemic
Tshering Dorji, Kunzang Dorji, Tandin Wangchuk, Tshering Pelki, Sonam Gyeltshen
Osong Public Health Res Perspect. 2023;14(6):494-507.   Published online December 14, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0209
  • 886 View
  • 40 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
The coronavirus disease 2019 (COVID-19) pandemic, caused by a dynamic virus, has had a profound global impact. Despite declining global COVID-19 cases and mortality rates, the emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants remains a major concern. This study provides a comprehensive analysis of the genomic sequences of SARS-CoV-2 within the Bhutanese population during the pandemic. The primary aim was to elucidate the molecular epidemiology and evolutionary patterns of SARS-CoV-2 in Bhutan, with a particular focus on genetic variations and lineage dynamics. Methods: Whole-genome sequences of SARS-CoV-2 collected from Bhutan between May 2020 and February 2023 (n=135) were retrieved from the Global Initiative on Sharing All Influenza Database. Results: The SARS-CoV-2 variants in Bhutan were predominantly classified within the Nextstrain clade 20A (31.1%), followed by clade 21L (20%) and clade 22D (15.6%). We identified 26 Pangolin lineages with variations in their spatial and temporal distribution. Bayesian time-scaled phylogenetic analysis estimated the time to the most recent common ancestor as February 15, 2020, with a substitution rate of 0.97×10–3 substitutions per site per year. Notably, the spike glycoprotein displayed the highest mutation frequency among major viral proteins, with 116 distinct mutations, including D614G. The Bhutanese isolates also featured mutations such as E484K, K417N, and S477N in the spike protein, which have implications for altered viral properties. Conclusion: This is the first study to describe the genetic diversity of SARS-CoV-2 circulating in Bhutan during the pandemic, and this data can inform public health policies and strategies for preventing future outbreaks in Bhutan.

PHRP : Osong Public Health and Research Perspectives