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Editorial
Efforts to return to a normal society
Jong-Koo Lee
Osong Public Health Res Perspect. 2022;13(6):391-393.   Published online December 30, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.13.6.01
  • 238 View
  • 21 Download
PDF
Brief Reports
The effectiveness of Paxlovid treatment in long-term care facilities in South Korea during the outbreak of the Omicron variant of SARS-CoV-2
Hanul Park, Young Joon Park, Hye Young Lee, Mi Yu, Yeong-Jun Song, Sang Eun Lee, Ji-Joo Lee, Eun-Sol Lee, Yeonjung Kim
Osong Public Health Res Perspect. 2022;13(6):443-447.   Published online December 23, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0262
  • 741 View
  • 63 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
On November 5, 2021, Pfizer Inc. announced Paxlovid (nirmatrelvir +ritonavir) asa treatment method that could reduce the risk of hospitalization or death for patients withconfirmed coronavirus disease 2019 (COVID-19).Methods: From February 6, 2022 to April 2, 2022, the incidence of COVID-19 and the effectsof treatment with Paxlovid were analyzed in 2,241 patients and workers at 5 long-term carefacilities during the outbreak of the Omicron variant of severe acute respiratory syndromecoronavirus 2 in South Korea.Results: The rate of severe illness or death in the group given Paxlovid was 51% lower thanthat of the non-Paxlovid group (adjusted risk ratio [aRR], 0.49; 95% confidence interval [CI],0.24−0.98). Compared to unvaccinated patients, patients who had completed 3 doses of thevaccine had a 71% reduced rate of severe illness or death (aRR, 0.29; 95% CI, 0.13−0.64) and a65% reduced death rate (aRR, 0.35; 95% CI, 0.15−0.79).Conclusion: Patients given Paxlovid showed a lower rate of severe illness or death and alower fatality rate than those who did not receive Paxlovid. Patients who received 3 dosesof the vaccine had a lower rate of severe illness or death and a lower fatality rate than theunvaccinated group.
A low risk of nosocomial transmission of subclinical tuberculosis to neonates in a postpartum care center under COVID-19 control measures
In Kyoung Kim, So Jung Kim, Kyoung Hee Bae, Mi Young Kim, Ji Eun Oh, Mi Gyeong Lee, Young Ae Kang, Jin Su Song
Osong Public Health Res Perspect. 2022;13(6):448-452.   Published online December 16, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0235
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AbstractAbstract PDF
We report the results of investigating and managing a tuberculosis (TB) exposure in apostpartum care center. Among the contacts exposed to a nursing assistant with subclinical TB,5 of 44 neonates (11.4%) had positive tuberculin skin tests (TSTs) at 3 months of age, and all theTST-positive neonates received the Bacille Calmette-Guérin vaccination. Seven of 28 healthcareworkers (25.0%) and 1 of 3 household contacts (33.3%) were positive in the initial or repeatedinterferon-gamma release assay. None of the contacts developed TB disease during the studyperiod. Annual TB examinations of healthcare personnel at a postpartum care center under theTuberculosis Prevention Act in South Korea enabled the early detection of subclinical TB, whichreduced the risk of transmission to neonates under strict coronavirus disease 2019 preventionmeasures.
Review Article
Carbapenem resistance in critically important human pathogens isolated from companion animals: a systematic literature review
Angie Alexandra Rincón-Real, Martha Cecilia Suárez-Alfonso
Osong Public Health Res Perspect. 2022;13(6):407-423.   Published online December 16, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0033
  • 441 View
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AbstractAbstract PDF
This study aimed to describe the presence and geographical distribution of Gram-negativebacteria considered critical on the priority list of antibiotic-resistant pathogens publishedby the World Health Organization, including carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Acinetobacter spp., and carbapenem-resistant Pseudomonas aeruginosa.A systematic review of original studies published in 5 databases between 2010 and 2021 wasconducted, including genotypically confirmed carbapenem-resistant isolates obtained fromcanines, felines, and their settings. Fifty-one articles met the search criteria. Carbapenemresistant isolates were found in domestic canines and felines, pet food, and on veterinarymedical and household surfaces. The review found that the so-called “big five”—that is, the5 major carbapenemases identified worldwide in Enterobacterales (New Delhi metallo-βlactamase, active-on-imipenem, Verona integron-encoded metallo-β-lactamase, Klebsiellapneumoniae carbapenemase, and oxacillin [OXA]-48-like)—and the 3 most importantcarbapenemases from Acinetobacter spp. (OXA-23-like, OXA-40-like, and OXA-58-like) hadbeen detected in 8 species in the Enterobacteriaceae family and 5 species of glucose nonfermenting bacilli on 5 continents. Two publications used molecular analysis to confirmcarbapenem-resistant bacteria transmission between owners and dogs. Isolating criticallyimportant human carbapenem-resistant Gram-negative bacteria from domestic canines andfelines highlights the importance of including these animal species in surveillance programsand antimicrobial resistance containment plans as part of the One Health approach.
Original Articles
mRNA vaccine effectiveness against SARS-CoV-2 B.1.617.2 (Delta) and B.1.1.529 (Omicron) variant transmission from home care cases to household contacts in South Korea
Hanul Park, Young Joon Park, Sang Eun Lee, Min Jei Lee, Hyungtae Ahn
Osong Public Health Res Perspect. 2022;13(6):435-442.   Published online November 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0243
  • 1,567 View
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
Household contacts of confirmed cases of coronavirus disease 2019 (COVID-19) areexposed to a high risk of viral transmission, and secondary incidence is an important indicatorof community transmission. This study analyzed the secondary attack rate and mRNA vaccineeffectiveness against transmission (VET) for index cases (patients treated at home) confirmedto be infected with the Delta and Omicron variants.Methods: The subjects of the study were 4,450 index cases and 10,382 household contacts.Logistic regression analysis was performed to compare the secondary attack rate byvaccination status, and adjusted relative risk and 95% confidence intervals were identified.Results: The secondary attack rate of the Delta variant was 27.3%, while the secondary attackrate of the Omicron variant was 29.8%. For the Delta variant, groups with less than 90 daysand more than 90 days after 2 doses of mRNA vaccination both showed a VET of 37%. For theOmicron variant, a 64% VET was found among those with less than 90 days after 2 doses ofmRNA vaccination.Conclusion: This study provides useful data on the secondary attack rate and VET of mRNAvaccines for household contacts of COVID-19 cases in South Korea.
Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates
Yongmoon Kim, Bryan Inho Kim, Sangwoo Tak
Osong Public Health Res Perspect. 2022;13(6):424-434.   Published online November 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0212
  • 508 View
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
Although it is widely used as a measure for mortality, the case fatality rate (CFR) ofcoronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons otherthan viral characteristics. To compare the CFRs of different countries in equal measure, weestimated comparable CFRs after adjusting for multiple covariates and examined the mainfactors that contributed to variability in the CFRs among 21 countries.Methods: For statistical analysis, time-series cross-sectional data were collected from OurWorld in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated bypooled generalized linear squares regression models for the panel data. Covariates includedthe predominant virus variant, reproduction rate, vaccination, national economic status,hospital beds, diabetes prevalence, and population share of individuals older than age 65. Intotal, 21 countries were eligible for analysis.Results: Adjustment for covariates reduced variation in the CFRs of COVID-19 across countriesand over time. Regression results showed that the dominant spread of the Omicron variant,reproduction rate, and vaccination were associated with lower country-level CFRs, whereasage, the extreme poverty rate, and diabetes prevalence were associated with higher countrylevel CFRs.Conclusion: A direct comparison of crude CFRs among countries may be fallacious, especiallyin a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over timefor a more proper comparison. In addition, our findings suggest that comparing CFRs amongdifferent countries without considering their context, such as the epidemic phase, medicalcapacity, surveillance strategy, and socio-demographic traits, should be avoided.
Review Article
SARS-CoV-2 in brief: from virus to prevention
Hassan Karami, Zeinab Karimi, Negin Karami
Osong Public Health Res Perspect. 2022;13(6):394-406.   Published online November 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0155
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AbstractAbstract PDF
The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ahighly transmissible virus with a likely animal origin, has posed major and unprecedentedchallenges to millions of lives across the affected nations of the world. This outbreak firstoccurred in China, and despite massive regional and global attempts shortly thereafter, itspread to other countries and caused millions of deaths worldwide. This review presents keyinformation about the characteristics of SARS-CoV-2 and its associated disease (namely,coronavirus disease 2019) and briefly discusses the origin of the virus. Herein, we also brieflysummarize the strategies used against viral spread and transmission.
Editorial
What measures should be considered in this 2022-2023 winter season
Jong-Koo Lee
Osong Public Health Res Perspect. 2022;13(5):313-315.   Published online October 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0286
  • 619 View
  • 42 Download
PDF
Original Article
Clinical outcomes of remdesivir-treated COVID-19 patients in South Korea
Mi Yu, Bryan Inho Kim, Jungyeon Kim, Jin Gwack
Osong Public Health Res Perspect. 2022;13(5):370-376.   Published online October 18, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0138
  • 585 View
  • 43 Download
AbstractAbstract PDF
Objectives
This study analyzed the clinical outcomes of remdesivir treatment in coronavirus disease 2019 (COVID-19) patients in South Korea.
Methods
This retrospective cohort study involved the secondary analysis of epidemiological data. Among patients diagnosed with COVID-19 from July 2, 2020 to March 23, 2021 (12 AM), 4,868 who received oxygen therapy and were released from isolation after receiving remdesivir treatment were assigned to the treatment group, and 6,068 patients who received oxygen therapy but not remdesivir were assigned to the untreated group. The study subjects included children under the age of 19. The general characteristics and severity were compared between the groups. Differences in the time to death and mortality were also compared.
Results
In the untreated group, the hazard ratio [HR] for mortality was 1.59 among patients aged ≥70 years and 2.32 in patients with severe disease in comparison to the treatment group. In a comparison of survival time among patients with severe disease aged ≥70 years, the HR for mortality before 50 days was 2.09 in the untreated group compared to the treatment group.
Conclusion
Patients with remdesivir treatment showed better clinical outcomes in this study, but these results should be interpreted with caution since this study was not a fully controlled clinical trial.
Brief Reports
Adverse events of the Pfizer-BioNTech COVID-19 vaccine in Korean children and adolescents aged 5 to 17 years
Seontae Kim, Yeseul Heo, Soon-Young Seo, Do Sang Lim, Enhi Cho, Yeon-Kyeng Lee
Osong Public Health Res Perspect. 2022;13(5):382-390.   Published online October 14, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0233
  • 821 View
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AbstractAbstract PDF
Objectives
This study aimed to identify potential safety signals and adverse events following the primary Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccination series among children and adolescents aged 5 to 17 years in the Republic of Korea. Methods: Adverse events reported through the COVID-19 vaccination management system (CVMS, a web-based passive vaccine safety surveillance system) and adverse events and health conditions collected from a text message-based survey were analyzed. Results: A total of 14,786 adverse events among 5 to 17-year-old children and adolescents were reported in the CVMS; 14,334 (96.9%) were non-serious and 452 (3.1%) were serious, including 125 suspected cases of acute cardiovascular injury and 101 suspected cases of anaphylaxis. The overall reporting rate was lower in 5 to 11-year-old children (64.5 per 100,000 doses) than in 12 to 17-year-old adolescents (300.5 per 100,000 doses). The text message survey identified that local and systemic adverse events after either dose were reported less frequently in 5 to 11-year-old children than in 12 to 17-year-old adolescents (p<0.001). The most commonly reported adverse events were pain at the injection site, myalgia, headache, and fatigue/tiredness. Conclusion: The overall results are consistent with the results of controlled trials; serious adverse events were extremely rare among 5 to 17-year-old children and adolescents following Pfizer-BioNTech COVID-19 vaccination. Adverse events were less frequent in children aged 5 to 11 years than in adolescents aged 12 to 17 years.
Presumed population immunity to SARS-CoV-2 in South Korea, April 2022
Eun Jung Jang, Young June Choe, Seung Ah Choe, Yoo-Yeon Kim, Ryu Kyung Kim, Jia Kim, Do Sang Lim, Ju Hee Lee, Seonju Yi, Sangwon Lee, Young-Joon Park
Osong Public Health Res Perspect. 2022;13(5):377-381.   Published online October 14, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0209
  • 1,068 View
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
We estimated the overall and age-specific percentages of the Korean population with presumed immunity against severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) as of April 2022 using the national registry.
Methods
We used the national coronavirus disease 2019 (COVID-19) infection and vaccination registry from South Korea, as described to define individuals with a previous history of COVID-19 infection, vaccination, or both, as persons with presumed immunity.
Results
Of a total of 53,304,627 observed persons, 24.4% had vaccination and infection, 58.1% had vaccination and no infection, 7.6% had infection and no vaccination, and 9.9% had no immunity. The SARS-CoV-2 Omicron variant emerged at a time when the presumed population immunity ranged from 80% to 85%; however, nearly half of the children were presumed to have no immunity.
Conclusion
We report a gap in population immunity, with lower presumed protection in children than in adults. The approach presented in this work can provide valuable informed tools to assist vaccine policy-making at a national level.
Review Articles
India’s efforts to achieve 1.5 billion COVID-19 vaccinations: a narrative review
Kapil Singh, Ashwani Verma, Monisha Lakshminarayan
Osong Public Health Res Perspect. 2022;13(5):316-327.   Published online October 14, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0104
  • 1,135 View
  • 60 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
The initial case of coronavirus disease 2019 (COVID-19) in India was reported on January 30, 2020, and subsequently, the number of COVID-19-infected patients surged during the first wave of April 2020 and the second wave in the same month of 2021. The government of India imposed a strict nationwide lockdown in April 2020 and extended it until May 2020. The second wave of COVID-19 in India overwhelmed the country’s health facilities and exhausted its medical and paramedical workforce. This narrative review was conducted with the aim of summarizing the evidence drawn from policy documents of governmental and non-governmental organizations, as well as capturing India's COVID-19 vaccination efforts. The findings from this review cover the Indian government's vaccination initiatives, which ranged from steps taken to combat vaccine hesitancy to vaccination roadmaps, deployment plans, the use of digital health technology, vaccination monitoring, adverse effects, and innovative strategies such as Har Ghar Dastak and Jan Bhagidari Andolan (people’s participation). These efforts collectively culminated in the successful administration of more than 1.8 billion doses of COVID-19 vaccines in India. This review also provides insights into other countries’ responses to COVID-19 and guidance for future pandemics.
Effects of medication adherence interventions for older adults with chronic illnesses: a systematic review and meta-analysis
Hae Ok Jeon, Myung-Ock Chae, Ahrin Kim
Osong Public Health Res Perspect. 2022;13(5):328-340.   Published online October 12, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0168
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AbstractAbstract PDF
This systematic review and meta-analysis aimed to understand the characteristics of medication adherence interventions for older adults with chronic illnesses, and to investigate the average effect size by combining the individual effects of these interventions. Data from studies meeting the inclusion criteria were systematically collected in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The results showed that the average effect size (Hedges’ g) of the finally selected medication adherence interventions for older adults with chronic illnesses calculated using a random-effects model was 0.500 (95% confidence interval [CI], 0.342−0.659). Of the medication adherence interventions, an implementation intention intervention (using face-to-face meetings and telephone monitoring with personalized behavioral strategies) and a health belief model–based educational program were found to be highly effective. Face-to-face counseling was a significantly effective method of implementing medication adherence interventions for older adults with chronic illnesses (Hedges’ g=0.531, 95% CI, 0.186−0.877), while medication adherence interventions through education and telehealth counseling were not effective. This study verified the effectiveness of personalized behavioral change strategies and cognitive behavioral therapy based on the health belief model, as well as face-to-face meetings, as medication adherence interventions for older adults with chronic illnesses.
Original Article
A case-control study of acute hepatitis A in South Korea, 2019
Jung Hee Hyun, Ju Young Yoon, Sang Hyuk Lee
Osong Public Health Res Perspect. 2022;13(5):352-359.   Published online October 12, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0141
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
We aimed to reconfirm the source of hepatitis A virus (HAV) infection through epidemiological and genotype investigations of individual cases in a 2019 outbreak in South Korea. Methods: We investigated food intake histories, associations with hepatitis A, and genotypes of HAV in 31 patients with hepatitis aged 20 to 49 years registered in the integrated disease and health management system during December 1–7, 2019 (case group) and in 35 sex- and agematched people without a history of HAV vaccination or infection among patients’ families and colleagues (control group). Results: The consumption of salted clams was a significant factor (odds ratio, 4.33; 95% confidence interval, 1.32–14.18) in the risk factor analysis of food intake history. HAV genotypes were analyzed in 24 of 31 patients. Type IA and type IIIA were found in 23 and 1 cases, respectively. Conclusion: Salted clams are considered to have been the source of HAV infection at 49 weeks of the HAV outbreak in 2019; this result was consistent with that of a previous epidemiological investigation conducted by the Korea Disease Control and Prevention Agency in September 2019. Therefore, monitoring of the production and distribution of salted clams needs to be continued.
Review Article
Zika virus as an emerging arbovirus of international public health concern
Samira Vaziri, Siavash Hamzeh Pour, Fateme Akrami-Mohajeri
Osong Public Health Res Perspect. 2022;13(5):341-351.   Published online October 12, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0101
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AbstractAbstract PDF
Zika virus (ZIKV) was identified in 1947 in a rhesus monkey during an investigation of the yellow fever virus in the Zika Forest of Uganda; it was also isolated later from humans in Nigeria. The main distribution areas of ZIKV were the African mainland and South-East Asia in the 1980s, Micronesia in 2007, and more recently the Americas in 2014. ZIKV belongs to the Flaviviridae family and Flavivirus genus. ZIKV infection, which is transmitted by Aedes mosquitoes, is an emerging arbovirus disease. The clinical symptoms of ZIKV infection are fever, headache, rashes, arthralgia, and conjunctivitis, which clinically resemble dengue fever syndrome. Sometimes, ZIKV infection has been associated with Guillain-Barré syndrome and microcephaly. At the end of 2015, following an increase in cases of ZIKV infection associated with Guillain-Barré syndrome and microcephaly in newborns in Brazil, the World Health Organization declared a global emergency. Therefore, considering the global distribution and pathogenic nature of this virus, the current study aimed at reviewing the virologic features, transmission patterns, clinical manifestations, diagnosis, treatment, and prevention of ZIKV infection.

PHRP : Osong Public Health and Research Perspectives