Prevention Agency Research Articles

Factors Affecting Mortality and Distribution of Co-morbidities in Chronic Obstructive Pulmonary Disease

Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. This study aims to identify the rules associated with major comorbidities in patients with COPD and analyze how they affect death, thereby suggesting patient management measures that are efficient and can improve the quality of medical care.Methods: For this purpose, among the Korea Disease Control and Prevention Agency’s discharge injury in-depth survey data of more than 3 million cases from 2006 to 2021, adult patients aged 19 years or older with a principal diagnosis of chronic obstructive pulmonary disease were targeted. <i>χ</i><sup>2</sup>-test and independent sample t-test were performed to analyze the distribution of deaths by demographic characteristics, and ARM (Association Rule Mining) was analyzed for association rules for comorbidities. Logistic regression analysis was performed on factors influencing death.Results: As a result of the analysis, the mortality rate was high in patients over 75 years of age, patients admitted to the emergency room, and patients discharged from medical institutions with more than 1,000 beds. The prevalence of comorbidities was high for E11 (Type 2 diabetes mellitus) and I10 (essential hypertension). As a result of analyzing the impact on death based on major association rules, other sepsis (A41) and essential hypertension (I10), other sepsis (A41) and pneumonia, organism unspecified (J18), sequelae of tuberculosis (B90) and J96 (respiratory Failure, NEC), sequelae of tuberculosis (B90), and I27 (other pulmonary heart diseases) were found to have a high probability of death.Conclusions: Based on the major association rules affecting death, we propose to apply them to a clinical decision support system for efficient patient management and personalized treatment.

An Investigation of the Relationship between Henoch-Schönlein Purpura and Viral Infection in Korea Using the Health Insurance Database.

(1) Background: This study investigated the epidemiology and viral connections of Henoch-Schönlein purpura (HSP) using information from the Korea Disease Control and Prevention Agency and the Health Insurance Review and Assessment database. (2) Method: Between 2016 and 2019, a total of 25,443 patients with HSP were identified, with 51.3% of patients under the age of 20 years and the highest incidence in March. (3) Results: The autoregressive integrated moving average model and Granger causality test were used to analyze the association between the virus positivity detection rate and HSP incidence. (4) Conclusions: The incidence of HSP was associated with rotavirus, bocavirus, parainfluenza virus, and respiratory syncytial virus in individuals under 20 years of age, whereas adenovirus, respiratory syncytial virus, and norovirus were associated with individuals above that age.

Case report: atypical presentation of mpox with massive hematochezia and prolonged viral shedding despite tecovirimat treatment

BackgroundThe outbreak of mpox that occurred between 2022 and 2023 is primarily being transmitted through sexual contact. As of now, there is no consensus on the recommended duration of isolation to prevent sexual transmission of the virus. Moreover, this particular mpox outbreak has presented with distinct complications in comparison to previous occurrences. In this report, we present a case involving severe rectal bleeding from an ulcer in a mpox patient with a history of engaging in receptive sexual contact.Case presentationA 30-year-old Korean man presented at the hospital with complaints of fever, multiple skin lesions, and anal pain. Monkeypox virus polymerase chain reaction (PCR) results were positive for skin lesions on the penis and wrist. The patient received a 12-day course of tecovirimat due to anal symptoms and perianal skin lesions. Following isolation for 12 days and after all skin scabs had naturally fallen off, with no new skin lesions emerging for a consecutive 48 hours—conforming to the criteria of the Korean Disease Control and Prevention Agency—the patient was discharged. However, 1 day after discharge, the patient returned to the hospital due to hematochezia. His hemoglobin level had significantly dropped from 14.0 g/dL to 8.2 g/dL. Sigmoidoscopy unveiled a sizable rectal ulceration with exposed blood vessels, prompting the application of hemostasis through metal clipping. Subsequent monkeypox virus real-time PCR conducted on rectal tissue and swabs yielded positive results (with cycle threshold values of 28.48 and 31.23, respectively). An abdominal CT scan exposed a perirectal abscess, for which ampicillin-sulbactam was administered.ConclusionThis case underscores the importance of monitoring for bleeding complications and confirming the resolution of rectal lesions before discharging patients from isolation, particularly in cases where patients have a history of engaging in receptive sexual contact with men or are presenting with anal symptoms.

Long-Term Particulate Matter Exposure and Mortality in Hospitalized Patients with COVID-19 in South Korea.

Rationale: Particulate matter (PM) exposure exacerbates health outcomes by causing lung damage. Objectives: To investigate whether prior exposure to particulate matter ⩽10 μm and ⩽2.5 μm in aerodynamic diameter (PM10 and PM2.5) was associated with clinical outcomes among patients with coronavirus disease (COVID-19). Methods: Data from the nationwide registration database of the National Health Insurance and Korea Disease Control and Prevention Agency in South Korea were used. The study included adult patients who were admitted to monitoring centers or hospitals between October 8, 2020 and December 31, 2021, after COVID-19 confirmation. AirKOREA database, which compiles air pollutant data from 642 stations in 162 cities and counties across South Korea, was used to extract data on PM levels. Average values of monthly exposure to PM10 and PM2.5 from the year previous to hospital admission because of COVID-19 to the date of confirmation of COVID-19 were calculated and used to define PM exposures of patients with COVID-19. Results: In total, 322,289 patients with COVID-19 were included, and 4,633 (1.4%) died during hospitalization. After adjusting for covariates, a 1-μg/m3 increase in PM10 and PM2.5 exposure was associated with 4% (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.03-1.05; P < 0.001) and 6% (OR, 1.06; 95% CI, 1.04-1.07; P < 0.001) increase in the risk of in-hospital mortality, respectively. In addition, a 1-μg/m3 increase in PM10 and PM2.5 was associated with 5% (OR, 1.05; 95% CI, 1.04-1.07; P < 0.001) and 8% (OR, 1.08; 95% CI, 1.06-1.10; P < 0.001) increase in the risks of requiring intensive care unit (ICU) admission and mechanical ventilation, respectively. Conclusions: PM10 and PM2.5 exposure was associated with increased in-hospital mortality and the need for ICU admission and mechanical ventilation among patients with COVID-19 in South Korea.

Factors affecting treatment outcomes of hospital injury patients in Korea.

To analyze the characteristics of hospital injured patients and the factors that affect treatment results. We used the data from the Korea National Hospital Discharge In-depth Injury Survey from 2019 to 2021 of the Korea Disease Control and Prevention Agency (KDCA), 18,037 people who experienced hospital injury accidents were analyzed. In a retrospective cross-sectional study, general characteristics and injury-related characteristics of patients with hospital-acquired injuries were collected. The data were analyzed using chi-square test and logistic regression analysis of complex sampling design. The significance of all statistical analyses was verified at the p-value (<0.05) level. Variables that significantly affected the death of patients with hospital injuries were gender, age, route of admission, type of hospital injury, principal diagnosis, and length of stay (p < 0.05). The risk of death was 3.174 times (95% confidence interval: 2.376-4.238) higher when neoplasm was the principal diagnosis compared to cases with principal diagnosis of other systems. It is necessary to do patient safety education to help medical personnel be more aware of groups of patients who had a high risk of death from hospital damage, such as male and elderly patients, patients who admitted through the emergency room, and patients whose principal diagnosis was neoplasm, circulatory system, or respiratory system disease.

Measuring the Intensity of Stress Experienced and Its Impact on Life in Patients with Diagnosed Alcohol Use Disorder.

Alcohol addiction is characterized by extensive alcohol consumption that dominates other behaviours previously important to a patient. According to data from The State Agency for Prevention of Alcohol-Related Problems, up to 900,000 people in Poland are addicted to alcohol. On average, approximately 9.7 L of pure alcohol per capita was consumed in 2021. Alcohol addiction may cause severe health problems and is one the key risk factors for various diseases. Stress plays an important role in the process of alcohol addiction and is also a predictor for lower enjoyment in life. On the other hand, sense of coherence may be a stronger protective factor. The aim of our study was to verify the relation between the level of perceived stress among patients with alcohol addiction and satisfaction with life. Because sense of coherence is a disposition that allows for managing stress effectively, the latter should be reflected in the results of multivariate analyses that take both the level of stress and sense of coherence into account. In the present study, sense of coherence and perceived stress were negatively correlated; therefore, strengthening internal resources for managing difficult and stressful situations is recommended.

Korean Adolescents before and after COVID-19: Changes in Physical Activity, Mental Health, and Hygiene Management.

Adolescence is when health behaviors, namely, physical activity (PA), mental health, and hygiene management, are established. As the young represent our future societal welfare, their health requires attention, particularly in the face of a pandemic. We explored changes in Korean adolescent PA, mental health, and hygiene management before and after the COVID-19 pandemic to identify recommendations for improving adolescent health. We collected 2019-2021 data from the Korea Youth Risk Behavior Surveys from the Korea Disease Control and Prevention Agency for 166,590 middle and high school students (2019: 57,069; 2020: 54,809; 2021: 54,712). We analyzed seven variables (regular PA, high-intensity PA, and strength exercise participation, stress recognition, sleep-time satisfaction, brushing practice, and handwashing practice) to examine changes in adolescent behavior during these years. The findings indicated statistically significant differences in all seven variables over the three years (P<0.05). Specifically, regular PA was higher in 2019 and 2021 than in 2020; high-intensity PAs were highest in 2019, followed by 2021 and 2020; strength exercises were the highest in 2020, followed by 2021 and 2019; stress recognition was higher in 2019 and 2021 than in 2020; sleep-time satisfaction was the highest in 2020, followed by 2021 and 2019; brushing practice was the highest in 2019, followed by 2020 and 2021; and handwashing practice was the highest in 2020, followed by 2021 and 2019. The results recommend the need to encourage structured moderate-to-vigorous adolescent PA and systematic health education to improve Korean adolescent health behavior after COVID-19.

The dark side of social capital: Geographic differences in COVID-19 preventive behaviors among older adults in South Korea.

The present study examined whether geographic location (i.e., rural vs. urban areas) moderated the relationship between social capital and COVID-19 preventive behaviors among older adults in South Korea. Participants were a nationally representative sample of 61 075 Korean adults aged 65 years or older from the 2021 Community Health Survey by the Korea Disease Control and Prevention Agency. The moderation analysis was conducted with PROCESS. After adjusting for covariates, the moderation analysis showed a significant moderation effect of geographic location on the relationship between social capital and COVID-19 preventive behaviors among older adults in South Korea. Specifically, in urban areas, older adults with higher social capital were more likely to adhere to COVID-19 preventive behaviors. However, social capital negatively impacted older adults' COVID-19 preventive behaviors in rural areas. Findings suggest that social capital is not always helpful for maintaining COVID-19 preventive behaviors among older adults in South Korea. The social characteristics of geographic location need to be considered when initiating COVID-19 prevention campaigns in South Korea. Geriatr Gerontol Int 2024; 24: 377-384.

Comparison of Xpert Xpress SARS-CoV-2 Assay Compared with Standard M nCoV Real-Time PCR: Prospective Study.

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can be diagnosed using rapid real-time polymerase chain reaction (PCR), real-time reverse transcription PCR (rRT-PCR), or rapid antigen testing. Among these, rRT-PCR is considered the gold standard assay. The Xpert Xpress SARS-CoV-2 assay is a rapid, real-time PCR test; approved by the Korean Disease Control and Prevention Agency in 2020. Current performance of the Xpert assay (Xpert) with the STANDARD M nCoV Real-Time Detection kit (SD) were determined. All samples used by the SD test team were immediately transferred to the Xpert test team within 24 hours. Both tests were conducted between April 2023 and July 2023. Exclusion criteria were studies which show either inconclusive, invalid, or erroneous results. Positive rate, sensitivity, specificity, overall concordance rate, positive concordance rate, discordance rate, false-positive rate, and false-negative rates of the Xpert assay with the STANDARD M nCoV Real-Time Detection kit were determined. Samples from 347 patients (174 men and 173 women) with a median age of 60 years (range; 6 - 90 years) were included. Positive rate, sensitivity, specificity, overall concordance rate, positive concordance rate, discordance rate, false-positive rate, and false-negative rates of the Xpert assay were 11.2%, 82.1%, 95.0%, 93.9%, 6.6%, 6.1%, 41.0%, and 1.6%, respectively. COVID-19 results from Xpert should be confirmed through rRT-PCR because of low sensitivity (82.1%) and high false-positive rate (41.0%).

Twenty Years of Progress and the Way Forward: Immunization Registry Information System in Korea.

The National Immunization Program in The Republic of Korea offers mandatory and free vaccinations to children under 12, regulated by the Infectious Disease Prevention and Control Act. Tracking vaccination coverage is crucial for population protection and public health strategies. Since 2002, the Immunization Registry Information System (IRIS) has been used nationwide to capture vaccination data. This study reviewed documents related to IRIS's establishment and development. The Republic of Korea legally supports IRIS's construction and data collection, integrating vaccination data with the Ministry of the Interior and Safety's resident registration to minimize errors. This collaboration also facilitates cost reimbursement and digital registration, promoting wider vaccination coverage. IRIS manages expense claims once vaccination details are logged, and authorized medical institutions can access these records in real-time. Since 2015, the Korea Disease Control and Prevention Agency has been compiling annual data on national vaccination coverage. IRIS also sends automated reminders in 12 languages, reports adverse effects, and issues vaccination certificates. However, IRIS lacks integration between vaccine and disease registries, unlike countries such as England, Denmark, and the Netherlands. Improving integration capabilities could enhance IRIS's support for public health through an integrated information system.

Estimating Excess Mortality During the COVID-19 Pandemic Between 2020-2022 in Korea.

The persistent coronavirus disease 2019 (COVID-19) pandemic has had direct and indirect effects on mortality, making it essential to analyze excess mortality to fully understand the impact of the pandemic. In this study, we constructed a mathematical model using number of deaths from Statistics Korea and analyzed excess mortality between 2020 and 2022 according to age, sex, and dominant severe acute respiratory syndrome coronavirus 2 variant period. Number of all-cause deaths between 2010 and 2022 were obtained from the annual cause-of-death statistics provided by Statistics Korea. COVID-19 mortality data were acquired from the Korea Disease Control and Prevention Agency. A multivariate linear regression model with seasonal effect, stratified by sex and age, was used to estimate the number of deaths in the absence of COVID-19. The estimated excess mortality rate was calculated. Excess mortality was not significant between January 2020 and October 2021. However, it started to increase monthly from November 2021 and reached its highest point during the omicron-dominant period. Specifically, in March and April 2022, during the omicron BA.1/BA.2-dominant period, the estimated median values for excess mortality were the highest at 17,634 and 11,379, respectively. Both COVID-19-related deaths and excess mortality increased with age. A notable increase in excess mortality was observed in individuals aged ≥ 65 years. In the context of excess mortality per 100,000 population based on the estimated median values in March 2022, the highest numbers were found among males and females aged ≥ 85 years at 1,048 and 910, respectively. This study revealed that the prolonged COVID-19 pandemic coupled with its high transmissibility not only increased COVID-19-related deaths but also had a significant impact on overall mortality rates, especially in the elderly. Therefore, it is crucial to concentrate healthcare resources and services on the elderly and ensure continued access to healthcare services during pandemics. Establishing an excess mortality monitoring system in the early stages of a pandemic is necessary to understand the impact of infectious diseases on mortality and effectively evaluate pandemic response policies.

Impact of COVID-19 pandemic on the incidence and severity of myasthenia gravis in Korea: using National Health Insurance Service database.

This study investigated the impact of COVID-19 pandemic on the incidence and severity of myasthenia gravis (MG) using the National Health Insurance Service (NHIS) database in Korea. We analyzed data from patients with MG in the NHIS registry from 2015 to 2021. MG was defined as (1) patients aged ≥18 years with the G70.0 code, and (2) patients who visited tertiary hospitals regarldless of department in Korea (outpatient clinics at least twice or hospitalization at least once), and (3) patients who were prescribed pyridostigmine as MG medications at least once. We designated pre-COVID-19 as 2019 and post-COVID-19 as 2021 and analyzed the MG incidence and prevalence in 2019 and 2021. We compared the clinical data of patients with MG between the two years. MG exacerbation was defined as the administration of intravenous immunoglobulin or plasma exchange. Analysis of COVID-19 cases was conducted using an integrated database from the Korea Disease Control and Prevention Agency and NHIS. Patients with MG were divided into two groups according to COVID-19 status to compare their clinical characteristics. A total of 6,888 and 7,439 MG cases were identified in 2019 and 2021, respectively. The standardized incidence was 1.56/100,000 in 2019, decreasing to 1.21/100,000 in 2021. Although the frequency of MG exacerbations was higher in 2019, there were no differences in the number and duration of hospitalizations, duration of ICU stays, hostalization expense, and mortality between 2019 and 2021. Patients with MG and COVID-19 had a higher frequency of MG exacerbations than patients without COVID-19, but there were no differences in the number and duration of hospitalizations, hospitalization expense, and mortality. This study was the first nationwide population-based epidemiological study of MG during COVID-19 pandemic in Korea. The incidence of MG decreased during COVID-19 pandemic, and the severity of MG was not affected by COVID-19.

Comparison of HIV characteristics across 3 datasets: the Korea HIV/AIDS Cohort Study prospective, retrospective, and national reporting system.

The Korea HIV/AIDS Cohort Study has been conducted prospectively for 18 years. However, it faces limitations in representing the entire population of patients with human immunodeficiency virus (HIV) in Korea. To address these limitations and validate the study design, we analyzed characteristics across several HIV datasets. We compared epidemiological and clinical characteristics from 3 datasets: the Korea HIV/AIDS Cohort Study (dataset 1, n=1,562), retrospective cohort data (dataset 2, n=2,665), and the national HIV reporting system of the Korea Disease Control and Prevention Agency (KDCA) (dataset 3, n=17,403). The demographic characteristics of age, sex, and age at HIV diagnosis did not differ significantly across datasets. However, dataset 3 contained a higher proportion of patients diagnosed after 2008 (69.5%) than the other datasets. Regarding transmission routes, same-sex contact accounted for a greater proportion of dataset 1 (59.8%) compared to datasets 2 (20.9%) and 3 (32.6%). The proportion of patients with CD4 T-cell counts below 200/mm3 at HIV diagnosis was higher in datasets 1 (39.4%) and 2 (33.3%) compared to dataset 3 (16.3%). Initial HIV viral load measurements were not obtained for dataset 3. The Korea HIV/AIDS Cohort Study demonstrated representativeness regarding the demographic characteristics of Korean patients. Of the sources, dataset 1 contained the most data on transmission routes. While the KDCA data encompassed all HIV patients, it lacked detailed clinical information. To improve the representativeness of the Korea HIV/AIDS Cohort Study, we propose expanding and revising the cohort design and enrolling more patients who have been recently diagnosed.

Epidemiological and Clinical Characteristics of Women Living with HIV in Korea.

While Korea maintains a low prevalence of human immunodeficiency virus (HIV), the number of newly diagnosed cases has been steadily rising, reaching approximately 1,000 annually in recent years. The 2022 annual report from the Korea Disease Control and Prevention Agency revealed that women living with HIV (WLWH) constitute 6.4% of the total confirmed people living with the HIV population, totaling 1,219 individuals. Despite this, only a few studies have focused on WLWH in Korea. This study aims to analyze the epidemiological and clinical characteristics of WLWH in Korea. We retrospectively collected data by reviewing the medical records of all WLWH who visited 10 urban referral hospitals across Korea between January 2005 and May 2023. A total of 443 WLWH were enrolled in this study. The predominant risk exposure was heterosexual contact, with 235 (53%) participants either married or cohabiting with a male partner at their initial clinic visit. Among the participants, 334 (77.7%) were Korean, 27 (6.1%) were Southeast Asian, and 19 (4.3%) were African. Antiretroviral therapy was initiated by 404 WLWH (91.2%). We observed 118 pregnancies in WLWH following their HIV diagnosis, resulting in 78 live births (66.1%), 18 induced abortions (15.2%), 10 pre-viable fetal losses (8.5%), and four stillbirths (3.4%). Over a cumulative follow-up duration of 3,202.1 years, the incidence rates of breast and cervical cancers were both 2.18 per 1,000 person-years. Additionally, the incidence rates of pelvic inflammatory disease, cervical intraepithelial neoplasm (above grade II), and osteoporosis were 4.67, 11.21, and 13.39 per 1,000 patient-years, respectively. This is the first multicenter study to investigate the clinical and epidemiological characteristics of WLWH in Korea. The incidence and prevalence of diseases in women, including breast cancer, cervical cancer, and chronic comorbidities, are high in WLWH in Korea; therefore, further research and efforts are needed to manage these diseases.

A Causality Assessment Framework for COVID-19 Vaccines and Adverse Events at the COVID-19 Vaccine Safety Research Center.

During the coronavirus disease 2019 (COVID-19) pandemic, conclusively evaluating possible associations between COVID-19 vaccines and potential adverse events was of critical importance. The National Academy of Medicine of Korea established the COVID-19 Vaccine Safety Research Center (CoVaSC) with support from the Korea Disease Control and Prevention Agency to investigate the scientific relationship between COVID-19 vaccines and suspected adverse events. Although determining whether the COVID-19 vaccine was responsible for any suspected adverse event necessitated a systematic approach, traditional causal inference theories, such as Hill's criteria, encountered certain limitations and criticisms. To facilitate a systematic and evidence-based evaluation, the United States Institute of Medicine, at the request of the Centers for Disease Control and Prevention, offered a detailed causality assessment framework in 2012, which was updated in the recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM) in 2024. This framework, based on a weight-of-evidence approach, allows the independent evaluation of both epidemiological and mechanistic evidence, culminating in a comprehensive conclusion about causality. Epidemiological evidence derived from population studies is categorized into four levels-high, moderate, limited, or insufficient-while mechanistic evidence, primarily from biological and clinical studies in animals and individuals, is classified as strong, intermediate, weak, or lacking. The committee then synthesizes these two types of evidence to draw a conclusion about the causal relationship, which can be described as "convincingly supports" ("evidence established" in the 2024 NASEM report), "favors acceptance," "favors rejection," or "inadequate to accept or reject." The CoVaSC has established an independent committee to conduct causality assessments using the weight-of-evidence framework, specifically for evaluating the causality of adverse events associated with COVID-19 vaccines. The aim of this study is to provide an overview of the weight-of-evidence framework and to detail the considerations involved in its practical application in the CoVaSC.

2023 Korean sexually transmitted infections guidelines by the Korean Association of Urogenital Tract Infection and Inflammation: Human papillomavirus vaccination.

The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII) and the Korea Disease Control and Prevention Agency updated the guidelines for human papillomavirus (HPV) vaccine against sexually transmitted HPV infections in Korea to respond to changing epidemiologic trends, evolving scientific evidence, and advances in laboratory diagnostics and research. Main purpose and recommendation of vaccination against HPV are as follows: (1) the purpose of HPV vaccine is to reduce the risk of genital warts and HPV-related cancers including cervical and vulvar cancer, head and neck cancer, anal cancer, and penile cancer; (2) in Korea, bivalent (16, 18) vaccines, quadrivalent vaccines (6, 11, 16, 18), and 9-valent vaccines (6, 11, 16, 18, 31, 33, 45, 52, 58) are used depending on the type of HPV; (3) bivalent and quadrivalent vaccines are national immunizations targeting girls aged 11-12 years and low-income young females aged 18-26 years (age and range of inoculation: routinely administered at 11 or 12 years of age, 2 doses at 0 and 6 months for 12-14 years of age; for females aged 15-26 years, 3 doses depending on the type of vaccine; vaccination can be given to those aged up to 45 years through consultation with a clinician); (4) in the case of administering 2 doses, at least 5 months apart; in the case of administering 3 doses, it is recommended to keep 4 weeks between the 1st and 2nd doses, 12 weeks between the 2nd and 3rd doses, and 5 months between the 1st and 3rd doses; (5) immunocompromised patients such as those with HIV, malignant neoplasms, and autoimmune diseases, and those undergoing transplantation or immunosuppressive therapy should receive 3 doses. HPV vaccine is not recommended during pregnancy.

노인성 류마티스 관절염에서의 당뇨병 위험: 한국인유전체역학조사사업(KoGES) 자료를 이용하여

Rheumatoid arthritis (RA) is one of representative geriatric diseases caused by a combination of various genetic and acquired factors. Chronic progressive systemic inflammation caused by RA is closely associated to the inflammatory pathway underlying the pathogenesis of diabetes mellitus. However, most studies to investigate the association have been conducted mainly in foreign countries, and the study results have been inconsistent. Thus, this study attempted to look at the factors affecting both the pre-diabetes stage and the development of diabetes in RA patients in Korea, and also sought to find risk factors for the development. For this purpose, data from RA patients aged 40 to 69 (n=501) were used among the community-based cohort data from the Korean Genome Epidemiology Study of the Korea Disease Control and Prevention Agency. Simple logistic regression was used to investigate factors influencing the development of pre-diabetes and diabetes. As a result, the prevalence of both pre-diabetes and diabetes in RA patients was found to be higher than that in the general population. RA patients’ risk of developing diabetes was higher if they were female, older, less educated, or had a larger waist circumference, higher body mass index, higher blood pressure, lower triglycerides, and lower high-density lipoprotein cholesterol. However, no association between RA and diabetes was found in factors such as marital status, income, occupation, fatigue, sleep time, smoking, and physical activity. The reason why the association was not found in factors such as the physical activity was discussed in the context of statistical errors made in the process of categorizing the raw data. Despite such weaknesses, the significance of this study was that it was an attempt to pursue the association between RA and diabetes based on demographic, physical measurement, and hematologic data.

광역시와 광역도 거주자의 우울경험 여부에 대한 분류 분석

This study attempted to determine the importance of variables that affect whether personal factors and health levels between metropolitan cities and provinces experience depression. The data for this study was used from the Korea Disease Control and Prevention Agency's 2021 Community Health Survey. 4,602 data from metropolitan cities were used, and 19,545 data from metropolitan provinces were used. The big data used in data analysis was subjected to frequency analysis, T-test, variance analysis, and Random Forest analysis, a machine learning technique, using R 4.3.0 for Windows. As a result of the study, there was no problem of overfitting between train and test data, and the classification model of the machine learning technique was found to be at about 94%. As a result of the analysis, the importance of experiencing depression was different between large cities and local cities. It is believed that more efficient policy establishment will be possible by approaching the causes of depression experienced by citizens in the two regions differently.

Comparison of pediatric injury patterns before and during the COVID-19 pandemic in Korea: a retrospective study.

The COVID-19 pandemic led to significant changes in the lifestyle patterns of children and affected the patterns of pediatric injuries. This study analyzed the changing patterns of pediatric injury overall and by age groups, based on the datasets before and during the COVID-19 pandemic. This study is based on the data of patients who presented with injuries at 23 hospital emergency departments participating in the Emergency Department-based Injury In-depth Surveillance (EDIIS) conducted by the Korea Disease Control and Prevention Agency. The surveillance data was categorized by injury mechanism, location, activity, and severity. We analyzed the injury patterns of pediatric patients aged 0 to 15 years. Subgroup analysis was conducted by age group in children aged 7 to 15 years, 1 to 6 years, and <1 year. When comparing the COVID-19 pandemic period to the pre-COVID-19 period, the total number of pediatric patients with injuries decreased by 38.7%, while the proportions of in-home injuries (57.9% vs. 67.9%), and minor injuries (38.9% vs. 39.7%) increased. In the 7 to 15 years group, bicycle riding injuries (50.9% vs. 65.6%) and personal mobility device injuries (2.4% vs. 4.6%) increased. The 1 to 6 years group also showed an increase in bicycle accident injuries (15.8% vs. 22.4%). In the <1 year group, injuries from falls increased (44.5% vs. 49.9%). Self-harm injuries in the 7 to 15 years group also increased (1.6% vs. 2.8%). During the COVID-19 pandemic period, the overall number of pediatric injuries decreased, while injuries occurring at home and during indoor activities increased. Traffic accidents involving bicycles and personal mobility devices and self-harm injuries increased in the 7 to 15 years group. In the <1 year group, the incidence of falls increased. Medical and societal preparedness is needed so that we might anticipate these changes in the patterns of pediatric injuries during future infectious disease pandemics.

Seasonality of syphilis in males through the 2011 to 2019 mandatory surveillance period: A cross-sectional study in South Korea.

Although the effects of seasonality on syphilis have been discussed previously, no previous study has evaluated the seasonality of syphilis incidence by sex and age group. We examined the seasonality of syphilis incidence by sex and age group in Korea from 2011 to 2019. The incidence of syphilis was calculated on the basis of Korea Diseases Control and Prevention Agency data, and an autoregressive integrated moving average (ARIMA) model and seasonal and trend decomposition using Loess were used to analyze the seasonality of the incidence in relation to epidemiological factors. The annual age-standardized incidence rates of primary, secondary, and congenital syphilis were 21.1, 8.8, and 64.0 cases/million persons, respectively, from 2011 to 2019. The highest incidence rates for primary and secondary syphilis were observed among those aged 20 to 29, 13 to 19, and 30 to 49 years, but not among the lower age groups. In analyses based on the ARIMA model, all univariate time series showed the highest goodness-of-fit results with ARIMA for primary syphilis (1,1,2), secondary syphilis (1,1,1), and congenital syphilis (0,1,2) (2,0,0) models. This study suggests that the incidence of secondary syphilis shows a summer seasonality for males and the highest incidence rate in the 20 to 29-year age group for both males and females in Korea. Public health action is needed to prevent an increase in syphilis incidence associated with sex, age group, and seasonal patterns.