Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions / 한국역학회지

The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.

Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions / 한국역학회지

The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.

Children with COVID-19 after Reopening of Schools, South Korea

Purpose@#To describe pediatric coronavirus disease 2019 (COVID-19) cases after the reopening of schools in the Republic of Korea and their transmission routes. @*Methods@#All case report forms and epidemiologic investigation forms for children aged 3–18 years reported as COVID-19 cases to the National Notifiable Disease Surveillance System from May 1 to July 12, 2020, were reviewed. @*Results@#After the schools were reopened in May 2020, a total of 127 pediatric COVID-19 cases were confirmed until July 12. Of these, 59 children (46%) were exposed to severe acute respiratory syndrome coronavirus 2 through family and relatives, followed by 18 children (14%) through cram schools or private lessons, 8 children (6%) through multi-use facilities, and 3 children (2%) through school. @*Conclusions@#The present data do not suggest an increased risk of COVID-19 transmission in the context of stringent school-based infection prevention measures introduced across the country.

Children with COVID-19 after Reopening of Schools, South Korea

Purpose@#To describe pediatric coronavirus disease 2019 (COVID-19) cases after the reopening of schools in the Republic of Korea and their transmission routes. @*Methods@#All case report forms and epidemiologic investigation forms for children aged 3–18 years reported as COVID-19 cases to the National Notifiable Disease Surveillance System from May 1 to July 12, 2020, were reviewed. @*Results@#After the schools were reopened in May 2020, a total of 127 pediatric COVID-19 cases were confirmed until July 12. Of these, 59 children (46%) were exposed to severe acute respiratory syndrome coronavirus 2 through family and relatives, followed by 18 children (14%) through cram schools or private lessons, 8 children (6%) through multi-use facilities, and 3 children (2%) through school. @*Conclusions@#The present data do not suggest an increased risk of COVID-19 transmission in the context of stringent school-based infection prevention measures introduced across the country.

Public health emergency preparedness and response in Korea

Infectious disease control and prevention in Korea are handled based on laws such as the Framework Act on the Management of Disasters and Safety and the Infectious Disease Control and Prevention Act. To fill the gaps in the national public health system that were identified during the 2015 Middle East respiratory syndrome outbreak in Korea, Korea has strengthened its capacity to prepare for and respond to public health emergency. The objectives are to prevent, promptly detect, and rapidly respond to imported infectious diseases; to fully mobilize public health and medical resources; to revise governance enhancing the role of the centralized decision-making structures; and to improve health care facilities to prevent health care-associated infections.

Government Measures against Pandemic Influenza

The alert regarding the emergence of novel influenza was issued by the WHO on April 24th, and the government has taken immediate actions to respond to the situation since then. Based on the presumption that a pandemic was imminent, countermeasures for the H1N1 influenza pandemic have been prepared by establishing and implementing effective public health crisis strategies over the past few years. Our main strategy during the pandemic influenza crisis has shifted in accord with the corresponding National Disaster Phases. In the Caution (Containment) Phase, our main goal was to contain the influx of disease from overseas. We focused on measures such as entry screening and quarantine inspection while monitoring travelers arriving from affected countries. In the Alert Phase I, our aim was deceleration and prevention of secondary community outbreaks through enhanced early detection. We intensified our surveillance and response system for possible mass outbreaks. During Alert Phase II, as the influenza had spread widely, our tactics switched to minimizing social and economic impact and preventing severe cases with early administration of antiviral agents, especially among high-risk patients. In the current Severe Phase, we are trying to reduce mortality cases with intensive care. Since we have implemented mass vaccination, we predict an early termination of the pandemic.

National Organ Transplantation Policy

Despite the increasing numbers of patients in need of organ transplantation following the increasing prevalence of chronic diseases such as CRF, chronic liver disease, disparities between the supply and demand of transplantable organs are getting increasingly widened. After the "Organ transplatation act" is enacted in 2000, brain death organ is equitably allocated by KONOS and illegal organ bargains are nearly eradicated. But unfortunately, brain death organ donation is not sufficiently activated, because of immature organ donation culture, absence of notification of potential brain death and active organ procurement system, and inflexibe organ donation processes. Ministry of Health and Welfare had made the comprehensive activation plan to solve the organ shortage problems, to increase organ procurments and transplantations at Oct. 2005. The major measures are strengthening the PR and education about organ donation, introduction of notification of potential brain death, and establishment of active organ procurement system through organ procurement organizations, strengthening of national responsibility and support.

National Blood Policy for Safe and Adequate Blood Supply

The Korea national blood services has been established since 1970 when the "Blood management law" was enacted. National blood services grew fast through 1980~1990 and the voluntary non-remunerated blood donation system was introduced successfully. However, blood-transmissible infections such as HIV, HCV, and HBV were documented since 2000, which compromised the confidentiality of national blood services. In 2004, the Korean government established the? National Blood Safety Plan? for the provision of safe and adequate blood supply. The major measures include the expansion of blood collection centers, improvement of blood screening laboratories, introduction of an investigation and compensation system of blood transfusion-related adverse events, introduction of blood transfusion guidelines and hospital blood services commitment, evolution of a national blood services organization, and the strengthening of national responsibility and support.

Sentinel Surveillance System for Pediatric Communicable Diseases / 한국역학회지

PURPOSE: The purpose of this study is to review the process for establishing a pediatric communicable diseases sentinel surveillance system, and the results of operation based on the accumulated data to understand the descriptive epidemiologic characteristics of pediatric communicable diseases. METHODS: A sentinel surveillance system for pediatric communicable diseases was developed in May 2001 with the 202 doctors in pediatric clinics who participated voluntarily. The target diseases for sentinel surveillance were measles, mumps, rubella, chicken pox and aseptic meningitis. The case definitions of those diseases for surveillance were divided into confirmed cases and suspected cases by the diseases definitions of national notifiable diseases system. The participants should report as soon as possible when they diagnosed measles, mumps, rubella cases including suspected ones. But chicken pox and aseptic meningitis cases were reported once a week in regular base including zero report. We collected the data from May 2001 to December 2003 and showed the descriptive epidemiologic characteristics of each disease. RESULTS: The average reporting proportion among survellance doctors has been increased, about 88% in 2003. For measles, 206 cases were reported in 2001, 10 cases in 2002, and 2 cases in 2003. Children under the age of 2 (53.4 %) showed the highest. Among the measles cases, 86.4% had no previous vaccination history. In case of mumps, 246 cases in 2001, 241 in 2002, and 566 cases in 2003 were reported. Mumps showed seasonality, highest from April to June in each year. The sex ratio was about 1.5(M:F = 6:4). Among the reported cases, 76.9 % had previous MMR immunization history at least one time. For Rubella, 9 cases in 2001, 3 in 2002, and no case were reported in 2003. The chicken pox case proportion per 100 pediatric consultations showed peak in from May to June and from November to January. 3-5 year-old children (45.7%) were showed high proportion by age. CONCLUSION: This study described the process of establishing and operating a system for the pediatric communicable disease sentinel surveillance. We analyzed the desriptive epidemiologic characteristic of the reported data from May 2001 to December 2003. These data maybe useful to build the policy of public health management for communicable diseases control system and vaccine preventable diseases.

Early Aberration Reporting System Modelling of Korean Emergency Syndromic Surveillance System for Bioterrism

PURPOSE: This study were designed to supply the opportunity to make a base of emergency syndromic surveillance warning system to detect the bioterrors through the construction of predictive models which were made by reported patients in 'Emergency Syndromic Surveillance System' who were diagnosed as waterborne contagious diseases. METHODS: On this study, we used the neural network analysis methods among the data mining to analyze the reliable variables which was extracted from the reported data bases in the Emergency Syndrome Surveillance System. RESULTS : In this study, we were using the patients data pools from 13th May 2002 to 13th May 2003 in Emergency Syndrome Surveillance System. So we could get the reliable variables - clinical symptoms, severity of patient, humidity and temperature - to predict the waterborne infections. This study shows the successful predictation rate of 96% in error rate of 0.4 with sensible variables through Chisquare analysis and the construction of one hidden layer which is near linearity. CONCLUSION: Early emergency syndromic surveillance warning models made by the neural network in Emergency Syndrome Surveillance System could make the early detection of waterborne infections, could also stop the transmission of waterborne infections in early stage, and furthermore could be used as the preventive and detective methods of bioterror attacks.

Analysis of Early Results from the Emergency Department Syndromic Surveillance System for Bioterrorism

PURPOSE: This study reviewed the development of and analyzed the early results from syndromic surveillance based on emergency departments, which was developed to detect bioterrorism attacks, especially during the 2002 FIFA Korea-Japan World Cup games. METHOD: Data from homepages and server computers were analyzed from May 13 2002, to August 5 2002. The data were gathered everyday from 121 emergency departments in Korea via the internet by using PC or PDA. Some data gathered via telephone or FAX were also digitalized. RESULTS: The daily report rate was 82.5% on average. Most of the cases were acute respiratory syndrome (63.4%) and acute sporadic diarrheal syndrome (34.8%). No bioterrorism was confirmed during this period. The peak times and distributions of sporadic and cluster cases of acute diarrheal syndrome are not equivalent. In the case of level 2 reports, there was an average of 12 cases per one institute and 32.8 cases per institute of level 1 and 2 reports totally. CONCLUSIONS: The emergency department syndromic surveillance system for bioterrorism is the first everyday reporting system based on the clinical basis in emergency depart-ments. It has been and is functioning without large problems, but exact knowledge of and more participation by reporting institutes are required. It is necessary to survey the results for a longer period and to correct the early problems if we want to know the ultimate usefulness of this system.

Surveillance and Management of Notifiable Communicable Diseases

Communicable diseases are a continuing menace to all people. Although some diseases have been conquered by antibiotics and vaccines, new ones are constantly emerging (such as HIV/AIDS, Legionnaires' disease), while others re-emerging (such as malaria, shigellosis). In 2000, the communicable disease control law had been amended to cope with emerging and re-emerging infectious diseases. The important amendatory contents are revision of statutory communicable diseases (3 class, 29 → 5 groups,63), shortening of the reporting time(group I,II,IV, immediately ; group III, V, within 7 days), and introduction of sentinel surveillance system, EDI reporting system, and reporting criteria.

The Strategic Plans for Preparedness and Response to Bioterrorism

Since bioterrorism has become reality after its occurrence in USA, our goverment is preparing and conducting strategic plans for preparedness and response to bioterrorism. The major plans consist of reinforcement of surveillance of notifiable communicable diseases, construction of supplementary surveillance systems, organization of emergency department and infection specialists networks, strengthening of laboratory capacity and network, and establishment of a stepwise response plan according to risk assessment. For the preparedness for bioterrorism, we are preparing a national pharamaceutical stockpile (antibiotics, smallpox vaccine, etc) and strengthening the organization, law, epidemiologic capacity, research, and management of critical infectious agents. It is very difficult to predict the risk of bioterrorism, which may be very low. Nevertheless, the complete preparedness is necessary to prevent social confusion by bioterrorism. Especially, phisician's role in response to bioterrorism such as case detection, report, management, and treatment is very important.

Epidemiologic Investigation of an Outbreak of Shigellosis in Kyongju, Korea / 예방의학회지

OBJECTIVES: This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among pupils of "M" primary school and residents near the school in Kyongju from Sept. 24 to Oct. 24, 1998. METHODS: The subjects who completed a questionnaire and a rectal swab for microbiologic examinations were 1,534 persons (781 males, 753 females), including 469 pupils of "M" primary school (268 males, 201 females). Bacteriological examinations of underground water and simple piped water were done. RESULTS: The attack rate of diarrhea was 28.7% in the subjects from Sept. 24 to Oct. 24, 1998. There was no difference in attack rate of diarrhea by gender, but it was significantly higher in the pupils of "M" primary school than others (p<0.01). The attack rate of diarrhea by resident areas was no different to the pupils of "M" primary school, but was significantly higher in the residents of Mohwa 2 Ri except pupils that "M" primary school is located in (p<0.01). The distribution of date of onset revealed the exposure date to be Sept, 22 and 23 in consideration of incubation periods and common source outbreak followed propagative spread in the epidemic curve. The major characteristics of diarrhea were watery (89.1%) in nature, 1~3 days (72.5%) in duration, 2~3 times (63.9%) in frequency. The clinical symptoms among the diarrheal cases included abdominal pain (74.1%), fever (56.4%), headache (55.9%), chill (40.4%) and tenesmus (31.4%). CONCLUSIONS: The source of infection was estimated to be contaminated underground water and simple piped water caused by leakage from the cess pool. It is highly necessary that the management of drinking water and cess pools should be done thoroughly.

A study on the practice variations according to physician characteristics / 예방의학회지

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount(total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners(GP), 107 regular family physicians(FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites(urban-rural). Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.

A comparison of reminder models for increasing compliance forcervical cancer screening in a family practice setting

No abstract available.

A quick measurement of stress in outpatient clinic setting

No abstract available.