Impact of COVID-19 Pandemic on Tuberculosis Preventive Services and Their Post-Pandemic Recovery Strategies: A Rapid Review of Literature

Background@#Coronavirus disease 2019 (COVID-19) pandemic has disrupted tuberculosis (TB) care and prevention around the world. The aim of this study is to review literature on the impact of COVID-19 on TB preventive services and discuss their policy options during and after the pandemic. @*Methods@#We conducted a rapid review of scientific literature on the impact of COVID-19 on TB preventive services and their recovery strategies. After conducting a line-by-line open coding, their codes were applied in the descriptive theme building process, which was guided by the End TB strategy. TB preventive measures were selected and classified into five analytical categories: 1) vaccination against TB, 2) detection and treatment of latent TB infection (LTBI), 3) screening and diagnostics, 4) active case finding and contact tracing, and 5) surveillance. @*Results@#We identified 93 articles, of which 65 were research articles. During the pandemic, we observed decrease in Bacillus Calmette-Guérin (BCG) coverage, TB diagnostic services, case finding activities, and LTBI management. TB case detection was declined, which was not resumed to the pre-pandemic level after loosening the lock-down. Several recommendations were highlighted: 1) secure BCG stocks and its supply chains, 2) consider catch-up activities of routine immunization and LTBI screening, 3) maintain minimal TB health services, infection prevention and control, and surveillance, 4) leverage laboratory capacity and contact tracing mechanisms, 5) consider simultaneous testing for TB and COVID-19, and 6) Incorporate digital health technologies. @*Conclusions@#Our findings and lessons learnt from the pandemic can aid in the development of future national TB control program.

A Comparative Analysis of Healthcare-Associated Infection Policy in South Korea and Its Implications in Coronavirus Disease 2019 / 보건행정학회지

Background@#Infection prevention and control (IPC) to manage healthcare-associated infection (HCAI) has emerged as one of the most significant public health issues in Korea. The purpose of this study is to draw implications in IPC policies by analyzing the context, process, and major actors in policy development and comparatively analyzing IPC policy contents of Korea with three other countries. Additionally, IPC policies were analyzed in the context of coronavirus disease 2019 (COVID-19) to provide implications for future pandemics and HCAI events. @*Methods@#This study incorporates a qualitative approach based on document and content analysis, applying codes and thematic categorization. IPC policy contents are comparatively analyzed by adopting the concept model, developed by the World Health Organization, which consists of core components of IPC structure at the national and facility level. @*Results@#National IPC policies were developed within a complex social and political context, through the involvement of various stakeholders. IPC policies in Korea place a high emphasis on establishing IPC programs and built environments in healthcare facilities, whereas there were potentials for improvement in policies involving patients and promoting a safety culture. IPC policies, which currently focus on general hospitals and certain functions of hospitals, should further be expanded to target all healthcare facilities and functions, to ensure more efficient and sustainable IPC responses in the current and future disease outbreaks. @*Conclusion@#IPC is a complex policy arena and lessons learned from the analysis of existing policies in the context of COVID-19 should provide valuable strategic implications for future policies.

Effect of Probiotic Lactobacillus (Lacidofil(R) Cap) for the Prevention of Antibiotic-associated Diarrhea: A Prospective, Randomized, Double-blind, Multicenter Study

Antibiotic-associated diarrhea (AAD) is a common complication of antibiotic use. There is growing interest in probiotics for the treatment of AAD and Clostridium difficile infection because of the wide availability of probiotics. The aim of this multicenter, randomized, placebo-controlled, double-blind trial was to assess the efficacy of probiotic Lactobacillus (Lacidofil(R) cap) for the prevention of AAD in adults. From September 2008 to November 2009, a total of 214 patients with respiratory tract infection who had begun receiving antibiotics were randomized to receive Lactobacillus (Lacidofil(R) cap) or placebo for 14 days. Patients recorded bowel frequency and stool consistency daily for 14 days. The primary outcome was the proportion of patients who developed AAD within 14 days of enrollment. AAD developed in 4 (3.9%) of 103 patients in the Lactobacillus group and in 8 (7.2%) of 111 patients in the placebo group (P=0.44). However, the Lactobacillus group showed lower change in bowel frequency and consistency (50/103, 48.5%) than the placebo group (35/111, 31.5%) (P=0.01). Although the Lacidofil(R) cap does not reduce the rate of occurrence of AAD in adult patients with respiratory tract infection who have taken antibiotics, the Lactobacillus group maintains their bowel habits to a greater extent than the placebo group.

The Associations between Social Support, Health-Related Behaviors, Socioeconomic Status and Depression in Medical Students / 한국역학회지

OBJECTIVES: The objective of this study was to estimate the prevalence of depression in medical students and to evaluate whether interpersonal social support, health-related behaviors, and socio-economic factors were associated with depression in medical students. METHODS: The subjects in this study were 120 medical students in Seoul, Korea who were surveyed in September, 2008. The subjects were all women and over the age of 20. Their age, body mass index (BMI), quality of sleep, diet, household income, smoking, alcohol consumption, exercise levels, and self-reported health status were surveyed. The degree of perceived social support was measured using the interpersonal support evaluation list (ISEL). Depression was evaluated using the center for epidemiology studies depression scale (CES-D). RESULTS: The mean CES-D score was 14.1+/-8.6 and 37.1% of the participants appeared to suffer from depression. Low levels of perceived interpersonal support increased the risk of depression by more than 10 times and having higher household income did not necessarily decrease the risk of depression. CONCLUSION: Medical students have a relatively high level of depression. Efforts should be made to encourage social support in order to promote mental health in medical students.

Body Weight at Birth and at Age Three and Respiratory Illness in Preschool Children / 예방의학회지

OBJECTIVES: The purpose of this study was to examine the associations of current body weight and body mass index (BMI) at age three and birth weight in developing chronic respiratory illness in childhood and identify possible interaction underlying its mechanism. METHODS: The study was carried out with 422 children who were enrolled in a hospital-based birth cohort. Birth related anthropometric data were collected at birth. At age 3 years, the presence of respiratory symptoms was evaluated by using the Korean version of core questionnaire for wheezing and asthma from the International Study of Asthma and Allergies in Childhood (ISAAC). Physical examination was carried out to measure the child's weight and height. RESULTS: Children in the lowest birth weight tertile (aOR = 3.97, 95% CI = 0.94-16.68) or highest BMI tertile (aOR = 3.68, 95% CI = 1.24-10.95) at three years of age were at an increased risk of chronic respiratory illness. Children who were initially in the lowest birth weight tertile but now belong in the highest weight tertile had higher risk of chronic respiratory illness compared to those who had remained in the middle tertile (OR=16.35, 95% CI=1.66-160.57). CONCLUSIONS: Children with lower birth weight or higher BMI were at an increased risk of chronic respiratory illness. In addition, children who were initially in the lowest birth weight tertile but are now in the highest weight tertile had higher risk of chronic respiratory illness compared to those who remained in the middle tertile.