Estimated impact of the national hepatitis B immunization program on acute viral hepatitis B among adolescents in Republic of Korea

Objectives We aimed to estimate the impact of the national hepatitis B immunization program on the incidence of acute hepatitis B infection among adolescents in South Korea. Methods We estimated the counterfactual incidence rate of reported acute hepatitis B among adolescents from 2016 to 2020 compared to the assumption that the national hepatitis B immunization program for children had not been implemented since 1995. The impact of the national hepatitis B immunization program for adolescents was measured by estimating the absolute risk reduction and averted acute hepatitis B infections among adolescents from 2016 to 2020 attributed to the national immunization program. Results The relative risk reduction of acute hepatitis B among adolescents was estimated to be 83.5% after implementing the national hepatitis B immunization program. The incidence rate of reported acute hepatitis B infections among adolescents decreased from 0.39 to 0.06 per 100,000 person-years, and 43 acute hepatitis B infections, including 17 symptomatic cases, were averted annually from 2016 to 2020 by the national hepatitis B immunization program. Conclusion The national hepatitis B immunization program for children was effective in preventing acute hepatitis B infection among adolescents in South Korea

Association between face covering policies and the incidence of coronavirus disease 2019 in European countries

Objectives This study was conducted to determine the impact of the strengthening or relaxation of face covering mandates on the subsequent national case incidence of coronavirus disease 2019 (COVID-19) in Europe as the full vaccination rate was increasing. Methods European countries in which case incidence increased for 3 consecutive weeks were monitored and analyzed using COVID-19 incidence data shared by the World Health Organization (WHO). The epidemic trend of COVID-19 in Europe was compared with that of countries elsewhere in the world based on WHO weekly epidemiological reports from June 20 to October 30, 2021. In addition, this study provided insight into the impact of government mask mandates on COVID-19 incidence in Europe by measuring the index scores of those facial covering policies before and after mandate relaxation or strengthening. The effects of the vaccination rate and the speed of vaccination on COVID-19 incidence were also analyzed. Results The incidence of COVID-19 after the relaxation of face covering mandates was significantly higher than before relaxation. However, no significant difference was observed in vaccination rate between countries with increased and decreased incidence. Instead, rapid vaccination delayed the resurgence in incidence. Conclusion The findings suggest that face covering policies in conjunction with rapid vaccination efforts are essential to help mitigate the spread of COVID-19

Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates

Objectives Although it is widely used as a measure for mortality, the case fatality rate (CFR) of coronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons other than viral characteristics. To compare the CFRs of different countries in equal measure, we estimated comparable CFRs after adjusting for multiple covariates and examined the main factors that contributed to variability in the CFRs among 21 countries. Methods For statistical analysis, time-series cross-sectional data were collected from Our World in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated by pooled generalized linear squares regression models for the panel data. Covariates included the predominant virus variant, reproduction rate, vaccination, national economic status, hospital beds, diabetes prevalence, and population share of individuals older than age 65. In total, 21 countries were eligible for analysis. Results Adjustment for covariates reduced variation in the CFRs of COVID-19 across countries and over time. Regression results showed that the dominant spread of the Omicron variant, reproduction rate, and vaccination were associated with lower country-level CFRs, whereas age, the extreme poverty rate, and diabetes prevalence were associated with higher country-level CFRs. Conclusion A direct comparison of crude CFRs among countries may be fallacious, especially in a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over time for a more proper comparison. In addition, our findings suggest that comparing CFRs among different countries without considering their context, such as the epidemic phase, medical capacity, surveillance strategy, and socio-demographic traits, should be avoided

Military Real-time Syndromic Surveillance System for Biosurveillance Portal in Korea

As a part of the Korea-US joint Biosurveillance Portal project, we have developed the military syndromic surveillance system with electronic medical records from military hospitals for early identification of bio-terror related events among Armed Forces in Korea. Respiratory, Gastrointestinal, Botulism, Dermatologic, Neurologic, Hemorrhagic and Fever syndromes were defined by different ICD-10 codes and their alert thresholds were developed based on the characteristics of time series derived using daily counts of ICD-10 codes for each syndrome

The association of major depressive episodes with income inequality and the human development index

The aim of this study was to estimate the association between country income distribution and human development with the 12-month occurrence of major depressive episodes across countries. A total of 251,158 people surveyed by the World Health Organization from 2002 to 2003 from 65 countries were included in the study. The survey contained items for identifying major depressive episodes (MDE) in the previous 12 months, attained education (used as an indicator of individual socioeconomic status) and other demographic information. Income inequality was measured with the Gini index, a national-level indicator; the United Nations human development index (HDI) measured overall country development. Country-level and multilevel linear regression models were utilized to study the associations. We found that moderately developed countries had the lowest adjusted prevalence of MDE followed by high and low developed countries. The Gini index was positively associated with major depressive episodes, but only among high HDI countries. After adjusting for age, gender, marital status, education and HDI, the multilevel prevalence ratio indicated a 4% increase in risk of MDE for a person living in a country associated with a 1% increment in income equality. This finding means, for example, that comparing two highly developed countries, one with low income inequality (Gini = 0.25) with another with high income inequality (Gini = 0.39), one would expect to see an increase in the prevalence of MDE from 4.0% to 6.2%. These findings raise important questions about the role of income inequality on social forces that can lead to depression.Income inequality Human development index Major depressive episode Mental health Multilevel modeling World Health Organization (WHO)