Epidemiology and Health

Volume 43; 2021

Original Article

Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis: Hwa Jeong Seo, Hyun Sook Oh; Epidemiol Health. 2021;43:e2021103. Published online December 17, 2021; DOI: https://doi.org/10.4178/epih.e2021103

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Abstract

OBJECTIVES
This study investigated the effectiveness of early medication treatment and metformin use for cancer prevention in type 2 diabetes patients.

METHODS

Population-based cohort data were used from the Korean National Health Insurance Service-National Sample Cohort database (KNHIS-NSC) for 2002-2013. Patient-specific medication prescription status was defined by the landmark time (LMT; a fixed time after cohort entry), considering both pre- and post-LMT prescriptions to control methodological biases in observational research. The LMT was set to 2 years. Logistic regression analysis with multivariable adjustment was conducted to analyze cancer incidence by patient-specific medication prescription status.

RESULTS

Only 33.4% of the subjects were prescribed medication early (before the LMT) with compliance. Cancer incidence in individuals with early prescription and compliance was 25% lower (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.67 to 0.84) than in those without. As early-prescribed medications, metformin monotherapy and metformin combination therapy were associated with 34% (OR, 0.66; 95% CI, 0.51 to 0.83) and 25% (OR, 0.75; 95% CI, 0.64 to 0.88) lower cancer risk than non-use, respectively. Patients who were prescribed late (post-LMT) but did not comply with the prescription had a 24% (OR, 1.24; 95% CI, 0.97 to 1.58) higher cancer incidence than non-users. Among patients who started monotherapy early without changes throughout the entire follow-up period, those who started on metformin had a 37% (OR, 0.63; 95% CI, 0.41 to 0.99) lower risk of cancer than non-metformin users.

CONCLUSIONS

Doctors must prescribe antidiabetic medication early, and patient compliance is required, regardless of the prescription time, to prevent cancer. Metformin monotherapy or combination therapy is recommended as an early prescription.

Summary

Korean summary
당뇨 환자는 암 발병 위험이 높으며 암은 주요 사망 원인이다. 당뇨환자의 암발생 예방을 위한 관리로서, 당뇨병 진단 후 약물 치료 시기에 대한 연구는 부족하다. 또한, 전 세계적으로 가장 흔히 처방되는 당뇨병 치료제인 메트포민은 암 예방 효과가 있다고 알려져 왔으나 관측연구에서 발생하는 선택 편향의 문제가 제기되었고, 최근 일부 연구에서 기존의 암 예방 효과와 상충되는 결과가 나오고 있어 논쟁이 이어지고 있다. 본 연구는 선택 편향을 통제한 코호트 연구에서 조기 약물 치료와 메트포민 사용이 당뇨환자의 암 예방에 효과적임을 밝혔다. 따라서 의사들은 처음 당뇨 진단을 받은 환자에게 조기에 약물 처방을 하고, 환자들은 처방에 잘 따라야 한다. 조기 처방 약물로서 메트포민이 권장된다.

Key Message
Diabetic patients have a high risk of developing cancer, and cancer is the leading cause of death. There are few studies on the timing of medication treatment after diagnosis of diabetes. In addition, metformin, the most commonly prescribed diabetes treatment worldwide, is known to have cancer-preventive effects, but the problem of selection bias that occurs in observational studies has been raised, and some studies have recently been contradicting the existing cancer-preventing effects of metformin. This study, in a cohort study controlled for selection bias, demonstrated that early medication treatment and metformin use were effective in preventing cancer in diabetic patients.

Citations

Citations to this article as recorded by

Association between metformin use and the risk of developing open-angle glaucoma among patients with diabetes: a retrospective cohort study and meta-analysis
Hong Kyu Kim, Wanhyung Lee, Ik Hee Ryu, Jin Kuk Kim, Hyungsu Kim, Tae Keun Yoo
International Ophthalmology.2024;[Epub] CrossRef
Metformin and HER2-positive breast cancer: Mechanisms and therapeutic implications
Sara S Bashraheel, Hadeel Kheraldine, Sarah Khalaf, Ala-Eddin Al Moustafa
Biomedicine & Pharmacotherapy.2023; 162: 114676. CrossRef
Effects of millimeter-wave for preventing joint stiffness in the immobilized knee rat model
Xiao-ping Shui, Feng Ye, Chun-ying Li, Xin Zhang, Min-jia Wang, Bin Li, Ke Chen, Ying-ying Liao
The Knee.2023; 42: 236. CrossRef

Editorial

Spatiotemporal analyses of the epidemiological characteristics of diabetes mellitus: Sang Youl Rhee; Epidemiol Health. 2021;43:e2021102. Published online December 16, 2021; DOI: https://doi.org/10.4178/epih.e2021102

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Abstract Summary PDF

Abstract

Research based on spatiotemporal analysis has been conducted to identify various factors that can affect an individual’s or community’s degree of health and disease. These spatiotemporal studies can effectively illustrate patterns in disease frequency, features, and temporal flow in different parts of a country. Furthermore, identifying these regional characteristics can aid in the development of disease prevention or intervention strategies.

Summary

Korean summary
1. 시공간 분석은 국가 혹은 지역의 질병 빈도, 특징 및 시간 흐름의 패턴을 효과적으로 설명할 수 있다. 2. 시공간 분석은 질병의 예방 또는 중재 전략 개발에 도움이 될 수 있다.

Key Message
1. Spatiotemporal analyses can effectively illustrate patterns in disease frequency, features, and temporal flow in different parts of a country. 2. Spatiotemporal analysis can aid in disease prevention or development of intervention strategies.

Citations

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Epidemiological characteristics and spatiotemporal analysis of mumps at township level in Wuhan, China, 2005–2019
Ying Peng, Peng Wang, De-guang Kong, Wen-zhen Li, Dong-ming Wang, Li Cai, Sha Lu, Bin Yu, Bang-hua Chen, Pu-Lin Liu
Epidemiology and Infection.2023;[Epub] CrossRef

Original Article

Late eating, blood pressure control, and cardiometabolic risk factors among adults with hypertension: results from the Korea National Health and Nutrition Examination Survey 2010-2018: Jee-Seon Shim, Hyeon Chang Kim; Epidemiol Health. 2021;43:e2021101. Published online November 24, 2021; DOI: https://doi.org/10.4178/epih.e2021101

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Abstract

OBJECTIVES
Despite growing concerns regarding the timing of eating, little is known about the association between late eating and health. This study aimed to investigate whether late eating is associated with blood pressure (BP) control and cardiometabolic risk factors among Korean adults with hypertension.

METHODS

Data from the Korea National Health and Nutrition Examination Survey 2010-2018 were used. Adults with hypertension aged 30-79 years (n=13,361) were included in this study. Dietary intake and information on meal timing were assessed using 1-day 24-hour recall. Late eating was defined as after the median midpoint between the times of the first and the last eating episode during the recall day. Logistic and linear regression models were used to estimate the associations of late eating with BP control and cardiometabolic risk factors.

RESULTS

Among late eaters, there were more men than women. Compared to early eaters, late eaters were younger, had a higher body mass index (BMI) and unhealthier habits, and their overall dietary quality score was lower. A negative association between late eating and BP control was found in a univariate model (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.94 to 1.12), but this association disappeared after adjustment for confounders (OR, 1.03; 95% CI, 0.94 to 1.12). Late eating was independently associated with higher BMI (p=0.03) and blood triglyceride concentration (p<0.01).

CONCLUSIONS

Our results do not support a link between late eating and BP control among adults with hypertension, but suggest that late eating is associated with cardiometabolic risk factors.

Summary

Korean summary
식사시간이 건강에 미치는 영향에 대한 관심이 증가하고 있지만, 이에 대한 근거는 많지 않다. 이 연구는 국민건강영양조사 자료를 활용하여 고혈압이 있는 성인의 늦은 식사와 혈압 조절, 심장대사 위험인자의 연관성을 분석하였다. 늦은 식사와 혈압 조절의 독립적 연관성은 찾지 못했지만, 늦은 식사는 높은 체질량지수, 혈중 지질 농도와 연관성을 보여 식사 시간 조정이 고혈압 환자의 예후 개선을 위한 유용한 대책이 될 수 있으리라는 근거를 지지한다.

Key Message
This study investigated whether late eating is associated with blood pressure (BP) control and cardiometabolic risk factors among Korean adults with hypertension using data from the Korea National Health and Nutrition Examination Survey 2010–2018. We did not find an independent association between late eating and BP control among Korean adults with hypertension, but found that late eating was significantly associated with higher BMI and a higher blood concentration of triglycerides, independent of potential confounders. Our findings support the suggestion that a time-based dietary approach can be used as a useful strategy to improve the prognosis of adults with hypertension.

Citations

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Eating patterns in Korean adults, 1998–2018: increased energy contribution of ultra-processed foods in main meals and snacks
Sukyoung Jung, Jee Young Kim, Sohyun Park
European Journal of Nutrition.2024; 63(1): 279. CrossRef
Association between time-of-day for eating, exercise, and sleep with blood pressure in adults with elevated blood pressure or hypertension: a systematic review
Thomas Keiser, Sarah Katz, Shannon M. Robson, Jody L. Greaney, Sean Healy, Susan K. Malone, Vahid Farrahi, Freda Patterson
Journal of Hypertension.2024; 42(6): 951. CrossRef
Relationship between omitting breakfast and late eating with obesity and metabolic disorders: a review focusing on chrononutrition
Gabriel da Silva Almeida, Manoela Oliveira De Souza, Leonardo Matthew Ribeiro Nunes Pereira
Journal Archives of Health.2023; 4(2): 466. CrossRef

COVID-19: Correspondence

Authors’ Reply: Vaccination, payment, and COVID-19: Jelena Dotlic, Vida Jeremic Stojkovic, Paul Cummins, Marija Milic, Tatjana Gazibara; Epidemiol Health. 2021;43:e2021100. Published online November 23, 2021; DOI: https://doi.org/10.4178/epih.e2021100

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Original Articles

Gender differences in under-reporting hiring discrimination in Korea: a machine learning approach: Jaehong Yoon, Ji-Hwan Kim, Yeonseung Chung, Jinsu Park, Glorian Sorensen, Seung-Sup Kim; Epidemiol Health. 2021;43:e2021099. Published online November 17, 2021; DOI: https://doi.org/10.4178/epih.e2021099

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study was conducted to examine gender differences in under-reporting hiring discrimination by building a prediction model for workers who responded “not applicable (NA)” to a question about hiring discrimination despite being eligible to answer.
METHODS
Using data from 3,576 wage workers in the seventh wave (2004) of the Korea Labor and Income Panel Study, we trained and tested 9 machine learning algorithms using “yes” or “no” responses regarding the lifetime experience of hiring discrimination. We then applied the best-performing model to estimate the prevalence of experiencing hiring discrimination among those who answered “NA.” Under-reporting of hiring discrimination was calculated by comparing the prevalence of hiring discrimination between the “yes” or “no” group and the “NA” group.
RESULTS
Based on the predictions from the random forest model, we found that 58.8% of the “NA” group were predicted to have experienced hiring discrimination, while 19.7% of the “yes” or “no” group reported hiring discrimination. Among the “NA” group, the predicted prevalence of hiring discrimination for men and women was 45.3% and 84.8%, respectively.
CONCLUSIONS
This study introduces a methodological strategy for epidemiologic studies to address the under-reporting of discrimination by applying machine learning algorithms.; Summary

Korean summary
본 연구는 한국노동패널조사(7차년도)에 포함된 3576명의 임금근로자의 자료를 이용해 성별에 따른 구직 과정 경험한 차별에 대한 과소보고의 규모를 확인하고자 하였다. 질문에 “예” 또는 “아니요”라고 응답한 임금근로자 3479명 데이터를 이용하여 고용 시 차별경험을 예측하는 머신러닝 모형을 구축하였고, 이를 활용해 이미 직장에서 일하고 있는 상태임에도 “해당사항 없음”이라고 응답한 임금근로자 97명이 차별을 경험했는지 여부를 예측하였다. 분석결과, “해당사항 없음”이라고 답한남성 근로자 64명 중 29명(45.3%), 여성 근로자 33명 중 28명(84.8%)가 실제로 차별을 경험한 것으로 추정되었다.

Key Message
We examined gender differences in under-reporting hiring discrimination for wage workers who responded “not applicable(NA)” to a question about hiring discrimination despite being eligible to answer “yes” or “no.” Using data from 3,576 wage workers of the Korea Labor and Income Panel Study, we estimated the prevalence of hiring discrimination among those who answered “NA,” based on the best-performing machine learning prediction model for “yes” or “no” group. Among the “NA” group, the predicted prevalence of hiring discrimination for men and women was 45.3% and 84.8%, respectively.

Spatiotemporal trends in diabetes-related mortality by school district in the state of Michigan, United States: Nurjannah Nurjannah, Kathleen M. Baker, Duduzile Phindi Mashinini; Epidemiol Health. 2021;43:e2021098. Published online November 9, 2021; DOI: https://doi.org/10.4178/epih.e2021098

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Abstract

OBJECTIVES
This study examined the spatiotemporal epidemiological status of diabetes-related death in relation to school district boundaries in the state of Michigan, United States.

METHODS

A retrospective observational study was conducted using death records spanning the years 2007-2014 in Michigan, with school districts as the geographic unit of analysis. Geocoding was performed for each death record. Cluster analysis used spatial autocorrelation with local Moran’s I, and spatiotemporal analysis used the Space Time Pattern Mining tool in ArcGIS Pro 2.1.

RESULTS

The study revealed spatial clusters of high-high locations of diabetes-related mortality rate by school district in Michigan from 2007 to 2014. Spatiotemporal analysis showed grids with intensifying, consecutive, sporadic, and persistent hotspots of diabetes-related death in the Lansing, Royal Oak, Flint City, Berkley, Detroit City, East Lansing, South Lake, and Holt public school districts. These school districts should be prioritized for school-based diabetes prevention programs

CONCLUSIONS

The study demonstrated the presence of various hotspots of diabetes-related deaths within the state of Michigan across the 8-year period of analysis. Understanding spatial and temporal hotspots could further improve our ability to evaluate diabetes burden across both time and space.

Summary

Key Message
Using existing secondary data with spatio-temporal analysis, the study identified diabetes-related death varies across space and time within the state of Michigan, USA at the school district level. This approach provided policy-relevant information to target high-risk school-district when having limited resources to prevent diabetes at schools.

Citations

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Spatiotemporal Epidemiological Trends of Mpox in Mainland China: Spatiotemporal Ecological Comparison Study
Shuli Ma, Jie Ge, Lei Qin, Xiaoting Chen, Linlin Du, Yanbo Qi, Li Bai, Yunfeng Han, Zhiping Xie, Jiaxin Chen, Yuehui Jia
JMIR Public Health and Surveillance.2024; 10: e57807. CrossRef
Asthma Hot Spots in New York Before and During the COVID-19 Pandemic
Samira Skochko, Trang Nguyen, Stephanie Mack, Brooke Turcotte, Catherine Adler, Eli S. Rosenberg, Christopher Joseph, Lynley Siag, Alexandra Dubuisson, Victoria L. Wagner
Preventing Chronic Disease.2024;[Epub] CrossRef
Spatiotemporal analyses of the epidemiological characteristics of diabetes mellitus
Sang Youl Rhee
Epidemiology and Health.2021; 43: e2021102. CrossRef

Real-world incidence of endopthalmitis after intravitreal anti-VEGF injections in Korea: findings from the Common Data Model in ophthalmology: Yongseok Mun, Seng Chan You, Da Yun Lee, Seok Kim, Yoo-Ri Chung, Kihwang Lee, Ji Hun Song, Young Gun Park, Young Hoon Park, Young-Jung Roh, Se Joon Woo, Kyu Hyung Park, Rae Woong Park, Sooyoung Yoo, Dong-Jin Chang, Sang Jun Park; Epidemiol Health. 2021;43:e2021097. Published online November 9, 2021; DOI: https://doi.org/10.4178/epih.e2021097

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Abstract

OBJECTIVES
The aim of this study was to evaluate the real-world incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (VEGF) injections using data from the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM).

METHODS

Patients with endophthalmitis that developed within 6 weeks after intravitreal anti-VEGF injections were identified in 3 large OMOP CDM databases.

RESULTS

We identified 23,490 patients who received 128,123 intravitreal anti-VEGF injections. The incidence rates of endophthalmitis were 15.75 per 10,000 patients and 2.97 per 10,000 injections. The incidence rates of endophthalmitis for bevacizumab, ranibizumab, and aflibercept (per 10,000 injections) were 3.64, 1.39, and 0.76, respectively. The annual incidence has remained below 5.00 per 10,000 injections since 2011 despite the increasing number of intravitreal anti-VEGF injections. Bevacizumab presented a higher incidence rate for endophthalmitis than ranibizumab and aflibercept (incidence rate ratio, 3.17; p=0.021).

CONCLUSIONS

The incidence of endophthalmitis after intravitreal anti-VEGF injections has stabilized since 2011 despite the explosive increase in anti-VEGF injections. The off-label use of bevacizumab accounted for its disproportionately high incidence of endophthalmitis. The OMOP CDM, which includes off-label uses, laboratory data, and a scalable standardized database, could provide a novel strategy to reveal real-world evidence, especially in ophthalmology.

Summary

Korean summary
- 공통데이터모델 (Observational Medical Outcomes Partnership Common Data Model, OMOP CDM)을 통해 유리체강내 항혈관내피성장인자 주입술 후 발생한 안내염의 실세계 발생률 (Real-world incidence)은 1만명 당 15.75명, 주사 1만회 당 2.97회였음을 알 수 있었다. - 베바시주맙에서 다른 항혈관내피성장인자에 비해 유리체강내 주사 후 안내염 발생 비율이 높았으며, 이는 약제의 분주로 인한 오염과 관련이 있을 것이다. - 공통데이터모델은 건강보험 청구자료가 포함하지 않는 유리체강내 베바시주맙 사용과 같은 오프라벨 의약품 사용 자료까지 포함하기 때문에, 유리체강내 항혈관내피성장인자 주입 후 발생한 안내염의 인구기반 발생률 추정을 가능케 했다.

Key Message
- The real-world incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (VEGF) injections was 15.75 per 10,000 patients and 2.97 per 10,000 injections based on data from the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). - Patients treated with bevacizumab showed a significantly higher incidence rate of post-injection endophthalmitis, which might have resulted from contamination related to the division of bevacizumab. - OMOP CDM provides insights into the population-based incidence rate of endophthalmitis since it covers off-label prescriptions including intravitreal bevacizumab, which the national claims database does not cover.

Citations

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Risk of post‐injection endophthalmitis peaks within the first three injections of anti‐vascular endothelial growth factor therapy: A nationwide registry‐based study
Benjamin Sommer Thinggaard, Frederik Pedersen, Ryo Kawasaki, Jimmi Wied, Yousif Subhi, Jakob Grauslund, Lonny Stokholm
Acta Ophthalmologica.2024;[Epub] CrossRef
Real-World Treatment Intensity and Patterns in Patients With Myopic Choroidal Neovascularization: Common Data Model in Ophthalmology
Manh-Hung Bui, Da Yun Lee, Sang Jun Park, Kyu Hyung Park
Journal of Korean Medical Science.2023;[Epub] CrossRef
Efficacy of Injection Interval Shortening in Neovascular Age-related Macular Degeneration with Limited Response to Bimonthly Aflibercept
Min Chul Kim, Jae Hui Kim
Journal of the Korean Ophthalmological Society.2023; 64(8): 700. CrossRef
Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome
Bar Davidov, Avi Ohayon, Omer Trivizki, Shulamit Schwartz, Shiri Shulman, Akio Oishi
Journal of Ophthalmology.2023;[Epub] CrossRef
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Real-world treatment intensities and pathways of macular edema following retinal vein occlusion in Korea from Common Data Model in ophthalmology
Yongseok Mun, ChulHyoung Park, Da Yun Lee, Tong Min Kim, Ki Won Jin, Seok Kim, Yoo-Ri Chung, Kihwang Lee, Ji Hun Song, Young-Jung Roh, Donghyun Jee, Jin-Woo Kwon, Se Joon Woo, Kyu Hyung Park, Rae Woong Park, Sooyoung Yoo, Dong-Jin Chang, Sang Jun Park
Scientific Reports.2022;[Epub] CrossRef
Blueprint for harmonising unstandardised disease registries to allow federated data analysis: prepare for the future
Johannes A. Kroes, Aruna T. Bansal, Emmanuelle Berret, Nils Christian, Andreas Kremer, Anna Alloni, Matteo Gabetta, Chris Marshall, Scott Wagers, Ratko Djukanovic, Celeste Porsbjerg, Dominique Hamerlijnck, Olivia Fulton, Anneke ten Brinke, Elisabeth H. Be
ERJ Open Research.2022; 8(4): 00168-2022. CrossRef
Towards effective data sharing in ophthalmology: data standardization and data privacy
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Joint association of aerobic physical activity and muscle-strengthening activities with metabolic syndrome : the Korean National Health and Nutrition Examination Survey 2014-2015: Jungjun Lim, Soyoung Park, Joon-Sik Kim; Epidemiol Health. 2021;43:e2021096. Published online November 6, 2021; DOI: https://doi.org/10.4178/epih.e2021096

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Abstract Summary PDF

Abstract

OBJECTIVES
The study aimed to examine whether simultaneously meeting the combined guidelines of accelerometer-assessed moderate to vigorous physical activity (MVPA) and self-reported muscle-strengthening activity (MSA) was associated with lower odds of metabolic syndrome (MetS) than meeting neither or 1 of the guidelines among the Koreans.

METHODS

This cross-sectional analysis included 1,355 participants from the Korea National Health and Nutrition Examination Survey (2014-2015). Logistic regression was used to analyze the associations across groups of MVPA-MSA guideline adherence (meeting neither [reference]; meeting MVPA only; meeting MSA only; meeting both MVPS and MSA) with MetS components (abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol [HDL-C], hypertension, and hyperglycemia). The odds ratios (ORs) were adjusted for covariates (e.g., sex, age, body mass index, and accelerometer wearing time).

RESULTS

MSA only significantly reduced the OR for abdominal obesity (OR, 0.34; 95% confidence interval [CI], 0.13 to 0.91). Meeting both MVPA and MSA reduced the OR for hypertriglyceridemia (OR, 0.59; 95% CI, 0.39 to 0.88) and low HDL-C (OR, 0.46; 95% CI, 0.31 to 0.68). Compared to meeting neither, MVPA only (OR, 0.63; 95% CI, 0.44 to 0.89) and both MVPA and MSA (OR, 0.46; 95% CI, 0.28 to 0.76) significantly reduced the OR for MetS.

CONCLUSIONS

Combined MVPA-MSA was more beneficially associated with MetS prevalence than MVPA only and MSA only. Considering that more than 85% of Korean adults do not meet both the MVPA and MSA guidelines, public health actions to promote adherence should be supported.

Summary

Korean summary
본 연구는 2014-2015 국민건강영양조사 자료의 가속도계 자료와 신체활동 설문지를 활용하여 한국 성인의 유산소 신체활동과 근력강화운동 지침 충족 여부에 따른 대사증후군의 오즈비를 확인하였다. 그 결과, 유산소 신체활동과 근력강화운동 지침을 모두 충족한 한국 성인은 둘 중 하나의 지침만을 충족하거나, 모두 충족하지 않는 성인에 비해 더 낮은 오즈비를 나타내었다.

Key Message
In this study, the 2014-2015 Korean National Health and Nutrition Examination Survey data, the odds ratio of metabolic syndrome was confirmed according to the guidelines for aerobic physical activities and muscle-strengthening activities were met in Korean adults. As a result, Korean adults who met both the guidelines for aerobic physical activity and muscle-strengthening activities showed a lower odds ratio than adults who met only one of the guidelines or did not meet both guidelines.

Citations

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Association Between Frequency of Muscle-Strengthening Exercise and Depression Symptoms Among Middle and High School Students: Cross-Sectional Survey Study
Hao Wang, Huaidong Du, Yunqi Guan, Jieming Zhong, Na Li, Jin Pan, Min Yu
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Aerobic or Muscle-Strengthening Physical Activity: Which Is Better for Health?
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COVID-19: Perspective

Magnifying the importance of collecting race, ethnicity, industry, and occupation data during the COVID-19 pandemic: Sai Krishna Gudi, Sophia M. George, Komal Krishna Tiwari; Epidemiol Health. 2021;43:e2021095. Published online November 6, 2021; DOI: https://doi.org/10.4178/epih.e2021095

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Abstract Summary PDF

Abstract

The contagiousness of coronavirus disease-2019 (COVID-19) led to the imposition of historical lockdowns in various countries. No scientific mind could have made accurate projections of the tremendous impact that COVID-19 would have on nations, communities, and the global-wide economy. Meanwhile, millions of workers have lost their jobs, while healthcare workers are overwhelmed and are reaching a state of mental and physical exhaustion. With the uncontrollable spread, researchers have been working to identify factors associated with COVID-19. In this regard, race, ethnicity, industry, and occupation have been found to be predominant factors of interest. However, unfortunately, the unavailability of such information has been a difficult reality. Since race, ethnicity, and employment are essential social determinants of health and could serve as potential risk-factors for COVID-19, collecting such information may offer important context for prioritising vulnerable groups. Thus, this perspective aims to highlight the importance and need for collecting race, ethnicity, and occupation-related data to track and treat the racial/ethnic groups that have been most strongly affected by the COVID-19 pandemic. Collecting such data will provide valuable insights and help public health officials recognise workplace-related outbreaks and evaluate the odds of various ethnic groups and professions contracting COVID-19.

Summary

Key Message
As essential social determinants of health, collecting and recording the race/ethnicity, occupation and industry information will provide valuable insights and help public health officials identify workplace-related outbreaks and evaluate the odds of various ethnic groups and professions contracting COVID-19.

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Evaluating COVID-19 Risk to Essential Workers by Occupational Group: A Case Study in Massachusetts
Beth M. Haley, Prasad Patil, Jonathan I. Levy, Keith R. Spangler, Koen F. Tieskens, Fei Carnes, Xiaojing Peng, R. Monina Klevens, T. Scott Troppy, M. Patricia Fabian, Kevin J. Lane, Jessica H. Leibler
Journal of Community Health.2023;[Epub] CrossRef

Original Articles

Misconceptions and stigma against people living with HIV/AIDS: a cross-sectional study from the 2017 Indonesia Demographic and Health Survey: Desi Suantari; Epidemiol Health. 2021;43:e2021094. Published online November 6, 2021; DOI: https://doi.org/10.4178/epih.e2021094

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Abstract Summary PDF

Abstract

OBJECTIVES
Data are not available in Indonesia to measure the main indicators of zero new infections, zero acquired immune deficiency syndrome (AIDS)-related deaths and zero discrimination. This study aimed to determine factors related to misconceptions about human immunodeficiency virus (HIV) transmission and the stigma against people living with HIV/AIDS (PLWHA) in Indonesia

METHODS

This cross-sectional study used secondary data from the 2017 Indonesia Demographic and Health Survey (IDHS). The sample was women and men aged 17-45 years and married (n=3,023).

RESULTS

Education and wealth index quintile were significantly related to misconceptions about HIV transmission. Respondents with low levels of education were more likely to have misconceptions about HIV transmission. Respondents who were in the poorest, poorer, middle, and richer quintiles of the wealth index were more likely to have misconceptions about HIV transmission than those in the richest quintile. Educational level, employment status, and wealth index quintile were predictors of stigma against PLWHA.

CONCLUSIONS

There are still many Indonesian people with misconceptions about HIV transmission and stigma against PLWHA. Future studies should focus on educational programs or interventions aimed at increasing public knowledge and awareness, promoting compassion towards PLWHA, and emphasizing respect for the rights of PLWHA. These interventions are particularly important for populations who are uneducated and living in poverty.

Summary

Key Message
Many Indonesians still experience misconceptions about HIV transmission and stigmatize PLWHA. Educational programs or interventions are needed to increase public knowledge and awareness, promoting compassion towards PLWHA, and emphasizing respect for the rights of PLWHA, particularly among the poor and uneducated.

Citations

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Prevalence and sociodemographic determinants of public stigma towards people with HIV and its impact on HIV testing uptake: A cross‐sectional study in 64 low‐ and middle‐income countries
Ana Mendez‐Lopez, Trenton M. White, María José Fuster‐RuizdeApodaca, Jeffrey V. Lazarus
HIV Medicine.2024; 25(1): 83. CrossRef
The Pandemics of Mass Destruction: A Comparative Analysis of HIV/AIDS and Coronavirus (COVID-19)
Robert Kajiita, Simon Kang'ethe
Journal of Multidisciplinary Healthcare.2024; Volume 17: 889. CrossRef
The Unheard Stories: Experiences of Young People Living with Human Immunodeficiency Virus in Dealing with Discrimination in the Philippines
Donna Sombrea, Sofia Liane Santarin, Trixie Gayle Verde, Andrea Tidalgo, Coleen Tolosa
HIV/AIDS - Research and Palliative Care.2024; Volume 16: 33. CrossRef
Real experience of caregivers of patients with HIV/AIDS from the perspective of iceberg theory: a qualitative research
Jie Tang, Jingxia Ren, Huiqun Wang, Min Shi, Xiaofeng Jia, Liman Zhang
BMJ Open.2024; 14(5): e079474. CrossRef
Endorsement of HIV-related stigma among men in Ghana: What are the determinants?
Sulemana Ansumah Saaka, Roger Antabe, Adedayo Ajidahun
PLOS ONE.2024; 19(7): e0305811. CrossRef
Stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among general adult population: the results from the 6th Thai National Health Examination Survey (NHES VI)
Sineenart Chautrakarn, Parichat Ong-Artborirak, Warangkana Naksen, Aksara Thongprachum, Jukkrit Wungrath, Suwat Chariyalertsak, Scott Stonington, Surasak Taneepanichskul, Sawitri Assanangkornchai, Pattapong Kessomboon, Nareemarn Neelapaichit, Wichai Aekpl
Journal of Global Health.2023;[Epub] CrossRef
Factor Associated with HIV/AIDS knowledge among males: Findings from 2017-18 Pakistan Demographic and Health Survey
Jamal Abdul Nasir, Muhammad Danish Khan, Syed Arif Ahmed Zaidi
Journal of Biosocial Science.2023; 55(6): 1169. CrossRef
Knowledge of HIV/AIDS and its determinants in India: Findings from the National Family Health Survey-5 (2019– 2021)
Mansi Malik, Siaa Girotra, Debolina Roy, Saurav Basu
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Effect of chemotherapy and radiotherapy on cognitive impairment in colorectal cancer: evidence from Korean National Health Insurance Database Cohort: Kwanghyun Kim, Chang Woo Kim, Aesun Shin, Hyunseok Kang, Sun Jae Jung; Epidemiol Health. 2021;43:e2021093. Published online November 2, 2021; DOI: https://doi.org/10.4178/epih.e2021093

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We investigated the risk of chemotherapy-related and radiotherapy-related cognitive impairment in colorectal cancer patients.

METHODS

Medical use data of colorectal cancer patients were obtained from the Korean National Health Insurance Database from 2004 to 2018. We randomly selected 40% of all colorectal cancer patients (n=148,848). Cognitive impairment was defined as having 1 or more International Classification of Diseases, 10th revision diagnostic codes for dementia or mild cognitive impairment. Patients aged 18 years or younger, patients diagnosed with cognitive impairment before colorectal cancer diagnosis (n=8,225), and patients who did not receive primary resection (n=45,320) were excluded. The effects of individual chemotherapy regimens on cognitive impairment were estimated. We additionally estimated the effect of radiotherapy in rectal cancer patients. Time-dependent competing risk Cox regression was conducted to estimate the overall and age-specific hazard ratios (HR) separately for colon and rectal cancer. Landmark analyses with different lag times were conducted as sensitivity analyses.

RESULTS

Chemotherapy did not increase the risk of cognitive impairment in colorectal cancer patients (colon cancer: HR, 0.92; 95% confidence interval [CI], 0.83 to 1.03; rectal cancer: HR, 0.88; 95% CI, 0.75 to 1.04), while radiotherapy was negatively associated with cognitive impairment in rectal cancer patients (HR, 0.01; 95% CI, 0.84 to 0.99). Varying directions of the associations between regimens and cognitive impairment were detected. The adverse effect of certain chemotherapy regimens on cognition was more prominent in older adults.

CONCLUSIONS

Chemotherapy and radiotherapy did not increase the risk of cognitive impairment. Older patients with low cognitive reserve could be affected by the adverse cognitive effects of chemotherapy.

Summary

Korean summary
- 대장암 환자를 대상으로 한 항암화학요법 및 방사선요법은 인지기능저하의 위험을 높이지 않았다 - 일부 항암화학요법의 경우 고령의 대장암 환자에서 인지기능저하의 위험을 증가시킬 수 있다

Key Message
Results from nationwide cohort of Korea showed that chemotherapy and radiotherapy did not increase the risk of cognitive impairment in colorectal cancer patients.

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Zhaobei Cai, Qianqian Chen, Enqiang Linghu
Clinical Cancer Investigation Journal.2024; 13(2): 34. CrossRef
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Yongjun Sunwoo, Sae Hyun Eom, Ji Seong Yun, Yujin Kim, Jeongmin Lee, Soo Hyeon Lee, Sooyoung Shin, Yeo Jin Choi
Medicina.2024; 60(7): 1028. CrossRef
Predictors of cognitive impairment in patients undergoing ileostomy for colorectal cancer: a retrospective analysis
Jing Xu, Yuelan Yang, Die Hu
PeerJ.2023; 11: e15405. CrossRef
Soluble HSPG and HS relaying neuroinflammation contribute to behavioral comorbidities associated with cancer located outside the central nervous system
Yue-peng Liu, Yan-jun Yang
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Chemotherapy-induced functional brain abnormality in colorectal cancer patients: a resting‐state functional magnetic resonance imaging study
Siwen Liu, Yesong Guo, Jie Ni, Na Yin, Chenchen Li, Xuan Pan, Rong Ma, Jianzhong Wu, Shengwei Li, Xiaoyou Li
Frontiers in Oncology.2022;[Epub] CrossRef
Association between multimorbidity status and incident dementia: a prospective cohort study of 245,483 participants
He-Ying Hu, Ya-Ru Zhang, Qiaolifan Aerqin, Ya-Nan Ou, Zuo-Teng Wang, Wei Cheng, Jian-Feng Feng, Lan Tan, Jin-Tai Yu
Translational Psychiatry.2022;[Epub] CrossRef

Association between early antenatal care and antenatal care contacts across low-and middle-income countries: effect modification by place of residence: Paschal Awingura Apanga, Maxwell Tii Kumbeni; Epidemiol Health. 2021;43:e2021092. Published online November 2, 2021; DOI: https://doi.org/10.4178/epih.e2021092

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The relationship between receiving early antenatal care (ANC) and 8 or more antenatal contacts (ANC8+) has not been well characterised across low-and middle-income countries (LMICs). It is also unclear whether the association between early ANC and ANC8+ is modified by a woman’s place of residence. Our primary aim was to assess the relationship between early ANC and ANC8+ and to investigate whether this relationship was modified by place of residence. We also estimated the coverage of ANC8+ across LMICs.

METHODS

We analysed data on 207,388 mothers with a recent live birth using multiple indicator cluster surveys conducted between 2017 and 2020 in 30 LMICS. Modified Poisson regression with robust variance was used to evaluate the relationship between early ANC and ANC8+, whilst adjusting for country, clustering, stratification, and sampling weights. Effect modification by place of residence was assessed on additive and multiplicative scales. A meta-analysis was conducted to pool prevalence estimates of ANC8+ across all countries.

RESULTS

The overall prevalence of ANC8+ was 35.6%, ranging from 1.7% in Madagascar to 99.4% in Belarus. Early ANC was positively associated with ANC8+ (adjusted prevalence ratio [aPR], 2.61; 95% confidence interval [CI], 1.82 to 3.74). There was evidence of positive effect modification on additive (relative excess risk due to interaction, 0.39; 95% CI, 0.35 to 0.44) and multiplicative (aPR, 1.78; 95% CI, 1.08 to 2.95) scales.

CONCLUSIONS

Many LMICs may not have adopted the 2016 World Health Organization guidelines on ANC8+. Receiving early ANC was associated with a higher likelihood of ANC8+, particularly for women in rural areas.

Summary

Key Message
Our findings suggest that early antenatal care (ANC) was associated with the likelihood of receiving eight or more ANC contacts (ANC8+) among all mothers across low-and middle-income countries. This association was modified by a woman’s place of residence such that mothers living in rural areas who received early ANC had a higher prevalence of ANC8+. Public health programs, which focus on increasing the coverage of ANC8+ should encourage all pregnant women to receive early ANC, particularly those living rural areas.

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Maxwell Tii Kumbeni, John Ndebugri Alem, Florence Assibi Ziba, Agani Afaya, Paschal Awingura Apanga
Journal of Biosocial Science.2024; : 1. CrossRef
Time to initiation of antenatal care and its predictors among pregnant women in Ethiopia: a multilevel mixed-effects acceleration failure time model
Befekadu Tesfaye Oyato, Husen Zakir Abasimel, Derara Girma Tufa, Hana Israel Gesisa, Tewodros Getachew Tsegaye, Mukemil Awol
BMJ Open.2024; 14(4): e075965. CrossRef
Multilevel modelling of factors associated with eight or more antenatal care contacts in low and middle-income countries: findings from national representative data
Biresaw Ayen Tegegne, Adugnaw Zeleke Alem, Tsegaw Amare, Fantu Mamo Aragaw, Rediet Eristu Teklu
Annals of Medicine & Surgery.2024; 86(6): 3315. CrossRef
Determinants of Focused Antenatal Care Utilization Among Women in Simiyu Region Tanzania
Agatha F. Ngowi, Serafina Mkuwa, Laura Shirima, Frida Ngalesoni, Gasto Frumence
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Contents of antenatal care services in Afghanistan: findings from the national health survey 2018
Muhammad Haroon Stanikzai, Essa Tawfiq, Massoma Jafari, Abdul Wahed Wasiq, Mohammad Khaled Seddiq, Sheena Currie, Hadia Sayam, Ahmad Haroon Baray, Sayed Ataullah Saeedzai
BMC Public Health.2023;[Epub] CrossRef
The moderating role of partners’ education on early antenatal care in northern Ghana
Paschal Awingura Apanga, Maxwell Tii Kumbeni, James Kotuah Sakeah, Ayokunle A. Olagoke, Olufemi Ajumobi
BMC Pregnancy and Childbirth.2022;[Epub] CrossRef

A comprehensive study of deaths due to exposure to humidifier disinfectant in Korea: focusing on medical records, assessment of exposure to humidifier disinfectants, and causes of death: Yeong Jun Ju, Seungho Lee, Seungsoo Sheen, Dong-Woo Choi, Jong-Han Leem, Soon Young Lee; Epidemiol Health. 2021;43:e2021091. Published online November 1, 2021; DOI: https://doi.org/10.4178/epih.e2021091

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We aimed to determine the characteristics of the deceased victims of deaths caused by exposure to humidifier disinfectants, and present the distribution of the victims’ data submitted for damage application, demographic characteristics, imaging findings, characteristics of humidifier disinfectant exposure, and distribution of the causes of death.

METHODS

An integrated database of victims was established using the medical records data of 1,413 victims submitted during the application for death damage caused by exposure to humidifier disinfectants, and the demographic characteristics, medical records, imaging findings, exposure characteristics, and cause of death were examined.

RESULTS

The average numbers of data submissions of each applicant for death damage were 3.0 medical use records. A total of 608 (43.0%) victims had more than one finding of acute, subacute, or chronic interstitial lung diseases. The average daily and cumulative use times of the victims were 14.40 and 24,645.81 hours, respectively, indicating greater exposure in this group than in the survivors. The humidifier disinfectants’ components comprised polyhexamethylene guanidine (72.8%), chloromethylisothiazolinone/methylisothiazolinone (10.5%), other components (15.0%), and oligo-[2-(2-ethoxy)-ethoxyethyl] guanidine chloride (1.5%). The components’ distribution was 67.8% for single-component use, which was higher than that in the survivors (59.8%). The distribution of the causes of death were: respiratory diseases (54.4%), neoplasms (16.8%), and circulatory diseases (6.3%). Other interstitial lung diseases (65.5%) were the most common cause of death among those who died due to respiratory diseases.

CONCLUSIONS

Careful discussions of appropriate remedies should be conducted based on a comprehensive understanding of the characteristics of the deceased victims, considering their specificities and limitations.

Summary

Korean summary
가습기 살균제 사망 피해 신청자 들 중 건강피해를 인정받지 못한 신청자들이 여전히 많이 남아있으며 (약 40%), 피해판정의 복잡성과 다양한 이슈들이 산적해 있어 사망 피해 신청자들의 적정 구제를 위해 종합적인 특성파악을 바탕으로 세심한 관점에서의 검토가 필요하다. 특히, 가습기 살균제 사망 피해 신청자의 특수성과 피해구제의 제한점을 고려하여야 하며, 기계적인 건강피해 판정을 지양하고 사망 피해 신청자 중심의 세밀한 특성 파악을 바탕으로 다양한 전문가집단이 참여하는 종합적인 논의를 통해 적정구제를 이루어 나가야 함을 제안한다.

Key Message
Careful discussions of appropriate remedies should be conducted based on a comprehensive understanding of the characteristics of the deceased victims, considering their specificities and limitations.

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Jun Woo Kim, Hyung Sik Kim, Ha Ryong Kim, Kyu Hyuck Chung
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Jung Eun Park, Seung-Hun Ryu, Satoshi Ito, Hyunil Shin, Young-Hee Kim, Jongho Jeon
Chemosphere.2024; 362: 142666. CrossRef
Toxicity and Safety Analysis of Polyhexamethylene Guanidine: A Comprehensive Systematic Review
Ivan Ivanov, Daria Kirillova, Kenes Erimbetov, Denis Shatalov
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Journal of Korean Medical Science.2022;[Epub] CrossRef

Systematic Reviews

The effect of peer support in diabetes self-management education on glycemic control in patients with type 2 diabetes: a systematic review and meta-analysis: Akhmad Azmiardi, Bhisma Murti, Ratih Puspita Febrinasari, Didik Gunawan Tamtomo; Epidemiol Health. 2021;43:e2021090. Published online October 22, 2021; DOI: https://doi.org/10.4178/epih.e2021090

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319 Download
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Diabetes self-management education (DSME) programs are a strategy to maintain healthy behaviors. Nevertheless, limited evidence has been reported from systematic evaluations of the effects of DSME integrated with peer support on glycemic control. This study aimed to review the effectiveness of DSME interventions integrated with peer support on glycemic control in patients with type 2 diabetes.

METHODS

A systematic search was carried out in electronic databases, including PubMed, Cochrane Library, ProQuest, SpringerLink, ScienceDirect, Scopus, and Google Scholar, for English-language articles published from 2005 until 2020. The effect size was estimated as the standard mean difference (SMD). The Cochrane Collaboration’s Risk of Bias tool was employed to assess the risk of bias.

RESULTS

Twelve studies were included in this study. DSME integrated with peer support effectively reduced glycated hemoglobin A1c (HbA1c) levels, with a statistically significant effect (SMD, -0.41; 95% confidence interval [CI], -0.69 to -0.13; p<0.001). Programs with a sample size <100 (SMD, -0.45; 95% CI, -0.79 to -0.11; p=0.009), duration of intervention ≤6 months (SMD, -0.52; 95% CI, -0.96 to -0.07; p=0.020), baseline HbA1c <8.5% (SMD, -0.42; 95% CI, -0.77 to -0.07; p=0.020), delivery by group (SMD, -0.28; 95% CI, -0.51 to -0.06; p=0.010), and high frequency of contact (SMD, -0.29; 95% CI, -0.48 to -0.10; p=0.003) had statistically significant effects on reducing HbA1c levels in patients with type 2 diabetes.

CONCLUSIONS

DSME integrated with peer support effectively enhances glycemic control in patients with type 2 diabetes. Programs with smaller participants groups, shorter interventions, weekly meetings, and closer group sessions improved glycemic control in patients with type 2 diabetes.

Summary

Key Message
We reviewed and assessed the quality of the twelve articles included in this systematic review and meta-analysis. The findings of this review show that peer support integrated with diabetes self-management education programs can significantly enhance glycemic control in type 2 diabetes patients. Peer support is a critical component of a successful diabetes self-management programme in patients with type 2 diabetes. interventions programme with smaller groups, shorter durations, lower HbA1c baseline levels, group sessions, and high frequencies of sessions significantly enhanced glycemic control.

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Chen Chen, Yuan Zhou, Jia-Yi Xu, Hai-Yan Song, Xu-Wen Yin, Ze-Juan Gu
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Elâ Ziegler, Thea Bartzsch, Alf Trojan, Nicole Usko, Ines Krahn, Sabine Bütow, Christopher Kofahl
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Nanna Lind, Merete Bechmann Christensen, Dorte Lindqvist Hansen, Ingrid Willaing, Kirsten Nørgaard
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Quality of biosafety guidelines for dental clinical practice throughout the world in the early COVID-19 pandemic: a systematic review: Renata Cristina Soares, Juliana Schaia Rocha, Saulo Vinicius da Rosa, Jéssica Rodrigues da Silva Noll Gonçalves, Priscilla Lesly Perlas Condori, Ana Elisa Ribeiro, Samuel Jorge Moysés, Márcia Helena Baldani; Epidemiol Health. 2021;43:e2021089. Published online October 22, 2021; DOI: https://doi.org/10.4178/epih.e2021089

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
To conduct a systematic review of coronavirus disease 2019 (COVID-19)-related biosafety guidelines for dental clinical practice in the early stage of the pandemic, focusing on quality assessment.

METHODS

Electronic (via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, and Cochrane Library) and gray literature searches were performed for documents published up to May 12, 2020. Guidelines updated until April 17, 2021 were identified. Documents were included as guidelines if they (1) consisted of a set of statements, directions, or principles presenting current or future rules or policy; (2) were developed by government agencies, institutions, organizations, or expert panels; and (3) were related to the general conduct of healthcare activities rather a particular condition. Two researchers, using the Appraisal of Guidelines for Research & Evaluation II, independently extracted the recommendations and evaluated the quality of the guidelines.

RESULTS

Twenty-seven documents from 19 countries were included in the review. These documents presented 122 recommendations related to (1) professional biosafety; (2) patients’/companions’ safety; (3) the organization and biosafety of the physical dental facility environment; and (4) the work process in dental care. Overall, the scientific quality of the guidelines was considered low. Some recommendations presented in these guidelines would require further research to establish their effectiveness.

CONCLUSIONS

We found a wide variety of biosafety guidelines for dental practice regarding COVID-19 in the early months of the pandemic, but their quality was low. Biosafety recommendations should be frequently updated.

Summary

Key Message
Despite the wide variety of biosafety guidelines for dental practice regarding COVID-19 in the early months of the pandemic, their quality was low. These findings demonstrate the need for more guidelines for dental practice with more high-quality evidence, focusing on clarification of the strictness of development, financing, conflicts of interest, and applicability. Guidelines with high scientific quality are essential for the formation of a robust scientific consensus facilitating the ability to offer safer and more reliable procedures in the pandemic context.

Citations

Citations to this article as recorded by

Food-Based Dietary Guidelines for Infants in Latin America and the Caribbean: A Systematic Review
Isabelle Cristina Daniel, Mariana Sofia Moro Siqueira, Gabriela Ulbricht Romaneli, Juliana Schaia Rocha Orsi, Renata Iani Werneck
Nutrients.2024; 16(8): 1233. CrossRef
Review on the biosafety measures for the prevention and control of SARS-CoV-2 infections in healthcare settings
Marew ALEMNEW, Birhanu ANDUALEM, Aschalew GELAW, Eyuel KASSA, Addis GETU
Journal of Life Science and Biomedicine.2024; : 30. CrossRef
Impact of COVID-19 on Dental Practices in El Salvador and Mexico: A Comprehensive Survey Analysis
Nuria Patiño-Marín, Wendy Yesenia Escobar de González, Katleen Argentina Aguirre de Rodríguez, Miguel Angel Casillas Santana, Carlo Eduardo Medina-Solís, Guillermo Alfonso Aguirre Escobar, Gabriel Alejandro Martínez-Castañón, Marco Salas
Cureus.2023;[Epub] CrossRef

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