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Brief Communications
Timely access to secondary pediatric services in Korea: a key to reducing child and adolescent mortality
Minku Kang, Young June Choe, Hye Sook Min, Saerom Kim, Seung-Ah Choe
Epidemiol Health. 2024;46:e2024059.   Published online July 5, 2024
DOI: https://doi.org/10.4178/epih.e2024059
  • 1,715 View
  • 80 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Geographic disparities in access to secondary pediatric care remain a significant issue in countries with universal health coverage, including Korea. This study investigated the link between geographic access to secondary pediatric care and mortality rates in children and adolescents (0-19 years) in Korea.
METHODS
We analyzed district-level data to assess the percentage of those aged 0-19 years residing outside of a 60-minute travel radius from the nearest secondary pediatric care provider (accessibility vulnerability index, AVI).
RESULTS
The AVI ranged from 0% to 100% across the districts for the study period. The confidence interval (CI) was -0.30 (95% CI, -0.41 to -0.19) in 2017 and -0.41 (95% CI, -0.52 to -0.30) in 2021, indicating that the proportion of those who could not access care within 60 minutes was disproportionately higher in districts with lower socioeconomic status. We found 8% rise in mortality rates among individuals aged 0-19 years for every 10% increase in AVI (95% CI, 1.06 to 1.10).
CONCLUSIONS
The study highlights disparities in pediatric care access and their impact on child survival, emphasizing the need for improved access to achieve true universal health coverage.
Summary
Korean summary
본 연구는 한국에서 소아 의료 서비스에 대한 지리적 접근성과 아동 사망률 사이의 연관성을 조사하여, 특히 COVID-19 대유행 기간 동안 접근성 제한이 높은 사망률과 관련이 있음을 발견하였다. 이 연구는 아동 및 청소년의 예방 가능한 사망률에 대한 지역 격차를 줄이기 위해 시기적절한 치료 접근성을 개선해야 할 필요성을 강조하였다.
Key Message
The study investigated the link between geographic access to pediatric services and child mortality in South Korea, finding that limited access, particularly during the COVID-19 pandemic, was associated with higher mortality. The research highlights the need for improved access to timely care to reduce regional disparities in preventable deaths among children and adolescents.
Assessing the impact and implications of the revised Act on the Aggravated Punishment of Specific Crimes in preventing child traffic injuries in school zones in Korea: an interrupted time series analysis
Hong Jin Ku, Jin-Hwan Kim, Young June Choe, Seung Ah Choe, Mark R. Zonfrillo
Epidemiol Health. 2024;46:e2024032.   Published online February 21, 2024
DOI: https://doi.org/10.4178/epih.e2024032
  • 6,257 View
  • 111 Download
AbstractAbstract AbstractSummary PDF
Abstract
In 2019, a child’s death in Korea led to legislation that imposed stricter penalties for school zone traffic violations. We assessed the impact of that legislation using 2017-2022 Traffic Accident Analysis System data. Adjusted analyses revealed a significant decline in severe injuries in school zones, decreasing from 11 cases to 8 cases per month (p=0.017). The legislation correlated with a reduced risk of all child traffic injuries (risk ratio, 0.987; 95% confidence interval, 0.977 to 0.997; p=0.002), indicating its efficacy in curbing accidents.
Summary
Korean summary
2019년 민식이법 도입 후 소아 교통사고에 미치는 영향을 평가하고자 하였다. 2017-2022 교통사고 분석 시스템 데이터를 통해 그 효과를 평가했고, 학군지역에서 심각한 부상이 월 평균 11건에서 8건으로 감소했다(p=0.017). 또한, 모든 어린이 교통사고 위험 비율도 감소했고(risk ratio, 0.987, 95% CI, 0.977-0.997; p=0.002), 사고 예방에 효과적임을 입증했다. 이 연구는 학군지역 어린이 안전에 법 조치의 긍정적 영향을 강조하며, 지속적인 도로 안전 강화의 중요성을 강조한다.
Key Message
Revised legislation in Korea, following a child’s tragic death, enforced stricter penalties for school zone traffic violations. Analysis of 2017-2022 data showed a significant decrease in severe injuries from 11 to 8 cases monthly (p=0.017). The legislation also reduced the risk of all child traffic injuries (risk ratio, 0.987; 95% CI, 0.977 to 0.997; p=0.002), demonstrating its effectiveness in preventing accidents. This study underscores the legislation’s positive impact on child safety in school zones, emphasizing the importance of ongoing enforcement efforts for road safety.
COVID-19: Cohort Profile
Cohort profile: investigating SARS-CoV-2 infection and the health and psychosocial impact of the COVID-19 pandemic in the Canadian CHILD Cohort
Rilwan Azeez, Larisa Lotoski, Aimée Dubeau, Natalie Rodriguez, Myrtha E. Reyna, Tyler Freitas, Stephanie Goguen, Maria Medeleanu, Geoffrey L. Winsor, Fiona S. L. Brinkman, Emily E. Cameron, Leslie Roos, Elinor Simons, Theo J. Moraes, Piush J. Mandhane, Stuart E. Turvey, Shelly Bolotin, Kim Wright, Deborah McNeil, David M. Patrick, Jared Bullard, Marc-André Langlois, Corey R. Arnold, Yannick Galipeau, Martin Pelchat, Natasha Doucas, Padmaja Subbarao, Meghan B. Azad
Epidemiol Health. 2023;45:e2023091.   Published online October 13, 2023
DOI: https://doi.org/10.4178/epih.e2023091
  • 9,694 View
  • 119 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected all Canadian families, with some impacted differently than others. Our study aims to: (1) determine the prevalence and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among Canadian families, (2) identify predictors of infection susceptibility and severity of SARS-CoV-2, and (3) identify health and psychosocial impacts of the COVID-19 pandemic. This study builds upon the CHILD Cohort Study, an ongoing multi-ethnic general population prospective cohort consisting of 3,454 Canadian families with children born in Vancouver, Edmonton, Manitoba, and Toronto between 2009 and 2012. During the pandemic, CHILD households were invited to participate in the CHILD COVID-19 Add-On Study involving: (1) brief biweekly surveys about COVID-19 symptoms and testing; (2) quarterly questionnaires assessing COVID-19 exposure and testing, vaccination status, physical and mental health, and pandemic-driven life changes; and (3) in-home biological sampling kits to collect blood and stool. In total, 1,462 households (5,378 participants) consented to the CHILD COVID-19 Add-On Study: 2,803 children (mean±standard deviation [SD], 9.0±2.7 years; range, 0-17 years) and 2,576 adults (mean±SD, 43.0±6.5 years; range, 18-85 years). We will leverage the wealth of pre-pandemic CHILD data to identify risk and resilience factors for susceptibility and severity to the direct and indirect pandemic effects. Our short-term findings will inform key stakeholders and knowledge users to shape current and future pandemic responses. Additionally, this study provides a unique resource to study the long-term impacts of the pandemic as the CHILD Cohort Study continues.
Summary
Key Message
· This study of 1,462 Canadian families (5,378 individuals) leverages a decade of extensive pre-pandemic CHILD Cohort Study data to identify risk and resilience factors for susceptibility to the direct and indirect effects of the COVID-19 pandemic. · Our short-term findings will inform key stakeholders and knowledge users to shape current and future pandemic responses. · This study provides a unique resource to study the long-term impacts of the pandemic as the CHILD Cohort Study continues.
Original Articles
Impact of early-life weight status on urinary tract infections in children: a nationwide population-based study in Korea
Hyung Eun Yim, Kyung Do Han, Bongseong Kim, Kee Hwan Yoo
Epidemiol Health. 2021;43:e2021005.   Published online December 29, 2020
DOI: https://doi.org/10.4178/epih.e2021005
  • 13,258 View
  • 341 Download
  • 2 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We aimed to evaluate the association between early-life weight status and urinary tract infection (UTI) risk in children.
METHODS
A nationwide study was conducted using Korean National Health Screening (NHS) data and National Health Insurance Service data. A sample cohort was selected using data from the 2014 and 2015 NHS for infants and children (4-71 months) and followed up until the end of 2017. Participants were divided into 4 groups (underweight, normal weight, overweight, and obese) based on the weight-for-age (< 2 years) or body mass index (≥ 2 years). Hazard ratios (HRs) with 95% confidence intervals (CIs) for developing UTIs, cystitis, and acute pyelonephritis (APN) were calculated using a Cox proportional hazard model.
RESULTS
Of 1,653,106 enrolled children, 120,142 (7.3%) developed UTIs, cystitis, and APN during follow-up. The underweight, overweight, and obese groups had higher risks of UTIs than the reference group after adjusting for age, sex, birth weight, and preterm birth. Between 2 years and 6 years of age, boys with underweight had a high risk of UTI and APN, while girls with overweight and obesity revealed elevated risks of UTIs, cystitis, and APN. The HRs for APN in boys with underweight and in girls with obesity were 1.46 (95% CI, 1.03 to 2.07) and 1.41 (95% CI, 1.13 to 1.75), respectively, after adjusting for age, sex, birth weight, and preterm birth. The incidence of APN did not decrease with age in underweight and obese children aged 2-6 years.
CONCLUSIONS
Children with underweight, overweight, and obesity may be at high risk for UTIs.
Summary
Korean summary
1. 영유아 및 소아에서 과소체중, 과체중 및 비만은 요로감염 발생 증가와 관련이 있다. 2. 본 전국적인 인구 기반 연구에서 2-6세 남아에서 과소체중을 보인 경우 요로감염과 신우신염 발생빈도가 증가하였으며, 2-6세 여아에서 과체중 및 비만을 보이는 경우 요로감염, 방광염, 신우신염 발생이 증가하였다. 3. 소아에서 적정체중을 유지하는 것이 요로감염, 방광염, 신우신염의 발생을 예방함에 있어서 중요하다.
Key Message
1. Being underweight, overweight, or obese can be associated with an increased risk of urinary tract infection in infants and children. 2. The underweight boys aged 2–6 years had a high risk of urinary tract infection and acute pyelonephritis, while the overweight and obese girls aged 2–6 years revealed increased risks of urinary tract infection, cystitis, and acute pyelonephritis in our nationwide population-based study on urinary tract infections. 3. Body weight control would be significant for the primary prevention of urinary tract infections, cystitis, and acute pyelonephritis in children.

Citations

Citations to this article as recorded by  
  • Risk factors for recurrent urinary tract infections in young infants under the age of 24 months
    Min Hwa Son, Hyung Eun Yim
    Childhood Kidney Diseases.2024; 28(1): 35.     CrossRef
  • Childhood Body Mass Index (BMI) and the Risk of Infection: A Narrative Review
    Houman Hashemian, Mohammad Ali Esfandiari, Setila Dalili
    Journal of Comprehensive Pediatrics.2023;[Epub]     CrossRef
  • Kidney Considerations in Pediatric Obesity
    Alexandra Sawyer, Evan Zeitler, Howard Trachtman, Petter Bjornstad
    Current Obesity Reports.2023; 12(3): 332.     CrossRef
  • Association of body weight and urinary tract infections during infancy: a nationwide comparative matched cohort study
    Peong Gang Park, Ji Hyun Kim, Yo Han Ahn, Hee Gyung Kang
    Childhood Kidney Diseases.2023; 27(2): 111.     CrossRef
  • Obesity and chronic kidney disease: prevalence, mechanism, and management
    Hyung Eun Yim, Kee Hwan Yoo
    Clinical and Experimental Pediatrics.2021; 64(10): 511.     CrossRef
Case Series of Pediatric Mycoplasma Pneumoniae Pneumonia Inpatients in A Hospital.
Young Sun Min, Hyun Sul Lim
Korean J Epidemiol. 2006;28(1):112-118.
  • 12,317 View
  • 56 Download
AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this report is to examine characteristics of pediatric Mycoplasma Pneumoniae pneumonia inpatients.
METHODS
The authors conducted a medical record survey among 236 children under seventeen were hospitalized in a university hospital due to Mycoplasma Pneumoniae pneumonia, 2001-2003. The author reviewed gender, age, address, developed date of symptoms, admission day, discharge day, etc.
RESULTS
The number of inpatients was increased during late summer and fall. The mean age of all cases was 3.7+/-2.9 years old. One hundred ninety three cases (81.8%) had lung infiltration findings. The mean symptomatic period was 11.9+/-6.4 days (maximum 44 days, minimum 4 days, median 10 days), the mean hospital length of stay was 5.2+/-2.5 days (maximum 17 days, minimum 0 day, median 5 days).
DISCUSSION
The authors reviewed characteristics during last 3 years for Mycoplasma Pneumoniae pneumonia. This report is meaningful with its basic data for the epidemiologic characteristics of Mycoplasma Pneumoniae pneumonia inpatients.
Summary
Sentinel Surveillance System for Pediatric Communicable Diseases.
Young Ohk Yoo, Eun Kyeong Jeong, Ok Park, Byung Chul Chun
Korean J Epidemiol. 2004;26(2):32-42.
  • 6,921 View
  • 27 Download
AbstractAbstract PDF
Abstract
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.
Summary

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