• 농촌의학ㆍ지역보건
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• 제1권1호
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• pp.10-21
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• 1976

The traditional application of night soil to vegetable gardens and rice paddies results in a most wide spread condition of parasitism, with a variety of helminths found in Korea. In addition to the above fact, the peculiar habit of the consumption of raw vegetables, fish, crustaceans and mammals provides a means of infestations of helminths. During the last sixty years numerous reports were found on the prevalence of helminths amongst the Korean population in different parts of the country, and it was generally recognized that ascariasis, hookworm disease, filariasis, clonorchiasis and paragonimiasis constitute the important helminthic disease in Korea. In practical measures of parasite control activities the main measures are summarized as mass-treatment, night-soil disposal and transmission control. Among the three, the mass-treatment has been commonly applied, however, no reduction of transmission has been obtained by treatment of a population. Therefore, the ultimate eradication of parasites will depend upon the application of comprehensive environmental sanitation measures. The basic environmental measures will be concerned with (a) the safe disposal of human excreta, (b) the provision of adequate and safe water supplies in such a way as to promote a higher standard of personal hygiene in the population, and (c) the prevention of food contamination by faecal material. Additional environmental measures will deal with the improvement of housing and housing hygiene and with general community development. Community development means social and cultural as well as economic development. The control measures on the parasitic endemic diseases, such as clonorchiasis and paragonimiasis are the good examples for community health development in Korea. The control of Clonorchis and Paragonimus infections are theoretically very simple, as the infection can only invade the human body by way of encysted metacercaria which are taken into the body when eating passive intermediate hosts(fishes, crabs and crayfishes). Although prophylactic measures in the case of the infections deal with above merely consist the fishes in cooking or submerging in hot water before eating them, it is exceedingly difficult to carry out such simple measures in face of century old traditions, to which the relatively primitive population clings with great tenacity. There is no one universally applicable method of control. The choice of methods must be dictated by the nature of the environment. the habit and custom of the people. the pattern of transmission and the resources of the country. There must exist a well organized public health infrastructure. Since a control programme is of necessity on a longterm basis and continuity in its implementation is essential. An investigation should be made on the prevalence of the diseases and its relationships to irrigation engineering, freshwater ecology, agricultural methods, hydro-electric schemes, and the development of communities in affected areas. In conclusion, however. the control of clonorchiasis and paragonimiasis in Korea is not an impossible task. A combination of efforts with major emphasis on health education and mass chemotherapy coupled with governmental aid in enforcing legislative public health measures could reduce the diseases. Health education in particular attempts following four things: (a) It supplies a person with enough general knowledge about a disease to make the preventive measures. (b) It makes a person feel sufficiently about the importance of his own health to make him alter his behavior and adopt these preventive measure. (c) It makes him concerned for the health others. (d) It tries to make him feel so strongly about the first three that be supports and even initiates preventive action by the community. Educational efforts should be directed primarily toward school children because it is during the early years that most persons become infected, and also because children are less entrenched in their food habits so that, the educational process should be involved at various levels in successive changes of knowledge, attitude, beha viour, habit and custom of their lives. The most parasitic endemic diseases are related to community diseases. In caring for a sick community. the first stage is to gather epidemiological data, the next is to make inferences from it-to make the community diagnosis. The third is to prescribe community treatment or community health action part of a community health action programme. The community health action is the sum of the steps decided upon to remedy the critical features revealed by the community diagnosis. Action takes various forms; health education is the most important.

• Parasites, Hosts and Diseases
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• 제58권6호
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• pp.647-652
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• 2020

Clonorchis sinensis is the most common fish-borne intestinal parasite in Korea. The aim of the present investigation was to survey the status of C. sinensis infection and analyze associated risk factors in residents of Haman-gun, Gyeongsangnam-do. A total of 5,114 residents from 10 administrative towns/villages voluntarily agreed to participate in the study, which comprised fecal examination, a questionnaire survey for risk factors, ultrasonography, and enzyme-linked immunosorbent assay for cancer biomarker detection in the blood. We detected C. sinensis eggs in 5.3% of the subjects. By region, Gunbuk-myeon had the highest number of residents with C. sinensis eggs. The infection rate and intensity were higher in male than in female residents. Based on the risk factor questionnaire, infection was highly associated with drinking, a history of C. sinensis infection, and the practice of eating of raw freshwater fish. Extension of the bile duct, infection intensity, and cancer biomarker detection significantly correlated with the presence of eggs in the study population. In conclusion, the development of feasible, long-term control policies and strategies for the elimination of C. sinensis in Korea is still required.

• Parasites, Hosts and Diseases
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• 제55권2호
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• pp.167-174
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• 2017

China still has more than 30,000 patients of advanced schistosomiasis while new cases being reported consistently. D-dimer is a fibrin degradation product. As ascites being the dominating symptom in advanced schistosomiasis, the present study aimed to explore a prediction model of ascites with D-dimer and other clinical easy-achievable indicators. A case-control study nested in a prospective cohort was conducted in schistosomiasis-endemic area of southern China. A total of 291 patients of advanced schistosomiasis were first investigated in 2013 and further followed in 2014. Information on clinical history, physical examination, and abdominal ultrasonography, including the symptom of ascites was repeatedly collected. Result showed 44 patients having ascites. Most of the patients' ascites were confined in the kidney area with median area of $20mm^2$. The level of plasma D-dimer and pertinent liver function indicators were measured at the initial investigation in 2013. Compared with those without ascites, cases with ascites had significantly higher levels of D-dimer ($0.71{\pm}2.44{\mu}g/L$ vs $0.48{\pm}2.12{\mu}g/L$, P=0.005), as well ALB (44.5 vs 46.2, g/L) and Type IV collagen (50.04 vs $44.50{\mu}g/L$). Receiver operating characteristic curve analyses indicated a moderate predictive value of D-dimer by its own area under curve (AUC) of 0.64 (95% CI: 0.54-0.73) and the cutoff value as $0.81{\mu}g/L$. Dichotomized by the cutoff level, D-dimer along with other categorical variables generated a prediction model with AUC of 0.76 (95% CI: 0.68-0.89). Risks of patients with specific characteristics in the prediction model were summarized. Our study suggests that the plasma D-dimer level is a reliable predictor for incident ascites in advanced schistosomiasis japonica patients.

• Tuberculosis and Respiratory Diseases
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• 제71권6호
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• pp.408-416
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• 2011

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a technique developed to allow mediastinal staging of lung cancer and also to evaluate intrathoracic lymphadenopathy. In a tuberculosis-endemic area, tuberculosis should be considered as an etiology of mediastinal lymphadenopathy. The aim of this study was to investigate the utility of the routine culture for tuberculosis from specimens of EBUS-TBNA. Methods: We prospectively performed routine culture for tuberculosis from aspiration or core biopsy specimens got from 86 patients who had undergone EBUS-TBNA due to mediastinal lymphadenopathy between March 2010 and March 2011. Results: A total of 135 lymph node aspiration and 118 core biopsy specimens were included in this analysis. We confirmed the malignancy in 62 (72.9%), tuberculosis in 7 (8.1%), sarcoidosis in 7 (8.1%), asperogillosis in 2 (2.3%) and pneumoconiosis in 2 (2.3%) patients. One lung cancer patient had pulmonary tuberculosis coincidentally and 5 patients had unknown lymphadenopathy. The number of positive culture for Mycobacterium tuberculsosis by EBUS-TBNA is 2 (1.5%) from 135 lymph node aspiration specimens and 2 (1.7%) from 118 core biopsy specimens. Out of eight patients confirmed with tuberculosis, only one patient had positive mycobacterial culture of aspiration specimen from EBUS-TBNA without histopathologic diagnosis. Conclusion: These results propose that routine culture for tuberculosis from EBUS-TBNA may not provide additional information for the diagnosis of coincident tuberculous lymphadenitis. However, if there is any possibility of tuberculous lymphadenopathy or pulmonary tuberculosis, it should be considered to perform EBUS-TBNA in patients who have negative sputum AFB smears or no sputum production.

• 농촌의학ㆍ지역보건
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• 제5권1호
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• pp.5-15
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• 1980

The first recorded trypanosomiasis epidemic in Uganda took place at the beginning of this century in the islands and in a strip along the northern shores of Lake Victoria, which resulted in deaths of 1/3 million people. The disease was partly controlled by early 1930's and continued to occur sporadically in certain localized foci. The disease has however flared up in an explosive outbreak in Busoga district along Lake Victoria since 1977. The incidence of disease in northern district adjacent to Southern Sudan is also increasing lately. This paper describes the three month observation on the surveillance and control activities in the epidemic areas and of various health units including the Vector Control Division, the Tsetse fly Control Division, Tororo Trypanosomiasis Research Institute, medical units in Busoga, and Acholi districts. Data analysis and review were made of disease information so far collected by various health units in the Ministry of Health and district health offices. The findings may be summarized in the following: 1) A total of 12, 100 patients and 38 deaths: have occured in Busoga district since 1977 onward, and over 100 cases of diseases arc occuring in the Northern region bordering Southern Sudan. 2) the distribution of trypanosomiasis is characterized with two district patterns. The disease caused by Trypanosoma rhodesiense occurs in Busoga and is transmitted by Glossina palpalis, G. fuscipes infested in the islands and in the northern shore of forests of Lake Victoria. Another type caused by Trypanosoma gambiense occurs in Madi and Acholi in the north and is transmitted by Glossina morsitans in Savannah. 3) The house survey in Rusoga indicated that most of patients keep domestic animals in their house premises, and are engaging in either farming or fishing. Practically all the patients remembered that they had been bitten by tsetse in the field. 4) The routine diagnostic methods in the hospital laboratory is carried out through the microscopic examination of trypanosome with Giemsa stain of blood and cerebro-spinal fluid, The measurement of ESR and IgM has been used by Tororo Tryponosomiasis Research Institute for field screening.

• 농촌의학ㆍ지역보건
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• 제15권1호
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• pp.49-55
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• 1990

Zoonoses are those diseases and infections that are naturally transmitted between vertebrate animals and man. At present, approximately 175 diseases caused by virus, rickettsia, bacteria, protozoa and helminthes as well as some of arthropods and the number is continually increasing. Although zoonoses are generally recognized as significant health problems, the actual prevalence and incidence of zoonotic infections is difficult to determine. Medical services in a rural area are scarce and ill persons may have little chance to see a physician. Furthermore, a lack of physician awareness and of appropriate diagnostic support is made often misdiagnosis. In rural Korea, parasitic disease is still important subject in the field of zoonotic infections considering its number and morbidity. Recently there was conspicuous reduction of soil-transmitted parasitic diseases (i.e. ascariasis. hookworms, trichuriasis), but clonorchiasis. intestinal trematodiases and taeniasis are a considerable problem. This is often significantly related to human behavioral patterns based on socio-economic and cultural conditions and linked with the local biologic and physical environment. The most of all parasitic zoonoses to man and animals are the food-transmitted parasitic diseases, and domestic animals such as dog, cat, pig, as well as fat and some mammals, ruminants and birds are act as reservoir hosts. In the present topics, current problems of parasitic zoonoses caused by protozoan infections (i. e. toxoplasmosis, pneumocystosis and cryptosporidiosis) which are the most common opportunistic in AIDS or immunocompromised persons, trematode infections (i.e. clonorchiasis, paragonimiasis and some intestinal tremadodiases). cestode infections such as cysticercosis and sparganosis, and some nematode infections of anisakiasis, thelaziasis and strongyloidiasis, are discussed here those on the occurrence in man and animals and the source of transmission as well as prevention and control measures in Korea.

• Parasites, Hosts and Diseases
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• 제59권1호
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• pp.97-101
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• 2021

The infection status with Clonorchis sinensis metacercariae (CsMc) was examined in freshwater fishes from Yongjeon-cheon (a branch of Nakdong-gang) located in Cheongsong-gun, Gyeongsangbuk-do, the Republic of Korea (Korea). A total of 750 fishes in 19 species were examined by the artificial digestion method for 2 years (2019 and 2020). CsMc were detected in 378 (51.4%) out of 735 fishes in 14 species (73.7%), and the infection intensity was 666 per fish infected. In 2019, CsMc were found in 172 (68.0%) out of 253 fishes in 10 species, and the infection intensity was 565 per fish infected. In 2020, CsMc were detected in 206 (62.2%) out of 331 fishes in 10 species, and the infection intensity was 751 per fish infected. The other zoonotic trematode, ie. Metagonimus spp., Centrocestus armatus, Echinostoma spp. and Clinostomum complanatum, metacercariae were also detected in fishes from the survey streams, but their endemicities were relatively low. Conclusively, it was first confirmed that CsMc are highly endemic in fishes from Yongjeon-cheon in Cheongsong-gun, Gyeongsangbuk-do, Korea.

• Parasites, Hosts and Diseases
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• 제33권1호
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• pp.61-64
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• 1995

참굴큰입흡충(Gymnophalloides seoi)은 참굴이 매개하는 우리 나라 고유의 인체기생 장흡충의 하나로서, 전남 신안군 도서 지방에서 큰 유행지가 발견된 바 있다. 이 흡충은 췌장 질환과의 관계가 의심되어 의학적 관심의 대상이 되고 있다 이번 증례 보고에서는 당뇨병과 동반된 흥미있는 G. seoi감염 2례를 발견하여 보고하고자 한다. 환자들은 당뇨병 치료를 위해 내원하였으며 내원시 대변검사에서 참굴큰입흡충류(gymnophallid)의 충란이 검출되었다 프라지콴텔 및 하제를 투여한 후 충체를 수집한 결과 G. seoi 충체 772마리 및 10마리가 각각 검출되었다. 증례 I은 62세 남자로 G. seoi의 유행지 부근인 목포에 거주하고 있었고, 증례 II는 인천에 거주하고 있으면서 참굴을 날로 즐겨 먹었다고 하였다. 이 증례들을 볼 때 G. seoi감염이 당뇨병과 어떠한 상관관계를 가지고 있을 가능성을 시사하였다.

• Parasites, Hosts and Diseases
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• 제55권5호
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• pp.473-480
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• 2017

Plasmodium vivax merozoite surface protein-1 (PvMSP1) gene codes for a major malaria vaccine candidate antigen. However, its polymorphic nature represents an obstacle to the design of a protective vaccine. In this study, we analyzed the genetic polymorphism and natural selection of the C-terminal 42 kDa fragment within PvMSP1 gene ($PvMSP1_{42}$) from 77 P. vivax isolates, collected from imported cases of China-Myanmar border (CMB) areas in Yunnan province and the inland cases from Anhui, Yunnan, and Zhejiang province in China during 2009-2012. Totally, 41 haplotypes were identified and 30 of them were new haplotypes. The differences between the rates of non-synonymous and synonymous mutations suggest that $PvMSP1_{42}$ has evolved under natural selection, and a high selective pressure preferentially acted on regions identified of $PvMSP1_{33}$. Our results also demonstrated that $PvMSP1_{42}$ of P. vivax isolates collected on China-Myanmar border areas display higher genetic polymorphisms than those collected from inland of China. Such results have significant implications for understanding the dynamic of the P. vivax population and may be useful information towards China malaria elimination campaign strategies.

• Journal of Preventive Medicine and Public Health
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• 제27권2호
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• pp.175-185
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• 1994

In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.