• Clinical and Experimental Pediatrics
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• 제55권12호
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• pp.455-461
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• 2012

Following the Five Year Measles Elimination Program, measles has been declared eliminated from the Republic of Korea since 2006. However, there remain challenges related to the surveillance of measles in the postelimination phase. Even though the routine surveillance system has revealed a gradual decrease in the number of reported cases since 2002, 4 resurgences have occurred, notably due to outbreaks. Because vaccine-modified measles is becoming widespread due to high vaccination coverage, conducting laboratory confirmation in each case becomes important. Moreover, susceptible individuals with measles have been identified through seroprevalence studies. Lastly, the efforts to improve the timeliness of measles reporting have led to the establishment of an active laboratory-based surveillance network, which has shortened the interval between diagnosis and notification. In these circumstances, searching for more sensitive and effective surveillance measures is important for maintaining the elimination status and preventing future outbreaks of measles in Korea.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8993-9004
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• 2014

Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7193-7196
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• 2013

Ovarian cancer patients need a surveillance program for the detection of tumor progression after completion of treatment. The methods generally consist of history taking, physical examination, tumor marker monitoring and imaging. However, the details of recurrence detection with each method are not well defined. To clarify this issue, ovarian cancer patients who achieved complete or partial responses and developed tumor progression at the follow up time between January 2004 and December 2010 in University Hospital Chiang Mai, Thailand, were reviewed. Clinical data, CA 125 level and imaging results at the tumor progression time were recorded and analyzed. There were 144 ovarian cancer patients meeting the inclusion criteria with the mean age of 51 years and 62.5% of them were in an advanced stage. Complete response was achieved in 89 patients (61.8%) after primary treatment. The median progression free survival and overall survival were 15.5 months and 37.5 months, respectively. Abnormal symptoms presented in 49.3% of the studied patients and 59.7% developed physical examination abnormalities. In addition, CA 125 was elevated in 89.6% while in 74.3% of tumor progression was identified by CT-scan. Short treatment time period and a high level of CA 125 were significant independent prognostic factors in these patients. In conclusion, careful history taking, physical examination and monitoring of CA 125 levels are important methods for tumor progression detection in a surveillance program for epithelial ovarian cancer patients.

• 대한수의학회지
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• 제47권4호
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• pp.417-423
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• 2007

Serological surveillance programs in animal populations are becoming increasingly important to estimate prevalence of a specific disease and subsequently to document disease-free status in a region or a country. For these purposes, the programs need to be based on both theoretical and economical aspects from the designing phase. From Aujeszky's disease (AD)-eradication program point of view, group of animals (aggregates, herds) not individual animal is the more important sampling unit of concern. In this study the authors therefore attempted to compute an appropriate sample size tailored to a current surveillance program against AD, assuming that the goal of this program is either herd-level prevalence estimation or documentation of AD-freedom. For prevalence estimation, assuming a finite population with imperfect sensitivity (Se) and specificity (Sp) of ELISA kit for AD diagnosis, the number of herds present, expected herd prevalence, and desired accuracy for a certain level of confidence, sample size was estimated at herd-level in the first stage and individual animal-level in the second stage. A two-stage sampling design was used to calculate a sample size to indicate AD-freedom. In this instance, the computation was based on the possible detection of a predetermined prevalence at a certain herd-level Se and Sp. This study indicated that the sample size varied with predetermined confidence, tolerance, Se and Sp at herd- and animal-level, and within- and among-herd prevalence. In general, smaller sample size was required to estimate AD prevalence than to document of AD-freedom. Compared to individual-based samples, two-stage sampling strategy requires a larger sample size to show disease-freedom. Statistical considerations including herd-level test characteristics when designing surveillance program also are further discussed.

• Asian Pacific Journal of Cancer Prevention
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• 제16권12호
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• pp.4901-4903
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• 2015

The gynecologic oncology patients surveillance network program was conducted with the collaboration of 5 provincial hospitals located in the north of Thailand (Chiang Rai, Lamphun Nan, Phayao and Phrae). The aim was to identify ways of reducing the burden and the cost to the gynecologic cancer patients who needed to travel to the tertiary care hospital for follow up. The clinical data of each patient was transferred to the provincial hospital by the internet via the website www.gogcmu.or.th. All the general gynecologists who participated in this project attended the training course set up for the program. From January 2011 to February 2014, 854 patients who were willing to have their next follow-up at the network hospitals close to their home were enrolled this project. Almost of them were residents in Chiang Rai province and the most common disease was cervical cancer. After the project had been running for 1 year, 604 of the enrolled patients and 21 health-care personnel who had participated in this project were interviewed to assess its success. Some 85.3% of the patients and 100% of the health-care personnel were satisfied with this project. However, 60 patients had withdrawn, the most common reason being the lack of confidence in the follow up at the local provincial hospital. In conclusion, it is possible to initiate a gynecologic oncology patients' surveillance network program and the initiation could reduce the problems associated with and the cost the patients incurred as they journeyed to the tertiary care hospital.

• 한국학교보건학회지
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• 제18권2호
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• pp.85-92
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• 2005

Purpose： This study reviews the Youth Risk Behavior Surveillance System (YRBSS) in the United States. This review focuses on the purposes, questionnaires, survey methods, and use of survey results. The author also discussesthe establishment and use of Korean Youth Risk Behavior Surveillance System. Results：The YRBSS was developed in 1990 to monitor priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The purpose of YRBSS is to determine the prevalence of health risk behaviors, to assess the trend of health risk behavior prevalence, provide comparable data, monitor progress toward achieving the Healthy People 2010. The questionnaires inquire about health-related behaviors, including tobacco use, unhealthydietary behaviors, inadequate physical activity, alcohol and drug use, sexual activity, behaviors that contribute to unintentional injuries and violence. The results of YRBS have been used to estimate the prevalence of risk behaviors among youth, to set goals for school health programs, for training and development of health program personnel, for the development of health education curriculum, to support enactment of health-related regulations, and to support funding for futher research. Conclusions： The YRBSS represents a potentially valuable program that can be applied in Korea. Assessment of risk behaviors among Korean youths will provide invaluable insight for many potential purposes.

• 한국산업보건학회지
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• 제22권4호
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• pp.276-283
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• 2012

Objectives: This study was conducted to survey the viewpoints on the material safety data sheets(MSDS) training for safety and health managers(SHMs) and workers. Subjects and Methods: A surveillance was made using a self-reported questionnaire for 78 SHMs and 122 workers to survey their viewpoints on the MSDS training. Survey results were analyzed using the SPSS program(Version 12.0 SPSS Inc., USA). Results: The result of the study shows that there are contrasts with the cognition of SHMs' and workers' on the education of MSDS and the program preference for education efficiency of MSDS. Workers were significantly more interested in the MSDS education than the SHMs did. Workers preferred the education program which is easily to be understood, to voluntarily participate on MSDS education, but SHMs did the quiz program. Also we found that the SHMs wanted to learn the education program via the expert(37.3%) rather than education resources(33.3%) which were served by government or relevant agency. In contrast, workers wanted the audio-visual education program, which is mainly consisted of accident cases (33.3%), rather than periodical education program(22.1%). Conclusions: This study showed that effectiveness of MSDS education was associated with the program served by company, and the education program for the voluntary participation of the workers should be made practical and attractive.

• 한국임상수의학회지
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• 제29권1호
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• pp.63-67
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• 2012

Mosquitoes are the vectors of a number of viral diseases in cattle, such as Akabane disease, bovine ephemeral fever, Ainovirus infection, Chuzan virus infection, and Ibaraki disease. These diseases are transmitted from an infected animal to a non-infected host via the blood feeding of the vector. In Korea, the National Veterinary Research and Quarantine Services, Ministry for Food, Agriculture, Forestry and Fisheries is responsible for planning, implementation, laboratory investigations and reporting the results of the national surveillance program for mosquito-borne bovine diseases (MBD). The surveillance program, which was started in 1993, focused to determine the seroprevalence of each disease in cattle herds in space and time. From the epidemiological point of view, more important component of the surveillance program is to monitor infection rates in vectors for specific pathogens because this information is essential for a more precise understanding the dynamics of these diseases in a given environment and for determining risk of transmission. The aim of this study was to describe and compare methods for estimation of vector infection rates using maximum likelihood (MLE) and minimum infection rate in pooled samples. Factors affecting MLE such as number of pools, pooling size and diagnostic test performance are also discussed, assuming some hypothetical sampling scenarios for MBD.

• Clinical and Experimental Pediatrics
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• 제65권3호
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• pp.127-128
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• 2022

• Safety and Health at Work
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• 제10권4호
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• pp.420-427
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• 2019

Introduction: To prevent and manage the societal and economic burden of occupational diseases (ODs), countries should develop strong prevention policies, health surveillance and registry systems. This study aims to contribute to the improvement of OD surveillance at national level as well as to identify priority actions in Turkey. Methods: The history and current status of occupational health studies were considered from the perspective of OD surveillance. Interpretative research was done through literature review on occupational health at national, regional and international level. Analyses were focused on countries' experiences in policy development and practice, roles and responsibilities of institutions, multidisciplinary and intersectoral collaboration. OD surveillance models of Turkey, Belgium and the Netherlands were examined through exchange visits. Face-to-face interviews were conducted to explore the peculiarities of legislative and institutional structures, the best and worst practices, and approach principles. Results: Some countries are more focused on exploring OD trends through effective and cost-efficient researches, with particular attention to new and emerging ODs. Other countries try to reach every single case of OD for compensation and rehabilitation. Each practice has advantages and shortcomings, but they are not mutually exclusive, and thus an effective combination is possible. Conclusion: Effective surveillance and registry approaches play a key role in the prevention of ODs. A well-designed system enables monitoring and assessment of OD prevalence and trends, and adoption of preventive measures while improving the effectiveness of redressing and compensation. A robust surveillance does not only provide protection of workers' health but also advances prevention of economic losses.