The impact of the COVID-19 pandemic on chlamydia infection in South Korea: a comparison between the pre-pandemic and during-pandemic periods.

Background: Prior to COVID-19 pandemic, a yearly upward trajectory in the number of chlamydia infection cases was observed in South Korea. However, in response to the COVID-19 pandemic, Korea implemented several public health and social measures, which were shown to have an impact on the epidemiology of other infectious diseases. This study aimed to estimate the impact of the COVID-19 pandemic on the incidence and number of reported chlamydia infections in South Korea. Methods: Using the monthly number of reported chlamydia infection data between 2017 and 2022, we compared the trends in the reported numbers, and the incidence rates (IR) of chlamydia infection stratified by demographic characteristics (sex, age group, and region) in the pre- and during COVID-19 pandemic period (January 2017-December 2019 and January 2020-December 2022). Results: We observed an irregular downward trajectory in the number of chlamydia infection in the during-pandemic period. A 30% decrease in the total number of chlamydia infection was estimated in the during-pandemic compared to the pre-pandemic period, with the decrease greater among males (35%) than females (25%). In addition, there was a decrease in the cumulative incidence rate of the during COVID-19 pandemic period (IR: 0.43; 95% CI: 0.42-0.44) compared to the pre-pandemic period (IR: 0.60; 95% CI: 0.59-0.61). Conclusions: We identified decrease in the number of chlamydia infection during COVID-19 pandemic which is likely due to underdiagnosis and underreporting for the infection. Therefore, strengthening surveillance for sexually transmitted infections including chlamydia is warranted for an effective and timely response in case of an unexpected rebound in the number of the infections.

Gaps in measles vaccination coverage in Kasese district, Western Uganda: results of a qualitative evaluation.

BACKGROUND: Despite the availability of a highly effective vaccine, measles remains a substantial public health problem in many countries including Uganda. In this study, conducted between June-August 2020 following a local outbreak, we sought to explore the factors that could affect measles vaccination coverage in rural western Uganda. METHODS: We conducted a descriptive study using qualitative data collection approaches in the Kasese district. The research team utilized purposive sampling to identify and select participants from the public health sector and district government. We conducted key informant interviews (KII) and one focus group discussion (FGD). Responses were recorded using portable electronic devices with the FGD and KII guide installed. Interviews were conducted at the health centre and district headquarters. Data was coded and analysed using ATLAS.ti version 8 software through deductive thematic analysis to identify key themes. RESULTS: Barriers to measles vaccination identified in this study were premised around six themes including: (i) availability of supplies and stock management, (ii) health worker attitudes and workload, (iii) financing of vaccination outreach activities, (iv) effectiveness of duty rosters (i.e., health workers' working schedules), (v) community beliefs, and (vi) accessibility of healthcare facilities. Respondents reported frequent vaccine supply disruptions, lack of resources to facilitate transportation of health workers to communities for outreach events, and health centre staffing that did not adequately support supplemental vaccination activities. Furthermore, community dependence on traditional medicine as a substitute for vaccines and long distances traveled by caregivers to reach a health facility were mentioned as barriers to vaccination uptake. CONCLUSIONS: Health system barriers limiting vaccination uptake were primarily logistical in nature and reflect inadequate resourcing of immunization efforts. At the same time, local beliefs favouring traditional medicine remain a persistent cultural barrier. These findings suggest an urgent need for more efficient supply management practices and resourcing of immunization outreaches in order to achieve the Uganda Ministry of Health's targets for childhood immunization and the prevention of disease outbreaks.

Predictors for High-Risk Carotid Plaque in Asymptomatic Korean Population.

AIMS: High-risk carotid plaque remains an important risk factor for atherosclerotic cardiovascular disease (ASCVD). We sought to evaluate the characteristics of carotid plaque and to find out the predictors for high-risk carotid plaque in asymptomatic Koreans. METHODS: Subjects (n = 801) without a history of ASCVD from 12 university hospitals in Korea underwent carotid ultrasound. The images were standardized at core laboratory. Morphologic characteristics of plaque were analyzed with laboratory and clinical characteristics. High-risk carotid plaque features included the highest quartile of carotid plaque score (cPS), irregular plaque surface, and hypoechoic and ulcerated plaque. RESULTS: The carotid plaque prevalence was 22.1% (177/801 persons, 293 plaques). The plaque was increased with age (p < 0.001) and conventional ASCVD risk estimator (p < 0.001) and the most frequently found in bulb (n = 190, 64.8%). The number of the highest quartile of cPS was 44/177 (24.9%). Irregular plaque was seen in 20.8% out of total plaque (61/293) and was more frequent in the high-risk 10-year ASCVD risk group than in the low-risk group (36.1% vs. 15.8%, p = 0.023). Hypoechoic and ulcerated plaques were seen in 14.3% (42/293) and 2% (6/293), respectively. The independent predictors for high-risk plaque were age (ß = 0.052, p < 0.001), HbA1c (ß = 0.182, p = 0.004), male (ß = 0.118, p = 0.006), hypertension (ß = 0.090, p = 0.032), and multiple plaques (OR: 4.810 (two plaques) and 8.621 (three plaques), all p < 0.001). CONCLUSIONS: This study suggests that high-risk carotid plaque was seen in 12.4% (99/801). The high-risk plaque was associated with diabetes control status reflected by the HbA1c level as well as traditional risk factors in asymptomatic Korean population.