Research trends in pediatric diseases in North Korea: a scoping review of North Korean medical journals, 2006-2019

Abstract

Background: This study analyzed the status of research trends in pediatric diseases in North Korea, as reported in North Korean medical journals. Despite the censorship and control exerted by the North Korean government, these journals provide critical insights into practical achievements and disease cases, serving as vital data sources for understanding North Korea's health landscape.

Methods: We reviewed 10 North Korean medical journals published from 2006 to 2019, specifically targeting the journals Pediatrics, Obstetrics and Gynecology; Surgery; and Chosun Medicine. From an initial pool of 7,739 articles, 728 pediatric research articles were selected for in-depth analysis. We categorized the articles according to publication year, field, article type, research method, statistical approach, and content. Pediatric diseases were classified using the International Classification of Diseases, Tenth Revision. We additionally investigated temporal changes, particularly between the Kim Jong-il and Kim Jong-un eras.

Results: Our analysis of pediatric research articles from North Korean medical journals demonstrated a consistent format and brevity, with the frequent inclusion of the ruling authority's directives and a lack of ethical discussion. Notably, epidemiological studies and randomized controlled trials were not reported. The research focused instead on practical applications, addressing high-burden diseases and the therapeutic effects of traditional medicines. Our distribution analysis revealed that congenital malformations (16.2%), infectious diseases (12.6%), respiratory diseases (11.2%), and gastrointestinal diseases (10.9%) were the most frequently studied topics, reflecting the primary causes of pediatric mortality in North Korea. A significant increase in the volume and diversity of pediatric research was observed during the Kim Jong-un era, coinciding with improved economic conditions and an increased emphasis on science and technology policies.

Conclusions: North Korean pediatric research exhibits distinct and practical characteristics, with trends of increasing diversity and volume over time. Our findings highlight the ongoing autonomous development of pediatric medicine in North Korea, which could have positive implications for future pediatric research in the country. Understanding these research trends is essential for developing strategies to improve children's health in North Korea.