North Korean leader Kim Jong-un has made his first public appearance in 20 days, the country’s state media reported early on Saturday, amid rumours about his health. The state-run media later released images that it said showed Kim cutting a ribbon at the inauguration of a fertiliser factory.

The Korean Central News Agency said Kim attended a ceremony, marking the completion of a fertiliser factory in Suncheon, near the capital of Pyongyang, with other senior officials, including his sister Kim Yo Jong.

People who attended the event “burst into thunderous cheers of ‘hurrah!’ for the supreme leader who is commanding the all-people general march for accomplishing the great cause of prosperity”, the state media reported.

Doubts were raised about Kim’s well-being after he missed the celebration of his grandfather’s birthday on April 15. On April 21, Daily NK, an online newspaper based in South Korea that reports on North Korea, said that Kim had undergone a heart surgery at Hyangsan Hospital due to “a number of factors, including his obesity, prolific smoking habits, and overwork”.

South Korea’s unification ministry had said that it was the first instance that Kim had failed to attend the ceremony at the palace to honour his grandfather since he came to power in 2012.

Meanwhile, United States President Donald Trump on Friday declined to comment on Kim’s alleged public appearance. “I’d rather not comment on it yet...,” he told reporters, according to CNN. “We will have something to say about it at the appropriate time.”

Last Sunday, South Korean presidential adviser Moon Chung-in said that the North Korean leader was “alive and well” despite speculation about his well-being. He claimed Kim had been staying in the Wonsan area on the country’s east coast since April 13. “No suspicious movements have so far been detected,” he added.

Getting inputs from North Korea has always been very difficult as the nuclear-armed country tightly controls any information surrounding its leader. Kim’s absence from state media had triggered speculations about his health earlier too. In 2014, he was not in the public eye for nearly six weeks. Days later, South Korea’s spy agency said he had a cyst removed from his ankle.