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Sonsupap C, Pokhakul P, Kariya T, Suzuki Y, Hamajima N, Yamamoto E. Characteristics of adverse drug reactions due to nonsteroidal anti-inflammatory drugs: a cross-sectional study. Nagoya J Med Sci 2023; 85:668-681. [PMID: 38155619 PMCID: PMC10751502 DOI: 10.18999/nagjms.85.4.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/04/2022] [Indexed: 12/30/2023]
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for treating pain and inflammation. Spontaneous adverse drug reaction (ADR) reports represent a rich data source for the detection of unknown and rare ADRs. This cross-sectional study aimed to analyze the characteristics of ADRs due to NSAIDs in Thailand. All ADR reports of NSAIDs for systemic use from 2015 to 2019 were extracted from the national database in Thailand. Patient characteristics, drug use information, adverse event information, and source of senders in 32,857 reports were analyzed. The annual number of ADR reports due to NSAIDs decreased from 7,008 in 2015 to 5,922 in 2019. The most frequently reported drug was ibuprofen (n=12,645, 38.5%) followed by diclofenac (n=7,795, 23.7%), most patients were 40-59 years old, and the major adverse reaction was angioedema (n=7,513, 22.9%). Serious reactions were recorded in 20.7% (n=6,801) of the total ADRs. Most patients (n=20,593, 62.7%) recovered without sequelae, but there were 5,420 patients (16.5%) who could not recover and 3,109 patients (9.5%) who were recovering. Eight patients (0.02%) died of Stevens-Johnson syndrome (n=3), toxic epidermal necrolysis (n=4), and anaphylactic shock (n=1), which were possibly related to ADRs. The number of ADR reports due to NSAIDs decreased from 2015 to 2019 in Thailand. Serious ADRs and death cases accounted for 20.7% and 0.02%, respectively. Most fatal cases exhibited severe drug-induced skin reactions.
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Affiliation(s)
- Cholticha Sonsupap
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Health Product Vigilance Center, Food and Drug Administration, Ministry of Public Health, Nonthaburi, Thailand
| | - Pattreya Pokhakul
- Health Product Vigilance Center, Food and Drug Administration, Ministry of Public Health, Nonthaburi, Thailand
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yunosuke Suzuki
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Inthaphatha S, Louangpradith V, Phoummalaysith B, Thanavanh B, Kariya T, Yamamoto E, Hamajima N. Reporting system on mortality statistics in Lao People's Democratic Republic. Nagoya J Med Sci 2023; 85:113-122. [PMID: 36923630 PMCID: PMC10009615 DOI: 10.18999/nagjms.85.1.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 03/01/2022] [Indexed: 03/18/2023]
Abstract
The system to collect information on mortality statistics in Lao PDR is not well established, accurate and timely death information is therefore not available. This article reports the system and process to make the mortality statistical data of Lao PDR. The country has a paper-based resident registration system, using a death notification document, a death certificate, and a family census book. The death notification document is important as it provides the cause of death, which is issued from a health facility and the village office. In the event of a death occurring at home, the family representative needs to report to the village office verbally to obtain a death notification document. On the other hand, if the death occurred in a medical facility, a death notification document from a health facility is provided. The family representative should bring the death notification document to the district Home Affairs office to register the death and obtain a death certificate. After that, the family representative needs to bring the death certificate to the district Public Security office for an amendment in the family census book. ICD-10 is under development regarding death notification from health facilities under the Ministry of Health. However, it is unclear how death notification from village offices can adopt ICD-10 as the majority of deaths occur outside health facilities. A comprehensive and integrated mortality reporting system is necessary in order to create a holistic health policy and welfare for the country.
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Affiliation(s)
- Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | | - Bounbouly Thanavanh
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Xayyabouly Provincial Health Department, Xayyabouly Province, Lao PDR
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Moeun S, Bhoomikumar J, Pat P, Kariya T, Suzuki Y, Hamajima N, Sok D, Yamamoto E. Children with neuro-developmental disorders at Center for Child and Adolescent Mental Health in Cambodia. Nagoya J Med Sci 2022; 84:593-606. [PMID: 36237880 PMCID: PMC9529632 DOI: 10.18999/nagjms.84.3.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/05/2021] [Indexed: 11/12/2022]
Abstract
The Center for Child and Adolescent Mental Health (CCAMH) is one of the centers that have psychiatric specialists for children in Cambodia. This study aims to understand the characteristics of children with neuro-developmental disorders, especially autism spectrum disorder (ASD), at CCAMH. This study included 440 cases that were randomly chosen from 2,147 new patients at CCAMH in 2018-2019 and were aged 0-12 years. Socio-demographic factors, parent's information, obstetrical factors, and clinical data were collected from patients' records. A logistic regression analysis and Pearson's chi-square test were used to compare the characteristics between children who were finally diagnosed with ASD and the others (non-ASD). Of the 440 patients, most were male (75.2%), 0-4 years old (57.7%), and diagnosed with ASD (50.0%). Common symptoms were delay of speech, playing alone, and hyperactivity. ASD was significantly more prevalent in male patients compared to females and in the 0-4 years age group compared to the 5-12 years age group. Parents who lived in Phnom Penh and had high education were more likely to visit the CCAMH with their children who were diagnosed with ASD. Regarding treatment, approximately half of all 440 patients had family counselling and psychosocial education. ASD patients had more speech therapy, special education and structured teaching, and networking and coordination therapy compared to non-ASD patients. To provide education and therapy to children with ASD and their parents from the early stage, information about the center and ASD should be widely distributed to all parents in Cambodia.
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Affiliation(s)
- Sreyleap Moeun
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Department of International Cooperation, Ministry of Health, Phnom Penh, Cambodia
| | - Jegannathan Bhoomikumar
- Center for Child and Adolescent Mental Health, Chey Chumneas Referral Hospital, Takhmau, Cambodia
| | - Puthy Pat
- Center for Child and Adolescent Mental Health, Chey Chumneas Referral Hospital, Takhmau, Cambodia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yunosuke Suzuki
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Dearozet Sok
- Center for Child and Adolescent Mental Health, Chey Chumneas Referral Hospital, Takhmau, Cambodia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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M Selvarajah T, Yamamoto E, Saw YM, Kariya T, Hamajima N. Satisfaction With Health Care Services at the Pediatric Specialist Clinic of the National Referral Center in Malaysia: Cross-sectional Study of Caregivers' Perspectives. JMIRx Med 2022; 3:e33025. [PMID: 37725531 PMCID: PMC10414228 DOI: 10.2196/33025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/30/2021] [Accepted: 01/27/2022] [Indexed: 09/21/2023]
Abstract
BACKGROUND The concept of customer satisfaction is gaining hold in all corporate sectors worldwide, and a satisfaction survey is used as a tool to discover service problems and as a chance for customers to rate their experience with health care services. A high degree of patient satisfaction with the services given has been found in numerous studies conducted in Malaysian public health care facilities. However, there is limited information available on caregiver satisfaction with pediatric clinics run by the Ministry of Health (MoH) of Malaysia. OBJECTIVE This was the first research performed at a public hospital's pediatric clinic, which was the first hospital to adopt the public-private-partnership model under the MoH, with the aim of discovering the prevalence and factors affecting the satisfaction of caregivers at the national referral center. METHODS Cross-sectional research using the standard self-administered SERVQUAL questionnaire was conducted among caregivers accompanying their children to the clinic. The questionnaire consists of 16 paired statements to evaluate their expectations and experiences with the clinic services. RESULTS A total of 459 caregivers were involved in this study with a majority aged between 30 and 39 years (n=254, 55.4%). Caregivers from the Indian community (adjusted odds ratio [AOR] 2.91, 95% CI 1.37-6.18) and lower income groups (AOR 2.94, 95% CI 1.87-4.64), and those with lower educational backgrounds (AOR 3.58, 95% CI 1.19-10.72) were more likely to be satisfied with the quality of pediatric clinic services. Housewives/househusbands (AOR 0.48, 95% CI 0.25-0.90), on the other hand, appeared less likely to be satisfied with the services provided during their visit to the clinic. Looking at overall patient satisfaction, 50.5% (n=232) of caregivers demonstrated satisfaction with the quality of services, compared to 49.5% (n=227) of dissatisfied respondents. CONCLUSIONS This paper suggests that, although most caregivers are satisfied with the services, greater emphasis must be placed on delivering reliable service in response to the MoH's mission to provide quality and integrated people-centered health services in Malaysia.
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Affiliation(s)
- Thinakaran M Selvarajah
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Hospital Putrajaya, Ministry of Health, Putrajaya, Malaysia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Thanavanh B, Hackpaserd S, Inthaphatha S, Kariya T, Suzuki Y, Yamamoto E, Hamajima N. Underlying cause of death at medical facilities in Xaiyabouli Province, Lao People's Democratic Republic. Nagoya J Med Sci 2022; 84:448-461. [PMID: 35967936 PMCID: PMC9350566 DOI: 10.18999/nagjms.84.2.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/11/2021] [Indexed: 11/22/2022]
Abstract
In Lao PDR, Ministry of Health introduced District Health Information Software 2 (DHIS2) in 2013. Although DHIS2 includes cause of death, Lao government did not request to report cause of death through DHIS2, resulting in no information on frequency of underlying cause of death even for the deaths at medical facility. This study aimed to collect the information on the underlying cause of death at all medical facilities in Xaiyabouli province, a rural area in Lao PDR. As well as the point estimate of the proportion, a 95% confidence interval (CI) based on a binomial distribution was calculated for each cause of death. According to the local government request, 226 deaths (128 males and 98 females) in 2019 were reported from all medical facilities in the province. Among them, infectious diseases were the most frequent (33.6%, 95% CI 27.5-40.2%); sepsis (16.8%, 95% CI 12.2-22.3%), pneumonia (8.8%, 95% CI 5.5-13.3%), and meningitis (4.9%, 95% CI 2.5-8.5%). Heart diseases were 15.9% (95% CI 11.4-21.4%) including heart failure and myocardial infarction. Injury was 10.2% (95% CI 6.2-14.4%) including brain injury. Neonatal death was 10.6% (95% CI 6.9-15.4%). Among those, preterm death was common (8.8%, 95% CI 5.3-13.3%). Renal failure was 8.0% (95% CI 4.8-12.3%). According to civil registration covering all deaths both at facilities and outside facilities, deaths at facilities were 16.8% of the whole deaths (1,372 deaths) in Xaiyabouli province. Although deaths outside facilities were not included, this is the first report demonstrating cause of death in one province in Lao PDR.
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Affiliation(s)
- Bounbouly Thanavanh
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Xaiyabouli Provincial Health Office, Xaiyabouli, Lao People’s Democratic Republic
| | - Singkham Hackpaserd
- Xaiyabouli Provincial Health Office, Xaiyabouli, Lao People’s Democratic Republic
| | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yunosuke Suzuki
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Tran TP, Nguyen DC, Dang TVQ, Tran TK, Vu PT, Vu MH, Le TH, Saw TN, Cho SM, Kariya T, Yamamoto E, Hamajima N, Saw YM. Development of a Vietnamese version of the Revised Hasegawa's Dementia scale. Nagoya J Med Sci 2022; 84:402-417. [PMID: 35967950 PMCID: PMC9350578 DOI: 10.18999/nagjms.84.2.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/06/2021] [Indexed: 12/05/2022]
Abstract
As the aging population grows worldwide, the problem of age-related health is becoming an important public health concern. Dementia is a devastating disease that places a significant physical, emotional, and financial burden on patients, their caregivers, and society. It is predicted to increase in developing countries. The Revised Hasegawa's Dementia Scale (HDS-R) has been used in many Asian countries to measure cognitive function. However, there is still no Vietnamese version of the HDS-R. Therefore, this paper describes the development of the HDS-R scale and manual in Vietnamese language. Two Vietnamese researchers translated the HDS-R from English to Vietnamese. To confirm the accuracy of the translation, two other Vietnamese researchers conducted a back-translation. Another pair of Vietnamese researchers compared the back-translated English version to the original one. All six researchers discussed the inconsistencies between English HDS-R scale and manual and derived the most suitable version for the Vietnamese context. In Questions 4 and Question 7, we changed the words from "cherry blossom" and "train" to "daisy flower" and "bicycle" for the first option, and from "plum blossom" to "rose" for the second option. We also changed the expressions in some places in the manual to fit the Vietnamese language. Future studies are needed to validate this version to be able to access cognitive function in both clinical and public healthcare settings.
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Affiliation(s)
- Thi Phuong Tran
- Department of Epidemiology, Faculty of Public Health, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Duy Cuong Nguyen
- Department of Emergency Resuscitation, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Thi Van Quy Dang
- Department of Environmental Health, Faculty of Public Health, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Thi Khuyen Tran
- Department of Epidemiology, Faculty of Public Health, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Phong Tuc Vu
- Department of Environmental Health, Faculty of Public Health, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Minh Hoang Vu
- Department of Dentomaxillofacial, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Thu Hang Le
- Department of Testing and Educational Quality Assurance, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Thu Nandar Saw
- Department of Community and Global Health, the University of Tokyo, Tokyo, Japan
| | - Su Myat Cho
- Department of Community and Global Health, the University of Tokyo, Tokyo, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Yu Mon Saw
- Department of Community and Global Health, the University of Tokyo, Tokyo, Japan
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Khalid KH, Yamamoto E, Hamajima N, Kariya T. Rates and Factors Associated With Serious Outcomes of Patient Safety Incidents in Malaysia: An Observational Study. Glob J Qual Saf Healthc 2022; 5:31-38. [PMID: 37260835 PMCID: PMC10229002 DOI: 10.36401/jqsh-21-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/30/2022] [Accepted: 04/05/2022] [Indexed: 06/02/2023]
Abstract
Introduction This study aimed to examine the reporting rate and the factors associated with serious outcomes of patient safety incidents at public hospitals in Malaysia. Methods All patient safety incidents reported in the e-Incident-Reporting System from January to December 2019 were included in the study. A descriptive study was used to describe the characteristics of incidents, and logistic models were used to identify factors associated with low reporting rates and severe harm or death outcomes of incidents. Results There were 9431 patient safety incidents reported in the system in 2019. The mean reporting rate was 2.1/1000 patient bed-days or 1.5% of hospital admissions. The major category of incidents was drug-related incidents (32.4%). No-harm incidents contributed to 56.1% of all the incidents, while 1.1% resulted in death. More hospitals in the eastern (odds ratio [OR], 12.1) and southern regions (OR, 6.1) had low reporting rates compared to the central region. Incidents with severe harm or death outcomes were associated with more males (OR, 1.4) than females and with the emergency department (OR, 10.6), internal medicine (OR, 5.7), obstetrics and gynecology (OR, 2.4), and surgical department (OR, 5.0) more than the pharmacy department. Compared to drug-related incidents, operation-related (OR, 3.0), procedure-related (OR, 3.5), and therapeutic-related (OR, 4.8) incidents had significantly more severe harm or death outcomes, and patient falls (OR, 0.4) had less severe harm or death outcomes. Conclusion The mean reporting rate was 2.1/1000 patient bed-days or 1.5% of hospital admissions. More hospitals in the eastern and southern regions had low reporting rates. Certain categories of incidents had significantly more severe outcomes.
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Affiliation(s)
- Khairulina Haireen Khalid
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Medical Development Division, Ministry of Health, Malaysia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Batbayar B, Kariya T, Boldoo T, Purevdorj E, Dambaa N, Saw YM, Yamamoto E, Hamajima N. Patient delay and health system delay of patients with newly diagnosed pulmonary tuberculosis in Mongolia, 2016-2017. Nagoya J Med Sci 2022; 84:339-351. [PMID: 35967952 PMCID: PMC9350575 DOI: 10.18999/nagjms.84.2.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
Although diagnosis and treatment of tuberculosis (TB) have been improved in many countries, delays in the diagnosis and treatment remain problematic in resource-limited countries. This study aimed to identify factors affecting delays in TB care in Mongolia. Data on TB cases registered from January 2016 to December 2017 were obtained from the national registry of TB at the Department of TB Surveillance and Research in National Center for Communicable Disease. The total number of TB cases registered in these two years was 8,166, including 3,267 cases of newly diagnosed pulmonary TB. Pulmonary TB cases (1,836 males and 1,431 females) were analyzed to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Patient delays longer than the median (28 days) were significantly associated with patient age >32 years (aOR=1.31, 95%CI: 1.14-1.51), residence in areas other than Ulaanbaatar (aimags) (aOR=1.38, 95%CI: 1.20-1.59), and smear-negative (aOR=0.57, 95%CI: 0.47-0.69). Health system delays longer than the median (7 days) were significantly associated with patient age >32 years (aOR=1.16, 95%CI: 1.00-1.33), residence in aimags (aOR=0.82, 95%CI: 0.71-0.95), special facilities including a prison hospital (aOR=4.40, 95%CI: 2.42-7.83), registration in 2017 relative to 2016 (aOR=0.83, 95%CI: 0.71-0.95), and smear-negative (aOR=1.72, 95%CI: 1.42-2.07). Total delays longer than the median (45 days) were significantly associated with patient age >32 years (aOR=1.39, 95%CI: 1.21-1.60), residence in aimags (aOR=1.27, 95%CI: 1.11-1.47), and smear-negative (aOR=0.74, 95%CI: 0.62-0.90). To shorten the total delay, improvement of the access to medical facilities in aimags is necessary.
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Affiliation(s)
- Batmunkh Batbayar
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Ministry of Health of Mongolia, Ulaanbaatar, Mongolia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Tsolmon Boldoo
- National Center for Communicable Diseases, Ministry of Health of Mongolia, Ulaanbaatar, Mongolia
| | - Enkhtamir Purevdorj
- National Center for Communicable Diseases, Ministry of Health of Mongolia, Ulaanbaatar, Mongolia
| | - Naranzul Dambaa
- National Center for Communicable Diseases, Ministry of Health of Mongolia, Ulaanbaatar, Mongolia
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Senavong P, Yamamoto E, Keomoungkhoune P, Prasith N, Somoulay V, Kariya T, Saw YM, Pongvongsa T, Hamajima N. Factors associated with severe dengue in Savannakhet Province, Lao People's Democratic Republic. Nagoya J Med Sci 2021; 83:749-763. [PMID: 34916719 PMCID: PMC8648533 DOI: 10.18999/nagjms.83.4.749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 03/10/2021] [Indexed: 11/21/2022]
Abstract
This study aimed to describe the socio-demographic and clinical characteristics of dengue inpatients at a provincial hospital, and to identify factors associated with severe dengue. This is a retrospective study involving 402 dengue patients admitted to the Savannakhet Provincial Hospital, Lao People's Democratic Republic (Lao PDR), between January 2018 and April 2019. Socio-demographic factors, clinical signs and laboratory data on admission, final diagnosis, use of health care services before admission, admission date, and hospitalization period were collected from patient records. The number of dengue inpatients was higher in the rainy season than in the dry season. Of the 402 patients, 205 patients (51.0%) were finally diagnosed with severe dengue. Children aged <15 years had more symptoms, higher proportion of severe dengue (69.8% vs. 35.9%), and longer hospitalization (3.5 days vs. 3.0 days) than adults aged ≥15 years. In multivariable analyses, factors associated with severe dengue were nausea on admission (adjusted odds ratio=3.57, 95% CI=1.05-12.09, P=0.04) in children and persistent vomiting on admission (adjusted odds ratio=3.82, 95% CI=1.23-11.92, P=0.02) in adults. In adults, the creatinine level on admission was significantly higher in patients with a final diagnosis of severe dengue compared to the others. The proportion of severe dengue in our study was higher than that in other countries. Nausea and persistent vomiting on admission were suggested to be predictive factors for severe dengue. To reduce the incidence of severe dengue in Lao PDR, improvements in access to health care, referral system, and training of health care workers are needed.
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Affiliation(s)
- Phetvilay Senavong
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Healthcare Administration Unit, Savannakhet Provincial Hospital, Savannakhet, Lao People’s Democratic Republic
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Phouvilay Keomoungkhoune
- Healthcare Administration Unit, Savannakhet Provincial Hospital, Savannakhet, Lao People’s Democratic Republic
| | - Nouda Prasith
- Public Health Office, Savannakhet, Lao People’s Democratic Republic
| | - Virasack Somoulay
- National Central Laboratory and Epidemiology, Ministry of Health, Lao People’s Democratic Republic
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Cho SM, Saw YM, Saw TN, Than TM, Khaing M, Khine AT, Kariya T, Soe PP, Oo S, Hamajima N. Prevalence and risk factors of anxiety and depression among the community-dwelling elderly in Nay Pyi Taw Union Territory, Myanmar. Sci Rep 2021; 11:9763. [PMID: 33963225 PMCID: PMC8105404 DOI: 10.1038/s41598-021-88621-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/07/2021] [Indexed: 12/02/2022] Open
Abstract
Providing elderly mental healthcare in Myanmar is challenging due to the growing elderly population and limited health resources. To understand common mental health problems among Myanmar elderly, this study explored the prevalence and risk factors of anxiety and depression among the elderly in the Nay Pyi Taw Union Territory, Myanmar. A cross-sectional study was conducted among 655 elderly by face-to-face interviews with a pretested questionnaire. Descriptive analysis and multiple logistic regression analyses were performed. The prevalence of anxiety and depression were 39.4% (33.5% for males and 42.4% for females) and 35.6% (33.0% for males and 36.9% for females), respectively. The adjusted odds ratio of having anxiety was significant for having low education level, having comorbidity, having BMI < 21.3, poor dental health, no social participation, and having no one to consult regarding personal problems, while that of having depression was significant for having comorbidity, having BMI < 21.3, poor vision, and having no one to consult regarding personal problems. The reported prevalence of anxiety and depression indicate the demand for mental healthcare services among Myanmar elderly. Myanmar needs to improve its elderly care, mental healthcare, and social security system to reflect the actual needs of its increasing elderly population. Screening for anxiety and depression among elderly with comorbidities should be promoted. Raising community awareness of mental health, encouraging social participation, and supportive counselling are also essential in combating anxiety and depression among Myanmar elderly.
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Affiliation(s)
- Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thu Nandar Saw
- Department of Community and Global Health, The University of Tokyo, 5th Floor, Medical Bldg. No. 3, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Thet Mon Than
- Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Office No. 4, Nay Pyi Taw, 15011, Nay Pyi Taw Union Territory, Myanmar
| | - Moe Khaing
- Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Office No. 4, Nay Pyi Taw, 15011, Nay Pyi Taw Union Territory, Myanmar
| | - Aye Thazin Khine
- Planning Unit, Department of Public Health, Ministry of Health and Sports, Office No. 47, Nay Pyi Taw, 15011, Nay Pyi Taw Union Territory, Myanmar
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Pa Pa Soe
- Department of Preventative and Social Medicine, University of Medicine, 30th Street, Between 73rd & 74th Streets, Mandalay, Myanmar
| | - San Oo
- Department of Neurology, Yangon General Hospital, Bo Gyoke Road, Lanmadaw Township 11131, Yangon, Myanmar
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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11
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Keng ZY, Saw YM, Thung SC, Chong WW, Albert A, Kariya T, Yamamoto E, Hamajima N. Rate of achievement of therapeutic outcomes and factors associated with control of non-communicable diseases in rural east Malaysia: implications for policy and practice. Sci Rep 2021; 11:3812. [PMID: 33589659 PMCID: PMC7884395 DOI: 10.1038/s41598-021-83168-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 01/25/2021] [Indexed: 12/02/2022] Open
Abstract
Non-communicable diseases (NCDs) are an increasing problem worldwide, including in Malaysia. National surveys have been performed by the government but had poor coverage in east Malaysia, particularly in rural regions. This study aimed to describe the achievement of target therapeutic outcomes in the control of diabetes mellitus (DM), hypertension (HPT), and dyslipidemia (DLP) among diabetic patients in rural east Malaysia. A cross-sectional study was conducted among DM patients who visited the NCDs clinic in Lundu Hospital, Sarawak, Malaysia, from Jan to March 2016. In total, 214 patients (male, 37.9%; female, 62.1%) were recruited using a systemic sampling method. Multiple logistic regression models were applied to estimate the adjusted odds ratio (AOR) and confidence interval (CI) for the target therapeutic achievement in the control of DM, HPT, and DLP. Compared to the national average, therapeutic target achievement in Lundu was higher for DM (43.0% vs. 23.8%), equal for DLP (35.8% vs. 37.8%) but lower for HPT (30.9% vs. 47.9%). DM patients who had at least yearly HbA1c monitoring (AOR 2.30, 95% CI 1.04–5.06, P = 0.039), and those 58.7 years or older (AOR 2.50, 95% CI 1.32–4.74, P = 0.005) were more likely to achieve the therapeutic target for DM. Health promotion and public education regarding HPT needs to be emphasized in rural Malaysia. HbA1c monitoring at least once a year was one of the important factors associated with achieving DM control in rural east Malaysia. Accessibility to HbA1c tests and monitoring should be ensured for diabetic patients.
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Affiliation(s)
- Zhi Yi Keng
- Department of Internal Medicine, Hospital Umum Sarawak, Sarawak, Malaysia.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan. .,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Senk Chung Thung
- Department of Family Medicine, Hospital University Sains Malaysia, Kelantan, Malaysia
| | - Woon Wee Chong
- Department of Emergency Medicine, Hospital University Sains Malaysia, Kelantan, Malaysia
| | - Amanda Albert
- Department of Psychiatry, Hospital Sentosa, Sarawak, Malaysia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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12
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Leak P, Yamamoto E, Noy P, Keo D, Krang S, Kariya T, Saw YM, Siek M, Hamajima N. Factors associated with neonatal mortality in a tertiary hospital in Phnom Penh, Cambodia. Nagoya J Med Sci 2021; 83:113-124. [PMID: 33727743 PMCID: PMC7938092 DOI: 10.18999/nagjms.83.1.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022]
Abstract
This study aimed to identify hospital neonatal mortality rate (NMR) and the causes of neonatal deaths, and to understand risk factors associated with neonatal mortality in a national tertiary hospital in Cambodia. The study included all newborn infants, aged 0-28 days old, hospitalized in the Pediatrics department of Khmer-Soviet Friendship Hospital between January 2016 and December 2017. In total, 925 infants were included in the study. The mean gestational age was 35.9 weeks (range, 24-42 weeks). Preterm infants and low birth weight accounted for 47.5% and 56.7%, respectively. With respect to payment methods, the government (53.5%) and non-governmental organizations (NGO) (13.7%) paid the fees as the families were not in a financial position to do so. The hospital NMR at the Pediatrics department was 9.3%. Respiratory distress syndrome (37.2%) was the main cause of deaths followed by hypoxic-ischemic encephalopathy (31.4%) and neonatal infection (21.0%). Factors associated with neonatal mortality were Apgar score at 5th minute <7 (adjusted odds ratio (AOR) = 3.57), payment by the government or NGO (AOR = 11.32), admission due to respiratory distress (AOR = 11.94), and hypothermia on admission (AOR = 9.41). The hospital NMR in the Pediatrics department was 9.3% (95% confidence interval 7.50-11.35) at Khmer-Soviet Friendship Hospital; prematurity and respiratory distress syndrome were the major causes of neonatal mortality. Introducing continuous positive airway pressure machine for respiratory distress syndrome and creating neonatal resuscitation guidelines and preventing hypothermia in delivery rooms are required to reduce the high NMR.
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Affiliation(s)
- Ponloeu Leak
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Pediatrics Department, Khmer-Soviet Friendship Hospital, Phnom Penh, Cambodia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Pisey Noy
- Pediatrics Department, Khmer-Soviet Friendship Hospital, Phnom Penh, Cambodia
| | - Dane Keo
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Sidonn Krang
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Meng Siek
- Pediatrics Department, Khmer-Soviet Friendship Hospital, Phnom Penh, Cambodia
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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13
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Louangpradith V, Yamamoto E, Inthaphatha S, Phoummalaysith B, Kariya T, Saw YM, Hamajima N. Trends and risk factors for infant mortality in the Lao People's Democratic Republic. Sci Rep 2020; 10:21723. [PMID: 33303939 PMCID: PMC7730153 DOI: 10.1038/s41598-020-78819-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/01/2020] [Indexed: 11/09/2022] Open
Abstract
A high infant mortality rate (IMR) indicates a failure to meet people's healthcare needs. The IMR in Lao People's Democratic Republic has been decreasing but still remains high. This study aimed to identify the factors involved in the high IMR by analyzing data from 53,727 live births and 2189 women from the 2017 Lao Social Indicator Survey. The estimated IMR decreased from 191 per 1000 live births in 1978-1987 to 39 in 2017. The difference between the IMR and the neonatal mortality rate had declined since 1978 but did not change after 2009. Factors associated with the high IMR in all three models (forced-entry, forward-selection, and backward-selection) of multivariate logistic regression analyses were auxiliary nurses as birth attendants compared to doctors, male infants, and small birth size compared to average in all 2189 women; and 1-3 antenatal care visits compared to four visits, auxiliary nurses as birth attendants compared to doctors, male infants, postnatal baby checks, and being pregnant at the interview in 1950 women whose infants' birth size was average or large. Maternal and child healthcare and family planning should be strengthened including upgrading auxiliary nurses to mid-level nurses and improving antenatal care quality.
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Affiliation(s)
- Viengsakhone Louangpradith
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Healthcare and Rehabilitation, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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14
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Wasiq AN, Saw YM, Jawid S, Kariya T, Yamamoto E, Hamajima N. Determinants of diarrhea in children under the age of five in Afghanistan: a secondary analysis of the Afghanistan Demographic and Health Survey 2015. Nagoya J Med Sci 2020; 82:545-556. [PMID: 33132438 PMCID: PMC7548244 DOI: 10.18999/nagjms.82.3.545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Diarrhea is the second leading cause of under-five mortality and globally accounts for 526,000 child deaths every year. Afghanistan, with 33,000 child deaths in 2012, was ranked 8th among nations, with the highest under-five deaths being from pneumonia and diarrhea. This study aimed to identify the determinants of diarrhea in children under the age of five in Afghanistan. A secondary data analysis of the Afghanistan Demographic and Health Survey (AfDHS) 2015 was focused on diarrhea in children under the age of five. The dataset of the AfDHS 2015 was used for the analysis. The subjects for this study were 30,238 under-five children. A logistic regression model was applied to examine the determinants of childhood diarrhea. This study found that 7,921 (26.2%) out of 30,238 under-five children had diarrhea within the two weeks preceding the survey. Higher maternal education accompanied a lower risk of childhood diarrhea with an adjusted odds ratio (AOR) of 0.70 (P<0.01) than did no education. Flush toilets (AOR=0.84, P<0.01) and traditional dry vaults (AOR=0.83, P<0.001) were less likely associated with diarrhea compared with pit latrines. Tube wells, public taps, and unprotected wells and springs were sources of drinking water with a higher risk of diarrhea than piped water. This study identified that the type of toilet facility, source of drinking water, age of the child, and maternal education were important determinants of under-five diarrhea. Intervention programs concerning improved sanitation facilities, sources of drinking water, and raising women’s level of education and health awareness are important.
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Affiliation(s)
- Ahmad Nasir Wasiq
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Ministry of Public Health, Kabul, Afghanistan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Sultani Jawid
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Ministry of Public Health, Kabul, Afghanistan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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15
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Liu P, Fukuma N, Hiroi Y, Ueda K, Kariya T, Numata G, Adachi Y, Toyoda M, Li Y, Noma K, Toko H, Kanai Y, Takimoto E, Liao J, Komuro I. Endothelial-specific Ablation of Non-nuclear Estrogen Receptor alpha Signaling Deteriorates Vascular Remodelling Response. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background and introduction
The difference in cardiovascular disease risk between age-matched women and men narrows as transition through menopause in observational studies. Estrogen exerts complex physiological effects via its non-nuclear and nuclear actions. Experimental studies have shown that endothelial estrogen receptors mediate vasoprotection via endothelial nitric oxide production, reendothelialization, and atherosclerosis. Prior studies in vitro addressed estrogen's effects on endothelial cells and vascular smooth muscle cells, leading to vasoprotection. However, the in vivo evidences are lacking for beneficial effects of endothelium non-nuclear ERα signaling on vascular remodelling in response to injury.
Purpose
This study aims to clarify the impact of endothelial ERα non-nuclear signaling in the vasoprotection, using a novel mouse model lacking tissue-specific ERα non-nuclear signaling.
Methods
We identified the amino acids of ERα which were responsible for its binding to p85α subunit of phosphatidylinositol 3-kinase in vitro. We generated a novel mouse model in which non-nuclear signaling of ERα was ablated in endothelial cells by crossing Tie2-Cre transgenic mice with floxed ERα mutants (RR259/260AA) in which p85α and ERα interaction was disrupted.
Results
In endothelial cells isolated from ERαKI/KITie2 cre/+ animals, E2 failed to induce phosphorylation of Akt, confirming the absence of ERα non-nuclear signaling. Baseline characteristics at 8 to 12 weeks of age were undistinguishable between the genotypes, including body weight, systolic blood pressure, uterine weight and echocardiographic fractional shortening. We then assessed how vascular remodelling process was impacted in a carotid artery wire injury model. Histological analyses with Elastica van Gieson staining two weeks after injury revealed that estrogen dependent suppression of remodelling response (intima to medial ratio) was abolished in ERαki/kiTie2cre/+mice (P=0.0004). Masson's Trichrome staining showed that in the presence of E2 fibrosis was significantly higher in ERαki/kiTie2cre/+ mice than ERαki/kiTie2cre/− mice (P=0.0015).
Conclusions
We generated a novel mouse model for tissue-specific ablation of ERα non-nuclear signaling by interfering ERα-PI3K interaction. Our results demonstrate that the pivotal role for ERα non-nuclear signaling of endothelial cells in carotid arterial protection following injury with its minimal impact on baseline cardiovascular phenotype.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Japan Heart Foundation Research Grant, SENSHIN Medical Research Foundation
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Affiliation(s)
- P.Y Liu
- National Defense Medical Center, Tri-Service General Hospital, Cardiology, Taipei, Taiwan
| | - N Fukuma
- University of Tokyo, Cardiovascular Medicine, Tokyo, Japan
| | - Y Hiroi
- National Center for Global Health and Medicine, Tokyo, Japan
| | - K Ueda
- University of Tokyo, Cardiovascular Medicine, Tokyo, Japan
| | - T Kariya
- University of Tokyo, Cardiovascular Medicine, Tokyo, Japan
| | - G Numata
- University of Tokyo, Cardiovascular Medicine, Tokyo, Japan
| | - Y Adachi
- University of Tokyo, Cardiovascular Medicine, Tokyo, Japan
| | - M Toyoda
- University of Tokyo, Cardiovascular Medicine, Tokyo, Japan
| | - Y Li
- Nihon University School of Medicine, Tokyo, Japan
| | - K Noma
- Research Institute for Radiation Biology and Medicine, Hiroshima, Japan
| | - H Toko
- University of Tokyo, Cardiovascular Medicine, Tokyo, Japan
| | - Y Kanai
- Wakayama Medical University, Wakayama, Japan
| | - E Takimoto
- University of Tokyo, Cardiovascular Medicine, Tokyo, Japan
| | - J.K Liao
- University of Chicago Medical Center, Department of Medicine, Section of Cardiology, Chicago, United States of America
| | - I Komuro
- University of Tokyo, Cardiovascular Medicine, Tokyo, Japan
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16
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Noe MTN, Saw YM, Saw TN, Kyaw YP, Zin PE, Cho SM, Kariya T, Yamamoto E, Win HH, Wann T, Hamajima N. Assessment of nutritional status and risk factors for malnutrition among the elderly in Loikaw, Myanmar. Nutrition 2020; 79-80:110933. [PMID: 32847774 DOI: 10.1016/j.nut.2020.110933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/03/2020] [Accepted: 06/06/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Malnutrition among the elderly is an important health concern in Myanmar. The country is challenged by both an aging population and poor nutritional status. The aim of this study was to estimate the prevalence of malnutrition and elucidate its associated factors among the elderly in Loikaw, Myanmar. METHODS A cross-sectional study was conducted from July to August 2019. Using a multistage sampling method, 747 elderly individuals (313 men and 434 women) were recruited. The nutritional status of these participants was assessed using the Mini-Nutritional Assessment tool, with a face-to-face interview method. Body mass index, mid-upper arm and calf circumference, blood pressure, and random blood sugar levels were also assessed. Multinomial logistic regression analysis was performed. RESULTS The prevalence of malnutrition and at risk for malnutrition were 21.7% and 59.4%, respectively. In the multivariate model, dental problem (adjusted odds ratio [aOR], 2.18; 95% confidence interval [CI], 1.24-3.83), low level of education (aOR, 3.13; 95% CI, 1.44-6.81), aged ≥70 y (aOR, 3.55; 95% CI, 1.83-6.88), current betel chewing (aOR, 2.82; 95% CI, 1.64-4.87), and having heart disease (aOR, 8.04; 95% CI, 2.29-18.13) were positively associated with malnutrition. CONCLUSION One in five elderly study participants were malnourished and 50% were at risk for malnutrition. Malnutrition was associated with being ≥70 y of age, having a low educational level, chewing betel, having a history of heart disease, and having dental problems. These findings may alert policymakers to develop and implement effective interventions for improving nutritional status of the elderly population.
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Affiliation(s)
- May Thet Nu Noe
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Public Health, Loikaw, Kayah State, Ministry of Health and Sports, Loikaw, Myanmar
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thu Nandar Saw
- Department of Community and Global Health, the University of Tokyo, Tokyo, Japan
| | - Yoon Pwint Kyaw
- Department of Public Health, Taunggyi, Shan State, Ministry of Health and Sports, Taunggyi, Myanmar
| | - Poe Ei Zin
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hla Hla Win
- University of Public Health, Yangon, Myanmar
| | - Tin Wann
- Department of Public Health, Loikaw, Kayah State, Ministry of Health and Sports, Loikaw, Myanmar
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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17
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Khaing M, Saw YM, Than TM, Mon AM, Cho SM, Saw TN, Kariya T, Yamamoto E, Hamajima N. Geographic distribution and utilisation of CT and MRI services at public hospitals in Myanmar. BMC Health Serv Res 2020; 20:742. [PMID: 32787832 PMCID: PMC7424658 DOI: 10.1186/s12913-020-05610-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diagnosis by computed tomography (CT) and magnetic resonance imaging (MRI) is important for patient care. However, the geographic distribution and utilisation of these machines in countries with limited resources, such as Myanmar, have not been sufficiently studied. Therefore, this study aims to identify the geographic distribution and utilisation of CT and MRI services at public hospitals in Myanmar. METHODS This nationwide, cross-sectional study was conducted at 43 public hospitals in Myanmar. Data were collected retrospectively using a prepared form from 1st January 2015 to 31st December 2017 at public hospitals in Myanmar. A descriptive analysis was performed to calculate the number of CT and MRI units per million population in each state and region of Myanmar. The distribution of CT and MRI units was assessed using the Lorenz curve and Gini coefficient, which are indicators of inequality in distribution. RESULTS In total, 45 CT and 14 MRI units had been installed in public hospitals in Myanmar by 2017. In total, 205,570 CT examinations and 18,981 MRI examinations have been performed within the study period. CT units per million population in 2017 varied from 0.30 in Rakhine State to 3.22 in Kayah State. However, MRI units were available only in public hospitals in five states/regions. The Gini coefficient for CT and MRI was 0.35 and 0.69, respectively. An upward trend in the utilisation rate of CT and MRI was also observed during the study period, especially among patients aged between 36 and 65 years. CONCLUSIONS Throughout Myanmar, CT units were more equally distributed than MRI units. CT and MRI units were mostly concentrated in the Yangon and Mandalay Regions, where the population density is higher. The geographic distribution and utilisation rate of CT and MRI units varied among states, regions, and patients' age group. However, the utilisation rates of CT and MRI increased annually in all states and regions during the review period. The Ministry of Health and Sports in Myanmar should consider the utilisation and population coverage of CT and MRI as an important factor when there will be procurement of those medical equipment in the future.
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Affiliation(s)
- Moe Khaing
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. .,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thet Mon Than
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Aye Myat Mon
- Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Thu Nandar Saw
- Department of Community and Global Health, The University of Tokyo, Tokyo, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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18
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Sereenen E, Saw YM, Erkhembayar R, Volodya B, Dashpagma O, Orsoo O, Kariya T, Ochir C, Yamamoto E, Hamajima N. Estimation of the unvaccinated among those aged less than 25 years according to aimag and its association with incidence of measles outbreak 2015-2016 in Mongolia. Nagoya J Med Sci 2020; 82:437-447. [PMID: 33132428 PMCID: PMC7548245 DOI: 10.18999/nagjms.82.3.437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 01/14/2020] [Indexed: 12/03/2022]
Abstract
Mongolia had an epidemic of measles in 2015-2016, even though more than 90% of the population have been vaccinated since 1997. This study aimed to examine the associations between unvaccinated proportion and measles incidence according to aimag. Mongolia has 21 provinces (aimag) with Ulaanbaatar as the capital city. Vaccination coverage between 1991 and 2014 and measles incidence according to aimag were obtained from the National Center for Communicable Diseases of Mongolia database. Accumulated unvaccinated proportion (AUP) among those aged 1 to 24 years in 2015 was estimated from the unvaccinated at the 1st dose of 1991 to 2014. From 1991 to 2014, unvaccinated proportion among those aged 1 to 24 years in the whole country has been reducing from 28.0% in 1991 to 1.8% in 2014. The AUP in 2015 varied from 2.7% (Selenge) to 21.8% (Govisumber). The incidence was remarkably higher in only two aimags with a large density of the unvaccinated aged 1 to 24 years (Ulaanbaatar and Darkhan-Uul) than in the other aimags. The incidence had no significant correlation with the AUP, although the correlation between the incidence and the density of unvaccinated aged 1 to 24 years was significant when the two aimags were included. In conclusion, the AUP between 2.7% and 21.8% had no correlation with the incidence according to aimags in Mongolia measles epidemic 2015-2016.
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Affiliation(s)
- Enkhbold Sereenen
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- E-Health Project, Ministry of Health, Ulaanbaatar, Mongolia
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Ryenchindorj Erkhembayar
- Department of International Cyber Education, Graduate School, Mongolian National University of Medical Science, Ulaanbaatar, Mongolia
| | - Baigal Volodya
- Immunization Department, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Otgonbayar Dashpagma
- Immunization Department, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Oyunchimeg Orsoo
- Department of Public Administration, Ministry of Health, Ulaanbaatar, Mongolia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Chimedsuren Ochir
- Department of International Cyber Education, Graduate School, Mongolian National University of Medical Science, Ulaanbaatar, Mongolia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Louangpradith V, Phoummalaysith B, Kariya T, Saw YM, Yamamoto E, Hamajima N. Disease frequency among inpatients at a tertiary general hospital in Lao PDR. Nagoya J Med Sci 2020; 82:113-121. [PMID: 32273639 PMCID: PMC7103859 DOI: 10.18999/nagjms.82.1.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In Lao People’s Democratic Republic (Lao PDR), reports on disease frequency are very limited. This study aimed to report frequencies of the main cause of admission among inpatients of a tertiary general hospital (Mittaphab Hospital) in Vientiane. Subjects were inpatients who were admitted from January 3 to February 2 in 2017. The dataset were made as a pilot run to establish hospital statistics. The data on sex, age, address (province), dates of admission and discharge, and main diagnosis were collected from paper-based medical charts. International Classification of Diseases 10 was applied for classifying the main diagnosis. During the 1-month period, 1,201 inpatients (637 males and 564 females) were admitted, including 171 (14.2%) aged <20 years and 254 (21.1%) aged ≥60 years. About 20% patients were from outside of Vientiane. Among them, 67.5% (62.5% in males and 73.8% in females) were admitted within 7 days. The main causes with more than 10% in males were injury and poisoning S00-T98 (49.8%), while those in females were injury and poisoning S00-T98 (25.2%), pregnancy and childbirth O00-O99 (19.0%), and diseases of genitourinary system N00-N99 (13.7%). Injury and poisoning S00-T98 among inpatients aged <20 years was 81.8% in males and 59.0% in females. Among those aged 20–59 years, it was 49.9% and 22.4%, and among those aged ≥60 years it was 22.3% and 16.9%, respectively. This is the first report on the frequencies of main diseases among inpatients in Lao PDR. Injury was the first main cause of admission at the tertiary hospital.
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Affiliation(s)
- Viengsakhone Louangpradith
- Nagoya University Graduate School of Medicine, Nagoya, Japan.,Mittaphab Hospital, Vientiane Capital, Lao PDR
| | | | - Tetsuyoshi Kariya
- Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Yu Mon Saw
- Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Nagoya University Graduate School of Medicine, Nagoya, Japan
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Taazan B, Yamamoto E, Baatar B, Amgalanbaatar A, Kariya T, Saw YM, Hamajima N. Estimating cost of hospitalization for childbirth at a tertiary hospital in Mongolia. Nagoya J Med Sci 2020; 82:47-57. [PMID: 32273632 PMCID: PMC7103872 DOI: 10.18999/nagjms.82.1.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Health services for pregnancy and delivery at public health facilities are fully subsidized by the government in Mongolia. However, it has been reported that health financing, budget planning, and implementation processes are weak. Therefore, this study aims to estimate the costs per inpatient of vaginal delivery and cesarean section (C-section) by using data gathered from a tertiary hospital in Ulaanbaatar. Inpatient and financial data were collected from the Statistics and Finance, Economics Department of National Center for Maternal and Child Health. A top-down method was used for the calculation of unit costs. The total number of deliveries in 2016 were 11,033, including 7,777 vaginal deliveries and 3,256 C-sections. The cost per inpatient stay for vaginal delivery and C-section were USD 255 and USD 592, respectively. The average cost per bed-day of the six departments of the obstetrics and gynecology hospital was USD 80. The percentage that represents employees’ salary in the cost per inpatient was as low as 12.4% for vaginal delivery and 18.5% for C-section, although the cost for salaries accounted for 51.2% of the total expenditure of the hospital. Results show that the cost per inpatient of C-section was two times higher than that of vaginal delivery. The cost of childbirths may account for approximately 9% of total health expenditure of the country. These results may be advantageous to the government in instituting a policy and controlling the health care budget to improve cost-effectiveness and equal access to all in health care services in Mongolia.
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Affiliation(s)
- Bolorchimeg Taazan
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Monitoring Evaluation and Internal Auditing Department, Ministry of Health, Ulaanbaatar, Mongolia.,Department of Gross Anatomy, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Bayart Baatar
- Monitoring Evaluation and Internal Auditing Department, Ministry of Health, Ulaanbaatar, Mongolia.,Department of Gross Anatomy, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Avirmed Amgalanbaatar
- Monitoring Evaluation and Internal Auditing Department, Ministry of Health, Ulaanbaatar, Mongolia.,Department of Gross Anatomy, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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21
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Htet H, Saw YM, Saw TN, Htun NMM, Lay Mon K, Cho SM, Thike T, Khine AT, Kariya T, Yamamoto E, Hamajima N. Prevalence of alcohol consumption and its risk factors among university students: A cross-sectional study across six universities in Myanmar. PLoS One 2020; 15:e0229329. [PMID: 32084226 PMCID: PMC7034886 DOI: 10.1371/journal.pone.0229329] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 02/04/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Globally, alcohol consumption is a significant public health concern and it is one of the most important risk behaviours among university students. Alcohol consumption can lead to poor academic performance, injuries, fights, use of other substances, and risky sexual behaviours among students. However, the study explored the prevalence of alcohol consumption and the associated risk factors among university students since these have not been fully examined in previous research. Therefore, the aim of this study was to explore the prevalence of alcohol consumption and the associated risk factors among university students in Myanmar. METHODS The present cross-sectional study was conducted using a sample of 15-24-year-old university students who were selected from six universities in Mandalay, Myanmar, in August 2018. In total, 3,456 students (males: 1,301 and females: 2,155) were recruited and asked to respond to a self-administered questionnaire. Multiple logistic regression analysis was used to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for alcohol consumption among university students. RESULTS The prevalence of alcohol consumption in the previous 30 days was 20.3% (males: 36.0%, females: 10.8%). The alcohol consumption was significantly higher among males (AOR = 2.3, 95% CI; 1.9-2.9), truant students (AOR = 2.1, 95% CI; 1.3-3.3), smokers (AOR = 7.0, 95% CI; 5.1-9.7), students who reported feeling of hopelessness or sadness (AOR = 1.4, 95% CI; 1.2-1.8), peers' alcohol consumption (AOR = 7.5, 95% CI; 4.8-11.7). CONCLUSION The present study revealed that males, smokers, peer alcohol consumption, and truant students had higher odds of alcohol consumption among the students. Therefore, effective campus-based counselling, peer education, and national surveillance systems that can monitor risky drinking behaviours among university students should be implemented. Further, government regulations that control the production, sale, promotion, advertising, and restriction of alcohol should be well developed and strengthened, as in the case of other Southeast Asian countries.
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Affiliation(s)
- Hein Htet
- Department of Preventive and Social Medicine, University of Medicine, Mandalay, Myanmar
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Thu Nandar Saw
- Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
- Myanma Perfect Research, Yangon, Myanmar
| | - Nang Mie Mie Htun
- Department of Preventive and Social Medicine, University of Medicine, Mandalay, Myanmar
| | - Khaing Lay Mon
- Department of Health Behaviour and Communication, University of Public Health, Yangon, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Thinzar Thike
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Aye Thazin Khine
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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22
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Cho SM, Saw YM, Latt NN, Saw TN, Htet H, Khaing M, Than TM, Win EM, Aung ZZ, Kariya T, Yamamoto E, Hamajima N. Cross-sectional study on tobacco advertising, promotion and sponsorship (TAPS) and violations of tobacco sale regulations in Myanmar: do these factors affect current tobacco use among Myanmar high school students? BMJ Open 2020; 10:e031933. [PMID: 32054624 PMCID: PMC7045140 DOI: 10.1136/bmjopen-2019-031933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine the associations of current tobacco use with tobacco advertising, promotion and sponsorship (TAPS), and illicit tobacco sales exposures among Myanmar high school students. DESIGN A quantitative, cross-sectional study. SETTING Seven high schools from both urban and rural areas of four states and regions in Myanmar. PARTICIPANTS In total, 1174 high school students (482 males and 692 females) were interviewed using a self-administered questionnaire. MAIN OUTCOME MEASURE Current tobacco use of participants, defined as using any kind of smoked or smokeless tobacco product at least one occasion within the past 30 days. RESULTS The prevalence of TAPS exposure was 90.9% among high school students in Myanmar. Current tobacco use was positively associated with being over 14 years old (adjusted OR (AOR) 9.81; 95% CI 4.54 to 21.19), being male (AOR 28.06; 95% CI 13.29 to 59.25), exposure to any kind of TAPS (AOR 6.59; 95% CI 2.33 to 18.64), having seen any smoked tobacco product for sale inside or within 100 feet of the school premises (AOR 4.17; 95% CI 1.65 to 10.58), having seen the sale or gifting of any smoked tobacco product to minors (AOR 6.46; 95% CI 2.18 to 19.12) and having seen the sale or distribution of any smoked tobacco product by minors (AOR 2.42; 95% CI 1.42 to 4.10). Having ever received health education about tobacco use (AOR 0.45; 95% CI 0.27 to 0.78), or having a higher perception score of tobacco use (AOR 0.17; 95% CI 0.10 to 0.30) were negatively associated with current tobacco use. CONCLUSIONS There was an alarming prevalence of TAPS exposure among Myanmar high school students. TAPS exposure and violations of tobacco sale regulations were strong risk factors for current tobacco use among Myanmar high school students, while health education about tobacco products was reported as an effective protective factor. Specific smokeless tobacco sale regulations for minors are needed immediately in Myanmar.
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Affiliation(s)
- Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Nyi Nyi Latt
- Aung Myin Myint Mo Hospital, Gyobingauk, Myanmar
| | - Thu Nandar Saw
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hein Htet
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Preventive and Social Medicine, University of Medicine, Mandalay, Myanmar
| | - Moe Khaing
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thet Mon Than
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Ei Mon Win
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Zaw Zaw Aung
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Thike TZ, Saw YM, Lin H, Chit K, Tun AB, Htet H, Cho SM, Khine AT, Saw TN, Kariya T, Yamamoto E, Hamajima N. Association between body mass index and ready-to-eat food consumption among sedentary staff in Nay Pyi Taw union territory, Myanmar. BMC Public Health 2020; 20:206. [PMID: 32041555 PMCID: PMC7011543 DOI: 10.1186/s12889-020-8308-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/31/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Ready-to-eat (RTE) food consumption has become popular in the working community with the increase in full-time jobs and the limited time to prepare food. Although RTE food is essential for this community, its consumption causes obesity. In Myanmar, obesity is a modifiable risk factor for non-communicable diseases, causing increases in morbidity and mortality. This study aimed to identify the association between body mass index (BMI) and RTE food consumption among sedentary staff in Nay Pyi Taw Union Territory, Myanmar. METHODS A cross-sectional study was conducted in 2018, in which 400 respondents participated in face-to-face interviews. The study area was selected using simple random sampling and drawing method. Measuring tape and digital weighing scale were used to measure the height and weight of the respondents. BMI was calculated by dividing the weight by height squared (kg/m2). Overweight and obesity were categorized by World Health Organization cut-off points. The collected data were analyzed using multiple logistic regression to estimate the adjusted odds ratio (AOR), and the 95% confidence interval (CI). RESULTS This study revealed that sedentary staff who consumed RTE food once or more per month were nearly five times more likely to be overweight and obese (AOR = 4.78, 95% CI 1.44-15.85) than those who consumed RTE food less frequently. In addition, five factors namely being older than 32 years (AOR = 3.97, 95% CI 1.82-8.69), preference for RTE food (AOR = 8.93, 95% CI 2.54-31.37), light-intensity of physical exercise (AOR = 3.55, 95% CI 1.63-7.73), sedentary leisure activities (AOR = 3.32, 95% CI 1.22-9.03), and smoking (AOR = 5.62, 95% CI 1.06-29.90) were positively associated with overweight and obesity. CONCLUSION Frequent consumers of RTE food and less physically active sedentary staff were more likely to be overweight and obese. This study highlights the urgent need to raise awareness regarding healthy lifestyle behaviors among the working community to reduce the burden of obesity-related chronic diseases. Moreover, sedentary workers should be aware of the food-based dietary guidelines of the country. Policy makers should strictly enforce nutritional labeling of RTE food, and strictly prohibit over-branding of RTE food.
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Affiliation(s)
- Thin Zar Thike
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Htin Lin
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Khin Chit
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Aung Ba Tun
- Directorate of Medical Service, Nay Pyi Taw, Myanmar
| | - Hein Htet
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Department of Preventative and Social Medicine, University of Medicine, Mandalay, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Aye Thazin Khine
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thu Nandar Saw
- Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
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Houattongkham S, Yamamoto E, Sithivong N, Inthaphatha S, Kariya T, Saw YM, Vongduangchanh A, Keosavanh O, Hamajima N. Etiologic agents of acute diarrhea in sentinel surveillance sites in Vientiane Capital, Lao People's Democratic Republic, 2012-2015. Eur J Clin Microbiol Infect Dis 2020; 39:1115-1122. [PMID: 31993879 DOI: 10.1007/s10096-020-03827-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/21/2020] [Indexed: 10/23/2022]
Abstract
This study aims to identify the pathogens of diarrhea in Vientiane Capital, Lao People's Democratic Republic (Lao PDR). The data of 2482 patients who visited eight health facilities due to diarrhea in 2012-2015 were retrospectively reviewed. Stool or rectal swabs collected from all patients were tested for bacteria. Children who were under 5 years old were additionally tested for rotavirus. Of 2482 cases, 1566 cases were under 5 years old, and at least one enteropathogen was detected in 475 cases (19.1%). Salmonella species was the most commonly detected bacterial pathogen. Enteropathogenic Escherichia coli (EPEC) and Salmonella species was the major pathogen in the dry season and the wet season, respectively. Eighty-seven patients tested positive for multiple bacteria. Rotavirus was detected in 291 children under 5 years old (32.4%), mostly from October to April. The major bacteria of coinfection with rotavirus were EPEC followed by Salmonella species. Salmonella species was the predominant bacterial pathogen of diarrhea of all ages, and rotavirus was the predominant pathogen among children under 5 years old. Further studies examining other types of pathogens for diarrhea and the introduction of a rotavirus vaccine for children are needed in Lao PDR.
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Affiliation(s)
- Souphatsone Houattongkham
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Epidemiology Section, Bacteriology Unit, National Center for Laboratory and Epidemiology, Km 3 Thadeau Road, Ban Thaphalarnxay, Sisathanack district, Vientiane Capital, Lao PDR
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Noikaseumsy Sithivong
- Laboratory Section, Bacteriology Unit, National Center for Laboratory and Epidemiology, Km 3 Thadeau Road, Ban Thaphalarnxay, Sisathanack district, Vientiane Capital, Lao PDR
| | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Arounnapha Vongduangchanh
- Laboratory Section, Bacteriology Unit, National Center for Laboratory and Epidemiology, Km 3 Thadeau Road, Ban Thaphalarnxay, Sisathanack district, Vientiane Capital, Lao PDR
| | - Onechanh Keosavanh
- Epidemiology Section, Bacteriology Unit, National Center for Laboratory and Epidemiology, Km 3 Thadeau Road, Ban Thaphalarnxay, Sisathanack district, Vientiane Capital, Lao PDR.,Laboratory Section, Bacteriology Unit, National Center for Laboratory and Epidemiology, Km 3 Thadeau Road, Ban Thaphalarnxay, Sisathanack district, Vientiane Capital, Lao PDR
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Khine AT, Saw YM, Htut ZY, Khaing CT, Soe HZ, Swe KK, Thike T, Htet H, Saw TN, Cho SM, Kariya T, Yamamoto E, Hamajima N. Assessing risk factors and impact of cyberbullying victimization among university students in Myanmar: A cross-sectional study. PLoS One 2020; 15:e0227051. [PMID: 31967998 PMCID: PMC6975531 DOI: 10.1371/journal.pone.0227051] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/11/2019] [Indexed: 11/25/2022] Open
Abstract
Background Cyberbullying is a global public health concern with tremendous negative impacts, not only on the physical and mental health of students but also on their well-being and academic performance. However, there are very few studies on cyberbullying among university students, especially in Myanmar. This study aims to determine the percentage of university students who suffered cyberbullying victimization in the last 12 months, and the association between students’ socio-demographic characteristics, adverse events following cyberbullying and cyberbullying victimization. Methods A cross-sectional study was conducted among university students aged 18 years and older at one medical university in Magway, Myanmar. A total of 412 students (277 males and 135 females) participated in the study. Data were collected from August to September, 2018 using a self-administered questionnaire. Multiple logistic regression analyses (models I and II) were performed to estimate the unadjusted (UOR) and adjusted odds ratios (AOR), and 95% confidence intervals (CI). Results In total, 40.8% of males and 51.1% of females in the study had suffered cyberbullying victimization in the past 12 months. In model I, students who had been studying at the university for 3 years or less (AOR = 1.81; 95% CI 1.14–2.85), and who had witnessed psychological, physical or sexual violence, or cyberbullying in their neighborhoods, (AOR = 2.95; 95% CI 1.48–5.91) were more likely to have suffered cyberbullying victimization in the past 12 months. In model II, being a victim of cyberbullying was associated with difficulties in concentrating and understanding lectures (AOR = 3.96; 95% CI 1.72–9.11), and substance abuse (AOR = 2.37; 95% CI 1.02–5.49). Non-resident students were at a higher risk of being cyberbullying victims than their resident peers (AOR = 1.86; 95% CI 1.04–3.34). Conclusion Two out of five students had suffered cyberbullying victimization in the past 12 months, and only half of the victims discussed their experience(s) with someone else. Students who suffered cyberbullying victimization faced academic difficulties and started or increased smoking, betel chewing or alcohol drinking. Counter measures to prevent and mitigate the adverse events related to cyberbullying victimization are urgently needed among university students in Myanmar. Periodic screening for cyberbullying, counseling services, cyber-safety educational programs, and awareness raising campaigns should be implemented.
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Affiliation(s)
- Aye Thazin Khine
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, the Republic of the Union of Myanmar
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
- * E-mail:
| | - Zaw Ye Htut
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, the Republic of the Union of Myanmar
| | - Cho Thet Khaing
- Department of Epidemiology, University of Public Health, Yangon, the Republic of the Union of Myanmar
| | - Htin Zaw Soe
- University of Community Health, Magway, the Republic of the Union of Myanmar
| | - Kyu Kyu Swe
- University of Community Health, Magway, the Republic of the Union of Myanmar
| | - Thinzar Thike
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, the Republic of the Union of Myanmar
| | - Hein Htet
- Department of Preventive and Social Medicine, University of Medicine, Mandalay, the Republic of the Union of Myanmar
| | - Thu Nandar Saw
- Department of Community and Global Health, the University of Tokyo, Tokyo, Japan
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Long-Hay P, Yamamoto E, Bun S, Savuth T, Buntha S, Sokdaro S, Kariya T, Saw YM, Sengdoeurn Y, Hamajima N. Outbreak detection of influenza-like illness in Prey Veng Province, Cambodia: a community-based surveillance. Nagoya J Med Sci 2019; 81:269-280. [PMID: 31241062 PMCID: PMC6556457 DOI: 10.18999/nagjms.81.2.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
On June 4, 2016, the Prey Veng Provincial Health Department reported a total of 107 patients with influenza-like illness (ILI) from Chakhlanh village to the Cambodian Ministry of Health. To confirm the outbreak and evaluate its clinical and epidemiological characteristics, the investigation team visited the village and reviewed the case-based surveillance (CBS) data on severe respiratory infection (SRI) and patients' records in health facilities. The team interviewed all households in the village from May 1 to June 5, 2016 and obtained the following data: age, medical history, date of onset, treatment, symptoms, and history of contact with patients or dead poultry. Nasal swab samples were collected from suspected ILI cases to test for influenza virus by RT-PCR. The investigation detected 498 suspected ILI cases, including 288 females. Although the incidence of suspected ILI cases who visited health centers was 63.0 per 1,000 persons per month, the attack rate was 27.1 per 100 population. The major age group was 5-14 years followed by 0-4 years. Major symptoms were cough, fever, runny nose, and headache. Six of seven nasal swab samples were positive for influenza A/H1N1 pdm09 virus. Most children with flu symptoms had contact with previous cases. This study showed that the ILI outbreak might be caused by seasonal influenza A/H1N1 pdm09 spread from person to person. Poor living conditions and poor hygiene and sanitation practices were environmental factors that caused the outbreak. As the CBS system was unable to identify this epidemic, it needs to be improved.
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Affiliation(s)
- Puthik Long-Hay
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Cambodian Applied Epidemiology Training, Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sreng Bun
- Cambodian Applied Epidemiology Training, Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Thai Savuth
- Cambodian Applied Epidemiology Training, Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - So Buntha
- Cambodian Applied Epidemiology Training, Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Soy Sokdaro
- Cambodian Applied Epidemiology Training, Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yi Sengdoeurn
- Cambodian Applied Epidemiology Training, Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Oo N, Saw YM, Aye HNN, Aung ZZ, Kyaw HN, Tun AM, Kariya T, Yamamoto E, Hamajima N. Consumption of foods containing prohibited artificial colors among middle-school children in Nay Pyi Taw union territory, Myanmar. BMC Public Health 2019; 19:344. [PMID: 30917801 PMCID: PMC6437872 DOI: 10.1186/s12889-019-6669-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 03/18/2019] [Indexed: 11/23/2022] Open
Abstract
Background Food safety control in Myanmar is regulated by the Department of Food and Drug Administration (FDA). FDA conducts food safety education programs in schools and regular market surveys of foods containing prohibited artificial colors. However, the consumption of foods containing FDA-prohibited artificial colors among school children is understudied. This study aimed to assess the consumption of foods containing FDA-prohibited artificial colors among middle-school children in Nay Pyi Taw Union Territory, Myanmar. Methods A cross-sectional study was conducted at eight public schools in Nay Pyi Taw Union Territory in 2017. The schools were selected using simple random sampling with a drawing method. In total, 776 students (359 boys and 417 girls) participated in face-to-face interviews using a structured questionnaire and photos of foods containing artificial color published by FDA. A multiple logistic regression was performed to estimate adjusted odds ratio (AOR) for consumption of such foods. Results In total, 519 (66.9%) children consumed foods with the FDA-prohibited colors. It was revealed that students at suburban schools were nearly five times more likely to consume foods containing FDA-prohibited artificial colors (AOR = 4.84; 95% confidence interval (CI) 2.99–7.82) compared to those at urban schools. In addition, being in the seventh grade (AOR = 3.38; 95% CI 2.30–4.98), availability of prohibited food in school canteen (AOR = 6.16; 95% CI 2.67–14.22), and having a less educated father (AOR = 1.76; 95% CI 1.06–2.92) were positively associated with consumption of the foods with the prohibited colors. Conclusion More than half of the students consumed foods with the prohibited colors. Consumption was more frequent among students from suburban schools, those with unsafe foods accessible at their school canteen, seventh graders, and students with a less educated father. The findings highlighted that school food safety programs, which focus on preventing consumption of foods containing FDA-prohibited artificial colors, are urgently required. Food safety regulation is also required to ban the sale of unsafe food, especially in school canteens. Electronic supplementary material The online version of this article (10.1186/s12889-019-6669-5) contains supplementary material, which is available to authorized users.
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Idei H, Onchi T, Kariya T, Tsujimura T, Kubo S, Kobayashi S, Sakaguchi M, Imai T, Hasegawa M, Nakamura K, Mishra K, Fukuyama M, Yunoki M, Kojima S, Watanabe O, Kuroda K, Hanada K, Nagashima Y, Ejiri A, Matsumoto N, Ono M, Higashijima A, Nagata T, Shimabukoro S, Takase Y, Fukuyama A, Murakami S. 28-GHz ECHCD system with beam focusing launcher on the QUEST spherical tokamak. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.02.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Win EM, Saw YM, Oo KL, Than TM, Cho SM, Kariya T, Yamamoto E, Hamajima N. Healthcare waste management at primary health centres in Mon State, Myanmar: the comparisons between hospital and non-hospital type primary health centres. Nagoya J Med Sci 2019; 81:81-91. [PMID: 30962657 PMCID: PMC6433624 DOI: 10.18999/nagjms.81.1.81] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Improper healthcare waste management (HCWM) poses a serious public health problem worldwide. Primary health centres (PHCs) provide public health and medical care services as the basic structural and functional units of healthcare services in Myanmar. However, no study has been conducted in Myanmar about HCWM at PHCs. This study aims to assess the practice of HCWM at PHCs in Mon State, Myanmar. A cross-sectional study was conducted in all ten townships in Mon State, Myanmar. In total, 93 PHCs (71 non-hospitals and 22 hospitals) were selected using simple random sampling. The observational checklist which was developed based on the World Health Organization’s standard guideline procedure of HCWM was used to determine the practice of HCWM at PHCs. Binary logistic regression was used for final data analysis. The burning in pits method was used as the final disposal method of healthcare waste in 78.5% of PHCs. Non-hospital type PHC were more likely not to have colour coding system for HCWM (odds ratio [OR] 7.54; 95% confidence interval [CI] 2.15–26.52), did not have equipment for accidental spillage of healthcare waste (OR 3.92; 95% CI 1.3–11.77) and did not have separate staff for HCWM (OR 8.27; 95% CI 2.77–24.64), relative to hospitals. Non-hospital type PHCs practices poorly on the colour coding for waste segregation, assigning separate staff for HCWM, and possessing equipment for accidental spillage of healthcare waste than hospital type PHCs. The Ministry of Health and Sports should issue technical guidelines of safe HCWM as a compulsory policy for both hospitals and non-hospital type PHCs.
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Affiliation(s)
- Ei Mon Win
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Occupational and Environmental Health Division, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Kyi Lwin Oo
- Occupational and Environmental Health Division, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thet Mon Than
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Azimi MW, Yamamoto E, Saw YM, Kariya T, Arab AS, Sadaat SI, Farzad F, Hamajima N. Factors associated with antenatal care visits in Afghanistan: secondary analysis of Afghanistan Demographic and Health Survey 2015. Nagoya J Med Sci 2019; 81:121-131. [PMID: 30962661 PMCID: PMC6433637 DOI: 10.18999/nagjms.81.1.121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Afghanistan is one of the countries with the poorest maternal mortality ratio in the world. Inadequate utilization of antenatal care (ANC) services increases the risk of maternal mortality. This study aimed to identify the factors associated with ANC visits in Afghanistan. The dataset of the Afghanistan Demographic and Health Survey (AfDHS) 2015 were used for taking the socio-demographic factors, cultural factors, and the number of ANC visits. The subjects of this study were 18,790 women who had at least one live birth in the last five years, and 10,554 women (56.2%) had availed of at least one ANC visit. Most women were 20-29 years old (53.3%), poor (41.7%), had 2–4 children (43.9%), lived in rural areas (76.1%), and had no education (85.0%) or no job (86.7%). Most women answered that husbands made a decision about their healthcare and that getting permission from their husbands was a major challenge. Multivariate analysis showed that age, ethnicity, area of residence, parity, women’s education, husband’s education, literacy, having a job, wealth, the decision maker for healthcare, and difficulty in getting permission from the husband were significantly correlated with availing of the ANC visits. This study showed that not only the socio-demographic factors but also the cultural factors were associated with ANC visits. The Afghanistan government should improve the education programs at schools and healthcare facilities, for both men and women. To augment women’s propensity to take a decision, the programs for women’s empowerment need to be supported and extended across the country.
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Affiliation(s)
- Mohammad Walid Azimi
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Monitoring Department, Ministry of Public Health, Kabul, Afghanistan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campus Institute, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campus Institute, Nagoya, Japan
| | - Ahmad Shekib Arab
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo, Japan
| | - Said Iftekhar Sadaat
- Research and Evaluation Department, Ministry of Public Health, Kabul, Afghanistan
| | - Fraidoon Farzad
- Chief of Staff Office, Ministry of Public Health, Kabul, Afghanistan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Narin P, Yamamoto E, Saw YM, Net N, Inthaphatha S, Kariya T, Hamajima N. Factors associated with HIV testing among the general male population in Cambodia: A secondary data analysis of the Demographic Health Survey in 2005, 2010, and 2014. PLoS One 2019; 14:e0219820. [PMID: 31318928 PMCID: PMC6638958 DOI: 10.1371/journal.pone.0219820] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 07/02/2019] [Indexed: 12/28/2022] Open
Abstract
In Cambodia, the human immunodeficiency virus (HIV) is predominantly transmitted between spouses and casual partners, with men having higher mortality and morbidity from HIV infection than women due to lesser access to healthcare services and antiretroviral therapy. This study aimed to identify the rate of HIV testing and barriers to HIV testing among the general male population in Cambodia. We analyzed secondary data of men who underwent HIV testing at Voluntary Confidential Counseling and Testing (VCCT) sites in 2006–2017 and of male participants in the Cambodia Demographic and Health Survey (CDHS) in 2005, 2010, and 2014. The number of men who underwent HIV testing at the VCCT sites increased during 2006–2010 and decreased during 2012–2015. CDHS data showed that the lifetime prevalence of HIV testing among men aged 15–49 years gradually increased from 14.7% in 2005 to 36.4% in 2014. Multivariate analysis revealed nine factors associated with a higher lifetime prevalence of HIV testing including: seven sociodemographic factors, namely CDHS year (2010 and 2014), age groups (20–35 and 36–49 years), urban residence, higher education, higher wealth index, having occupations other than agriculture, ever-married status (married and widowed/divorced); and two factors of HIV risk behavior, namely two or more lifetime sexual partners and condom use during the last sexual intercourse. To our knowledge, this is the first study that assessed factors associated with the lifetime prevalence of HIV testing among the general male population in Cambodia. The factors were mostly sociodemographic factors, and no factors were related to condom use, or the diagnosis or symptoms of sexually transmitted infections (STIs). These results suggest that reproductive health education at primary schools and strengthening of healthcare provider-initiated testing and counseling for patients with STIs are highly needed in Cambodia.
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Affiliation(s)
- Piseth Narin
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- National AIDS Authority, Phnom Penh, Cambodia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- * E-mail:
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ny Net
- Department of International Cooperation, Ministry of Health, Phnom Penh, Cambodia
| | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Kounnavong S, Ratsavong K, Soundavong K, Xayavong S, Kariya T, Saw YM, Yamamoto E, Horibe K, Toba K, Hamajima N. Cognitive function measured with the Revised Hasegawa's Dementia Scale among elderly individuals in Lao PDR. Nagoya J Med Sci 2019; 81:281-290. [PMID: 31239596 PMCID: PMC6556450 DOI: 10.18999/nagjms.81.2.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In Lao PDR, measurement of cognitive function has rarely been conducted among elderly individuals. This study aimed to investigate the cognitive function among elderly individuals who lived at their homes with family in Lao PDR. Participants were elderly individuals aged 60 years or over registered with the local government in urban (Vientiane capital; VC) and rural areas (Khammouane province; KP). Those with serious mental/physical diseases, those who could not walk by themselves, or those who could not speak the Lao language were excluded. The information was collected through interviews with the participants and their family members. A newly developed Lao version of the Revised Hasegawa’s Dementia Scale (HDS-R) was applied to measure cognitive function. The participants were 414 elderly individuals (224 males and 190 females) aged 60 to 98 years. The average HDS-R score was 23.0 among 115 men in VC, 22.7 among 92 women in VC, 20.3 among 109 men in KP, and 17.5 among 98 women in KP. The main caregiver was a daughter (40.6%) followed by a spouse (31.4%). Among 414 elderly individuals, 42 (10.0%) stated the necessity of support. Those with HDS-R < 20 accounted for 38.8% in men and 48.9% in women. The adjusted odds ratio of HDS-R < 20 was significant for those in rural areas (3.83) relative to those in urban areas. Among superficially healthy elderly individuals residing with their families, those with reduced cognitive function were more common among women and in rural areas.
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Affiliation(s)
- Sengchanh Kounnavong
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR
| | - Kethmany Ratsavong
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR
| | | | - Syda Xayavong
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kentaro Horibe
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Toba
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Keohavong B, Vonglokham M, Phoummalaysith B, Louangpradith V, Inthaphatha S, Kariya T, Saw YM, Yamamoto E, Hamajima N. Antibiotic prescription for under-fives with common cold or upper respiratory tract infection in Savannakhet Province, Lao PDR. Trop Med Health 2019; 47:16. [PMID: 30858755 PMCID: PMC6394019 DOI: 10.1186/s41182-019-0143-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background The irrational use of antibiotics has been identified as a major problem in healthcare, and it can lead to antimicrobial resistance, treatment failure, and increased healthcare costs. Although many studies worldwide have focused on the irrational use of drugs, reports on prescription practice in Lao PDR remained limited. This study aimed to examine the patterns of antibiotic prescription for under-fives with common cold or upper respiratory tract infection (URTI) at pediatric outpatient divisions. Methods One provincial hospital (PH) at Kaisone Phomvihane and four district hospitals (DHs) at Songkhone, Champhone, Atsaphangthong, and Xepon in Savannakhet Province were selected. Healthcare providers at these hospitals were interviewed and medical records of under-fives from 2016 were examined. Results Of the 54 healthcare providers interviewed, 85.2% had seen the standard treatment guideline, 77.8% adhered to this guideline, and 90.7% knew about antimicrobial resistance, while 18.5% participated in antimicrobial resistance activities. Medical records of 576 outpatients (311 boys and 265 girls) with common cold or URTI were examined, 154 at the PH and 422 at the DHs. Although antibiotics prescription proportions were similar between facilities at both levels (68.8% and 70.9% at the PH and DHs, respectively), antibiotics were exclusively prescribed for URTIs (96.4%), not for common cold (4.9%). First-line antibiotics recommended by WHO Model List of Essential Medicines for Children the 6th List were prescribed for 81.5% of patients; mainly, beta-lactam antibiotics were prescribed (87.2% of prescribed antibiotics). There were no cases in which two or more antibiotics were prescribed. The correct dose according to the National STG was 31.9% as a whole. The difference in the correct dose between the PH (52.8%) and the DHs (24.4%) was significant (p < 0.001). Conclusions This study demonstrated the patterns of antibiotic prescription for under-fives with common cold or URTI among healthcare providers from two different levels of facilities. Although an appropriate number of generic first-line antibiotics in the essential drug list were prescribed, the dosage and duration of antibiotic use were not appropriate. In order to further improve antibiotic prescription practices, regulation by the government is necessary; this could also decrease antimicrobial resistance and improve treatment outcomes.
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Affiliation(s)
- Bounxou Keohavong
- 1Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550 Japan.,2Food and Drug Department, Ministry of Health, Simuang road, Vientiane Capital, Lao People's Democratic Republic
| | - Manithong Vonglokham
- 3Lao Tropical and Public Health Institute, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic
| | - Bounfeng Phoummalaysith
- 4National Health Insurance Bureau, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic
| | - Viengsakhone Louangpradith
- 1Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550 Japan.,Mittaphab Hospital, Phonsavang V, Chanthabouly D, Vientiane Capital, Lao People's Democratic Republic
| | - Souphalak Inthaphatha
- 1Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550 Japan
| | - Tetsuyoshi Kariya
- 1Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550 Japan
| | - Yu Mon Saw
- 1Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550 Japan
| | - Eiko Yamamoto
- 1Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550 Japan
| | - Nobuyuki Hamajima
- 1Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550 Japan
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Jigjidsuren A, Byambaa T, Altangerel E, Batbaatar S, Saw YM, Kariya T, Yamamoto E, Hamajima N. Free and universal access to primary healthcare in Mongolia: the service availability and readiness assessment. BMC Health Serv Res 2019; 19:129. [PMID: 30786897 PMCID: PMC6381625 DOI: 10.1186/s12913-019-3932-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/28/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The government of Mongolia mandates free access to primary healthcare (PHC) for its citizens. However, no evidence is available on the physical presence of PHC services within health facilities. Thus, the present study assessed the capacity of health facilities to provide basic services, at minimum standards, using a World Health Organization (WHO) standardized assessment tool. METHODS The service availability and readiness assessment (SARA) tool was used, which comprised a set of indicators for defining whether a health facility meets the required conditions for providing basic or specific services. The study examined all 146 health facilities in Chingeltei and Khan-Uul districts of Ulaanbaatar city, including private and public hospitals, family health centers (FHCs), outpatient clinics, and sanatoriums. The assessment questionnaire was modified to the country context, and data were collected through interviews and direct observations. Data were analyzed using SPSS 21.0, and relevant nonparametric tests were used to compare median parameters. RESULTS A general service readiness index, or the capacity of health facilities to provide basic services at minimum standards, was 44.1% overall and 36.3, 61.5, and 62.4% for private clinics, FHCs, and hospitals, respectively. Major deficiencies were found in diagnostic capacity, supply of essential medicines, and availability of basic equipment; the mean scores for general service readiness was 13.9, 14.5 and 47.2%, respectively. Availability of selected PHC services was 19.8%. FHCs were evaluated as best capable (69.5%) to provide PHC among all health facilities reviewed (p < 0.001). Contribution of private clinics and sanatoriums to PHC service provisions were minimal (4.1 and 0.5%, respectively). Service-specific readiness among FHCs for family planning services was 44.0%, routine immunization was 83.6%, antenatal care was 56.5%, preventive and curative care for children was 44.5%, adolescent health services was 74.2%, tuberculosis services was 53.4%, HIV and STI services was 52.2%, and non-communicable disease services was 51.7%. CONCLUSIONS Universal access to PHC is stipulated throughout various policies in Mongolia; however, the present results revealed that availability of PHC services within health facilities is very low. FHCs contribute most to providing PHC, but readiness is mostly hampered by a lack of diagnostic capacity and essential medicines.
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Affiliation(s)
- Altantuya Jigjidsuren
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Asian Development Bank, Mongolia Resident Mission, Ulaanbaatar, Mongolia
| | | | | | | | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
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Orsoo O, Saw YM, Sereenen E, Yadamsuren B, Byambaa A, Kariya T, Yamamoto E, Hamajima N. Epidemiological characteristics and trends of a Nationwide measles outbreak in Mongolia, 2015-2016. BMC Public Health 2019; 19:201. [PMID: 30770746 PMCID: PMC6377723 DOI: 10.1186/s12889-019-6511-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 02/04/2019] [Indexed: 11/24/2022] Open
Abstract
Background Mongolia was one of the four countries that received a measles-elimination certificate from the World Health Organization Regional Office for the Western Pacific in 2014. Following the outbreaks in many countries including China, a large measles outbreak occurred in Mongolia in 2015. This study reports 2015–2016 measles outbreak incidence, mortality, and complications, according to time, geographical distribution, and host characteristics. Methods The epidemiological characteristics and trends of measles outbreak were analyzed using the Mongolian national surveillance data reported to the Center for Health Development, Ministry of Health, from January 2015 to December 2016. Results In total, 23,464 cases of measles including eight deaths were reported in 2015, and 30,273 cases of measles including 132 deaths were reported in 2016, which peaked in June 2015 and March 2016, respectively. Majority of the cases were reported from Ulaanbaatar (35,397, 65.9%). The highest attack rates were 241 per 10,000 population in Darkhan-Uul aimag, and 263 per 10,000 population in Ulaanbaatar. Measles-related death, nosocomial infection, and complications were most frequent among children aged < 1 year. Conclusions Following no reports of measles since 2011, a large nationwide outbreak occurred in Mongolia, despite the high vaccination coverage in the past. The highest incidence rate was reported in Ulaanbaatar city, and Umnugovi aimag in 2015 and Darkhan-Uul aimag in 2016. The most affected age group were aged < 1 year and those aged 15–24 years. Mortality cases were prominent among children aged < 1 year who were not eligible for vaccination. A systematic vaccination strategy is required to prevent another measles outbreak. Electronic supplementary material The online version of this article (10.1186/s12889-019-6511-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Oyunchimeg Orsoo
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Department of Medical Service, Ministry of Health, Ulaanbaatar, Mongolia
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. .,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Enkhbold Sereenen
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Department of Public Administration and Management, Ministry of Health, Ulaanbaatar, Mongolia
| | | | - Ariunsanaa Byambaa
- Department of Microbiology and Immunology, School of Pharmacy and Bio-Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Saw YM, Than TM, Win EM, Cho SM, Khaing M, Latt NN, Aung ZZ, Oo N, Aye HNN, Kariya T, Yamamoto E, Hamajima N. Myanmar language version of the Revised Hasegawa's Dementia Scale. Nagoya J Med Sci 2019; 80:435-450. [PMID: 30587859 PMCID: PMC6295428 DOI: 10.18999/nagjms.80.4.435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Reduced cognitive function among the elderly is an important issue not only in developed countries, but also in developing countries. As a test to measure cognitive function, the Revised Hasegawa’s Dementia Scale (HDS-R) has been used in Asian countries including Japan, Korea, and China. Since there was no HDS-R version in Myanmar language, a questionnaire and manual for the HDS-R were developed. The translation from English to Myanmar language was done by two Myanmar researchers. Back-translation was conducted to confirm the accuracy of the translation by two other Myanmar researchers. Back-translated English was compared to the original by two Japanese researchers, and inconsistencies were discussed by all six researchers to reach consensus. Five Myanmar researchers independently read the questionnaire and manual to verify the expressions are familiar in Myanmar language. The modified points were as follows. 1) The date order in Question 2 is day/month/year. 2) The words to be memorized in Questions 4 and 7 are padauk tree, cat, and bullock cart for the first set, and tamarind tree, dog, and car for the second set. 3) The objects to be memorized in Question 8 are shown with pictures, not actual objects. 4) Like the Lao version, we introduced two new rules; a clear time definition for no reply (10 seconds), and repeating questions twice for those with hearing problems. The revised version of the HDS-R has been prepared to be an applicable standard questionnaire for use on assessment of cognitive function in suspected dementia cases in Myanmar, both in the clinical and public healthcare setting.
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Affiliation(s)
- Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Thet Mon Than
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Ei Mon Win
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Moe Khaing
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Nyi Nyi Latt
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Aung Myin Myint Mo Hospital, Gyobingauk, The Republic of the Union of Myanmar
| | - Zaw Zaw Aung
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Nwe Oo
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Hnin Nwe Ni Aye
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Mandalay Regional Public Health Department, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Kaur J, Hamajima N, Yamamoto E, Saw YM, Kariya T, Soon GC, Amin A, Halim AN, Aziz FA, Sharon SH. Patient satisfaction on the utilization of traditional and complementary medicine services at public hospitals in Malaysia. Complement Ther Med 2019; 42:422-428. [PMID: 30670278 DOI: 10.1016/j.ctim.2018.12.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/16/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Traditional and complementary medicine (T&CM) has been integrated into the Malaysian public healthcare system since the establishment of the first T&CM unit at a public hospital in 2007. Assessing patient satisfaction is a vital component of health service evaluation. The main objective of this study is to determine the level of patient satisfaction with the utilization of T&CM services at public hospitals in Malaysia and assess the sociodemographic influence on the overall reporting of satisfaction. This study also aims to analyze the response of the patients towards expansion of T&CM services in the public sector in Malaysia. MATERIALS AND METHODS A study was conducted to analyze data on the utilization of T&CM services within public hospitals. Secondary data on 822 patients' satisfaction with services offered at 15 T&CM units was analyzed to examine the overall levels of satisfaction with T&CM services in public hospitals in Malaysia. RESULTS Overall, 99.4% of patients were satisfied with T&CM services and most patients (91.8%) felt that T&CM treatment positively impacted their health. Overall satisfaction was not affected by lower levels of satisfaction with subcategories of service, such as the number of treatment sessions received (90.7% satisfied), date to the next appointment (90.7% satisfied), and the absence of adverse effects of treatment received (87.1% satisfied). There were no significant associations between the socioeconomic status of the respondents and the level of satisfaction reported; however, respondents with a monthly salary of Ringgit Malaysia (RM) 1000 to RM 3000 were more than twice as likely to be strongly satisfied with services received (adjusted odds ratios [AOR]: 2.12, 95% CI: 1.19-3.78). CONCLUSION This study revealed a high level of satisfaction among patients who had received T&CM treatment at public hospitals in Malaysia. High satisfaction with T&CM treatment validates the integrative management approach adopted in patient care within the public hospitals in Malaysia.
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Affiliation(s)
- Jaspal Kaur
- Department of Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Traditional and Complementary Medicine Division, Ministry of Health, Malaysia.
| | - Nobuyuki Hamajima
- Department of Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Goh Cheng Soon
- Traditional and Complementary Medicine Division, Ministry of Health, Malaysia
| | - Ariyani Amin
- Traditional and Complementary Medicine Division, Ministry of Health, Malaysia
| | - Adilla Nur Halim
- Traditional and Complementary Medicine Division, Ministry of Health, Malaysia
| | - Farhana Abdul Aziz
- Traditional and Complementary Medicine Division, Ministry of Health, Malaysia
| | - Suraya Hani Sharon
- Traditional and Complementary Medicine Division, Ministry of Health, Malaysia
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Shigemoto E, Mizuno M, Suzuki Y, Kobayashi K, Sakata F, Kariya T, Katsuno T, Maruyama S, Ito Y. Increase of Eosinophil in Dialysate during Induction of Peritoneal Dialysis. Perit Dial Int 2019; 39:90-92. [DOI: 10.3747/pdi.2017.00205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
As a rare complication in patients on peritoneal dialysis (PD), increase of eosinophil (peritoneal dialysate fluid [PDF] eosinophilia), including eosinophilic peritonitis, was observed in PDF. The majority of eosinophilic peritonitis cases are detected during the early phase of PD induction. However, the frequency of and mechanisms underlying PDF eosinophilia remain unclear. We therefore investigated the frequency of PDF eosinophilia and what mechanisms, specifically complement activation, might contribute to its occurrence. In 48 patients, eosinophil counts and concentrations of complement activation products, such as C3a, C5a, and sC5b-9, interleukin (IL)-5, and IL-6 in PDF were evaluated on days 1, 2, and 4 after starting PD therapy. We focused on the relationships between patient background characteristics and eosinophil counts and levels of C3a, C5a, and sC5b-9 as complement activation products in PDF. In 33.3% of PD patients, increased PDF eosinophils were observed on day 1. Eosinophil counts correlated with PDF levels of C3a on days 1 and 2, IL-5 on days 1, 2, and 4, and IL-6 on day 1. In terms of background characteristics, only the duration the PD catheter was left in place differed significantly between PDF eosinophilia and non-PDF eosinophilia. Notably, PDF levels of C3a differed significantly between patients with and without eosinophilia, suggesting that C3a might be a candidate for induction of increased eosinophil. PDF eosinophilia was frequently observed during PD initiation. Our results suggest that PD catheter insertion and complement activation might be related to increases in eosinophils in PDF during PD initiation.
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Affiliation(s)
- Emi Shigemoto
- Nephrology Nagoya University Postgraduate School of Medicine Nagoya, Japan
| | - Masashi Mizuno
- Nephrology Nagoya University Postgraduate School of Medicine Nagoya, Japan
- Renal Replacement Therapy Nagoya University Postgraduate School of Medicine Nagoya, Japan
| | - Yasuhiro Suzuki
- Nephrology Nagoya University Postgraduate School of Medicine Nagoya, Japan
- Renal Replacement Therapy Nagoya University Postgraduate School of Medicine Nagoya, Japan
| | - Kazuma Kobayashi
- Nephrology Nagoya University Postgraduate School of Medicine Nagoya, Japan
| | - Fumiko Sakata
- Nephrology Nagoya University Postgraduate School of Medicine Nagoya, Japan
| | - Tetsuyoshi Kariya
- Nephrology Nagoya University Postgraduate School of Medicine Nagoya, Japan
| | - Takayuki Katsuno
- Nephrology Nagoya University Postgraduate School of Medicine Nagoya, Japan
| | - Shoichi Maruyama
- Nephrology Nagoya University Postgraduate School of Medicine Nagoya, Japan
| | - Yasuhiko Ito
- Nephrology Nagoya University Postgraduate School of Medicine Nagoya, Japan
- Renal Replacement Therapy Nagoya University Postgraduate School of Medicine Nagoya, Japan
- Department of Nephrology and Rheumatology Aichi Medical University Nagakute, Japan
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Aung ZZ, Saw YM, Saw TN, Oo N, Aye HNN, Aung S, Oo HN, Cho SM, Khaing M, Kariya T, Yamamoto E, Hamajima N. Survival rate and mortality risk factors among TB-HIV co-infected patients at an HIV-specialist hospital in Myanmar: A 12-year retrospective follow-up study. Int J Infect Dis 2018; 80:10-15. [PMID: 30572021 DOI: 10.1016/j.ijid.2018.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/05/2018] [Accepted: 12/11/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Myanmar is listed as one of the countries with the highest burden of tuberculosis and HIV infections (TB-HIV) in the world. However, the survival rate and risk factors for mortality among TB-HIV co-infected patients in the country remain unstudied. Therefore, the purpose of this study was to examine these factors. METHODS A 12-year retrospective follow-up study was conducted among 3598 TB-HIV co-infected patients (2452 male and 1146 female) aged 15 years and above, enrolled on antiretroviral therapy (ART) from July 1, 2005 to December 31, 2016. Hazard ratios (HR) were estimated using the Cox proportional hazards model. Survival rates at the beginning of ART were calculated using the Kaplan-Meier method. RESULTS A total of 494 (13.7%) patients died during this period. The survival rate of TB-HIV co-infected patients was 82.0% at 5 years and 58.1% at 10 years. The risk factors for mortality were being bedridden (adjusted hazard ratio (aHR) 2.70, 95% confidence interval (CI) 2.13-3.42), having a low baseline CD4 count (aHR 1.53, 95% CI 1.25-1.87), and being on a second-line ART regimen (aHR 8.12, 95% CI 3.56-18.54). CONCLUSIONS Two out of five TB-HIV patients died within 10 years after ART initiation. Current HIV prevention and treatment programs should focus more on bedridden patients, those on second-line ART, and those with low baseline CD4 counts.
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Affiliation(s)
- Zaw Zaw Aung
- National AIDS Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thu Nandar Saw
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nwe Oo
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Hnin Nwe Ni Aye
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Mandalay Regional Public Health Department, Ministry of Health and Sports, Mandalay, Myanmar
| | - Sithu Aung
- National Tuberculosis Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Htun Nyunt Oo
- National AIDS Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Moe Khaing
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Abstract
Medical facility statistics provide essential information to policymakers, administrators, academics, and practitioners in the field of health services. In Japan, the Health Statistics Office of the Director-General for Statistics and Information Policy at the Ministry of Health, Labour and Welfare is generating these statistics. Although the statistics are widely available in both Japanese and English, the methodology described in the technical reports are primarily in Japanese, and are not fully described in English. This article aimed to describe these processes for readers in the English-speaking world. The Health Statistics Office routinely conduct two surveys called the Hospital Report and the Survey of Medical Institutions. The subjects of the former are all the hospitals and clinics with long-term care beds in Japan. It comprises a Patient Questionnaire focusing on the numbers of inpatients, admissions, discharges, and outpatients in one month, and an Employee Questionnaire, which asks about the number of employees as of October 1. The Survey of Medical Institutions consists of the Dynamic Survey, which focuses on the opening and closing of facilities every month, and the Static Survey, which focuses on staff, facilities, and services as of October 1, as well as the number of inpatients as of September 30 and the total number of outpatients during September. All hospitals, clinics, and dental clinics are requested to submit the Static Survey questionnaire every three years. These surveys are useful tools for collecting essential information, as well as providing occasions to implicitly inform facilities of the movements of government policy.
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Affiliation(s)
- Nobuyuki Hamajima
- Department of Health Care Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Sugimoto
- Department of Health Care Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryo Hasebe
- Department of Health Care Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Su Myat Cho
- Department of Health Care Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Moe Khaing
- Department of Health Care Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Medical Services, Ministry of Health and Sports, Republic of the Union of Myanmar
| | - Tetsuyoshi Kariya
- Department of Health Care Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Health Care Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Health Care Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Aye HNN, Saw YM, Thar AMC, Oo N, Aung ZZ, Tin H, Than TM, Kariya T, Yamamoto E, Hamajima N. Assessing the operational costs of routine immunization activities at the sub-center level in Myanmar: What matters for increasing national immunization coverage? Vaccine 2018; 36:7542-7548. [PMID: 30377065 DOI: 10.1016/j.vaccine.2018.10.051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/13/2018] [Accepted: 10/15/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Myanmar's national immunization program was launched in 1978. Routine immunization is mainly provided at sub-center level with midwives assigned as main vaccinators. The vaccinators at the sub-centers have to obtain vaccines from their designated township health department's cold room for immunization services. This study aimed to calculate the operational costs of routine immunization at sub-centers in Myanmar. METHODS A cross-sectional study was conducted among 160 sub-centers throughout the country. Face-to-face interviews were conducted with the main vaccinator at each sub-center using a pre-tested questionnaire. The study analyzed the operational costs per facility and the associations between sub-center characteristics and operational costs. RESULTS In Myanmar, the average operational costs of routine immunization per sub-center ranged from 434,700-990,125 MMK for rural areas and 235,875-674,250 MMK for urban areas. The operational costs increased by 8,749.50 MMK (95% CI: 6,805.79-10,693.21; p < 0.001) per mile and 5,752.50 MMK (95% CI: 914.22-10,590.79; p < 0.05) per working day. CONCLUSION This study indicated that the operational costs at sub-centers were high and varied significantly among the different geographical areas. The operational costs could be reduced by additional support for the resources, for example, installing cold chain facilities at sub-centers and opening new sub-centers throughout the country.
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Affiliation(s)
- Hnin Nwe Ni Aye
- Expanded Programme on Immunization/Communicable Diseases Unit, Mandalay Regional Public Health Department, Ministry of Health and Sports, Mandalay, Myanmar; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Aye Mya Chan Thar
- Central Expanded Programme on Immunization, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Nwe Oo
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Zaw Zaw Aung
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Htun Tin
- Central Epidemiological Unit, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thet Mon Than
- Department of Medical Services, Ministry of Health and Sports, Myanmar
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Nyi Latt N, Saw YM, Myat Cho S, Kariya T, Yamamoto E, Hamajima N. Tobacco Control Law awareness, enforcement, and compliance among high school students in Myanmar. Nagoya J Med Sci 2018; 80:379-389. [PMID: 30214087 PMCID: PMC6125651 DOI: 10.18999/nagjms.80.3.379] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/01/2018] [Indexed: 11/30/2022]
Abstract
In Myanmar, the Control of Smoking and Consumption of Tobacco Products Law (Tobacco Control Law; TCL), which covers the prohibition of sale of tobacco to minors and all forms of tobacco advertisement, was enacted in 2006. This study aimed to examine the awareness of the TCL among high school students. A cross-sectional study was conducted in November 2015. Participants were 1,339 high school students (554 boys and 785 girls) from two regions and two states of Myanmar. Data were collected using anonymous self-administered questionnaires and revealed that 78.0% of boys and 86.5% of girls responded the sale of tobacco products in or within 100 feet from school, and 83.4% of boys had ever seen someone selling tobacco products to minors. More than half of the students had ever seen minors selling or distributing tobacco products, and had knowledge about the TCL, while only 9.7% knew about the penalties. The adjusted odds ratio (95% confidence interval) of awareness of the TCL was 2.12 (1.35-3.31) for students who had ever received tobacco products free of charge, or seen/heard about their distribution free of charge, 1.86 (1.20-2.89) for current smokeless tobacco users, and 0.58 (0.43-0.77) for students who had ever seen someone selling tobacco products to minors. The majority of high school students did not know that the violation of the TCL could be punished with a fine and/or imprisonment. These findings suggest that awareness of the TCL was very low among high school students, highlighting that TCL enforcement and compliance, and tobacco-related health education programs are not satisfactory in Myanmar.
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Affiliation(s)
- Nyi Nyi Latt
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Aung Myin Myint Mo Hospital, Gyobingauk, Myanmar
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Rasekh B, Saw YM, Azimi S, Kariya T, Yamamoto E, Hamajima N. Associations of treatment completion against drug addiction with motivational interviewing and related factors in Afghanistan. Nagoya J Med Sci 2018; 80:329-340. [PMID: 30214082 PMCID: PMC6125658 DOI: 10.18999/nagjms.80.3.329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite the increase in the number of drug treatment centers, patients with drug addicts have been increasing without the improvement of treatment in Afghanistan. This study aimed to examine the associations of the completion of drug addiction treatment with motivational interviewing (MI) and other factors among male drug users in Afghanistan. Subjects were patients admitted to Jangalak Hospital in Kabul, Afghanistan in 2014 and 2015. Systematic sampling and supplementary sampling were applied. The records of 327 males aged 18 to 54 years were collected from those of 3,373 male inpatients. Completion of treatment was defined as presence and receiving treatment in the hospital for at least 45 days. Multiple logistic regression models were applied to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for the completion of drug addiction treatment. Among the patients, heroin was the most commonly used drug, followed by opium, crystal, hashish, and other drugs. Patients with treatment history for drug addiction (AOR 2.46; 95% CI 1.14-5.30), those attended MI before admission (AOR 43.98; 95% CI 17.21-112.39), and those used heroin (AOR 4.74; 95% CI 1.32-16.97) were more likely to complete the drug addiction treatment. Among the factors examined in this study, attending MI was most strongly associated with the completion of drug addiction treatment. Amendments to policies to include compulsory MI in standard operational procedures of drug addiction treatment before hospitalization may be recommended.
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Affiliation(s)
- Bakhtar Rasekh
- Drug Demand Reduction Department, Ministry of Public Health, Kabul, Afghanistan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sayed Azimi
- Mental Health Department, Ministry of Public Health, Kabul, Afghanistan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Kanzaki A, Kato Y, Kariya T, Kanda Y, Shirai K, Arai T, Tsuboi R. Response of basal cell carcinoma to imiquimod was associated with the Gli1 : Gli3 expression ratio. Br J Dermatol 2018; 179:1406-1407. [PMID: 30019418 DOI: 10.1111/bjd.17015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Kanzaki
- Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.,Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Y Kato
- Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.,Department of Dermatology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 193-0944, Japan
| | - T Kariya
- Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.,Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Y Kanda
- Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.,Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - K Shirai
- Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.,Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - T Arai
- Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.,Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - R Tsuboi
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
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Kariya T, Nishimura H, Mizuno M, Suzuki Y, Matsukawa Y, Sakata F, Maruyama S, Takei Y, Ito Y. TGF-β1-VEGF-A pathway induces neoangiogenesis with peritoneal fibrosis in patients undergoing peritoneal dialysis. Am J Physiol Renal Physiol 2018; 314:F167-F180. [DOI: 10.1152/ajprenal.00052.2017] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The characteristic features of chronic peritoneal injury with peritoneal dialysis (PD) are submesothelial fibrosis and neoangiogenesis. Transforming growth factor (TGF)β and vascular endothelial growth factor (VEGF)-A are the main mediators of fibrosis and neoangiogenesis, respectively; however, the effect of the interaction between them on the peritoneum is not well known. In this study, we investigated the relationship between TGF-β1 and VEGF-A in inducing peritoneal fibrosis by use of human tissues and dialysate, cultured cells, and animal models. The VEGF-A concentration correlated with the dialysate-to-plasma ratio of creatinine (D/P Cr) ( P < 0.001) and TGF-β1 ( P < 0.001) in human PD effluent. VEGF-A mRNA levels increased significantly in the peritoneal tissues of human ultrafiltration failure (UFF) patients and correlated with number of vessels ( P < 0.01) and peritoneal thickness ( P < 0.001). TGF-β1 increased VEGF-A production in human mesothelial cell lines and fibroblast cell lines, and TGF-β1-induced VEGF-A was suppressed by TGF-β receptor I (TGFβR-I) inhibitor. Incremental peak values of VEGF-A mRNA stimulated by TGF-β1 in human cultured mesothelial cells derived from PD patients with a range of peritoneal membrane functions correlated with D/P Cr ( P < 0.05). To evaluate the regulatory mechanisms of VEGF-A and neoangiogenesis in vivo, we administered TGFβR-I inhibitor intraperitoneally in a rat chlorhexidine-induced peritoneal injury (CG) model. TGFβR-I inhibitor administration in the CG model decreased peritoneal thickness ( P < 0.001), the number of vessels ( P < 0.001), and VEGF-A levels ( P < 0.05). These results suggest that neoangiogenesis is associated with fibrosis through the TGF-β1-VEGF-A pathway in mesothelial cells and fibroblasts. These findings are important when considering the strategy for management of UFF in PD patients.
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Affiliation(s)
- Tetsuyoshi Kariya
- Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hayato Nishimura
- Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Futatsuya Hospital, Ishikawa, Japan
| | - Masashi Mizuno
- Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Suzuki
- Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fumiko Sakata
- Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shoichi Maruyama
- Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshifumi Takei
- Department of Biochemistry, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Medical Biochemistry, School of Pharmacy, Aichi Gakuin University, Nagoya, Japan
| | - Yasuhiko Ito
- Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Aichi, Japan
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46
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Than TM, Saw YM, Khaing M, Win EM, Cho SM, Kariya T, Yamamoto E, Hamajima N. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting? BMC Health Serv Res 2017; 17:669. [PMID: 28927450 PMCID: PMC5605979 DOI: 10.1186/s12913-017-2619-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/13/2017] [Indexed: 11/30/2022] Open
Abstract
Background Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. Methods A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015–2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. Results The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. Conclusion The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the available resources. Electronic supplementary material The online version of this article (10.1186/s12913-017-2619-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thet Mon Than
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. .,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Moe Khaing
- Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Ei Mon Win
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Occupational and Environmental Health Division, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Imai T, Ichimura M, Nakashima Y, Sakamoto M, Katanuma I, Yoshikawa M, Kariya T, Hirata M, Kohagura J, Minami R, Numakura T, Ikezoe R, Oki K, Sakamoto K. GAMMA 10/PDX Project Status and Future. Fusion Science and Technology 2017. [DOI: 10.13182/fst13-1t29] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Imai
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - M. Ichimura
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - Y. Nakashima
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - M. Sakamoto
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - I. Katanuma
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - M. Yoshikawa
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Kariya
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - M. Hirata
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - J. Kohagura
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - R. Minami
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Numakura
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - R. Ikezoe
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - K. Oki
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - K. Sakamoto
- Japan Atomic Energy Research Institute(JAEA), Naka, Japan
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48
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Kariya T, Minami R, Imai T, Kubo S, Shimozuma T, Takahashi H, Yoshimura Y, Ito S, Mutoh T, Ota M, Endo Y, Sakamoto K. Development of Mega-Watt Gyrotrons for Fusion Research. Fusion Science and Technology 2017. [DOI: 10.13182/fst11-a11622] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Kariya
- Plasma Research Center (PRC), University of Tsukuha, Tsukuha, lharaki, 305-8577, Japan
| | - R. Minami
- Plasma Research Center (PRC), University of Tsukuha, Tsukuha, lharaki, 305-8577, Japan
| | - T. Imai
- Plasma Research Center (PRC), University of Tsukuha, Tsukuha, lharaki, 305-8577, Japan
| | - S. Kubo
- National Institute for Fusion Science (NIFS), Toki, Gifu, 509-5292, Japan
| | - T. Shimozuma
- National Institute for Fusion Science (NIFS), Toki, Gifu, 509-5292, Japan
| | - H. Takahashi
- National Institute for Fusion Science (NIFS), Toki, Gifu, 509-5292, Japan
| | - Y. Yoshimura
- National Institute for Fusion Science (NIFS), Toki, Gifu, 509-5292, Japan
| | - S. Ito
- National Institute for Fusion Science (NIFS), Toki, Gifu, 509-5292, Japan
| | - T. Mutoh
- National Institute for Fusion Science (NIFS), Toki, Gifu, 509-5292, Japan
| | - M. Ota
- Plasma Research Center (PRC), University of Tsukuha, Tsukuha, lharaki, 305-8577, Japan
| | - Y. Endo
- Plasma Research Center (PRC), University of Tsukuha, Tsukuha, lharaki, 305-8577, Japan
| | - K. Sakamoto
- Japan Atomic Energy Agency (JAEA), Naka, lharaki, 311-0193, Japan
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Imai T, Ichimura M, Nakashima Y, Katanuma I, Yoshikawa M, Kariya T, Minami R, Miyata Y, Yamaguchi Y, Ikezoe R, Shimozuma T, Kubo S, Yoshimura Y, Takahashi H, Mutoh T, Sakamoto K, Mizuguchi M, Ota M, Ozawa H, Hosoi K, Yaguchi F, Yonenaga R, Imai Y, Murakani T, Yagi K, Nakamura T, Aoki1 H, Iizumi H, Ishii T, Kondou H, Takeda H, Ichioka N, Masaki S, Yokoyama T. Status and Plan of GAMMA 10 Tandem Mirror Program. Fusion Science and Technology 2017. [DOI: 10.13182/fst11-a11563] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Imai
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - M. Ichimura
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - Y. Nakashima
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - I. Katanuma
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - M. Yoshikawa
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Kariya
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - R. Minami
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - Y. Miyata
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - Y. Yamaguchi
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - R. Ikezoe
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Shimozuma
- National Institute of Fusion Science(NIFS), Toki, Japan
| | - S. Kubo
- National Institute of Fusion Science(NIFS), Toki, Japan
| | - Y. Yoshimura
- National Institute of Fusion Science(NIFS), Toki, Japan
| | - H. Takahashi
- National Institute of Fusion Science(NIFS), Toki, Japan
| | - T. Mutoh
- National Institute of Fusion Science(NIFS), Toki, Japan
| | - K. Sakamoto
- Japan Atomic Energy Research Institute(JAEA), Naka, Japan
| | - M. Mizuguchi
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - M. Ota
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - H. Ozawa
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - K. Hosoi
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - F. Yaguchi
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - R. Yonenaga
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - Y. Imai
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Murakani
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - K. Yagi
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | | | - H. Aoki1
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - H. Iizumi
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Ishii
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - H. Kondou
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - H. Takeda
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - N. Ichioka
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - S. Masaki
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Yokoyama
- Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
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50
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Imai T, Tatematsu Y, Numakura T, Sakamoto K, Minami R, Watanabe O, Kariya T, Mitsunaka Y, Kamata Y, Machida N, Kaizuka T, Nakamura M, Saito T, Cho T. Upgrade Program of ECRH System for GAMMA 10. Fusion Science and Technology 2017. [DOI: 10.13182/fst07-a1352] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Imai
- Plasma Research Center, University of Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Tatematsu
- Plasma Research Center, University of Tsukuba, Ibaraki 305-8577, Japan
| | - T. Numakura
- Plasma Research Center, University of Tsukuba, Ibaraki 305-8577, Japan
| | - K. Sakamoto
- Naka Fusion Research Est., Japan Atomic Energy Agency, Naka,Ibaraki, Japan
| | - R. Minami
- Plasma Research Center, University of Tsukuba, Ibaraki 305-8577, Japan
| | - O. Watanabe
- Plasma Research Center, University of Tsukuba, Ibaraki 305-8577, Japan
| | - T. Kariya
- Toshiba Electron Tubes & Devices Co. Ltd, Otawara, Tochigi, Japan
| | - Y. Mitsunaka
- Toshiba Electron Tubes & Devices Co. Ltd, Otawara, Tochigi, Japan
| | - Y. Kamata
- Plasma Research Center, University of Tsukuba, Ibaraki 305-8577, Japan
| | - N. Machida
- Plasma Research Center, University of Tsukuba, Ibaraki 305-8577, Japan
| | - T. Kaizuka
- Plasma Research Center, University of Tsukuba, Ibaraki 305-8577, Japan
| | - M. Nakamura
- Plasma Research Center, University of Tsukuba, Ibaraki 305-8577, Japan
| | - T. Saito
- Toshiba Electron Tubes & Devices Co. Ltd, Otawara, Tochigi, Japan
| | - T. Cho
- Research Center for Dev. of Far Infrared Region, Univ. of Fukui, Fukui, Japan
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