Publications by authors named "Kayako Sakisaka"

27 Publications

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Factors Associated with Regular Zumba Practice as Preliminary Results: A Population-Based Approach in Cebu Province, the Philippines.

Int J Environ Res Public Health 2021 05 17;18(10). Epub 2021 May 17.

National Nutrition Council Region VII, Cebu City 6000, Philippines.

The prevalence of overweight/obesity in the adult population in the Philippines has doubled in the past 20 years. Zumba exercise has recently been implemented throughout the Philippines. However, there is scarce information on the effects of Zumba on obesity and Zumba participants' characteristics in the Philippines. This study described the current practice of Zumba in the Philippines, along with the practitioners' characteristics, and identified factors associated with Zumba participation. In this observational, cross-sectional study, a structured questionnaire was used to survey 10 Zumba locations in September 2019. Anthropometric measurements of participants were assessed. Respondents included 171 women (88.6%) and 22 men (11.4%), with a mean (±standard deviation [SD]) age of 44.1 (±8.9) years. All respondents answered that Zumba was enjoyable, and some answered "very enjoyable". Determinants of frequent participation were as follows: being older than the mean age of participants, starting Zumba to enjoy dancing, starting Zumba not to lose weight, shopping mall location, and participation fee required. "To enjoy dance" being a motivation for Zumba practice was identified as a determinant of frequent participation rather than "to lose weight." The element of "enjoyable" may strongly influence the continuation and frequent participation of Zumba exercise in the Philippines.
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http://dx.doi.org/10.3390/ijerph18105339DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8157069PMC
May 2021

Self-Esteem, Socioeconomic Status and Social Participation of Persons with Disabilities Living in Areas Affected by Armed Conflict in Colombia.

Int J Environ Res Public Health 2021 04 19;18(8). Epub 2021 Apr 19.

School of Public Health, Teikyo University Graduate, Tokyo 173-8605, Japan.

This cross-sectional study explored the association between self-esteem and social participation of persons with disabilities living in two municipalities affected by armed conflict in Colombia. We studied the socioeconomic status, communication level, social participation, and self-esteem of the participants. The Rosenberg Self-Esteem Scale (RSES) was used to evaluate the level of self-esteem. We performed bivariate analysis and multiple regression analysis to identify the determinants of higher self-esteem in the target populations. In total, there were 579 participants in the study. The mean RSES score was 28.8 (SD = 4.5). Self-esteem was associated with monthly household income (β = 0.45, = 0.028), education level (β = 0.65, = 0.048), current job (β = 1.00, = 0.017), type of disability (β = -1.17, = 0.002), frequency of communication with neighbors or friends (β = 0.53, = 0.013), and participation in community organization activities (β = 0.89, = 0.019). Frequent communication with their own community, higher levels of school education, and having a job were determinants of higher self-esteem in persons with disabilities. We suggest the importance of an active inclusive reconstruction program to support persons with disabilities in local municipalities affected by armed conflict in developing countries.
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http://dx.doi.org/10.3390/ijerph18084328DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073117PMC
April 2021

Motivation for and Effect of Cooking Class Participation: A Cross-Sectional Study Following the 2011 Great East Japan Earthquake and Tsunami.

Int J Environ Res Public Health 2020 10 27;17(21). Epub 2020 Oct 27.

Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.

We explored the association between the motivation for and effects of cooking class participation in disaster-affected areas following the 2011 Great East Japan Earthquake and Tsunami. We conducted questionnaire surveys in January and February 2020, and applied three Poisson regression models to a cross-sectional dataset of participants, analyzing three perceived participation effects: increase in new acquaintances and friends, increase in excursion opportunities, potential for gaining motivation, and a new sense of life purpose. We also applied the interaction term of motivation variables and usual eating patterns (eating alone or with others). We obtained 257 valid responses from 15 cooking venues. The interaction term for participants' motivation and eating patterns was associated with their perceived participation effects. "Motivation for nutrition improvement × eating alone" was positively associated with an increase in new acquaintances and friends (IRR: 3.05, 95% CI, 1.22-7.64). "Motivation for increasing personal cooking repertoire × eating alone" was positively associated with increased excursion opportunities (IRR: 5.46, 95% CI, 1.41-21.20). In contrast, the interaction effect of "motivation of increasing nutrition improvement × eating alone" was negatively associated with increased excursion opportunities (IRR: 0.27, 95% CI, 0.12-0.69). The results show that the cooking class was effective, as residents' participation improved their nutritional health support and increased their social relationships.
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http://dx.doi.org/10.3390/ijerph17217869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7672545PMC
October 2020

Surgical symptomatic knowledge among medical staff and community health workers in rural Cambodia: a descriptive study for workforce improvement.

J Rural Med 2020 Apr 1;15(2):57-62. Epub 2020 Apr 1.

Teikyo University Graduate School of Public Health, Japan.

The surgical workforce needs to at least double by 2030. To increase the workforce, training for non-physician healthcare professionals and community health workers (CHWs) in rural areas is promising to decrease the numbers of untreated surgical patients. Nevertheless, few studies have been conducted on surgical activities of non-physician healthcare professionals and CHWs in rural Cambodia. We sought to measure the level of knowledge of surgical symptoms, and identify factors associated with it. A questionnaire survey was administered to people in rural areas of Kratie Province to determine their knowledge of surgical symptoms, and to strengthen the surgical workforce among medical staff and CHWs. To evaluate the knowledge of surgical symptoms among medical staff and CHWs, a self-reported questionnaire was administered to medical staff, CHWs, and villagers in a rural area of Kratie province, Cambodia. The rating score of the number of correct answers among medical staff, CHWs, and villagers was set as the primary outcome. A total of 91 participants, including 31 medical staff, 24 CHWs, and 36 villagers, completed the survey. The median scores for knowledge of symptoms indicative of surgery were 8 (7-8) [median (interquartile range)] in medical staff, 8 (7-8.5) in CHWs, and 8.5 (8-9) in villagers. There was no significant difference in the scores of surgical symptoms among each of the occupational groups. The group of people who recognized low subjective knowledge of surgical symptom by themselves had significantly higher objective score of knowledge of surgical symptom. Knowledge of surgical symptoms among medical staff and CHWs was inadequate. To at least double the surgical workforce by 2030 successfully, accurate evaluation and improvement of surgical symptomatic knowledge among medical staff in rural areas is crucial.
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http://dx.doi.org/10.2185/jrm.2019-016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110098PMC
April 2020

Anxiety and perceived psychological impact associated with needle stick and sharp device injury among tertiary hospital workers, Vientiane, Lao PDR.

Ind Health 2020 Aug 19;58(4):388-396. Epub 2020 Feb 19.

Reproductive Health and Research, World Health Organization, Switzerland.

Occupational needle stick and sharp injuries (NSSIs) affect healthcare workers' (HCWs') mental health, however, limited evidence is available on the psychological impact of NSSIs, especially in developing countries where most of NSSIs have been reported. A cross-sectional study was conducted to evaluate the anxiety and psychological impact regarding NSSIs among HCWs at tertiary hospitals in Lao PDR. In this study, four among seven items of anxiety scale in Hospital Anxiety and Depression Scale (HADS) (Cronbach's α=0.80) was applied. Participants who experienced NSSIs in the past 6 months showed significantly higher anxiety scores than those who did not experienced (p=0.004) and the average anxiety scores was high shortly after the NSSI. The 42.7% of them were more afraid of needles and sharp devices in the 2 wk after the NSSI than the time of the interview. The results encourage developing countries to adapt a comprehensive NSSI management policy including not only to take adequate precaution measures but psychological support and treatment for HCWs from immediately after NSSIs to improve safety for HCWs and patients. Further studies are needed to develop normative psychiatric scales with cultural adaptation in developing countries which provide convenient mental disorder assessment after NSSIs.
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http://dx.doi.org/10.2486/indhealth.2019-0088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7417503PMC
August 2020

Corrigendum to "Myanmar's human resources for health: current situation and its challenges" [Heliyon 5 (3), (March 2019), e01390].

Heliyon 2019 Oct 1;5(10):e02737. Epub 2019 Nov 1.

Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Japan.

[This corrects the article DOI: 10.1016/j.heliyon.2019.e01390.].
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http://dx.doi.org/10.1016/j.heliyon.2019.e02737DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838809PMC
October 2019

Myanmar's human resources for health: current situation and its challenges.

Heliyon 2019 Mar 27;5(3):e01390. Epub 2019 Mar 27.

Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Japan.

Background: Human resources for health (HRH) are the cornerstone of health systems, enabling the improvement of health service coverage. The systematic fortification of healthcare in Myanmar has accelerated since a new ruling party took office. Since 2006, Myanmar has been listed as one of the 57 crisis countries facing critical health workforce shortages. Therefore, this study aimed to assess the current situation of HRH in the public health sector where major healthcare services are provided to the people of Myanmar.

Methods: A cross-sectional study was conducted from January to May 2017 by collecting secondary data from the official statistic of the Ministry of Health and Sports (MoHS), official reports, press-releases, and presentations of Government officials. The data were collected using a formatted excel spreadsheet. A descriptive analysis was applied and the density ratio per 1,000 population for medical doctors and health workers was calculated.

Findings: In total, 16,292 medical doctors and 36,054 nurses working at 1,134 hospitals were under the management of MoHS in 2016. The finding revealed that 13 out of 15 States and Regions were below the WHO recommended minimum number of 1 per 1,000 population for medical doctor. The distribution of medical doctors per 1,000 population in the public sector showed a gradually decreasing trend since 2006. Urban and rural medical doctor ratios observed wide disparities.

Interpretation: The HRH shortage occurred in almost all State and Regions of Myanmar, including major cities. Wide disparities of HRH were found in urban and rural areas. The Myanmar government needs to consider the proper cost-effective HRH supply-chain management systems and retention strategies. The projection of health workforce, distribution of workforce by equity, effective management, and health information systems should be strengthened.
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http://dx.doi.org/10.1016/j.heliyon.2019.e01390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441837PMC
March 2019

Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study.

BMJ Open 2018 11 25;8(11):e022737. Epub 2018 Nov 25.

Healthcare New Frontier Promotion Headquarters Office, Kanagawa Prefectural Government, Yokohama, Japan.

Objectives: To examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011.

Design: A population-based ecological study using publicly available data.

Setting: Twenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi).

Participants: Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008-2010) and after GEJET (2012-2014).

Results: Between 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (β=-189.9, p=0.02) and public health nurses (β=-1.7, p=0.01) was negatively associated with mortality rate per person in 2011.

Conclusions: In 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates.
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http://dx.doi.org/10.1136/bmjopen-2018-022737DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254400PMC
November 2018

Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study.

BMJ Open 2018 11 25;8(11):e022737. Epub 2018 Nov 25.

Healthcare New Frontier Promotion Headquarters Office, Kanagawa Prefectural Government, Yokohama, Japan.

Objectives: To examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011.

Design: A population-based ecological study using publicly available data.

Setting: Twenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi).

Participants: Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008-2010) and after GEJET (2012-2014).

Results: Between 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (β=-189.9, p=0.02) and public health nurses (β=-1.7, p=0.01) was negatively associated with mortality rate per person in 2011.

Conclusions: In 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates.
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http://dx.doi.org/10.1136/bmjopen-2018-022737DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254400PMC
November 2018

Examining the relationship between socioeconomic status and the double burden of maternal over and child under-nutrition in Bangladesh.

Eur J Clin Nutr 2019 04 25;73(4):531-540. Epub 2018 Apr 25.

Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi, 6205, Bangladesh.

Background/objectives: There is little research on the association between socioeconomic status (SES) and the familial co-existence of maternal over and child under-nutrition (MOCU). Most of these studies conducted in the Latin American countries. Therefore, we intended to further this important area of query by exploring the relationship between SES and the dual burden of MOCU in Bangladesh.

Subjects/methods: We used data from the 2014 Bangladesh Demographic Health Survey (BDHS). The analyses were based on the responses of 5687 mother-child pairs. We focused standard of living (hereafter referred to as wealth) as a measure of SES. We determined MOCU if there were an undernourished child and an overweight mother in the same household.

Results: Maternal overweight and MOCU prevalence is higher among the wealthier segment whereas prevalence of child under-nutrition is higher among the poorest segment of the households. The relative risk of a household having MOCU increased by the factors of 2.84 (confidence interval (CI) = 1.58-5.12) among households with richest bands of wealth compared to the poorest category. Household from the medium (Relative risk ratio (RRR) = 1.87, 95% CI = 1.07-3.28) and richer SES groups (RRR = 2.56, 95% CI = 1.39-4.69) had increased chance for MOCU as compared to the household from poorest SES group.

Conclusions: As opposed to findings from other Latin American countries, the prevalence of MOCU in Bangladesh is higher in the wealthiest households. Findings of our study therefore suggest that overweight prevention programs in wealthier households of Bangladesh need to think out the possibility that their focus households may also include underweight persons.
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http://dx.doi.org/10.1038/s41430-018-0162-6DOI Listing
April 2019

Prevalence and risk factors of needle stick and sharp injury among tertiary hospital workers, Vientiane, Lao PDR.

J Occup Health 2017 Nov 13;59(6):581-585. Epub 2017 Sep 13.

Reproductive Health and Research, World Health Organization.

Objectives: Health care workers (HCWs) face risks of needle stick and sharp injuries (NSIs). Most NSIs occur in developing countries, however, no epidemiological study on NSIs is publicly available in Lao PDR. The objective of this study is to identify the prevalence and risk factors of NSIs among HCWs in Lao PDR.

Methods: This cross-sectional study was designed to determine the prevalence and risk factors of NSIs among four tertiary hospitals in Vientiane, Lao People's Democratic Republic.

Results: Six months before the survey, 11.4% (106/932) of hospital staff had experienced NSIs, while 42.1% did in their entire career. Key protective factors of NSIs among nurses included adequate availability of needles, syringes, and sharp equipment (p = 0.042; odds ratio [OR], 0.47) and attendance to educational or refresher courses on safety regarding NSIs (p = 0.038; OR, 0.50). As an on-site practice, single-handed recapping was prevalent (46.7%, 257/550) among participants.

Conclusions: The result showed that high rates of NSIs persist among HCWs. The findings of this research call for comprehensive health and injection safety programs for HCWs involved in clinical practice.
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http://dx.doi.org/10.1539/joh.17-0084-FSDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721280PMC
November 2017

Effect of a school-based oral health education in preventing untreated dental caries and increasing knowledge, attitude, and practices among adolescents in Bangladesh.

BMC Oral Health 2016 Mar 25;16:44. Epub 2016 Mar 25.

Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh.

Background: There is a dearth of published literature that demonstrates the impact and effectiveness of school-based oral health education (OHE) program in Bangladesh and it is one of the most neglected activities in the field of public health. Keeping this in mind, the objectives of this study were to assess the effectiveness of OHE program in: 1) increasing oral health knowledge, attitude, and practices and 2) decreasing the prevalence of untreated dental caries among 6-8 grade school students in Bangladesh.

Methods: This intervention study was conducted in Araihazar Thana, Narayanganj district, Bangladesh during April 2012 to March 2013. The total participants were 944 students from three local schools. At baseline, students were assessed for oral health knowledge, attitude and practices using a self-administered structured questionnaire and untreated dental caries was assessed using clinical examination. Follow up study was done after 6 months from baseline. McNemar's chi-square analysis was used to evaluate the impact of OHE program on four recurrent themes of oral health between the baseline and follow-up. Multiple logistic regression analyses were used to determine the impact of the intervention group on our outcome variables.

Results: Significant improvement was observed regarding school aged adolescents' self-reported higher knowledge, attitude and practices scores (p < 0.001) at follow-up compared with baseline. The prevalence of untreated dental caries of the study population after the OHE program was significantly (p < 0.01) reduced to 42.5 %. Multiple logistic regression analyses showed that the OHE intervention remained a significant predictor in reducing the risk of untreated dental caries (adjusted odds ratio [AOR] =0.51; 95 % confidence interval [CI] = 0.37, 0.81). In the follow-up period participants were 2.21 times (95 % CI = 1.87, 3.45) more likely to have higher level of knowledge regarding oral health compared to baseline. Compared with baseline participants in the follow-up were 1.89 times (95 % CI = 1.44-2.87) more likely to have higher attitude towards oral health. In addition, OHE intervention was found to be significantly associated with higher level of practices toward oral health (AOR = 1.64; 95 % CI = 1.12, 3.38).

Conclusions: This study indicated that OHE intervention was effective in increasing i) knowledge, ii) attitude, and iii) practices towards oral health; it also significantly reduced the prevalence of untreated dental caries among school aged adolescents from grade 6-8 in a deprived rural area of Bangladesh.
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http://dx.doi.org/10.1186/s12903-016-0202-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807560PMC
March 2016

Introduction of a community water supply in rural western Kenya: impact on community wellbeing and child health.

Int Health 2015 May 2;7(3):204-11. Epub 2015 Apr 2.

Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Japan.

Background: This study aimed to examine water availability and community health before and after tube wells were introduced in a rural western Kenyan community. Differences in impact among income quintile groups were quantified, and users' perceptions of their water supply measured.

Methods: We conducted a two-part pre- (2009) and post-intervention (2011), cross-sectional study using structured questionnaires for mothers.

Results: In total, 1391 (576 in 2009 and 815 in 2011) mothers participated. Well introduction changed the households' drinking-water source from river to ground water. The median distance to the water source was reduced by 40% (500 to 300 metres) and median collection time was reduced by 50% (30 to 15 minutes). Water consumption per household increased by approximately 20% (from 82.6 to 99.0 L) and drinking of untreated water decreased by approximately 10%. Regression analyses revealed mothers with higher monthly incomes had the highest satisfaction levels (β=0.167, p<0.001). Positive impacts were strongest among wealthier groups.

Conclusions: The small-scale community water supply dramatically affected user hygiene behaviours and daily life. Water supply access improved from 'no access' to 'basic access'. Household connections to a water supply and hygiene education are important steps to enhance community health.
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http://dx.doi.org/10.1093/inthealth/ihv015DOI Listing
May 2015

The effect of a school-based educational intervention on menstrual health: an intervention study among adolescent girls in Bangladesh.

BMJ Open 2014 Jul 3;4(7):e004607. Epub 2014 Jul 3.

Faculty of Policy Studies, Chuo University, Tokyo, Japan.

Objectives: To assess the impact of a school-based menstrual education programme on: (1) menstrual knowledge, beliefs and practices, (2) menstrual disorders experienced, and (3) restrictions on menstruating adolescents.

Design: Intervention study.

Setting: Araihazar area, Bangladesh.

Participants: 416 adolescent female students aged 11-16 years, in grade 6-8, and living with their parents.

Interventions: A school-based health education study conducted from April 2012 to April 2013.

Primary And Secondary Outcome Measures: We randomly selected 3 of 26 high schools in the study area. We delivered 6 months of educational intervention by trained (by an obstetrician and gynaecologist) research assistants (RAs) on menstrual hygiene among school girls. RAs read the questionnaire and participants answered. The changes in knowledge, beliefs and practices regarding menstruation, menstrual disorders experienced, and the restrictions and behaviours practiced by menstruating adolescents were compared between the baseline and the follow-up assessments.

Results: After health education, participants reported a significant improvement (p<0.001) in 'high knowledge and beliefs' scores compared to baseline (51% vs 82.4%). Significant improvement was also observed in overall good menstrual practices (28.8% vs 88.9%), including improvements in using sanitary pads (22.4% change after the intervention), frequency of changing pads/cloths per day (68.8%), drying the used absorbent (77.6%), methods of disposing of the used absorbent (25.5%), and cleaning of genitalia (19.2%). During the follow-up, the participants reported significant improvements in the regularity of their menstrual cycle (94.5% vs 99.5%) and fewer complications during menstruation (78.6% vs 59.6%).

Conclusions: The programme produced significant changes in the knowledge, beliefs and practices of menstrual hygiene, complications from lack of hygiene, and the behaviour and restrictions of the menstruating adolescents. These results demonstrate the feasibility of implementing a health education programme for adolescents on menstrual hygiene in secondary schools serving rural Bangladesh.
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http://dx.doi.org/10.1136/bmjopen-2013-004607DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091465PMC
July 2014

Mental health status among Burmese adolescent students living in boarding houses in Thailand: a cross-sectional study.

BMC Public Health 2013 Apr 12;13:337. Epub 2013 Apr 12.

Immunobiology Group, Department of Tropical Infectious Diseases, Center of Molecular Biosciences, Tropical Biosphere Research Center, University of the Ryukyus, Senbaru 1, Nishihara, Okinawa 903-0213, Japan.

Background: In Tak province of Thailand, a number of adolescent students who migrated from Burma have resided in the boarding houses of migrant schools. This study investigated mental health status and its relationship with perceived social support among such students.

Methods: This cross-sectional study surveyed 428 students, aged 12-18 years, who lived in boarding houses. The Hopkins Symptom Checklist (HSCL)-37 A, Stressful Life Events (SLE) and Reactions of Adolescents to Traumatic Stress (RATS) questionnaires were used to assess participants' mental health status and experience of traumatic events. The Medical Outcome Study (MOS) Social Support Survey Scale was used to measure their perceived level of social support. Descriptive analysis was conducted to examine the distribution of sociodemographic characteristics, trauma experiences, and mental health status. Further, multivariate linear regression analysis was used to examine the association between such characteristics and participants' mental health status.

Results: In total, 771 students were invited to participate in the study and 428 students chose to take part. Of these students, 304 completed the questionnaire. A large proportion (62.8%) indicated that both of their parents lived in Myanmar, while only 11.8% answered that both of their parents lived in Thailand. The mean total number of traumatic events experienced was 5.7 (standard deviation [SD] 2.9), mean total score on the HSCL-37A was 63.1 (SD 11.4), and mean total score on the RATS was 41.4 (SD 9.9). Multivariate linear regression analysis revealed that higher number of traumatic events was associated with more mental health problems.

Conclusions: Many students residing in boarding houses suffered from poor mental health in Thailand's Tak province. The number of traumatic experiences reported was higher than expected. Furthermore, these traumatic experiences were associated with poorer mental health status. Rather than making a generalized assumption on the mental health status of migrants or refugees, more detailed observation is necessary to elucidate the unique nature and vulnerabilities of this mobile population.
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http://dx.doi.org/10.1186/1471-2458-13-337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636114PMC
April 2013

Quality of life and mental health status of arsenic-affected patients in a Bangladeshi population.

J Health Popul Nutr 2012 Sep;30(3):262-9

Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

Contamination of groundwater by inorganic arsenic is one of the major public-health problems in Bangladesh. This cross-sectional study was conducted (a) to evaluate the quality of life (QOL) and mental health status of arsenic-affected patients and (b) to identify the factors associated with the QOL. Of 1,456 individuals, 521 (35.78%) were selected as case and control participants, using a systematic random-sampling method. The selection criteria for cases (n=259) included presence of at least one of the following: melanosis, leucomelanosis on at least 10% of the body, or keratosis on the hands or feet. Control (nonpatient) participants (n=262) were selected from the same villages by matching age (±5 years) and gender. The Bangladeshi version of the WHOQOL-BREF was used for assessing the QOL, and the self-reporting questionnaire (SRQ) was used for assessing the general mental health status. Data were analyzed using Student's t-test and analysis of covariance (ANCOVA), and the WHOQOL-BREF and SRQ scores between the patients and the non-patients were compared. The mean scores of QOL were significantly lower in the patients than those in the non-patients of both the sexes. Moreover, the mental health status of the arsenic-affected patients (mean score for males=8.4 and females=10.3) showed greater disturbances than those of the non-patients (mean score for males=5.2 and females=6.1) of both the sexes. The results of multiple regression analysis revealed that the factors potentially contributing to the lower QOL scores included: being an arsenic-affected patient, having lower age, and having lower annual income. Based on the findings, it is concluded that the QOL and mental health status of the arsenic-affected patients were significantly lower than those of the non-patients in Bangladesh. Appropriate interventions are necessary to improve the well-being of the patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489942PMC
http://dx.doi.org/10.3329/jhpn.v30i3.12289DOI Listing
September 2012

High rate of unintended pregnancies after knowing of HIV infection among HIV positive women under antiretroviral treatment in Kigali, Rwanda.

Biosci Trends 2011 Dec;5(6):255-63

Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Japan.

More than 90% of pediatric AIDS results from the transmission of the virus through HIV positive pregnant mothers to their children. However, little has been known about factors associated with unintended pregnancies after knowing their HIV seropositive status, or contraceptive use among HIV positive women under antiretroviral treatment (ART). We investigated thus factors associated with unintended pregnancies after knowing seropositive status, and also factors associated with the non-use of contraceptives among HIV positive women under ART. We carried out a cross-sectional study in Kigali, Rwanda in 2007. A total of 565 HIV positive women under ART were interviewed. We examined the associated factors of unintended pregnancies or non-use of contraceptives using logistic regression analysis. Among all the respondents (n = 565), 132 women became pregnant after knowing their HIV seropositive status. Among them, 82 (62.7%) got pregnant unintentionally. Those who had two or more children (adjusted OR, 3.83) were more likely to get pregnant unintentionally. Meanwhile, among all, 263 had sexual intercourse during the last three months. Of them, 85 women did not use any contraceptives. Those who did not agree that 'HIV positive children can survive as long as HIV negative children' (adjusted OR, 2.28), and those who 'can always ask partner to use a condom' (adjusted OR, 9.83), were more likely to use contraceptives. This study suggests that HIV positive women under ART need special support to avoid unintended pregnancies especially those who have two or more children. Moreover, interventions are also needed to improve women's understanding of the prognosis of pediatric AIDS, and condom-use negotiation skills.
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http://dx.doi.org/10.5582/bst.2011.v5.6.255DOI Listing
December 2011

Social capital and life satisfaction: a cross-sectional study on persons with musculoskeletal impairments in Hanoi, Vietnam.

BMC Public Health 2011 Apr 1;11:206. Epub 2011 Apr 1.

Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.

Background: Social capital has been recognized as a major social determinant of health, but less attention has been given to social capital of persons with musculoskeletal impairments. The present study aimed to explore the associations between social capital and life satisfaction of persons with musculoskeletal impairments in Hanoi, Vietnam.

Methods: A cross-sectional study was conducted in Hanoi, Vietnam. From June to July 2008, we collected data from 136 persons with musculoskeletal impairments who belonged to disabled people's groups. Social capital was measured using a short version of the Adapted Social Capital Assessment Tool that included group membership, support from groups, support from individuals, citizenship activities, and cognitive social capital. Life satisfaction was measured using the Satisfaction with Life Scale. As possible confounding factors, we measured socio-economic factors and disability-related factors such as activities of daily living.

Results: After controlling for confounding effects, group membership remained significantly associated with the level of life satisfaction reported by the persons with musculoskeletal impairments. In particular, being an active member of two or more groups was associated with higher life satisfaction. In contrast, other components of social capital such as citizenship activities and cognitive social capital were not significant in the multiple regression analysis of this study.

Conclusions: The findings suggest the importance of considering an active participation in multiple groups toward the enhancement of the life satisfaction among persons with musculoskeletal impairments. To encourage persons with musculoskeletal impairments to have multiple active memberships, their access to groups should be facilitated and enhanced.
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http://dx.doi.org/10.1186/1471-2458-11-206DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3088538PMC
April 2011

Changing poor mothers' care-seeking behaviors in response to childhood illness: findings from a cross-sectional study in Granada, Nicaragua.

BMC Int Health Hum Rights 2010 Jun 1;10:10. Epub 2010 Jun 1.

Takemi Program in International Health, Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts USA.

Background: In 2008, approximately 8.8 million children under 5 years of age died worldwide. Most of these deaths occurred in developing countries, but little is known about poor mothers' care-seeking behaviors for their children.We examined poor mothers' care-seeking behaviors in response to childhood illness, and identified factors affecting their choices. We also assessed mothers' perception of the medical services and their confidence in the health care available for their children.

Methods: We carried out a community-based cross-sectional study with structured questionnaires. Participants were 756 mothers and their young children (0-23 months) in Nandaime municipality, Granada province, Nicaragua. We took the children's anthropometric measurements and we assessed the mothers according to their income. We divided them into 3 global absolute poverty categories (income: <1 USD/day, 1-2 USD/day, >2 USD/day), and 4 quintile.

Results: When a child showed symptoms of illness, most mothers (>75%) selected public health facilities as their first choice. More than half (>58%) were satisfied with the medical services, but the poorest mothers expressed more dissatisfaction (p = 0.003), when we divided the participants into 4 quintiles groups according to their income. In the poorest group, the main reasons for dissatisfaction were cost (46.6%), and distance to the facilities (25.8%). Almost half (41.3%) of mothers lacked confidence in the health care offered to their child, while most of the wealthiest mothers (75.7%) did have confidence in it (p = 0.001). The poorest mothers showed greater interest in health education than the wealthiest (86.2% vs. 77.8%) (p = 0.015). We found that poor mothers (
Conclusions: Determination of the severity of a childhood disease is a difficult task for mothers. The national rural health system was functioning, yet the services were often limited. We should consider the feasibility of providing a more effective primary care system for the poor.To encourage mothers' care-seeking behaviors in poor settings, the referral system and the social safety net need to be strengthened. Poor mothers need further education about the danger signs of childhood illness.
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http://dx.doi.org/10.1186/1472-698X-10-10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895585PMC
June 2010

Wives' attitudes toward gender roles and their experience of intimate partner violence by husbands in Central Province, Sri Lanka.

J Interpers Violence 2011 Feb 6;26(3):414-32. Epub 2010 May 6.

University of Tokyo, Japan.

The authors conducted a community based, cross-sectional study to describe the prevalence of intimate partner violence (IPV) by husbands and the association between wives' attitudes toward gender roles and their experience of IPV in Central Province, Sri Lanka. This article included a representative sample of 624 wives between 15 and 49 years of age and examined the prevalence of physical, psychological, and sexual abuse. Then, using multivariate logistic regression analysis, the authors examined the association between wives' attitudes toward gender roles and IPV. Of the 624 wives, 36% had experienced at least one episode of physical, psychological, or sexual abuse by their husbands during their life time (ever abuse), and 19% had experienced such abuse during the past 12 months (current abuse). The wives were less likely to experience current abuse by husbands if they believed that "outsiders should not intervene to protect abused wives." They were more likely to experience ever and current isolated psychological abuse by husbands if they did not believe that "a good wife always obeys her husband." This study suggests that the prevalence of IPV is high in Sri Lanka. Although several published studies on IPV suggest that traditional gender role attitudes tend to increase women's vulnerability to IPV, this study suggests that in Sri Lanka, the wives who respect cultural norms tend to experience less IPV by husbands.
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http://dx.doi.org/10.1177/0886260510363420DOI Listing
February 2011

Factors affecting routine immunization coverage among children aged 12-59 months in Lao PDR after regional polio eradication in western Pacific region.

Biosci Trends 2007 Aug;1(1):43-51

Department of Health Policy and Planning, School of International Health, the University of Tokyo, Tokyo, Japan.

The global poliomyelitis eradication programme had a great impact on routine immunization coverage in Lao PDR: DPT3 increased 23% in 1992 to 56% in 1999; OPV3 27% to 64%. However, after the achievement of regional eradication, coverage became stagnant in accordance with the withdrawal of various sources of financial supports. In place of the former funds, a public-private global partnership began to support EPI. We aim to explore factors affecting routine immunization coverage. From February to March of 2005, a cross-sectional questionnaire survey was conducted, targeting 341 mothers living in two districts where immunization coverage was the lowest and the middle in Oudomxay province. DPT3 coverage was 72%, higher than the national target of 65%; however, the drop-out rate was 21%. Influential factors on fully immunized child was distance, literacy, possession of livestock; mothers knowledge of immunization target diseases, measles immunization schedule; and mother's willingness to pay for immunization. In total, 98% of all mothers lived within a 30-minute walk of the immunization site. Household visits increased the immunization status among mothers who were illiterate, utilizing an outreach site for immunization, not willing to pay for immunization, receiving home delivery, and without health education attendance. The much higher routine immunization coverage especially in a district of poor EPI activities suggests a well-designed primary health care approach under the district strategy, the zone-zero social mobilization strategy and good lines of communications; it also points to the benefits of the polio eradication initiative. Household visits were found to be effective for people living with difficulties in such as education, living location, and finance. An equally shared funding system for the basic health as well as international policy for respecting the existing system in poor country is important.
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August 2007

Health-care waste management in Lao PDR: a case study.

Waste Manag Res 2005 Dec;23(6):571-81

Department of Health Policy & Planning, School of International Health, University of Tokyo, Tokyo, Japan.

This study investigated the health-care waste (HCW) management at each health-care facility level at two selected sites in the Lao People's Democratic Republic (Lao PDR): Vientiane Municipality; and Bolikhamxay province. It focused on the amount of HCW, its segregation and the factors influencing HCW management, particularly segregation procedures. A high proportion of incorrectly segregated medical waste was found at each level of health-care facility. Re-segregation revealed 39, 62, 57 and 37% at national hospital, provincial hospital, district hospital and health centre level, respectively, was poorly segregated. The mean of generated HCW was 0.62 kg/bed per day (Vientiane Municipality) and 0.38 kg/bed per day (Bolikhamxay) at two study sites. A higher proportion of medical waste (MW) from the inpatient department at the primary health-care level was found. Thus, HCW management at primary health-care facilities needs more attention and should be better understood.
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http://dx.doi.org/10.1177/0734242X05059802DOI Listing
December 2005

Domestic hygiene behaviour of mothers with children aged 0-5 years old in Tayabo village, Nueva Ecija, the Philippines.

Asia Pac J Public Health 2002 ;14(2):91-8

Department of Community Health, School of International Health, Graduate School of Medicine, University of Tokyo, Japan.

A cross-sectional survey was carried out in a rural village in Nueva Ecija province in the Philippines to identify the association between mothers' hygiene behaviour and their socioeconomic status and household environment. A total of 206 mothers with children aged 0-5 years old participated in this study. Household visits with face-to-face interviews using a structured questionnaire and observation of household environments were conducted. Logistic regression analysis revealed that the frequency of water boiling in mothers was significantly associated with children aged under two years old and the availability of domestic electricity. Availability of domestic electricity, mother's educational level, possession of a private lavatory and of a private well were significant predictors of whether hand-washing with soap was practiced after defecation. For hand-washing with soap before feeding children, child's age under one year old and the volume of the water supply were statistically significant. The volume of the water supply was identified as a significant predictor. Although health educational programme participation rates were very high (83.2%), no significant association with hygiene behaviour was observed. This study indicates that improvements in water availability, household environment and health education may contribute to more frequent hand-washing.
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http://dx.doi.org/10.1177/101053950201400207DOI Listing
August 2003
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