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Hachiya M, Vynnycky E, Mori Y, Do HT, Huynh MK, Trinh LH, Nguyen DD, Tran NAT, Hoang TT, Hoang HHT, Vo NDT, Le TH, Ichimura Y, Miyano S, Okawa S, Thandar MM, Yokobori Y, Inoue Y, Mizoue T, Takeda M, Komada K. Age-specific prevalence of IgG against measles/rubella and the impact of routine and supplementary immunization activities: A multistage random cluster sampling study with mathematical modelling. Int J Infect Dis 2024; 144:107053. [PMID: 38641317 DOI: 10.1016/j.ijid.2024.107053] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Vietnam continues to have measles and rubella outbreaks following supplementary immunization activities (SIA) and routine immunization despite both having high reported coverage. To evaluate immunization activities, age-specific immunity against measles and rubella, and the number of averted Congenital Rubella Syndrome (CRS) cases, must be estimated. METHODS Dried blood spots were collected from 2091 randomly selected individuals aged 1-39 years. Measles and rubella virus-specific immunoglobulin G (IgG) were measured by enzyme immunoassay. Results were considered positive at ≥120 mIU/mL for measles and ≥10 IU/mL for rubella. The number of CRS cases averted by immunization since 2014 were estimated using mathematical modelling. RESULTS Overall IgG seroprevalence was 99.7% (95%CI: 99.2-99.9) for measles and 83.6% (95%CI: 79.3-87.1) for rubella. Rubella IgG seroprevalence was higher among age groups targeted in the SIA than in non-targeted young adults (95.4% [95%CI: 92.9-97.0] vs 72.4% [95%CI: 63.1-80.1]; P < 0.001). The estimated number of CRS cases averted in 2019 by immunization activities since 2014 ranged from 126 (95%CI: 0-460) to 883 (95%CI: 0-2271) depending on the assumed postvaccination reduction in the force of infection. CONCLUSIONS The results suggest the SIA was effective, while young adults born before 1998 who remain unprotected for rubella require further vaccination.
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Affiliation(s)
- Masahiko Hachiya
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
| | - Emilia Vynnycky
- United Kingdom Health Security Agency, London, UK; London School of Hygiene & Tropical Medicine, London, UK
| | - Yoshio Mori
- Department of Virology 3 and World Health Organization Global Specialized Laboratory for Measles and Rubella, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Hung Thai Do
- Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Mai Kim Huynh
- Microbiology and Immunology, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Long Hoang Trinh
- Microbiology and Immunology, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Duy Duc Nguyen
- Microbiology and Immunology, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Nhu Anh Thi Tran
- Microbiology and Immunology, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Thanh Tien Hoang
- Infectious Diseases Control and Prevention, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Hai Hang Thi Hoang
- Infectious Diseases Control and Prevention, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Ngoc Dieu Thi Vo
- Infectious Diseases Control and Prevention, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Thieu Hoang Le
- Infectious Diseases Control and Prevention, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Yasunori Ichimura
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Shinsuke Miyano
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Sumiyo Okawa
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Moe Moe Thandar
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yuta Yokobori
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Makoto Takeda
- Department of Virology 3 and World Health Organization Global Specialized Laboratory for Measles and Rubella, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Kenichi Komada
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
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Rahman MO, Kamigaki T, Thandar MM, Haruyama R, Yan F, Shibamura-Fujiogi M, Khin Maung Soe J, Islam MR, Yoneoka D, Miyahara R, Ota E, Suzuki M. Protection of the third-dose and fourth-dose mRNA vaccines against SARS-CoV-2 Omicron subvariant: a systematic review and meta-analysis. BMJ Open 2023; 13:e076892. [PMID: 38128943 DOI: 10.1136/bmjopen-2023-076892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES The rapid spread of the SARS-CoV-2 Omicron variant has raised concerns regarding waning vaccine-induced immunity and durability. We evaluated protection of the third-dose and fourth-dose mRNA vaccines against SARS-CoV-2 Omicron subvariant and its sublineages. DESIGN Systematic review and meta-analysis. DATA SOURCES Electronic databases and other resources (PubMed, Embase, CENTRAL, MEDLINE, CINAHL PLUS, APA PsycINFO, Web of Science, Scopus, ScienceDirect, MedRxiv and bioRxiv) were searched until December 2022. STUDY ELIGIBILITY CRITERIA We included studies that assessed the effectiveness of mRNA vaccine booster doses against SARS-CoV-2 infection and severe COVID-19 outcomes caused by the subvariant. DATA EXTRACTION AND SYNTHESIS Estimates of vaccine effectiveness (VE) at different time points after the third-dose and fourth-dose vaccination were extracted. Random-effects meta-analysis was used to compare VE of the third dose versus the primary series, no vaccination and the fourth dose at different time points. The certainty of the evidence was assessed by Grading of Recommendations, Assessments, Development and Evaluation approach. RESULTS This review included 50 studies. The third-dose VE, compared with the primary series, against SARS-CoV-2 infection was 48.86% (95% CI 44.90% to 52.82%, low certainty) at ≥14 days, and gradually decreased to 38.01% (95% CI 13.90% to 62.13%, very low certainty) at ≥90 days after the third-dose vaccination. The fourth-dose VE peaked at 14-30 days (56.70% (95% CI 50.36% to 63.04%), moderate certainty), then quickly declined at 61-90 days (22% (95% CI 6.40% to 37.60%), low certainty). Compared with no vaccination, the third-dose VE was 75.84% (95% CI 40.56% to 111.12%, low certainty) against BA.1 infection, and 70.41% (95% CI 49.94% to 90.88%, low certainty) against BA.2 infection at ≥7 days after the third-dose vaccination. The third-dose VE against hospitalisation remained stable over time and maintained 79.30% (95% CI 58.65% to 99.94%, moderate certainty) at 91-120 days. The fourth-dose VE up to 60 days was 67.54% (95% CI 59.76% to 75.33%, moderate certainty) for hospitalisation and 77.88% (95% CI 72.55% to 83.21%, moderate certainty) for death. CONCLUSION The boosters provided substantial protection against severe COVID-19 outcomes for at least 6 months, although the duration of protection remains uncertain, suggesting the need for a booster dose within 6 months of the third-dose or fourth-dose vaccination. However, the certainty of evidence in our VE estimates varied from very low to moderate, indicating significant heterogeneity among studies that should be considered when interpreting the findings for public health policies. PROSPERO REGISTRATION NUMBER CRD42023376698.
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Affiliation(s)
- Md Obaidur Rahman
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Taro Kamigaki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Moe Moe Thandar
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Rei Haruyama
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Fangyu Yan
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Miho Shibamura-Fujiogi
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - July Khin Maung Soe
- Graduate School of Public Health, St Luke's International University, Chuo-ku, Tokyo, Japan
| | - Md Rafiqul Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Daisuke Yoneoka
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Reiko Miyahara
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Erika Ota
- Graduate School of Nursing Science, Department of Global Health Nursing, St Luke's International University, Chuo-ku, Tokyo, Japan
| | - Motoi Suzuki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
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Thandar MM, Rahman MO, Haruyama R, Matsuoka S, Okawa S, Moriyama J, Yokobori Y, Matsubara C, Nagai M, Ota E, Baba T. Effectiveness of Infection Control Teams in Reducing Healthcare-Associated Infections: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022; 19:17075. [PMID: 36554953 PMCID: PMC9779570 DOI: 10.3390/ijerph192417075] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
The infection control team (ICT) ensures the implementation of infection control guidelines in healthcare facilities. This systematic review aims to evaluate the effectiveness of ICT, with or without an infection control link nurse (ICLN) system, in reducing healthcare-associated infections (HCAIs). We searched four databases to identify randomised controlled trials (RCTs) in inpatient, outpatient and long-term care facilities. We judged the quality of the studies, conducted meta-analyses whenever interventions and outcome measures were comparable in at least two studies, and assessed the certainty of evidence. Nine RCTs were included; all were rated as being low quality. Overall, ICT, with or without an ICLN system, did not reduce the incidence rate of HCAIs [risk ratio (RR) = 0.65, 95% confidence interval (CI): 0.45-1.07], death due to HCAIs (RR = 0.32, 95% CI: 0.04-2.69) and length of hospital stay (42 days vs. 45 days, p = 0.52). However, ICT with an ICLN system improved nurses' compliance with infection control practices (RR = 1.17, 95% CI: 1.00-1.38). Due to the high level of bias, inconsistency and imprecision, these findings should be considered with caution. High-quality studies using similar outcome measures are needed to demonstrate the effectiveness and cost-effectiveness of ICT.
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Affiliation(s)
- Moe Moe Thandar
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Md. Obaidur Rahman
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
- Center for Evidence-Based Medicine and Clinical Research, Dhaka 1230, Bangladesh
| | - Rei Haruyama
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Sadatoshi Matsuoka
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Sumiyo Okawa
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Jun Moriyama
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Yuta Yokobori
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Chieko Matsubara
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Mari Nagai
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Sciences, St. Luke’s International University, Tokyo 104-0044, Japan
- Tokyo Foundation for Policy Research, Minato, Tokyo 106-0032, Japan
| | - Toshiaki Baba
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
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Ichimura Y, Yanagisawa N, Thandar MM, Pathammavong C, Phounphenghuk K, Nouanthong P, Tengbriacheu C, Khamphaphongphane B, Franzel-Sassanpour LE, Yang TU, Raaijmakers H, Ota T, Komada K, Hachiya M, Miyano S. The determinants of immunization coverage among children aged between 12 and 35 months: a nationwide cross-sectional study in Lao People's Democratic Republic. BMC Public Health 2022; 22:2259. [PMID: 36463130 PMCID: PMC9719255 DOI: 10.1186/s12889-022-14522-w] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/02/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Immunization is one of the most important public health interventions for reducing morbidity and mortality in children. However, factors contributing to low immunization coverage are not fully understood in the Lao People's Democratic Republic (Lao PDR). Therefore, this study aimed to identify factors associated with full immunization coverage among children between 12 and 35 months, providing up-to-date information for immunization programs in Lao PDR. METHODS We analyzed the subpopulation of a nationwide cross-sectional survey using a multistage cluster sampling procedure to evaluate the measles and rubella seroepidemiology. In addition, we categorized children aged between 12 and 35 months into two groups: "fully immunized" children with a birth dose of Bacillus Calmette and Guérin vaccine, hepatitis B vaccine (Hep B), one and three doses for the measles-containing vaccine (MCV) and pentavalent vaccine and pneumococcal conjugate vaccine (PCV) and "partially immunized" children who missed any dose of vaccine. Immunization coverage was calculated as the ratio of "fully immunized" to the total. We compared the groups' demographic characteristics and health service utilization as independent variables. Multivariate logistic regression was used to assess the relationship between immunization coverage, various demographic factors, and health service utilization. RESULTS Overall, 256 of the 416 targeted pairs were included in the analysis. In total, 67.6% of the children were fully immunized. Childbirth at hospitals or health facilities (adjusted odds ratio: 9.75, 95% confidence interval: 5.72-16.62, p < 0.001) was the predictor of full immunization coverage. The 83 children in the partially immunized groups were attributed to Hep B at birth (46, 55.4%), three doses of PCV (34, 41.0%), and the first dose of the MCV (27, 32.5%). CONCLUSION Our study elucidated that the immunization status among children aged between 12 and 35 months in Lao PDR is satisfactory in improving access to healthcare by strengthening communication with residents regarding health service utilization, and expanding mobile outreach services may play a pivotal role in this endeavor. Further research is warranted to evaluate efforts to increase immunization coverage and target populations with limited access to healthcare.
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Affiliation(s)
- Yasunori Ichimura
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan.
| | - Naoki Yanagisawa
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Moe Moe Thandar
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Chansay Pathammavong
- grid.415768.90000 0004 8340 2282National Immunization Program, Ministry of Health, Simuang Road, Vientiane, Lao People’s Democratic Republic
| | - Kongxay Phounphenghuk
- grid.415768.90000 0004 8340 2282National Immunization Program, Ministry of Health, Simuang Road, Vientiane, Lao People’s Democratic Republic
| | - Phonethipsavanh Nouanthong
- grid.415768.90000 0004 8340 2282Institute Pasteur du Laos, National Immunization Technical Advisory Group, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak district, Vientiane, Lao People’s Democratic Republic
| | - Chankham Tengbriacheu
- grid.415768.90000 0004 8340 2282Mother and Child Health Center, Ministry of Health, Simuang Road, Vientiane, Lao People’s Democratic Republic
| | - Bouaphane Khamphaphongphane
- National Center Laboratory and Epidemiology, KM3 Thadeua road, Sisattanak District, Vientiane, Lao People’s Democratic Republic
| | - Lauren Elizabeth Franzel-Sassanpour
- Vaccine-Preventable Diseases and Immunization section, World Health Organization Representative Office in the Lao People’s Democratic Republic, 125 Saphanthong Road, Unit 5, Ban Saphangthongtai, Sisattanak District, Vientiane, Lao People’s Democratic Republic
| | - Tae Un Yang
- Vaccine-Preventable Diseases and Immunization section, World Health Organization Representative Office in the Lao People’s Democratic Republic, 125 Saphanthong Road, Unit 5, Ban Saphangthongtai, Sisattanak District, Vientiane, Lao People’s Democratic Republic
| | - Hendrikus Raaijmakers
- Health and Nutrition section, United Nations Children’s Fund Lao People’s Democratic Republic, KM3 Thadeua road, Sisattanak District, Vientiane, Lao People’s Democratic Republic
| | - Tomomi Ota
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Kenichi Komada
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Masahiko Hachiya
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
| | - Shinsuke Miyano
- grid.45203.300000 0004 0489 0290Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655 Japan
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Ichimura Y, Yamauchi M, Yoshida N, Miyano S, Komada K, Thandar MM, Tiwara S, Mita T, Hombhanje FW, Mori Y, Takeda M, Hachiya M. Effectiveness of immunization activities on measles and rubella immunity among individuals in East Sepik, Papua New Guinea: A cross-sectional study. IJID Regions 2022; 3:84-88. [PMID: 35755474 PMCID: PMC9216679 DOI: 10.1016/j.ijregi.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/21/2022]
Abstract
Measles and rubella are endemic in Papua New Guinea. The target age group had low anti-measles and anti-rubella IgG prevalence. The target group for immunization had higher measles and rubella IgG prevalence. The immunization program should be intensified to eliminate measles and rubella.
Objectives This study aimed to assess measles and rubella immunity by measuring virus-specific immunoglobulin G (IgG) prevalence among individuals and evaluate the effectiveness of recent supplementary immunization activities (SIAs) by comparing the antibody positivity rates of the SIA target age groups in 2015 with those in 2019 as measles and rubella are endemic in Papua New Guinea. Methods A cross-sectional study. The measles- and rubella-specific IgG levels of patients aged ≥1 year at two clinics in East Sepik province, Papua New Guinea were assessed with commercially available virus-specific IgG EIA kits. Results In total, 297 people participated in the study and 278 samples with sufficient volume, relevant information, and age inclusion criteria were analyzed. The overall IgG prevalence rates were 62.6% for measles and 82.0% for rubella. The age groups targeted in the 2019 SIAs had a higher IgG prevalence than those targeted in the 2015 SIAs for both the infectious diseases. Moreover, the IgG prevalence for rubella was higher than measles in these groups. Conclusions The anti-measles and anti-rubella IgG prevalence in the target groups were lower than those required for herd immunity. The immunization program should be emphasized to eliminate measles and rubella. Further population-based studies are warranted.
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Akashi H, Kodoi H, Noda S, Tamura T, Baba H, Chinda E, Thandar MM, Naito K, Watanabe Y, Suzuki Y, Narita T, Shimazu T. Reporting on the implementation to set up a "care and isolation facility" for mild COVID-19 cases in Tokyo. Glob Health Med 2022; 4:71-77. [PMID: 35586771 PMCID: PMC9066461 DOI: 10.35772/ghm.2022.01022] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 06/15/2023]
Abstract
The increasing number of COVID-19 cases has placed pressure on medical facilities. Against this backdrop, the Tokyo Metropolitan Government established a facility for mild and asymptomatic COVID-19 cases by using existing hotels. These kinds of facilities were established in several countries, and represented a spectrum from hotel-like to hospital-like care. In this article, we focused on implementation and related strategies for establishing such a facility in Tokyo as implementation research, while ensuring patient and staff safety. This facility had three functions: care, isolation, and buffering. For the implementation strategy, we used several strategies from the Expert Recommendations for Implementing Change (ERIC) to implement functions similar to an ordinary hospital, but using fewer inputs. This experience can be applied to other resource-limited settings such as that in less developed countries.
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Affiliation(s)
- Hidechika Akashi
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruka Kodoi
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichiro Noda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Toyomitsu Tamura
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroko Baba
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Eiki Chinda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Moe Moe Thandar
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keisuke Naito
- Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Tokyo, Japan
| | - Yu Watanabe
- Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Tokyo, Japan
| | - Yuko Suzuki
- Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Tokyo, Japan
| | - Tomoyo Narita
- Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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Thandar MM, Matsuoka S, Rahman O, Ota E, Baba T. Infection control teams for reducing healthcare-associated infections in hospitals and other healthcare settings: a protocol for systematic review. BMJ Open 2021; 11:e044971. [PMID: 33674376 PMCID: PMC7938975 DOI: 10.1136/bmjopen-2020-044971] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Healthcare-associated infections (HCAIs) are a worldwide problem. Infection control in hospitals is usually implemented by an infection control team (ICT). Initially, ICTs consisted of doctors, nurses, epidemiologists and microbiologists; then, in the 1980s, the infection control link nurse (ICLN) system was introduced. ICTs (with or without the ICLN system) work to ensure the health and well-being of patients and healthcare professionals in hospitals and other healthcare settings, such as acute care clinics, community health centres and care homes. No previous study has reported the effects of ICTs on HCAIs. This systematic review aims to assess the effectiveness of ICTs with or without the ICLN system in reducing HCAIs in hospitals and other healthcare settings. METHODS AND ANALYSIS We will perform a comprehensive literature search for randomised controlled trials in four databases: PubMed, Embase, CINAHL and the Cochrane Library. The primary outcomes are: patient-based/clinical outcomes (rate of HCAIs, death due to HCAIs and length of hospital stay) and staff-based/behavioural outcomes (compliance with infection control practices). The secondary outcomes include the costs to the healthcare system or patients due to extended lengths of stay. Following data extraction, we will assess the risk of bias by using the Cochrane Effective Practice and Organization of Care risk of bias tool. If data can be pooled across all the studies, we will perform a meta-analysis. ETHICS AND DISSEMINATION We will use publicly available data, and therefore, ethical approval is not required for this systematic review. The findings will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER CRD42020172173.
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Affiliation(s)
- Moe Moe Thandar
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sadatoshi Matsuoka
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Obaidur Rahman
- Department of Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Erika Ota
- Department of Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Toshiaki Baba
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Thandar MM, Baba T, Matsuoka S, Ota E. Interventions to reduce non-prescription antimicrobial sales in community pharmacies. Hippokratia 2020. [DOI: 10.1002/14651858.cd013722] [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: 11/10/2022]
Affiliation(s)
- Moe Moe Thandar
- Bureau of International Health Cooperation; National Center for Global Health and Medicine; Shinjuku-ku Japan
| | - Toshiaki Baba
- Bureau of International Health Cooperation; National Center for Global Health and Medicine; Shinjuku-ku Japan
- Minds Tokyo GRADE Center, Department of Evidence-Based Medicine and Guidelines; Japan Council of Quality Health Care; Chiyoda-ku Japan
| | - Sadatoshi Matsuoka
- Bureau of International Health Cooperation; National Center for Global Health and Medicine; Shinjuku-ku Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science; St. Luke's International University; Chuo-ku Japan
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Thandar MM, Kiriya J, Shibanuma A, Ong KIC, Tin KN, Win HH, Jimba M. Women's knowledge on common non-communicable diseases and nutritional need during pregnancy in three townships of Ayeyarwaddy region, Myanmar: a cross-sectional study. Trop Med Health 2019; 47:12. [PMID: 30723383 PMCID: PMC6352420 DOI: 10.1186/s41182-019-0137-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 01/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background Health systems in many countries do not adequately address non-communicable diseases (NCDs) during pregnancy, especially in low- and middle-income countries. In Myanmar, most studies on NCDs have investigated risk factors and prevalence of NCDs in the general population. This study aimed to assess the level of knowledge of common NCDs and nutritional need during pregnancy and to identify the factors associated with such knowledge, in three townships of Ayeyarwaddy region in Myanmar. Methods A cross-sectional study was conducted among pregnant women aged between 18 and 49 years. We interviewed 630 pregnant women by using a pretested structured questionnaire. Knowledge questionnaire had five categories: general knowledge in NCDs, hypertension, diabetes, anemia, and nutritional need during pregnancy. Knowledge scores ranged from 0 to 56. We used Bloom’s cut-off point to classify the knowledge into three levels: low level as 59% or below (0–33 scores), moderate level as 60–80% (34–49 scores), and high level as 80–100% (50–56 scores). We conducted multiple linear regression analyses to find the association between different exposure variables (behavioral risk factors, pre-existing NCDs in pregnant women, and family history of NCDs) and knowledge on common NCDs and nutritional need during pregnancy adjusted for socioeconomic factors. Results Among pregnant women, 64.8% had moderate level of knowledge, 22.7% had low level, and only 12.5% had high level. The mean knowledge scores were 39.6 (standard deviation 10.2). Pregnant women with the following factors were more likely to have higher knowledge: their belonging to the second, middle, and fourth quintiles of wealth index and their family members’ status of having some kind of NCDs. Conclusions Majority of pregnant women had low to moderate level of knowledge on common NCDs and nutritional need during pregnancy. Wealth and family history of NCDs were significantly associated with their knowledge. Prevention and promotion of NCDs should be integrated in maternal and child health programs and should emphasize for the pregnant women who are in the poorest or richest wealth quintiles and who do not have family history of NCDs.
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Affiliation(s)
- Moe Moe Thandar
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Kiriya
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Shibanuma
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ken Ing Cherng Ong
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Khaing Nwe Tin
- 2Maternal and Reproductive Health Division, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Hla Hla Win
- 3Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Myanmar
| | - Masamine Jimba
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Ong KIC, Kosugi H, Thoeun S, Araki H, Thandar MM, Iwagami M, Hongvanthong B, Brey PT, Kano S, Jimba M. Systematic review of the clinical manifestations of glucose-6-phosphate dehydrogenase deficiency in the Greater Mekong Subregion: implications for malaria elimination and beyond. BMJ Glob Health 2017; 2:e000415. [PMID: 29082022 PMCID: PMC5656182 DOI: 10.1136/bmjgh-2017-000415] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 05/19/2017] [Revised: 07/06/2017] [Accepted: 07/09/2017] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION To achieve malaria elimination in the Greater Mekong Subregion (GMS) by 2030, proper case management is necessary. 8-aminoquinolines, such as primaquine, are the only available medicines effective in preventing relapse of the hypnozoite stage of Plasmodium vivax, as well as the onward transmission of Plasmodium falciparum. However, primaquine can cause haemolysis in individuals who have glucose-6-phosphate dehydrogenase deficiency (G6PDd). We conducted a systematic review on the reported clinical manifestations of G6PDd to provide a comprehensive overview of the situation in the GMS. METHODS The protocol for this systematic review was registered on PROSPERO: International prospective register of systematic reviews (CRD42016043146). We searched the PubMed/MEDLINE, CINAHL, and Web of Science databases for published articles describing the clinical manifestations of G6PDd in the GMS. We included articles of all study designs from inception until 31 July 2016, reporting the clinical manifestations of G6PDd. We then performed a narrative synthesis of these articles. RESULTS We included 56 articles in this review, 45 of which were from Thailand. Haemolysis in G6PD-deficient individuals was caused not only by primaquine but also by other medicines and infections. Other clinical manifestations of G6PDd that were found were favism, neonatal jaundice and chronic non-spherocytic haemolytic anaemia. G6PDd also influenced the clinical presentations of genetic disorders and infections, such as thalassemia and typhoid fever. CONCLUSION As G6PDd also affects the clinical presentations of other infections, the benefits of G6PD testing and proper record keeping transcend those of malaria case management. Therefore, healthcare workers at the community level should be made familiar with complications resulting from G6PDd as these complications extend beyond the scope of malaria.
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Affiliation(s)
- Ken Ing Cherng Ong
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane Capital, Lao People's Democratic Republic
| | - Hodaka Kosugi
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sophea Thoeun
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hitomi Araki
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane Capital, Lao People's Democratic Republic
| | - Moe Moe Thandar
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Moritoshi Iwagami
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane Capital, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic.,Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Bouasy Hongvanthong
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane Capital, Lao People's Democratic Republic.,Center of Malariology, Parasitology and Entomology, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic
| | - Paul T Brey
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane Capital, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic
| | - Shigeyuki Kano
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane Capital, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic.,Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane Capital, Lao People's Democratic Republic
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Thandar MM, Kyaw MP, Jimba M, Yasuoka J. Caregivers' treatment-seeking behaviour for children under age five in malaria-endemic areas of rural Myanmar: a cross-sectional study. Malar J 2015; 14:1. [PMID: 25557741 PMCID: PMC4326195 DOI: 10.1186/1475-2875-14-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [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: 09/18/2014] [Accepted: 12/15/2014] [Indexed: 11/13/2022] Open
Abstract
Background A community-based malaria intervention was introduced through fixed and mobile clinics in rural Myanmar. This study attempted to identify treatment-seeking behaviour of caregivers for children under five and the determinants of appropriate treatment-seeking behaviour in mobile clinic villages (MV) and non-mobile clinic villages (NMV) in malaria-endemic rural areas in Myanmar. Methods A cross-sectional study was conducted in 23 MV and 25 NMV in Ingapu Township, Myanmar. Appropriate treatment-seeking behaviour was operationally defined as seeking treatment from trained personnel or at a health facility within 24 hours after the onset of fever. Multiple logistic regression analyses were conducted to identify the determinants of appropriate treatment-seeking behaviour. Results Among the 597 participants in both types of villages, 166 (35.3%) caregivers sought appropriate treatment. No significant difference in appropriate treatment-seeking behaviour was found between the two types of villages (adjusted odds ratio (AOR), 0.80; 95% confidence interval (CI), 0.51-1.24). Determinants of behaviour include proximity to public health facilities (AOR, 5.86; 95% CI, 3.43-10.02), knowledge of malaria (AOR, 1.90; 95% CI, 1.14-3.17), malaria prevention behaviour (AOR, 1.76; 95% CI, 1.13-2.76), treatment at home (AOR, 0.26; 95% CI, 0.15-0.45), and treatment and transportation costs (AOR, 0.52; 95% CI, 0.33-0.83). Conclusions Caregivers’ treatment-seeking behaviour was poor for fever cases among children under age five, and did not differ significantly between MV and NMV. It is necessary to educate caregivers, particularly for early treatment seeking and appropriate use of health care options for fever, and catering to their medical needs. These findings can help promote awareness and prevention, and improve the quality of interventions at the community level.
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Affiliation(s)
| | | | | | - Junko Yasuoka
- Community and Global Health Department, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
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Saw YM, Win KL, Shiao LWS, Thandar MM, Amiya RM, Shibanuma A, Tun S, Jimba M. Taking stock of Myanmar's progress toward the health-related Millennium Development Goals: current roadblocks, paths ahead. Int J Equity Health 2013; 12:78. [PMID: 24025845 PMCID: PMC3847191 DOI: 10.1186/1475-9276-12-78] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 05/22/2013] [Accepted: 09/08/2013] [Indexed: 12/01/2022] Open
Abstract
Myanmar is a developing country with considerable humanitarian needs, rendering its pursuit of the Millennium Development Goals (MDGs) an especially high priority. Yet progress to date remains under-examined on key fronts. Particularly within the three health-related MDGs (MDGs 4, 5, and 6), the limited data reported point to patchy levels of achievement. This study was undertaken to provide an overview and assessment of Myanmar’s progress toward the health-related MDGs, along with possible solutions for accelerating health-related development into 2015 and beyond. The review highlights off-track progress in the spheres of maternal and child health (MDGs 4 and 5). It also shows Myanmar’s achievements toward MDG 6 targets – in the areas of HIV/AIDS, malaria, and tuberculosis. Such achievements are especially notable in that Myanmar has been receiving the lowest level of official development assistance among all of the least developed countries in Asia. However, to make similar progress in MDGs 4 and 5, Myanmar needs increased investment and commitment in health. Toward moving forward with the post-2015 development agenda, Myanmar’s government also needs to take the lead in calling for attention from the World Health Organization and its global development partners to address the stagnation in health-related development progress within the country. In particular, Myanmar’s government should invest greater efforts into health system strengthening to pave the road to universal health coverage.
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Affiliation(s)
- Yu Mon Saw
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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