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Komasawa M, Sato M, Ssekitoleko R, Waiswa P, Gitta S, Nabugoomu J, Honda S, Saito K, Aung MN. Study protocol for a type-II hybrid effectiveness-implementation trial to reach teenagers using mobile money shops to reduce unintended pregnancies in Uganda. BMJ Open 2024; 14:e084539. [PMID: 38582537 PMCID: PMC11002355 DOI: 10.1136/bmjopen-2024-084539] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/22/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION Unintended teenage pregnancies have become a global public health challenge, particularly in sub-Saharan Africa. There is a notably high prevalence of unintended pregnancies among unmarried teenagers in Uganda. This study will develop an intervention programme using mobile money shops (vendors) as a platform to deliver sexual and reproductive health and rights (SRHR) services to teenagers and assess its effectiveness and scalability in Uganda. METHODS AND ANALYSES This hybrid study comprises two integral components: an intervention study to assess the effectiveness of vendor-mediated intervention and implementation research to evaluate the implementation process. 30 vendors will be recruited for both intervention and control arms in 2 municipalities in Eastern Uganda, which have a high unintended pregnancy prevalence rate among unmarried teens aged 15-19 years. A preintervention and postintervention repeated survey involving 600 participants for each arm will be conducted over 4 months. The primary outcome is the rate of condom users among teenage vendor users. The secondary outcomes include the rate of preference for receiving SRHR services at vendors and knowledge regarding SRHR. A difference-in-differences analysis will be used to determine the effectiveness of the intervention. The Bowen model will be employed to evaluate the implementation design. ETHICS AND DISSEMINATION Ethical approval was obtained from the Ethics Review Committee of Uganda Christen University and JICA Ogata Sadako Research Institute for Peace and Development in Japan. The findings will be widely disseminated. This study was registered with the University Hospital Medical Information Network in Japan (UMIN000053332) on 12 January 2024. TRIAL REGISTRATION NUMBER UMIN000053332.
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Affiliation(s)
- Makiko Komasawa
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Japan
- Department of Global Health Research, Juntendo University, Bunkyo-ku, Japan
| | - Miho Sato
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | - Peter Waiswa
- School of Public Health, Makerere University, Kampala, Uganda
- Busoga Health Forum, Jinja, Uganda
| | - Sheba Gitta
- School of Public Health, Uganda and Busoga Health Forum, Jinja, Uganda
- Makerere University, Kampala, Uganda
| | | | - Sumihisa Honda
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kiyoko Saito
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Juntendo University, Bunkyo-ku, Japan
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Kalandarova M, Ahmad I, Aung TNN, Moolphate S, Shirayama Y, Okamoto M, Aung MN, Yuasa M. Association Between Dietary Habits and Type 2 Diabetes Mellitus in Thai Adults: A Case-Control Study. Diabetes Metab Syndr Obes 2024; 17:1143-1155. [PMID: 38465346 PMCID: PMC10924810 DOI: 10.2147/dmso.s445015] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/01/2024] [Indexed: 03/12/2024] Open
Abstract
Background The prevalence of T2DM is escalating in Thailand affecting over 10% of adults aged 20-79 years old. It is imperative to identify modifiable risk factors that can potentially help mitigate the risk of developing diabetes. Objective This study aimed to investigate the relationship between dietary habits and type 2 diabetes in Chiang Mai, Thailand. Methods This case-control study involved 300 individuals aged 25-74 years residing in Chiang Mai, Thailand including 150 newly diagnosed T2DM patients (cases) and 150 community residents without diabetes (controls). Dietary habits were assessed based on Food Frequency Questionnaire (FFQ). Socio-demographic characteristics and anthropometric information of the participants were collected. Data analysis was performed using the STATA-17. Results The case group participants were older and had a higher proportion of males compared to the control group. The case group exhibited a significantly higher consumption of meat, beans, nuts, soft drinks, and topping seasonings (p<0.001), conversely, a lower intake of vegetables (p<0.001), fruits (p=0.006), fish, rice (p<0.001), eggs (p=0.032), milk products, coffee, and tea (p<0.001) compared to the control group. Furthermore, the case group demonstrated a higher level of certain dietary practices such as a greater frequency of having meals with family, not removing visible fat from food (p<0.001), and eating snacks between meals compared to controls. Multiple logistic regression analysis showed that after adjusting for potential confounding factors not removing visible fat from food (aOR 5.61, 95% CI: 2.29-13.7, p<0.001) and using topping seasonings (aOR 3.52 95% CI: 1.69-7.32 p=0.001) were significantly associated with the risk of T2DM, whereas daily vegetable intake (aOR 0.32 95% CI: 0.15-0.68 p=0.003) was inversely associated with T2DM. Conclusion The study findings caution against the consumption of food rich in fat and using salty seasonings, while advocating for an increased intake of vegetables to prevent the prevalence of T2DM.
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Affiliation(s)
- Makhbuba Kalandarova
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
| | - Ishtiaq Ahmad
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
| | - Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, 50300, Thailand
| | - Yoshihisa Shirayama
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
| | - Miyoko Okamoto
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
- Juntendo Advanced Research Institute for Health Sciences, Juntendo University, Tokyo, 113-8421, Japan
| | - Motoyuki Yuasa
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
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Baba H, Aung MN, Miyagi A, Masu A, Yokobori Y, Kiyohara H, Otake E, Yuasa M. Exploring the contribution of Japan's experience in addressing rapid aging in Asia: Focus on dementia care. Glob Health Med 2024; 6:19-32. [PMID: 38450119 PMCID: PMC10912802 DOI: 10.35772/ghm.2023.01124] [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: 12/04/2023] [Revised: 12/25/2023] [Accepted: 01/11/2024] [Indexed: 03/08/2024]
Abstract
This review article explores the potential contribution of Japan's experience in addressing rapid aging in Asia with a specific focus on dementia care. As Japan is a frontrunner in terms of aging society, we consider valuable insights and lessons from Japanese policy history and reflect on its contribution. The World Health Organization, Regional Office for the Western Pacific Regional Action Plan on Healthy Ageing for the Western Pacific was compared with the Japanese "Outline for Promotion of Dementia Policies". The following five issues were discussed: i) improving awareness of dementia and community engagement in Japan from a mutual aid perspective; ii) social activities for prevention of dementia at the local level; iii) human resources for medical and long-term care; iv) local coordinators for old people care at home to evaluate the needs for care and tailor the care-plan on an individual basis; v) research and development of long-term care products. Given these factors, it is important to address the aging society through a combined cross-sectoral approach, including policy, research, development of care products, community, and education of care workers. Aging population measures in Japan do not provide a definitive answer, which prompts the consideration of better solutions derived from Japan's trial and error. The aging rate of 7%, 14%, and 21% are commonly used in international comparisons as indicators of the speed of the aging process, but before this 7% is reached, policies tailored to each country should be considered.
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Affiliation(s)
- Hiroko Baba
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Ayumi Miyagi
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayako Masu
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuta Yokobori
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Kiyohara
- International Affairs Division, Minister's Secretariat, Ministry of Health, Labour, and Welfare, Tokyo, Japan
| | - Eriko Otake
- Department of Gerontic Nursing, National College of Nursing, Tokyo, Japan
| | - Motoyuki Yuasa
- Department of Global Health Research, Juntendo University, Graduate School of Medicine, Tokyo, Japan
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Aung TNN, Shirayama Y, Moolphate S, Lorga T, Angkurawaranon C, Yuasa M, Aung MN. Prevalence and social determinants of depression: A cross-sectional survey of Myanmar migrant workers in Chiang Mai, Northern Thailand. Glob Public Health 2024; 19:2334316. [PMID: 38584449 DOI: 10.1080/17441692.2024.2334316] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/19/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Depression is a common mental disorder and the sixth leading cause of disability in Thailand. Chiang Mai has historically been a city of attraction for labour migration for Shan migrants from the adjacent Southern Shan State of Myanmar. Currently, only infectious diseases are screened during the pre-employment period. Prevention and early detection of noncommunicable diseases can improve a healthy workforce and reduce the healthcare burden on the host country. Therefore, we aimed to determine the prevalence of depression and associated factors. METHODS A cross-sectional survey was done among Myanmar migrant adults legally working in Chiang Mai, Thailand. RESULTS The final analysis included 360 participants and the prevalence of depression was 14.4%. Being female, duration of stay in Thailand of more than 10 years, co-residence with co-workers, and marginalisation pattern of acculturation were significant associated factors affecting depression in a multivariate regression analysis model. CONCLUSION Although the culture and dialect were not different between the host and country of origin, Myanmar migrant workers of Shan ethnicity suffered from depression. Our findings highlighted the importance of social determinants beyond common predictors of depression among migrants and the need for public health measures to promote migrants' integration into the host culture.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Yoshihisa Shirayama
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, Thailand
| | - Thaworn Lorga
- Faculty of Nursing, Chiang Mai Rajabhat University, Mae Hong Son, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo, Japan
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Lee H, Nam HK, Zhao B, Jeong HR, Lim S, Chun A, Kim MK, Kim DH, Aung MN, Koyanagi Y, Nam EW. Analysis of digital capacity-related factors influencing health promotion participation and active aging of older adults residing in rural areas in South Korea: A structural equation model. Digit Health 2024; 10:20552076241226958. [PMID: 38269368 PMCID: PMC10807383 DOI: 10.1177/20552076241226958] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
Objective This study aimed to identify the correlation between digital capacity, health promotion participation, and active aging of older people living in rural areas in South Korea to assess the factors influencing participation in programs for health promotion and active aging. Methods Data were collected through a 1:1 face-to-face survey using a structured questionnaire from 13 February to 24 February 2023 during the older individuals' visits in the senior citizen welfare centers and senior citizen centers in the region. The Measuring Digital Skills questionnaire used to assess the digital competence of South Korean individuals was employed in this study. To confirm the structural relationship between digital capacity and health promotion participation and active aging in the older population aged 65 years and older based on the collected data, a structural equation modeling analysis was performed. Results Active health promotion participation had a positive effect on active aging. The pathway that older adults in Korea can led to participation in health promotion and active aging in the current situation is not mainly through the digital competency whereas mobile internet skill showed positive influneces. Conclusions In the digital era and super-aged society, various programs are provided to older individuals to enhance the utilization of smartphones. However, education and programs for strengthening digital capacity should be organized to explain the advantages of digital use and to inform of the dangers of addiction to ensure healthy aging through social participation and exchange both online and offline.
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Affiliation(s)
- Hocheol Lee
- Healthy City Research Center, Yonsei University, Wonju, Gangwon-do, South Korea
- Department of Health Administration, Yonsei University, Wonju, Gangwon-do, South Korea
| | - Hae Kweun Nam
- Department of Preventive Medicine Wonju Medical College, Yonsei University, Wonju, Gangwon-do, South Korea
| | - Bo Zhao
- Healthy City Research Center, Yonsei University, Wonju, Gangwon-do, South Korea
| | - Hee Ra Jeong
- Department of Health and Medical Administration, Yeoju Institute of Technology, Yeoju, Gyeonggi-do, South Korea
| | - Subean Lim
- Healthy City Research Center, Yonsei University, Wonju, Gangwon-do, South Korea
| | - Ayoung Chun
- Healthy City Research Center, Yonsei University, Wonju, Gangwon-do, South Korea
| | - Min Kyoung Kim
- Healthy City Research Center, Yonsei University, Wonju, Gangwon-do, South Korea
| | - Dong Hyun Kim
- Department of Information Statistics, Yonsei University, Wonju, Gangwon-do, South Korea
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo,
Japan
| | - Yuka Koyanagi
- Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Eun Woo Nam
- Healthy City Research Center, Yonsei University, Wonju, Gangwon-do, South Korea
- Department of Global Health Research, Graduate School of Medicine, Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo,
Japan
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Komasawa M, Aung MN, Nsereko C, Ssekitoleko R, Isono M, Saito K, Nantume J, Shirayama Y, Chandani S, Yuasa M. Impact of Hospital Closure on Patients with Communicable and Non-Communicable Diseases During the COVID-19 Pandemic in Uganda: A Cross-Sectional and Mixed-Methods Study. Risk Manag Healthc Policy 2023; 16:2593-2607. [PMID: 38045563 PMCID: PMC10691269 DOI: 10.2147/rmhp.s419969] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/28/2023] [Indexed: 12/05/2023] Open
Abstract
Background The COVID-19 pandemic and its measures have had a profound impact on universal access to health services. We investigated the impact of the closure of the Entebbe Regional Referral Hospital (ERRH) for two years on the accessibility to necessary healthcare among non-COVID-19 patients. Methods This mixed-methods study focused on ERRH patients with tuberculosis (TB), human immunodeficiency virus (HIV), diabetes/hypertension, and mental illness. A quantitative study used a structured-questionnaire with a primary outcome measure to assess the discontinuation of healthcare accessibility. A qualitative study with a focus group discussion (FGD) was conducted on eight patients. Results Of the 202 quantitative survey participants, 17.8% discontinued necessary healthcare due to the ERRH closure, and the discontinuation rates differed by disease: 48.1% of TB patients, 16.0% of HIV patients, 7.8% of diabetes/hypertension patients, and 4.0% of mental health patients (P < 0.001). Almost 90% of the patients reported a worsened health condition, regardless of the disease. Multivariable logistic regression analysis showed that patients with diabetes/hypertension (adjusted odds ratio [AOR], 12.69; 95% confidence interval [CI], 2.57-62.52) and HIV (AOR, 7.52; 95% CI, 1.37-41.27) were more likely to discontinue healthcare than those with mental illness. The factors associated with discontinued healthcare included age ≥50 years vs ≤30 years (AOR, 4.88; 95% CI, 1.07-22.34), and high transportation cost vs low cost (AOR, 3.15; 95% CI, 1.13-8.75). The FGD also identified difficulties in obtaining medication, especially for TB, even though ERRH provided the outreach services. Conclusion Our study revealed that the ERRH closure and lockdowns had an overall profound negative impact on access to healthcare and health conditions. Younger patients and those with TB were the most affected patients. This study provides practical suggestions from the field for policy makers to strengthen universal health access during health crises in Uganda and other sub-Saharan countries.
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Affiliation(s)
- Makiko Komasawa
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Tokyo, Japan
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Christopher Nsereko
- Department of Internal Medicine, Entebbe Regional Referral Hospital, Entebbe, Uganda
| | | | - Mitsuo Isono
- Department of Human Development, Japan International Cooperation Agency, Tokyo, Japan
| | - Kiyoko Saito
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Tokyo, Japan
| | - Jesca Nantume
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Yoshihisa Shirayama
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Shrestha Chandani
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Tokyo, Japan
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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Saito K, Komasawa M, Ssekitoleko R, Aung MN. Enhancing community health system resilience: lessons learnt during the COVID-19 pandemic in Uganda through the qualitative inquiry of the COVID Task Force. Front Public Health 2023; 11:1214307. [PMID: 38035292 PMCID: PMC10687165 DOI: 10.3389/fpubh.2023.1214307] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 10/06/2023] [Indexed: 12/02/2023] Open
Abstract
Objective This study aimed to explore the elements of a resilient community health system during the COVID-19 pandemic and discuss whether the frameworks described in previous studies can be applied to real-world situations with those who implemented the Community Engagement Strategy, a strategy to make health systems work in their communities during health crises in Uganda. Methods Focus group discussions (22 participants in total) were conducted with COVID Task Force members in four districts in Uganda in March 2022. These districts implemented a Community Engagement Strategy to ensure that health systems in their communities continued to function during health scares, and have been evaluated to ensure that the strategies have been implemented. Results A thematic analysis was applied. From the results some factors which can enhance the resiliency of community health systems were identified: including health "knowledge," "communication," "governance," and "resources" health. The most important elements changed depending on the phase of the outbreak. VHTs are the key players in the transition from knowledge-and resource-oriented initiatives to communication and governance by community residents. Conclusion COVID-19, a new infectious disease, provides lessons for a resilient community health system. First, the health system should be flexible enough to be able to change the elements on which it is focused, and second, VHTs play an important role in the flexibility of the health system. This suggests that it is time to assess whether VHTs are still able to continue their activities after the pandemic is over, and whether the environment, including financial and non-financial support, has improved.
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Affiliation(s)
- Kiyoko Saito
- JICA Ogata Sadako Research Institute for Peace and Development, Tokyo, Japan
| | - Makiko Komasawa
- JICA Ogata Sadako Research Institute for Peace and Development, Tokyo, Japan
- Department of Global Health Research, Juntendo University, Bunkyō, Japan
| | | | - Myo Nyein Aung
- Department of Global Health Research, Juntendo University, Bunkyō, Japan
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Aung TNN, Lorga T, Moolphate S, Koyanagi Y, Angkurawaranon C, Supakankunti S, Yuasa M, Aung MN. Towards Cultural Adequacy of Experience-Based Design: A Qualitative Evaluation of Community-Integrated Intermediary Care to Enhance the Family-Based Long-Term Care for Thai Older Adults. Healthcare (Basel) 2023; 11:2217. [PMID: 37570457 PMCID: PMC10419003 DOI: 10.3390/healthcare11152217] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/26/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
In this qualitative study, we provided an in-depth understanding of how Community-Integrated Intermediary Care (CIIC), a new service model for family-based long-term care (LTC), was perceived by its users. The CIIC, established in Chiang Mai, Northern Thailand, consisted of three main interventions: (1) A temporary respite care center; (2) A family-centered care capacity building; (3) Functional training delivered as community group exercise and home exercise to improve healthy ageing for independent older adults. Ten pairs of dependent Thai older adults, their primary family caregivers, and ten village health volunteers were recruited using the purposive sampling method. Data were collected via semistructured in-depth interviews. A thematic descriptive qualitative analysis was used for data analysis. The findings revealed that CIIC helped reduce the burden of family caregivers by providing respite, relief, and care coordination. The experiences of the CIIC users indicated possibilities for service redesign, development, and delivery strategies to better meet the LTC needs of older adults and family caregivers. Following the local stakeholders' commitment and local community health volunteers' network, a well-integrated formal and informal care CIIC model can be implied as an effective and sustainable ageing care service model in Thailand and other Asian countries in the future.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (T.N.N.A.); (C.A.)
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Thaworn Lorga
- Faculty of Nursing, Chiang Mai Rajabhat University, Mae Hong Son Campus, Mae Hong Son 58000, Thailand;
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand;
| | - Yuka Koyanagi
- Department of Judo Therapy, Faculty of Medical and Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo 135-0063, Japan;
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (T.N.N.A.); (C.A.)
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siripen Supakankunti
- Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan;
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
| | - Myo Nyein Aung
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand;
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan;
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan
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Yokobori Y, Kiyohara H, Mulati N, Lwin KS, Bao TQQ, Aung MN, Yuasa M, Fujita M. Roles of Social Protection to Promote Health Service Coverage among Vulnerable People toward Achieving Universal Health Coverage: A Literature Review of International Organizations. Int J Environ Res Public Health 2023; 20:ijerph20095754. [PMID: 37174271 PMCID: PMC10177917 DOI: 10.3390/ijerph20095754] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/19/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
A wider range of social protection services, including social insurance and social assistance, are gaining global attention as a key driver of improved health service coverage and financial protection among vulnerable populations. However, only a few studies have investigated the associations between social protection and universal health coverage (UHC). Therefore, we conducted a literature review on relevant international organizations with respect to this topic. We found that many international organizations consider the wide range of social protection services, including social insurance and social assistance, essential for achieving UHC in 2030. In specific health programs, social protection is considered an important service to promote health service access and financial protection, especially among vulnerable populations. However, discussions about social protection for achieving UHC are not given high priority in the World Health Organization. Currently, the coverage of social protection services is low among vulnerable populations in low- and middle-income countries. To address this issue, we employed the metrics recommended by the migrant integration policy index (MIPEX). Based on our findings, a conceptual framework was developed. We expect this framework to lead synergy between social protection and health systems around the globe, resulting in healthy ageing.
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Affiliation(s)
- Yuta Yokobori
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Hiroyuki Kiyohara
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Nadila Mulati
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Kaung Suu Lwin
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Truong Quy Quoc Bao
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue 530000, Vietnam
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Masami Fujita
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
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Lee H, Kong F, Yuasa M, Aung MN, Shirayama Y, Zhao B, Kim M, Nam EW. COVID-19 Phobia among Korean, Chinese, and Japanese students: An international comparative study. Heliyon 2023; 9:e15275. [PMID: 37070080 PMCID: PMC10081880 DOI: 10.1016/j.heliyon.2023.e15275] [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: 09/12/2022] [Revised: 03/22/2023] [Accepted: 03/31/2023] [Indexed: 04/19/2023] Open
Abstract
This study aimed to identify the characteristic differences and potential contributing factors of coronavirus disease 2019 (COVID-19) phobia between undergraduate and graduate students in Korea, Japan, and China. We used the online survey tool, we retained 460 responses from Korea, 248 responses from Japan, and 788 responses from China for analysis. We performed the statistical analysis; ANOVA F-test and Multiple linear regression. We visualized the results of these calculations using GraphPad PRISM 9. The mean COVID-19 phobia score was highest in Japan at 50.5 points. Psychological fear was identically prevalent in Japan and China, at an average of 17.3 points. Psychosomatic fear was highest in Japan at 9.2 points. Further, economic fear was highest in Korea at 13 points, whereas social fear was highest in China at 13.1 points. In Korea, COVID-19 phobia scores were significantly higher among women than in men. In Japan, COVID-19 phobia scores were significantly higher in individuals who complied with social distancing mandates. In China, a lack of previous experience with self-administered testing kits was associated with significantly lower phobia scores. Individuals who were avoiding crowded places had significantly higher scores in 3 countries. This implies that the students knew that it was necessary to comply with COVID-19 preventive behaviors to prevent infections. The findings of this study could be used as a reference when establishing an approach strategy to reduce COVID-19 phobia among Chinese, Japanese, and Korean students.
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Affiliation(s)
- Hocheol Lee
- Yonsei Global Health Center, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
| | - Yoshihisa Shirayama
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
| | - Bo Zhao
- Yonsei Global Health Center, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Mahyeon Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Eun Woo Nam
- Department of Health Administration, Software Digital Healthcare Convergence College, Yonsei University, Wonju 26493, South Korea
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11
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Chen WT, Shiu C, Lee FR, Moolphate S, Aung MN. Infrastructure collapsed, health care access disrupted, Myanmar people with chronic diseases are in danger. J Glob Health 2023; 13:03002. [PMID: 36625038 PMCID: PMC9830275 DOI: 10.7189/jogh.13.03002] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Chengshi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, California, USA,School of Social Work, National Taiwan University, Taipei, Taiwan
| | - Franco R Lee
- Palos Verdes Peninsula High School, Palos Verdes, California, USA
| | - Saiyud Moolphate
- Department of Public Health, Chiangmai Rajabhat University, Chiangmai, Thailand
| | - Myo Nyein Aung
- Faculty of International Liberal Arts and Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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12
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Mulati N, Aung MN, Field M, Nam EW, Ka CMH, Moolphate S, Lee H, Goto Y, Kweun NH, Suda T, Koyanagi Y, Nagamine Y, Yuasa M. Digital-Based Policy and Health Promotion Policy in Japan, the Republic of Korea, Singapore, and Thailand: A Scoping Review of Policy Paths to Healthy Aging. Int J Environ Res Public Health 2022; 19:16995. [PMID: 36554873 PMCID: PMC9778868 DOI: 10.3390/ijerph192416995] [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] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
People are living longer, and our life has become more digital. Hence, the benefits from digital technology, including economic growth, increasing labor productivity, and ensuring health equity in the face of an aging population emerged as a vital topic for countries around the world. Japan, the Republic of Korea (ROK), Singapore, and Thailand are in the top ten rankings in terms of information and communication technology (ICT) development within the Asia Pacific Region and all are facing challenges of population aging. Well-designed national ICT policy and health promotion policies enabled the countries to make significant progress and development in terms of digitalization and healthy aging. This paper aims to answer questions regarding digitization and health promotion: when it started, how it is going, what are the achievements, and what it holds for the future, considering healthy aging and digitalization by reviewing the national ICT policy and health promotion policies of Japan, Korea, Singapore, and Thailand. This paper is expected to help readers build a comprehensive understanding of each country's journey towards building a healthy aging digital society. Furthermore, we hope this paper can be a source for countries to exchange experiences and learn from each other with a joint goal of building a healthy aging digital society.
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Affiliation(s)
- Nadila Mulati
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
| | - Malcolm Field
- Faculty of Social Sciences, Kyorin University, Tokyo 181-8611, Japan
- Faculty of International Liberal Arts, Waseda University, Tokyo 169-0051, Japan
| | - Eun Woo Nam
- Department of Health Administration, Software Digital Healthcare Convergence College, Yonsei University, Wonju 26493, Republic of Korea
| | - Carol Ma Hok Ka
- Gerontology Programmes & Senior Fellow (Service-Learning & Community Engagement), Centre for Experiential Learning, S R Nathan School of Human Development, Singapore University of Social Science, 463 Clementi Road, Singapore 599494, Singapore
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand
| | - Hocheol Lee
- Department of Health Administration, Software Digital Healthcare Convergence College, Yonsei University, Wonju 26493, Republic of Korea
| | - Yuki Goto
- Department of Global Health Promotion, Tokyo Dental and Medical University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
- Department of Family Medicine, Graduate School of Medical and Dental Sciences, Tokyo Dental and Medical University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Nam Hae Kweun
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea
| | - Takumi Suda
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yuka Koyanagi
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
- Department of Judo Therapy, Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo 135-0063, Japan
| | - Yuiko Nagamine
- Division of the Health for the Elderly, Ministry of Health, Labour and Welfare, 1-2-2 Kasumigaseki Chiyoda-ku, Tokyo 100-8916, Japan
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
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13
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Aung MN, Moolphate S, Aung TNN, Koyanagi Y, Kurusattra A, Chantaraksa S, Supakankunti S, Yuasa M. Effectiveness of a community-integrated intermediary care (CIIC) service model to enhance family-based long-term care for Thai older adults in Chiang Mai, Thailand: a cluster-randomized controlled trial TCTR20190412004. Health Res Policy Syst 2022; 20:110. [PMID: 36443788 PMCID: PMC9706835 DOI: 10.1186/s12961-022-00911-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Populations around the world are ageing faster, with the majority living in low- and middle-income countries where health and social care are yet to be universal and inclusive for the ageing population. This community-integrated intermediary care (CIIC) model is a novel prevention-based, long-term care model enhancing the family-based care system traditionally practised in Thailand and neighbouring Asian countries, and many low-and middle-income countries globally. This study assessed the effectiveness of the CIIC model in Chiang Mai, Thailand. METHODS The two-arm parallel intervention study was designed as a cluster-randomized controlled trial. The study population at randomization and analysis was 2788 participants: 1509 in six intervention clusters and 1279 in six control clusters. The research protocol was approved by the WHO Research Ethics Review Committee (WHO/ERC ID; ERC.0003064). The CIIC service intervention model is a combination of formal care and informal care in a subdistrict setting consisting of three components: (1) care prevention delivered as community group exercise and home exercise; (2) care capacity-building of the family caregiver; and (3) community respite service. The primary outcome was family caregivers' burden at 6-month follow-up, and secondary outcome was activities of daily living. Analysis applied the intention-to-treat approach using cluster-level analysis via STATA 16 SE. RESULTS Baseline characteristics did not differ between the two arms. Loss of follow up was 3.7%. Mean age of the participants was 69.53 years. Women constituted 60%. The COVID-19 pandemic caused delayed implementation. The proportion of families with reduced caregiver burden at 6-month follow-up was higher among the intervention clusters (mean 39.4%) than control clusters (mean 28.62%). The intervention clusters experienced less functional decline and fewer people with depression. CONCLUSIONS When communities are integrated for preventing care, and families are empowered for giving care, it is possible to secure universal access to health and social care for the older persons, with basic resources mobilized from communities. This study had shown the CIIC model as an effective and potential step to the realization of universal health and long-term care coverage being inclusive of ageing populations in Thailand and globally. TRIAL REGISTRATION This trial was registered at the Thailand Clinical Trial Registry-Trial registration number TCTR20190412004, https://www.thaiclinicaltrials.org/.
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Affiliation(s)
- Myo Nyein Aung
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan. .,Advanced Research Institute for Health Sciences, Juntendo University, Tokyo, 113-8421, Japan. .,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan. .,Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, 50300, Thailand.
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, 50300, Thailand
| | - Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Yuka Koyanagi
- Department of Judo Therapy, Faculty of Medical and Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, 135-0063, Japan
| | - Akrapon Kurusattra
- Department of Health Service Support, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Sutatip Chantaraksa
- Department of Health Service Support, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Siripen Supakankunti
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan.,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan.,Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Motoyuki Yuasa
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan.,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
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14
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Lee S, Aung MN, Kawatsu L, Uchimura K, Miyahara R, Takasaki J, Ohkado A, Yuasa M. Characteristics and Treatment Outcomes among Migrants with Pulmonary Tuberculosis: A Retrospective Cohort Study in Japan, 2009-2018. Int J Environ Res Public Health 2022; 19:12598. [PMID: 36231897 PMCID: PMC9566645 DOI: 10.3390/ijerph191912598] [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: 08/30/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to describe characteristics and treatment outcomes of overseas-born pulmonary tuberculosis (PTB) patients in Japan, and identify the factors associated with "treatment non-success". We conducted a retrospective analysis of overseas-born patients with drug-susceptible PTB using cohort data of PTB cases newly registered in the Japan tuberculosis (TB) surveillance system between 2009 and 2018. Overall, 9151 overseas-born PTB cases were included in this study, and 70.3% were aged 34 years old or younger. "Students of high school and higher" (28.6%) and "regular workers other than service related sectors" (28.5%) accounted for over half of the study population, and they have continued to increase. Overall, the treatment success rate was 67.1%. Transferred-out constituted the largest proportion (14.8%) among the treatment non-success rate (32.9%). Multiple logistic regression analysis revealed patients whose health insurance type was "others and unknown", including the uninsured (adjusted OR (AOR) = 3.43: 95% Confidence Intervals (CI) 2.57-4.58), those diagnosed as TB within "one year" (AOR = 2.61, 95% CI 1.97-3.46) and "1-5 years" (AOR = 2.44, 95% CI 1.88-3.17) of arrival in Japan, and males (AOR = 1.34, 95% CI 1.16-1.54), which were the main factors associated with treatment non-success. These findings imply that Japan needs to develop TB control activities considering the increasing trends of overseas-born PTB patients, the majority of whom are young and highly mobile. There is a need to pay greater attention to overseas-born PTB patients diagnosed within a short duration after entering Japan, who may be socially and economically disadvantaged for their treatment completion.
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Affiliation(s)
- Sangnim Lee
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City, Tokyo 204-8533, Japan
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
- Global Health Service, Faculty of International Liberal Arts, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Lisa Kawatsu
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City, Tokyo 204-8533, Japan
| | - Kazuhiro Uchimura
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City, Tokyo 204-8533, Japan
| | - Reiko Miyahara
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo 162-8640, Japan
- Genome Medical Science Project, The Research Institute, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Jin Takasaki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Akihiro Ohkado
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City, Tokyo 204-8533, Japan
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
- Global Health Service, Faculty of International Liberal Arts, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
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15
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Aung TNN, Moolphate S, Koyanagi Y, Angkurawaranon C, Supakankunti S, Yuasa M, Aung MN. Determinants of Health-Related Quality of Life Among Community-Dwelling Thai Older Adults in Chiang Mai, Northern Thailand. Risk Manag Healthc Policy 2022; 15:1761-1774. [PMID: 36164477 PMCID: PMC9508892 DOI: 10.2147/rmhp.s370353] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background Population aging has been growing worldwide and Thailand has become an aged society with 20% of its population aged 60 and over. Age-related decline in physical and mental health impacts the health-related quality of life (HRQOL) of older adults. Purpose We aimed to describe the HRQOL of Thai older adults, residing in the community. Methods This cross-sectional survey was part of a Community-Integrated Intermediary Care project (CIIC), TCTR20190412004. A total of 1509 participants from an intervention arm of a cluster randomized controlled trial were included. A Thai version of the Euro-Qol questionnaire (EQ-5D-5L) was used to determine the HRQOL and associated sociodemographic background, health behaviors and underlying diseases of a representative sample from Maehia, Chiang Mai, Thailand. SPSS version 24 was used to analyze data via descriptive analysis and binary logistic regression. Results The mean age of the participants was 69.31±7.10 years, and nearly a quarter (23.8%) was older than 75 years. The mean EQ index score was 0.81±0.23 and older age, lower educational attainment, unemployment, lack of exercise habits, current smokers, having history of a fall in the last 6 months, diabetes, hyperlipidemia, dependency assessed using Barthel's Activity of Daily Living (ADL) Index, and depression using the Geriatric Depression Scale (GDS) were more likely to represent HRQOL-related problems. Conclusion Our findings have highlighted the factors affecting the HRQOL of community-dwelling older adults which could be of importance in preparing for active and healthy aging communities. The routine dependency assessment using the ADL index will be useful in estimating the HRQOL of the aging population. Fall prevention programs are also recommended to reduce dependency. Moreover, the association of having diabetes and hyperlipidemia with problems in HRQOL dimensions highlight the need for public health intervention not only to prevent the increasing burden of non-communicable diseases but also to improve the HRQOL of older adults.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.,Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiangmai, 50300, Thailand
| | - Yuka Koyanagi
- Department of Medical and Health Science, Tokyo Ariake University, Tokyo, 135-0063, Japan
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.,Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Siripen Supakankunti
- Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan, and.,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan, and.,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan.,Advanced Research Institute for Health Sciences, Juntendo University, Tokyo, 113-8421, Japan
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Saito K, Komasawa M, Aung MN, Khin ET. COVID-19 Vaccination Willingness in Four Asian Countries: A Comparative Study including Thailand, Indonesia, the Philippines, and Vietnam. Int J Environ Res Public Health 2022; 19:12284. [PMID: 36231586 PMCID: PMC9566518 DOI: 10.3390/ijerph191912284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Globally, 67% of the population has received at least one COVID-19 vaccine dose, but coverage varies across countries. This study aimed to compare people's willingness to receive COVID-19 vaccination across Thailand, Indonesia, Philippines, and Vietnam, where vaccination intention tends to be high, to determine factors associated with willingness, and to obtain suggestions for developing strategies. We conducted a secondary data analysis of the Japan International Cooperation Agency survey "Building Resilience: COVID-19 Impact and Responses in Urban Areas-Case of Southeast Asia," including1842 unvaccinated participants from Thailand (n = 461), Indonesia (n = 246), the Philippines (n = 609), and Vietnam (n = 526). Vaccination willingness was high in all countries (69.6%), but the social and psychological factors motivating people to undergo vaccination differed among these countries. The highest vaccination willingness was in the Philippines, followed by Vietnam and Indonesia, whereas the lowest vaccination willingness was in Thailand. Vaccination willingness was affected by not only sociodemographic attributes, but also risk perception and beliefs, which, in turn, were shaped by social factors such as infection trends and vaccine policies. To achieve effective vaccination promotion programs, a system allowing the flexible modification of promotion methods in response to social conditions must be established.
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Affiliation(s)
- Kiyoko Saito
- JICA Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency (JICA), Tokyo 169-8433, Japan
| | - Makiko Komasawa
- JICA Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency (JICA), Tokyo 169-8433, Japan
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Ei Thinzar Khin
- JICA Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency (JICA), Tokyo 169-8433, Japan
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
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17
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Aung TNN, Moolphate S, Koyanagi Y, Angkurawaranon C, Supakankunti S, Yuasa M, Aung MN. Depression and Associated Factors among Community-Dwelling Thai Older Adults in Northern Thailand: The Relationship between History of Fall and Geriatric Depression. Int J Environ Res Public Health 2022; 19:ijerph191710574. [PMID: 36078289 PMCID: PMC9518436 DOI: 10.3390/ijerph191710574] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Globally, population aging is happening more quickly than in the past, and Thailand ranks the world's number three among the rapidly aging countries. Age-related decline in physical and mental health would impact depression among older adults. We aimed to determine the depression among the community-dwelling Thai older adults in Chiang Mai, Thailand. METHODS The baseline data, collected by door-to-door household visits of an intervention arm from a cluster randomized controlled trial (Community-Integrated Intermediary Care (CIIC): TCTR20190412004), were included in this cross-sectional study. Descriptive analysis and binary logistic regression were applied. RESULTS The mean age was 69.31 ± 7.10 years and 23.8% of study participants were older than 75 years. The Thai geriatric depression scale showed 6.5% had depression. Adjusted risk factors for depression were older age, being single, drinking alcohol daily, having diabetes, having experience of a fall last year, self-rated health as neutral, poor/very poor, and moderate/severe dependency by ADL scoring. CONCLUSION Our findings highlighted the potentially modifiable risk factors in addition to the common predictors affecting depression among community-dwelling older adults. Fall prevention programs and public health interventions to prevent diabetes are recommended. Furthermore, self-rated health and Barthel's ADL scoring would be simple tools to predict risk factors for geriatric depression.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand
| | - Yuka Koyanagi
- Department of Medical and Health Science, Tokyo Ariake University, Tokyo 135-0063, Japan
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siripen Supakankunti
- Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok 10330, Thailand
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan
- Correspondence:
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18
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Aziz Z, Haregu T, Kyobutungi C, Yan L, Irazola V, Absetz P, Bandurek I, Roberts M, Vedanthan R, Folkes S, Cao Y, Wen Y, Aung MN, Danhieux K, Desloge A, Oldenburg B. Strengthening Capacity for Implementation Research Amid COVID-19 Pandemic: Learnings From the Global Alliance for Chronic Diseases Implementation Science School. Int J Public Health 2022; 67:1604944. [PMID: 36016964 PMCID: PMC9395543 DOI: 10.3389/ijph.2022.1604944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
Objective: To describe the design, delivery and evaluation of the 3rd Global Alliance for Chronic Diseases (GACD) Implementation Science School (ISS), delivered virtually in 2020 for the first time. Methods: Since 2014, GACD has supported the delivery of more than ten Implementation Science Workshops for more than 500 international participants. It has also been conducting an annual ISS since 2018. In this study, we described the design, delivery and evaluation of the third ISS. Results: Forty-six participants from 23 countries in five WHO regions attended the program. The virtual delivery was well-received and found to be efficient in program delivery, networking and for providing collaborative opportunities for trainees from many different countries. The recently developed GACD Implementation Science e-Hub was found to be an instrumental platform to support the program by providing a stand-alone, comprehensive online learning space for knowledge and skill development in implementation research. Conclusion: The delivery of the virtual GACD ISS proved to be feasible, acceptable and effective and offers greater scalability and sustainability as part of a future strategy for capacity strengthening in implementation research globally.
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Affiliation(s)
- Zahra Aziz
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Tilahun Haregu
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- *Correspondence: Tilahun Haregu,
| | | | | | - Vilma Irazola
- Instituto de Efectividad Clinicay Sanitaria (IECS), Buenos Aires, Argentina
- Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Pilvikki Absetz
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Isobel Bandurek
- Global Alliance for Chronic Diseases, London, United Kingdom
| | - Morven Roberts
- Global Alliance for Chronic Diseases, London, United Kingdom
| | | | - Sheree Folkes
- Global Alliance for Chronic Diseases, London, United Kingdom
| | - Yingting Cao
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Yu Wen
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | | | | | | | - Brian Oldenburg
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- La Trobe University, Melbourne, VIC, Australia
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19
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Aung MN, Koyanagi Y, Nagamine Y, Nam EW, Mulati N, Kyaw MY, Moolphate S, Shirayama Y, Nonaka K, Field M, Cheung P, Yuasa M. Digitally Inclusive, Healthy Aging Communities (DIHAC): A Cross-Cultural Study in Japan, Republic of Korea, Singapore, and Thailand. Int J Environ Res Public Health 2022; 19:ijerph19126976. [PMID: 35742230 PMCID: PMC9223148 DOI: 10.3390/ijerph19126976] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 12/10/2022]
Abstract
One out of three people in Japan will be an older person before 2040. Half of those currently do not utilize the internet, smartphone apps, or digital technology. On the other hand, more than 70% of seniors in Republic of Korea use the internet, and 55% in Singapore had access to it in 2019. The use of digital technology for health promotion has the potential to promote individual and community empowerment, advocating for healthy, active aging. Maintaining equity in health promotion practice requires the digital inclusion of every senior. Therefore, we propose a cross-cultural study to explain the contextual influences of digital inclusion and its consequences on healthy aging in Japan, Korea, Singapore, and Thailand. Quantitatively: digital skills, e-health literacy, participation in health promotion, and quality of life will be analyzed in structural equation models. Qualitatively: thematic analysis will be developed to identify cultural patterns and contextual factors, making sense of what older persons in different countries materialize, say, do, think, and feel to reveal deeper beliefs and core values about digital inclusion and healthy aging. Logics and methods from this protocol would be useful to replicate the study in many countries globally. Evidence from this study is expected to pave the way to digitally inclusive, healthy aging communities (DIHAC) across Japan and Asia.
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Affiliation(s)
- Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan; (Y.K.); (N.M.); (M.Y.K.); (Y.S.); (M.Y.)
- Advanced Research Institute for Health Sciences, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Correspondence:
| | - Yuka Koyanagi
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan; (Y.K.); (N.M.); (M.Y.K.); (Y.S.); (M.Y.)
- Department of Judo Therapy, Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo 135-0063, Japan
| | - Yuiko Nagamine
- Department of Family Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Eun Woo Nam
- Department of Health Administration, Software Digital Healthcare Convergence College, Yonsei University, Wonju 26493, Korea;
| | - Nadila Mulati
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan; (Y.K.); (N.M.); (M.Y.K.); (Y.S.); (M.Y.)
| | - Myat Yadana Kyaw
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan; (Y.K.); (N.M.); (M.Y.K.); (Y.S.); (M.Y.)
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand;
| | - Yoshihisa Shirayama
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan; (Y.K.); (N.M.); (M.Y.K.); (Y.S.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
| | - Kumiko Nonaka
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan;
| | - Malcolm Field
- Faculty of Social Sciences, Kyorin University, Tokyo 181-8611, Japan;
- Faculty of International Liberal Arts, Waseda University, Tokyo 169-0051, Japan
| | - Paul Cheung
- Asia Competitiveness Institute (ACI), Lee Kuan Yew School of Public Policy, Singapore 259772, Singapore;
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo 113-8421, Japan; (Y.K.); (N.M.); (M.Y.K.); (Y.S.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
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20
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Aung TNN, Shirayama Y, Moolphate S, Lorga T, Jamnongprasatporn W, Yuasa M, Aung MN. Prevalence and Risk Factors for Hypertension among Myanmar Migrant Workers in Thailand. Int J Environ Res Public Health 2022; 19:ijerph19063511. [PMID: 35329196 PMCID: PMC8955730 DOI: 10.3390/ijerph19063511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023]
Abstract
Background: Non-communicable diseases (NCDs) are showing an increasing trend worldwide, and the COVID-19 pandemic may interrupt or delay NCD care, the leading cause of mortality in Thailand, which is hosting 2–3 million migrant workers. The transition of epidemiological risk factors, limited access to health-promoting activities, and pandemic containment measures may adversely impact NCD risks. Therefore, hypertension and associated risk factors were determined among registered Myanmar migrant workers in Thailand. Methods: A cross-sectional survey with structured questionnaires was conducted in Thailand in 2017. Having hypertension was analyzed as a dependent variable, and the associated risk factors were explored by binary logistic regression analysis. Results: A total of 414 participants with a mean age of 29.45 ± 9.03 years were included, and 27.8 percent of the study participants were hypertensive, which was a rate higher than that in their host country (24.7%) and country of origin (26.4%). An older age, being male, current alcohol drinking, and being overweight and obese with reference to the body mass index (BMI) were significantly associated with hypertension. Conclusions: Our findings reaffirmed the idea that NCDs are important public health concerns, and a simple BMI measurement would be a valuable tool with which to determine hypertension risks. Targeted surveillance and an appropriate health policy are necessary for such a vulnerable population in Thailand.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Yoshihisa Shirayama
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (Y.S.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand;
| | - Thaworn Lorga
- School of Nursing, Mae Fah Luang University, Chiang Rai 57100, Thailand;
| | | | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (Y.S.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (Y.S.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan
- Correspondence:
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21
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Sodeno M, Aung MN, Yuasa M, Moolphate S, Klinbuayaem V, Srikhamsao A, Aung TNN, Sato S, Tanigawa T. Association Between Physical Activity and Type 2 Diabetes Using the International Physical Activity Questionnaires: A Case-Control Study at a Health Promoting Hospital in Chiang Mai, Northern Thailand. Diabetes Metab Syndr Obes 2022; 15:3655-3667. [PMID: 36452131 PMCID: PMC9701779 DOI: 10.2147/dmso.s382528] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Health education and promotion is active in Thailand where diabetes is prevalent at 11.6% of the general adult population in 2021. PURPOSE This study aimed to describe and compare the levels of physical activity between patients with newly diagnosed diabetes and non-diabetic controls in northern Thailand. METHODS This observational case-control study included participants aged between 25 and 74 years in Chiang Mai. We recruited 150 patients with type 2 diabetes mellitus (T2DM) at Sanpatong District Hospital and 150 control participants (non-T2DM) in the community. Interviews were conducted using the International Physical Activity Questionnaires-Short Form. Anthropometric measurements and social demographic information were collected from both patients and controls in 2019. RESULTS The mean age of the participants was 58.8 ± 8.4 years in the T2DM group and 56.5 ± 9.9 years in the non-T2DM group. Compared to controls, patients with T2DM had received significantly more physical activity education (P < 0.001, Fisher's test). Most cases (93.3%) had received such education at a hospital or health center. The median total metabolic equivalents (METs) minutes per week (min/week) for participants in the T2DM group were higher than those in the non-T2DM group (2726 vs 1140 METs min/week) (P < 0.001, Mann-Whitney test). Comparing the case and control groups in the category of PA level, we found that the case group had a higher proportion of high-level physical activity (P < 0.001, chi-square test). CONCLUSION Diabetes patients attending a community hospital exhibited high levels of physical activity. The majority of them received education related physical activity from a primary health care service.
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Affiliation(s)
- Miho Sodeno
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine Juntendo University, Tokyo, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
- Correspondence: Myo Nyein Aung; Miho Sodeno, Juntendo University, Hongo 2-1-1, Bunkyo Ku, Tokyo, 113-8421, Japan, Email ;
| | - Motoyuki Yuasa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Global Health Research, Graduate School of Medicine Juntendo University, Tokyo, Japan
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiangmai, Thailand
| | | | - Aranya Srikhamsao
- Ban Hua Rin Subdistrict Health Promotion Hospital, Chiang Mai, 50120, Thailand
| | - Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Setsuko Sato
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
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22
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Komasawa M, Aung MN, Saito K, Isono M, Tanaka G, Makimoto S. Overcoming Current and Preventing Future Nosocomial Outbreaks during the COVID-19 Pandemic: Lessons Learned at Three Hospitals in Japan. Int J Environ Res Public Health 2021; 18:ijerph181910226. [PMID: 34639526 PMCID: PMC8508432 DOI: 10.3390/ijerph181910226] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/12/2022]
Abstract
Hospitals are increasingly challenged by nosocomial infection (NI) outbreaks during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Although standardized guidelines and manuals regarding infection prevention and control (IPC) measures are available worldwide, case-studies conducted at specified hospitals that are required to cope with real settings are limited. In this study, we analyzed three hospitals in Japan where large-scale NI outbreaks occurred for hints on how to prevent NI outbreaks. We reviewed openly available information from each hospital and analyzed it applying a three domain framework: operation management; identification of infection status; and infection control measures. We learned that despite having authorized infection control teams and using existing standardized IPC measures, SARS-CoV-2 may still enter hospitals. Early detection of suspected cases and confirmation by PCR test, carefully dealing with staff-to-staff transmission were the most essential factors to prevent NI outbreaks. It was also suggested that ordinary training on IPC for staff does not always provide enough practical knowledge and skills; in such cases external technical and operational supports are crucial. It is expected that our results will provide insights into preventing NI outbreaks of COVID-19, and contribute to mitigate the damage to health care delivery systems in various countries.
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Affiliation(s)
- Makiko Komasawa
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Tokyo 1628433, Japan; (K.S.); (M.I.); (S.M.)
- Correspondence: ; Tel.: +81-3-3269-2916
| | - Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Bunkyo-ku, Tokyo 1138421, Japan;
| | - Kiyoko Saito
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Tokyo 1628433, Japan; (K.S.); (M.I.); (S.M.)
| | - Mitsuo Isono
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Tokyo 1628433, Japan; (K.S.); (M.I.); (S.M.)
| | - Go Tanaka
- Human Development Department, Japan International Cooperation Agency, Chiyuda-ku, Tokyo 1028012, Japan;
| | - Saeda Makimoto
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Tokyo 1628433, Japan; (K.S.); (M.I.); (S.M.)
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23
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Aung MN, Stein C, Chen WT, Garg V, Saraswati Sitepu M, Thu NTD, Gundran CPD, Hassan MR, Suthutvoravut U, Soe AN, Nour M, Gyi KK, Brandl R, Yuasa M. Community responses to COVID-19 pandemic first wave containment measures: a multinational study. J Infect Dev Ctries 2021; 15:1107-1116. [PMID: 34516418 DOI: 10.3855/jidc.15254] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/13/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION National strategies to control COVID-19 pandemic consisted mostly of social distancing measures such as lockdowns, curfews, and stay-home guidelines, personal protection such as hand hygiene and mask wearing, as well as contact tracing, isolation and quarantine. Whilst policy interventions were broadly similar across the globe, there were some differences in individual and community responses. This study explored community responses to COVID-19 containment measures in different countries and synthesized a model. This exaplains the community response to pandemic containment measures in the local context, so as to be suitably prepared for future interventions and research. METHODOLOGY A mutlinational study was conducted from April-June 2020 involving researchers from 12 countries (Japan, Austria, U.S., Taiwan, India, Sudan, Indonesia, Malaysia, Philippines, Myanmar, Vietnam and Thailand). Steps in this research consisted of carrying out open-ended questionnaires, qualitative analyses in NVivo, and a multinational meeting to reflect, exchange, and validate results. Lastly, a commuinty response model was synthesized from multinational experiences. RESULTS Effective communication is key in promoting collective action for preventing virus transmission. Health literacy, habits and social norms in different populations are core components of public health interventions. To enable people to stay home while sustaining livelihoods, economic and social support are essential. Countries could benefit from previous pandemic experience in their community response. Whilst contact tracing and isolation are crucial intervention components, issues of privacy and human rights need to be considered. CONCLUSIONS Understanding community responses to containment policies will help in ending current and future pandemics in the world.
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Affiliation(s)
- Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan.
| | | | - Wei-Ti Chen
- UCLA School of Nursing, Los Angeles, CA 90095, United States
| | - Vandana Garg
- Manav Rachna International Institute of research and Studies, Faridabad, Haryana, India
| | | | - Nguyen Thi Dang Thu
- Faculty of Public Health, University of Medicine and Pharmacy, Hue Univeristy, Thua Thien Hue,Vietnam
| | - Carlos Primero D Gundran
- Department of Health Policies and Administration, College of Public Health, University of Phillipines, Manila, Phillipines
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Unyaporn Suthutvoravut
- Department of Family Medicine, Faculty of Medicine, Ramathiboidi Hospital, Mahidol University, Bangkok, Thailand
| | - Aung Naing Soe
- City Cancer Foundation, Yangon, Myanmar, and Geneva, Switzerland
| | - Magde Nour
- Kristiania University College, Oslo, Norway
| | - Khin Khin Gyi
- Central Epidemiology Unit, Department of Public Health, Ministry of Health and Sports, Myanmar
| | | | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
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24
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Aung MN, Koyanagi Y, Ueno S, Tiraphat S, Yuasa M. Age-friendly environment and community-based social innovation in Japan: A mixed-method study. Gerontologist 2021; 62:89-99. [PMID: 34383029 DOI: 10.1093/geront/gnab121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/02/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES While governments are building age-friendly environments, community-based social innovation (CBSI) provides opportunities for older community residents to interact. Common CBSIs in Japan are in the form of group exercise activities or social cultural activities, such as reading, writing, poetry, chorus, calligraphy, card game, knitting, planting trees and cooking, etc. In this study, an age-friendly environment in Japan was assessed quantitatively and qualitatively through the perceptions of community residents and their interaction with the environment. RESEARCH DESIGN AND METHODS A cross-sectional survey of 243 participants and multiple in-depth interviews were carried out. Quantitative study applied the WHO framework of 20 age-friendly environmental factors with analysis applying a structural equation model. Qualitative study applied focus-group meetings and in-depth interviews to conduct thematic analysis of Japanese community residents' activities according to the WHO scope of CBSI for healthy ageing. RESULTS This age-friendly environment in Japan has provided pathways for the older people to sustain their social network, which promotes civic participation and engagement in peer group activities leading to active ageing. CBSIs are the factors that lead to an age-friendly environment resulting in a sustainable quality of life. DISCUSSION AND IMPLICATIONS It is important to sustain CBSIs in the era of COVID-19 pandemic as those are the paths leading to healthy ageing communities and quality of older residents' life. The lessons learnt about how physical environment and social participation result in healthy, active quality of life for older adults in Japan may be applicable to other contexts around the world.
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Affiliation(s)
- Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Yuka Koyanagi
- Department of Judo Therapy, Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Satomi Ueno
- Department of Nursing, Faculty of Nursing, Seisen Jogakuin College, Nagano, Japan
| | - Sariyamon Tiraphat
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
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25
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Lee H, Park SJ, Kim JE, Kong F, Zhao B, Nam H, Koh SB, Nam S, Yuasa M, Aung MN, Medina JRC, Palutturi S, Berhe H, Terefe E, Nam S, Kang Y, Rönnebeck N, Lee JH, Lee GR, Jung Y, Cosme CR, Shin DE, Herrera M, Ndombi GO, Mansiangi P, Moon SJ, Yoon H, Chung MA, Lim SB, Lee YL, Kim D, Nam EW. International Comparison of Depression During the COVID-19 Pandemic Among University Students in 13 Countries: A Web-Based Cross-Sectional Survey. Asia Pac J Public Health 2021; 33:928-931. [PMID: 34350800 PMCID: PMC8592100 DOI: 10.1177/10105395211034062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hocheol Lee
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | | | - Ji Eon Kim
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | | | - Bo Zhao
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Haekweun Nam
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Sang Baek Koh
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | | | | | | | | | | | | | | | - Seungwoo Nam
- Korea International Cooperation Agency, Gyeonggi-do, Republic of Korea
| | - Yanghee Kang
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | | | - Ji Ho Lee
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Ga Ram Lee
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Yeseul Jung
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | | | - Dong Eun Shin
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | | | | | - Paul Mansiangi
- Kinshasa University, Kinshasa, Democratic Republic of the Congo
| | - Seok Jun Moon
- Korea Institute for Health and Social Affair, Se Jong, Republic of Korea
| | - Hyejin Yoon
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Min Ah Chung
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Su Been Lim
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Yu Lim Lee
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Dohyeong Kim
- Korea International Cooperation Agency, Gyeonggi-do, Republic of Korea
| | - Eun Woo Nam
- Yonsei University, Wonju, Gangwon-do, Republic of Korea
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26
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Khin ET, Aung MN, Ueno S, Ahmad I, Latt TS, Moolphate S, Yuasa M. Social Support between Diabetes Patients and Non-Diabetes Persons in Yangon, Myanmar: A Study Applying ENRICHD Social Support Instrument. Int J Environ Res Public Health 2021; 18:ijerph18147302. [PMID: 34299754 PMCID: PMC8303506 DOI: 10.3390/ijerph18147302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 12/28/2022]
Abstract
Diabetes patients, due to the chorionic nature of the disease, need complex and long-term care for control and prevention of complications. The patients themselves find it difficult to adopt appropriate disease management after diagnosis and they need social support from family, friends, and their environment, especially in lower- and middle-income countries where medical service is limited, and they need self-care of disease and lifestyle modification. In Myanmar, however, the study for social support among diabetes patients is still limited. Therefore, we conducted a case-control study to investigate the social support among diabetes patients and the association between socioeconomic factors in Yangon, which has the highest prevalence of diabetes in Myanmar. Social support between diabetes patients who came to diabetes special clinics and non-diabetes community control was assessed by applying transculturally translated ENRICHD Social Support Instrument (ESSI). Among the diabetes patients’ group, more than 70% had high perceived social support, specifically higher level of informational and emotional social support. Robust multiple regression models revealed significant positive associations between total social support and independent variables: p value < 0.001 for monthly household income and being married, and p value < 0.05 for household number and frequency of having meals together with family. These findings suggest that perceived social support among patients with diabetes may be mainly affected by the patients’ family conditions, such as household income and living with a spouse, in Myanmar culture.
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Affiliation(s)
- Ei Thinzar Khin
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
| | - Myo Nyein Aung
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Correspondence: ; Tel.: +81-33813-3111
| | - Satomi Ueno
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
- Faculty of Nursing, Seisen Jogakuin College, Nagano 381-0085, Japan
| | - Ishtiaq Ahmad
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
| | - Tint Swe Latt
- Myanmar Diabetes Association (MMDA), Yangon 11211, Myanmar;
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiangmai 50300, Thailand;
| | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
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Aung TNN, Aung MN, Moolphate S, Koyanagi Y, Supakankunti S, Yuasa M. Caregiver Burden and Associated Factors for the Respite Care Needs among the Family Caregivers of Community Dwelling Senior Citizens in Chiang Mai, Northern Thailand. Int J Environ Res Public Health 2021; 18:ijerph18115873. [PMID: 34070766 PMCID: PMC8197883 DOI: 10.3390/ijerph18115873] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Families are the backbone of caregiving for older adults living in communities. This is a tradition common to Thailand and many low- and middle-income countries where formal long-term care services are not so available or accessible. Therefore, population aging demands more and more young people engaging as family caregivers. Informal caregiving can become an unexpected duty for anyone anytime. However, studies measuring the burden of informal caregivers are limited. We aimed to determine the caregiver burden, both from the perspective of the caregivers as well as that of their care recipients. METHOD We used the baseline survey data from a cluster randomized controlled trial providing a community integrated intermediary care (CIIC) service for seniors in Chiang Mai, Thailand, TCTR20190412004. Study participants were 867 pairs of older adults and their primary family caregivers. Descriptive analysis explored the characteristics of the caregivers and binary logistic regression identified factors influencing the caregivers' burden. RESULTS The mean age of family caregivers was 55.27 ± 13.7 years and 5.5% indicated the need for respite care with Caregiver Burden Inventory (CBI) scores ≥24. The highest burden was noted in the time-dependence burden domain (25.7%). The significant associated factors affecting CBI ≥24 were as follows: caregivers older than 60 years, being female, current smokers, having diabetes, and caring for seniors with probable depression and moderate to severe dependency. CONCLUSIONS A quarter of caregivers can have their careers disturbed because of the time consumed with caregiving. Policies to assist families and interventions, such as respite service, care capacity building, official leave for caregiving, etc., may reduce the burden of families struggling with informal care chores. Furthermore, caregiver burden measurements can be applied as a screening tool to assess long-term care needs, complementing the dependency assessment. Finally, implementation research is required to determine the effectiveness of respite care services for older people in Thailand.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (T.N.N.A.); (M.Y.)
| | - Myo Nyein Aung
- Advanced Research Institute for Health Sciences, Juntendo University, Bunkyo City, Hongo, 2 Chome-1-1, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Correspondence:
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand;
| | - Yuka Koyanagi
- Tokyo Ariake University of Medical and Health Sciences, Tokyo 135-0063, Japan;
| | - Siripen Supakankunti
- Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (T.N.N.A.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
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Affiliation(s)
- Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Chengshi Shiu
- Department of Social Work, National Taiwan University, Taipei, Taiwan; UCLA School of Nursing, Los Angeles, CA 90095, USA
| | - Wei-Ti Chen
- UCLA School of Nursing, Los Angeles, CA 90095, USA.
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Aung MN, Moolphate S, Yuasa M, Aung TNN, Koyanagi Y, Supakankunti S, Ahmad I, Kayano R, Ong P. Community-Integrated Intermediary Care (CIIC) Service Model to Enhance Family-Based, Long-Term Care for Older People: Protocol for a Cluster Randomized Controlled Trial in Thailand. JMIR Res Protoc 2021; 10:e20196. [PMID: 33759787 PMCID: PMC8088866 DOI: 10.2196/20196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/02/2020] [Accepted: 02/24/2021] [Indexed: 01/22/2023] Open
Abstract
Background Thailand is one of the most rapidly aging countries in Asia. Traditional family-based care, which has been the basis of most care for older people, is becoming unsustainable as families become smaller. In addition, women tend to be adversely affected as they still form the bulk of caregivers for older people, and many are likely to exit the labor market in order to provide care. Many family caregivers also have no or minimal training, and they may be called upon to provide quite complex care, increasing the proportion of older people receiving suboptimal care if they rely only on informal care that is provided by families and friends. Facing the increasing burden of noncommunicable diseases and age-related morbidity, Thai communities are increasingly in need of community-integrated care models for older persons that can link existing health systems and reduce the burden upon caring families. This need is common to many countries in the Association of Southeast Asian Nations (ASEAN). Objective In this study, we aimed to assess the effectiveness of a community-integrated intermediary care (CIIC) model to enhance family-based care for older people. Methods This paper describes a cluster randomized controlled trial comprised of 6 intervention clusters and 6 control clusters that aim to recruit 2000 participants in each arm. This research protocol has been approved by the World Health Organization Ethics Review Committee. The intervention clusters will receive an integrated model of care structured around (1) a community respite service, (2) the strengthening of family care capacity, and (3) an exercise program that aims to prevent entry into long-term care for older people. Control group clusters receive usual care (ie, the current system of long-term care common to all provinces in Thailand), consisting principally of a volunteer-assisted home care service. The trial will be conducted over a period of 2 years. The primary outcome is family caregiver burden measured at a 6-month follow-up, as measured by the Caregiver Burden Inventory. Secondary outcomes consist of biopsychosocial indicators including functional ability, as measured using an activity of daily living scale; depression, as measured by the Geriatric Depression Scale; and quality of life of older people, as measured by the EuroQol 5-dimensions 5-levels scale. Intention-to-treat analysis will be followed. Results The CIIC facility has been established. Community care prevention programs have been launched at the intervention clusters. Family caregivers are receiving training and assistance. However, the COVID-19 pandemic delayed the intervention. Conclusions Since ASEAN and many Asian countries share similar traditional family-based, long-term care systems, the proposed CIIC model and the protocol for its implementation and evaluation may benefit other countries wishing to adopt similar community-integrated care models for older people at risk of needing long-term care. Trial Registration Thai Clinical Trials Registry TCTR20190412004; http://www.thaiclinicaltrials.org/# International Registered Report Identifier (IRRID) DERR1-10.2196/20196
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Affiliation(s)
- Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, Thailand
| | - Motoyuki Yuasa
- Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan.,Department of Public Health, Juntendo University, Tokyo, Japan
| | | | - Yuka Koyanagi
- Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | | | - Ishtiaq Ahmad
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Ryoma Kayano
- Centre for Health Development, World Health Organisation, Kobe, Japan
| | - Paul Ong
- Centre for Health Development, World Health Organisation, Kobe, Japan
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Aung MN, Koyanagi Y, Yuasa M. Health inequality among different economies during early phase of COVID-19 pandemic. J Egypt Public Health Assoc 2021; 96:3. [PMID: 33595767 PMCID: PMC7887563 DOI: 10.1186/s42506-021-00067-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/20/2021] [Indexed: 11/11/2022]
Abstract
Background The new coronavirus outbreak originated in Wuhan, China, started in January 2020 is escalating as a pandemic across the globe in March 2020. It causes unprecedented morbidity and shocked health systems and the supply chains in new epicenters such as Italy, Spain, and the USA, claiming thousands of lives. Meanwhile, the pandemic is reaching swiftly and silently to low-income countries where international media cover less. How likely health outcomes among the countries with different economies may differ during the pandemic has not been reported yet. Methodologically, we conducted an analysis of COVID-19 deaths comparing case fatality rate (CFR) among countries with different income categories, applying COVID-19 global data from the European Centre for Disease Control including 199 countries’ data as of 31 March 2020, in the early phase of the pandemic. We categorized countries into high-income countries (HIC), upper-middle-income countries (UMIC), lower-middle-income countries (LMIC), and low-income countries (LIC) according to World Bank classification by income as of 2020. Finding Statistically, countries in different income groups are significantly different in terms of new cases identified in the last 2 weeks and the case fatality rate (MANOVA, P value < 0.001). New tests and detected case numbers shot up in HICs where CFR shot up in LMICs and LICs. The results of this analysis pointed out an important gap among countries with different economic status during the ongoing pandemic. Conclusion In the HIC, contact tracing, testing capacity, and outbreak response, as well as clinical services, are strong. In the LICs, there is a low capacity of outbreak response which is reflected by the significantly lower number of diagnostic tests. Consequently, the reported number of COVID-19 cases in LICs may not reflect the actual burden of the pandemic. Without effective prevention, the pandemic can readily break into the weak health system and over-burden the hospitals and clinical services in poor countries. This finding is showing health inequality between the rich and the poor being amplified by the COVID-19 pandemic. Addressing such a gap through the local governance and integrated global responses will not only prevent unprecedented deaths, but also preserve the momentum towards Sustainable Development Goals (SDGs).
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Affiliation(s)
- Myo Nyein Aung
- Juntendo Advanced Research Institute for Health Science, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. .,Global Health Service, Faculty of International Liberal Arts, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Yuka Koyanagi
- Tokyo Ariake University of Health Science, Tokyo, Japan
| | - Motoyuki Yuasa
- Global Health Service, Faculty of International Liberal Arts, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Department of Public Health, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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Ahmad I, Aung MN, Ueno S, Khin ET, Latt TS, Moolphate S, Yuasa M. Physical Activity of Type 2 Diabetes Mellitus Patients and Non-Diabetes Participants in Yangon, Myanmar: A Case-Control Study Applying the International Physical Activity Questionnaires (IPAQ-S). Diabetes Metab Syndr Obes 2021; 14:1729-1739. [PMID: 33907434 PMCID: PMC8068492 DOI: 10.2147/dmso.s291468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/22/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite the evidence that physical activity (PA) can prevent type 2 diabetes mellitus (T2DM), limited research investigated the level of PA among diabetes and non-diabetes in Myanmar, where there is the escalating prevalence of diabetes recently. We investigated PA as modified the risk of diabetes, in a case-control study. METHODS We conducted a case-control study which included 150 cases and 150 controls age 25-74 years (Mean age 43.3±14.7 years) among the cases and (55.1±10.9 years) among the controls, both sex and residence in Yangon. Cases were newly diagnosed with T2DM within six months before data collection, with laboratory-confirmed fasting blood glucose level ≥126mg/dl. Controls were community residents, without diabetes, confirmed with a laboratory test. The IPAQ-S was used to assess the PA level. Multiple logistic regression analysis was applied in STATA 15, using the interaction terms for age and PA, adjusting age, sex and BMI. RESULTS In comparison to controls, cases were older and having less PA knowledge. The levels of vigorous PA were mean 254.9±standard deviations (SD) 845.6 METsmin.wk-1 among controls, 73.06±392.1 cases, moderate PA 631.5±1240.8 METsmin.wk-1 among controls and 1050.9±1601.6 cases and walking PA 569.8±1060 METsmin.wk-1 among controls and 777.4±1249 cases, respectively. The multiple logistic regression analysis showed adjusted odds ratios (aOR) 3.84, 95% confidence interval (CI) 1.18-12.42 (P<0.05) for those aged 40 and older, with moderate PA and aOR 18.01, Cl 6.45-50.26 (P<0.001) for those aged 40 and older, with low PA. Comparing the strength of association, the risk of T2DM among people aged 40 and older with moderate PA is lower than age over 40 with low PA. CONCLUSION PA lessened the risk of T2DM, posted by increasing age. The findings highlighted the importance of promoting PA to reduce the T2DM prevalence in the context of Yangon, Myanmar, a low- and middle-income Asian country.
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Affiliation(s)
- Ishtiaq Ahmad
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
- Correspondence: Myo Nyein Aung Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Bunkyo City, Hongo, 2 Chome-1-1, Tokyo, 〒113-8421, JapanTel +813-3813-3111 Email
| | - Satomi Ueno
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ei Thinzar Khin
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Tint Swe Latt
- Myanmar Diabetes Association (MMDA), Yangon, Myanmar
| | - Saiyud Moolphate
- Department of Public Health, Chiang Mai Rajabhat University, Chiang Mai, Thailand
| | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
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Zhao B, Kong F, Aung MN, Yuasa M, Nam EW. Novel Coronavirus (COVID-19) Knowledge, Precaution Practice, and Associated Depression Symptoms among University Students in Korea, China, and Japan. Int J Environ Res Public Health 2020; 17:E6671. [PMID: 32933212 PMCID: PMC7558700 DOI: 10.3390/ijerph17186671] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 11/17/2022]
Abstract
This study assessed university students' knowledge and precaution practices of Novel Coronavirus (COVID-19) in South Korea, China, and Japan, and investigated their depressive states during the pandemic. This cross-sectional survey collected data from 821 respondents, using an anonymous online questionnaire designed by the Yonsei Global Health Center, from 23 March to 20 April 2020, which included socio-demographic questions, knowledge and perceptions of COVID-19, preventative practices, and the Patient Health Questionnaire-9 (PHQ-9) scale to assess mental health. High proportions of respondents showed good knowledge of the transmission pathways and information related to COVID-19. Contact history as well as concerns about family members and the disease showed statistically significant distinctions by nationality and gender. On the whole, all participants reported good levels of preventative practices. The Chinese group reported the highest preventative practice scores; and females scored higher than males. Moreover, the Japanese group showed the most severe depressive states; overall, females experienced more severe depression than males. Thus, authorities should especially emphasize the importance of COVID-19 precautions to males. Educational departments and health authorities should observe the mental health of university adults during the pandemic and plan interventions to improve it.
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Affiliation(s)
- Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 26493, Korea;
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Myo Nyein Aung
- Juntendo Advanced Research Institute for Health Science, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan;
- Global Health Service Course, Faculty of International Liberal Arts, Juntendo University, Hongo 2-1-1, Bumkyo-ku, Toyko 113-8421, Japan;
| | - Motoyuki Yuasa
- Global Health Service Course, Faculty of International Liberal Arts, Juntendo University, Hongo 2-1-1, Bumkyo-ku, Toyko 113-8421, Japan;
| | - Eun Woo Nam
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 26493, Korea;
- Healthy City Research Center, Institute of Health and Welfare, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 26493, Korea
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Aung MN, Koyanagi Y, Ueno S, Tiraphat S, Yuasa M. A Contemporary Insight into an Age-Friendly Environment Contributing to the Social Network, Active Ageing and Quality of Life of Community Resident Seniors in Japan. Journal of Aging and Environment 2020. [DOI: 10.1080/26892618.2020.1813232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Yuka Koyanagi
- Tokyo Ariake Medical and Health Science University, Tokyo, Japan
| | | | - Sariyamon Tiraphat
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
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Aung TNN, Shirayama Y, Moolphate S, Lorga T, Yuasa M, Nyein Aung M. Acculturation and Its Effects on Health Risk Behaviors among Myanmar Migrant Workers: A Cross-Sectional Survey in Chiang Mai, Northern Thailand. Int J Environ Res Public Health 2020; 17:E5108. [PMID: 32679842 PMCID: PMC7399838 DOI: 10.3390/ijerph17145108] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 01/31/2023]
Abstract
Thailand hosts many workers who have migrated from neighboring countries and is facing a large burden of non-communicable diseases (NCDs). Health screening for migrant workers routinely emphasizes infectious diseases but overlooks NCDs. We surveyed prevalent health behaviors for NCDs and their influencing factors, particularly cultural adaptation patterns among Myanmar migrant workers in Chiang Mai, Northern Thailand. A total of 414 migrant workers consented to participate in the study. Lack of exercise (75.8%), current alcohol consumption (40.8%), current smoking (26.9%), and central obesity (24.3%) were major lifestyle problems. Being female and uneducated was associated with a lack of exercise. Current alcohol consumption was significantly associated with being male and being of Myanmar ethnicity, with an integrative strategy for acculturation, and with a higher income. Male participants and participants with a lower mean score of marginalization were more likely to smoke. Central obesity was associated with being older than 40 years, being female, engaging in an assimilation strategy, and being uneducated. These findings highlight the need for gender inclusive health promotion, the screening of NCD risk behaviors, and timely health education for migrant workers. It may assist authorities to devise strategies to extend health promotion and universal health coverage to the migrant population.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (T.N.N.A.); (M.Y.)
| | - Yoshihisa Shirayama
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan;
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand;
| | - Thaworn Lorga
- School of Nursing, Mae Fah Luang University, Chiang Rai 57000, Thailand;
| | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (T.N.N.A.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan;
| | - Myo Nyein Aung
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan;
- Advanced Research Institute for Health Sciences, Juntendo University, 2 Chome-1-1 Hongo, Bunkyo City, Tokyo 113-8421, Japan
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35
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Aung MN, Yuasa M, Koyanagi Y, Aung TNN, Moolphate S, Matsumoto H, Yoshioka T. Sustainable health promotion for the seniors during COVID-19 outbreak: a lesson from Tokyo. J Infect Dev Ctries 2020; 14:328-331. [PMID: 32379708 DOI: 10.3855/jidc.12684] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/28/2020] [Indexed: 12/19/2022] Open
Abstract
The COVID-19 pandemic is novel corona virus infection outbreak that has gone global in 2020. Current prevention policies consist of hand hygiene and social distancing. Emergencies overloaded health services and shocked the logistics chains in many countries, especially Italy and China. Having more than a quarter of its population being elderly, Japan is at high risk for COVID-19 induced morbidity and mortality. This situation cancelled schedules of all routine group exercise activities for the seniors in Japan. While the outbreak is ongoing, staying at home is safe. However, successive days of being house-ridden and limited movement can lead to excessive physical inactivity. Some elderly who are not moving much can lose a significant amount of muscle strength, flexibility and aerobic capacity. It can accelerate the frailty and dependency of the seniors, and subsequently, claiming of care and health services. Moreover, existing and new evidences showed that physical activity can promote antiviral immunity. An alternative to usual group exercise activities is crucial to keep seniors active without affecting social distancing. While staying at home for long, functional exercises maintaining basic level of physical activity and movements are urgently required to be introduced to the seniors in Tokyo and around the world to prevent functional decline. Home exercise is a practical option. Therefore, we made a home-version of the functional training exercise video with different sets of 10-minutes exercise for 7 days a week. This breakthrough alternative may sustain health promotion for the elderly persons to preserve their active aging and maintain optimal health.
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Aung TNN, Shirayama Y, Moolphate S, Aung MN, Lorga T, Yuasa M. Health risk behaviors, musculoskeletal disorders and associated cultural adaptation, depression: a survey among Myanmar migrant workers in Chiangmai, Northern Thailand. Int J Gen Med 2019; 12:283-292. [PMID: 31616175 PMCID: PMC6698613 DOI: 10.2147/ijgm.s207022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/04/2019] [Accepted: 07/10/2019] [Indexed: 11/23/2022] Open
Abstract
Background and purpose When migrants go to a new country to work, they experience transition of epidemiological risk factors, a new system of access to healthcare and changing life styles. Their comprehension of health risk factors will depend on acculturation pattern. Moreover, musculoskeletal disorders (MSDs) are significantly prevalent in such a population due to the manual work in their jobs. Myanmar immigrant’s acculturation level has not yet been studied in relation to prevalent diseases. This study aimed to investigate health risk behaviors, the prevalence of musculoskeletal disorders, and associated factors. Methods A cross-sectional study surveyed 414 Myanmar migrant workers in Chiangmai, Thailand. Face-to-face interviews administered structured questionnaires which comprised the transculturally validated East Asian Acculturation Measure scale, Standardized Nordic musculoskeletal questionnaires, Patient Health Questionnaires 2 and 9 for depression and questionnaires to screen health behaviors and jobs. Data analysis applied binary logistic regression. Results About 26.3% were current smokers and 40.8% current drinkers. Of the 75.8% of participants did not exercise, 40.1% were overweight and obese, 44.7% had prehypertension, 27.1% hypertension, and 13% had depression. The prevalence of MSDs at any site over the previous 12 months was 53.4% and it was significantly associated (P-value≤0.05) with female (adjusted odd ratio (aOR)=1.75; 95% confidence interval (CI)=1.04–2.94), depression (aOR=2.19;CI=1.10–4.39), marginalization pattern of acculturation (aOR=1.87;CI=1.09–3.21) and MSDs at any site last week (aOR=8.41;CI=4.09–17.30). Conclusion Health behaviors in this young, working migrant population are risky, and MSDs are common problems for migrant workers in northern Thailand. Findings of the current study highlighted health behaviors and cultural adaption as attributes to chronic, disabling, and common health problems of migrant workers. Public health interventions and recommendations considering this evidence may improve migrants’ health status, leading to better quality-of-life and productivity.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | | | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiangmai, Thailand
| | - Myo Nyein Aung
- Advanced Research Institute for Health Science, and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Thaworn Lorga
- Department of Research and Community Engagement, Research Coordinating Unit, Boromrajonani College of Nursing, Nakhon Lampang, Thailand
| | - Motoyuki Yuasa
- Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
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Chen WT, Shiu C, Yang JP, Tun MMM, Zhang L, Wang K, Chen LC, Aung MN, Lu H, Zhao H. Tobacco use and HIV symptom severity in Chinese people living with HIV. AIDS Care 2019; 32:217-222. [PMID: 31116021 DOI: 10.1080/09540121.2019.1620169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Exposure to nicotine among people living with HIV (PLWH) may impact physical health as indicated by experienced symptoms. Yet, the empirical evidence documenting the relations between tobacco use and symptom experiences among PLWH remains limited. This study aims to assess the relationships between tobacco use and HIV symptoms through a cross-sectional survey conducted in Beijing and Shanghai. The WHO ASSIST screening test was used for frequency of tobacco use. Sixty-four items from the revised signs and symptoms checklist for persons with HIV disease (SSC-HIVrev) were used. "Total number of symptoms" was created by summing all the binary coded and "Maximal symptom severity" was created by taking the maximal severity level across all symptoms for each participant. After controlling for confounding variables, tobacco use was not associated with the total number of symptom, yet was associated with the maximal symptom severity. This study documents the link between tobacco use and experienced symptoms among PLWH by demonstrating that higher frequency of tobacco use is associated with greater odds of reporting more severe symptoms. Smoking cessation strategies should be integrated into symptom management interventions for PLWH to optimize their effectiveness.
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Affiliation(s)
- Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Chengshi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Joyce P Yang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,VA Palo Alto Health Care System, National Center for PTSD, Palo Alto, CA, USA
| | - Myo Mie Mie Tun
- The Union, Integrated HIV Care (IHC) Program, Shan State, Myanmar
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China
| | - Kerong Wang
- Beijing Ditan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Li-Chen Chen
- School of Nursing, National Cheng Kung University, Tainan, Taiwan
| | - Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China
| | - Hongxin Zhao
- Beijing Ditan Hospital, Capital Medical University, Beijing, People's Republic of China
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Aung MN, Yuasa M, Moolphate S, Lorga T, Yokokawa H, Fukuda H, Kitajima T, Tanimura S, Hiratsuka Y, Ono K, Thinuan P, Minematsu K, Deerojanawong J, Suya Y, Marui E. Effectiveness of a new multi-component smoking cessation service package for patients with hypertension and diabetes in northern Thailand: a randomized controlled trial (ESCAPE study). Subst Abuse Treat Prev Policy 2019; 14:10. [PMID: 30795811 PMCID: PMC6387550 DOI: 10.1186/s13011-019-0197-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 02/08/2019] [Indexed: 11/21/2022]
Abstract
Background Smoking cessation is an achievable behavioral change, which reduces the risks of cardiovascular diseases, cancers and tobacco-related diseases. There is a need for an effective smoking cessation service for low and middle income country settings where the smoking rate is generally very high whilst a cessation service is not usually accessible. This study devised a new smoking cessation service package and assessed its effectiveness in the primary health care setting of northern Thailand. Methods This randomized controlled trial was centered at Maetha district hospital, Lampang province, Thailand, and its network of mobile non-communicable disease clinics at seven primary care units. A total of 319 eligible patients who consented to participate in the study, were randomly allocated to an intervention arm (160) and a control arm (159), applying block randomization. The multi-component intervention service consisted of:regular patient motivation by the same nurse over a 3-month period; a monthly piCO+ Smokerlyzer test for 3 months; continual assistance from a trained family member, using a smoking-cessation- diary; and optional nicotine replacement chewing gum therapy.
The control group received the routine service comprising of brief counseling and casual follow-up. Smoking cessation, confirmed by six months of abstinence and the piCo+ Smokerlyzer breath test, was compared between the two services after a year follow-up. The trial is registered as an international current control trial at the ISRCTN registry. ISRCTN89315117. Results The median age of the participants was 64 years, with females constituting 28.84%. Most of the participants smoke hand-rolled cigarettes (85%). The intervention arm participants achieved a significantly higher smoking cessation rate than the control arm 25.62% vs 11.32%, with an adjusted odd ratio of 2.95 and 95% confidence interval 1.55–5.61. Conclusion In relation to accessing smoking cessation services within the primary health care setting, participants who received the evidence-based intervention package were about three times more likely to succeed in giving up smoking than those who received the routine service. Utilizing community resources as major intervention components, the evidence from this trial may provide a useful and scalable smoking cessation intervention for low and middle income countries. Trial registration Current controlled trials ISRCTN89315117. WHO international clinical trial identifier number: U1111–1145-6916; 3/2013.
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Affiliation(s)
- Myo Nyein Aung
- Advanced Health Science Institute, and Faculty of International Liberal Arts, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan. .,WHO Collaborating Center for Medical Education, Faculty of Medicine, Chulalogkorn University, 5th fl Ananda Mahidol Building, 1873 Heneri Dunant road, Pathuwam, Bangkok, 10330, Thailand.
| | - Motoyuki Yuasa
- Faculty of International Liberal Arts and Department of Public Health, School of Medicine, Juntendo University , Tokyo, Japan
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, Thailand
| | | | - Hirohide Yokokawa
- Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroshi Fukuda
- Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | | | - Susumu Tanimura
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshimune Hiratsuka
- Department of Opthalmology, Juntendo University School of Medicine, Tokyo, Japan
| | - Koichi Ono
- Department of Opthalmology, Juntendo University School of Medicine, Tokyo, Japan
| | | | - Kazuo Minematsu
- Graduate School of Education, Nagasaki University, Nagasaki, Japan
| | - Jitladda Deerojanawong
- WHO Collaborating Center for Medical Education, Faculty of Medicine, Chulalogkorn University, 5th fl Ananda Mahidol Building, 1873 Heneri Dunant road, Pathuwam, Bangkok, 10330, Thailand
| | | | - Eiji Marui
- Department of Human Arts and Sciences, University of Human Arts and Sciences, Saitama, Japan
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Chen WT, Shiu C, Yang JP, Li CSR, Wang K, Zhang L, Zhang J, Bao M, Aung MN, Chen LC, Zhao H, Lu H. Substance use, anxiety, and self-management efficacy in HIV-positive individuals: A mediation analysis. J Subst Use 2018; 23:408-414. [PMID: 30906222 DOI: 10.1080/14659891.2018.1436603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Context In China, the social stigma of both substance use and HIV remains major barriers. HIV+ individuals have been demonstrated to have higher psychosocial distress in the literature. To ensure quality of life among HIV+ Chinese individuals, self-efficacy in HIV-related management including substance use and anxiety is the key to suppress viral load and maintain healthy lives. Objectives We examine the mediation relationship among substance use, anxiety, and self-management efficacy. Method A cross-sectional study design was used. 137 HIV+ individuals were recruited from two premier Chinese hospitals: Beijing's Ditan Hospital and Shanghai's Public Health Clinic Center (SPHCC). Results HIV+ substance users had significantly lower HIV-management efficacy and higher anxiety scores. About a third of the relations between substance use and anxiety was mediated by HIV-management self-efficacy. Those who used substances in the previous week had higher anxiety levels suggesting the presence of a recent effect. Their higher levels of anxiety could be largely explained by their lower HIV-management efficacy. Conclusion It is useful for healthcare providers to assess substance use behaviors in HIV+ individuals as well as provide support in managing anxiety in this population. Meanwhile, enhancing self-management efficacy to ensure healthy lifestyles may support achieving optimal lives with HIV.
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Affiliation(s)
- Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA
| | - Chengshi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA
| | - Joyce P Yang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Chiang-Shan Ray Li
- Psychiatry and of Neuroscience, School of Medicine, Yale University, New Haven, CT
| | - Kerong Wang
- Ditan Hospital, Capital Medical University, Beijing, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jing Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Meijuan Bao
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | | | - Li-Chen Chen
- National Cheng Kung University, School of Nursing, Tainan, Taiwan
| | - Hongxin Zhao
- Ditan Hospital, Capital Medical University, Beijing, China
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Aung MN, Moolphate S, Kitajima T, Siriwarothai Y, Takamtha P, Katanyoo C, Okamura H, Field M, Noyama O, Deerojanawong J, Klinbuayaem V. Perceived stigma of HIV patients receiving task-shifted primary care service and its relation to satisfaction with health service. J Infect Dev Ctries 2017; 11:697-704. [PMID: 31600161 DOI: 10.3855/jidc.9461] [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: 05/28/2017] [Accepted: 09/22/2017] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION HIV stigma is the remaining challenge to end the global epidemics of HIV. Whether stigma may form a barrier to the provision of ART within the community-based, primary care setting was not studied yet. Therefore, this study intended (1) to compare the levels of 'perceived stigma' in PLHIV attending district hospital and primary care units (PCUs), and (2) to measure the relation between HIV stigma and the satisfaction of patients with their health service. METHODOLOGY In this cross-sectional study, two matched PLHIV attending district hospitals were recruited for every PLHIV attending a PCU, within a pilot project, until the end of 2014. 198 informed and consented participants were recruited. We used validated Thai version instruments to measure the levels of 'perceived stigma' and 'internal shame' and the Patient Satisfaction Questionnaire 18 (PSQ18) to measure patients' satisfaction with the health service. Analysis applied MANOVA and multivariate robust regression. RESULTS The level of 'perceived stigma' and 'internal shame' levels were not significantly different between district hospitals attendants and PCU attendants (P>0.05 MANOVA). Moreover, the more patients were satisfied with the health service, the less likely to have 'perceived stigma' (β -5.9, 95% confidence interval -7.7 to -4.1) and 'internal shame' (β -5.7, 95% CI -8.3 to -3.2), P<0.001). CONCLUSIONS HIV associated stigma would be minimized through the attempt to promote PLHIV's satisfaction with ART service. There is ample role of health professional education and training to improve patients' satisfaction. It may contribute to the aim of zero discrimination.
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Affiliation(s)
| | - Saiyud Moolphate
- Faculty of Science and Technology, Chiang Mai Rajabhat University, Thailand.
| | | | | | | | - Chitima Katanyoo
- Faculty of Science and Technology, Chiang Mai Rajabhat University, Thailand.
| | | | - Malcom Field
- Faculty of Social Sciences, Kyorin University, Japan.
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Aung MN, Moolphate S, Aung TNN, Katonyoo C, Khamchai S, Wannakrairot P. The social network index and its relation to later-life depression among the elderly aged ≥80 years in Northern Thailand. Clin Interv Aging 2016; 11:1067-74. [PMID: 27540286 PMCID: PMC4982492 DOI: 10.2147/cia.s108974] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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] [Indexed: 11/28/2022] Open
Abstract
Background Having a diverse social network is considered to be beneficial to a person’s well-being. The significance, however, of social network diversity in the geriatric assessment of people aged ≥80 years has not been adequately investigated within the Southeast Asian context. This study explored the social networks belonging to the elderly aged ≥80 years and assessed the relation of social network and geriatric depression. Methods This study was a community-based cross-sectional survey conducted in Chiang Mai Province, Northern Thailand. A representative sample of 435 community residents, aged ≥80 years, were included in a multistage sample. The participants’ social network diversity was assessed by applying Cohen’s social network index (SNI). The geriatric depression scale and activities of daily living measures were carried out during home visits. Descriptive analyses revealed the distribution of SNI, while the relationship between the SNI and the geriatric depression scale was examined by ordinal logistic regression models controlling possible covariants such as age, sex, and educational attainment. Results The median age of the sample was 83 years, with females comprising of 54.94% of the sample. The participants’ children, their neighbors, and members of Buddhist temples were reported as the most frequent contacts of the study participants. Among the 435 participants, 25% were at risk of social isolation due to having a “limited” social network group (SNI 0–3), whereas 37% had a “medium” social network (SNI 4–5), and 38% had a “diverse” social network (SNI ≥6). The SNI was not different among the two sexes. Activities of daily living scores in the diverse social network group were significantly higher than those in the limited social network group. Multivariate ordinal logistic regression analysis models revealed a significant negative association between social network diversity and geriatric depression. Conclusion Regular and frequent contact with various social contacts may safeguard common geriatric depression among persons aged ≥80 years. As a result, screening those at risk of social isolation is recommended to be integrated into routine primary health care-based geriatric assessment and intervention programs.
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Affiliation(s)
- Myo Nyein Aung
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Saiyud Moolphate
- Department of Public Health, Chiang Mai Rajabhat University, Chiang Mai, Thailand
| | | | - Chitima Katonyoo
- Department of Public Health, Chiang Mai Rajabhat University, Chiang Mai, Thailand
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Aung MN, Somboonwong J, Jaroonvanichkul V, Wannakrairot P. Assessment of preclinical students' academic motivation before and after a three-day academic affair program. Int J Gen Med 2016; 8:373-80. [PMID: 26719719 PMCID: PMC4687725 DOI: 10.2147/ijgm.s93649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 11/23/2022] Open
Abstract
Background Medical students’ motivation is an important driving factor for academic performance, and therefore medical teachers and educators are often highly interested in this topic. This study evaluated the impact of an academic affair program upon preclinical year medical students’ motivation to study. Design and methods An intervention study was conducted using a pretest-posttest study design. A total of 296 preclinical year medical students who had just passed their first year and were about to attend their second year at the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, participated in the study. The intervention comprised of dialogues for personality development, pictorial expression in groups, as well as small group lectures delivered by senior students giving information on how to prepare for the forthcoming classes. Students’ academic motivation was measured before and after the intervention program, applying the transculturally translated Academic Motivation Scale (AMS). Cronbach’s alpha of Thai version AMS was 0.8992. The average scores in seven scales of AMS were compared between the pre- and posttest results, using the Wilcoxon signed-rank test. The differences were confirmed by using the multivariate analysis of variance. Results Students’ academic motivation increased after participation in the three-day academic program. There was also a significant increase in introjected extrinsic motivation, which can enhance the students’ self-esteem and feeling of self-worth (P<0.001). Moreover, intrinsic motivation toward accomplishment increased significantly (P<0.001). This is related to the enjoyment of passing academic milestones, and a step ahead of autonomous motivation. Amotivation level declined significantly (P<0.001). The change of academic motivational constructs before and after the intervention was altogether significant (P=0.036, multivariate analysis of variance). Conclusion After experiencing a three-day intervention, the new students’ motivation advanced along the continuum of self-determination toward autonomous motivation. Therefore, it is considered to be worthwhile conducting an academic intervention to catalyze the evolution of preclinical year medical students’ academic motivation. Moreover, educators and faculties should evaluate the impact of interventions in evidence-based approaches to secure both controlled and autonomous types of motivation.
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Affiliation(s)
- Myo Nyein Aung
- Medical Education Unit, Chulalongkorn University, Bangkok, Thailand
| | - Juraiporn Somboonwong
- Quality Management Division and Department of Physiology, Chulalongkorn University, Bangkok, Thailand
| | | | - Pongsak Wannakrairot
- Academic Affairs Division, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Aung MN, Moolphate S, Kitajima T, Siriwarothai Y, Takamtha P, Katanyoo C, Okamura H, Field M, Noyama O, Wannakrairot P, Klinbuayaem V. Satisfaction of HIV patients with task-shifted primary care service versus routine hospital service in northern Thailand. J Infect Dev Ctries 2015; 9:1360-6. [PMID: 26719942 DOI: 10.3855/jidc.7661] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 11/16/2015] [Accepted: 11/16/2015] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Shifting the task of HIV care to primary care providers is an important strategy to sustain expanding access to antiretroviral therapy (ART) in high HIV burden countries like Thailand. In a pilot project, the task of following up ART-receiving patients was shifted from a physician-led HIV clinic team based at district level community hospital, to a nurse-led primary healthcare team of seven primary care centers, based at sub-district level in a district of Chiang Mai in northern Thailand. This study aimed to evaluate the task-shifted ART service in a patient-centered approach. METHODOLOGY Patients' satisfaction level was assessed cross-sectionally in a sample of 198 patients, which included 66 people living with HIV (PLHIV) receiving task-shifted ART service and matched controls in a ratio of 1:2. HIV immunological outcome was compared in a retrospective cohort of a year follow-up. Transculturally translated patient satisfaction questionnaire short form (PSQ-18) was used. Multivariate analysis of variance compared seven domains of patients' satisfaction levels. RESULTS Community hospital patients expressed significantly higher levels of satisfaction with the technical quality, communication, and time spent by the service provider, whereas the task-shifted model patients experienced significantly better accessibility and convenience of the service. At the one-year follow up, CD4 counts of the two groups were not significantly different. CONCLUSION Future research and training programs should aim to improve the technical quality and communication skills of nurse-led ART service teams to shift the task of HIV care and sustain expansion of ART access in primary care settings.
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Affiliation(s)
- Myo Nyein Aung
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
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Paudel D, Aung MN, Nguanmoo PS, Suvedi S, Paudel A, Sharma D. Diversity of Hepatitis B genotypes in Nepal and updated Phylogenetic Tree: a Pilot Survey in 2012. JNMA J Nepal Med Assoc 2014; 52:982-991. [PMID: 26982897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Hepatitis B virus (HBV) is a current global health problem. HBV genotypes influence the treatment and long term outcome of HBV infected patients. Moreover, HBV genotypes differ in various region of the world. Such data was reported haphazardly but yet to be comprehensive for Nepal. This study attempted to find out the diverse hepatitis B genotypes in Nepal. METHODS A convenient serum sample of 58 HBsAg positive patients from different parts of the country mainly from Nepalgunj, Palpa and Kathmandu were screened for hepatitis B genotype. Sequencing was done and Phylogenetic tree was created. RESULTS Among 58 samples, 23 were genotype D, 17were genotype A and B wereC/D recombinant. Phylogenetic trees were created by distance-matrix and neighbor-joining analyses after bootstrapping to 1000 replicates. DISCUSSION HBV genotypes A and D are the most common genotype in Nepal. Horizontal transmission is common in these genotypes. C/D recombinant genotype may be transmitted from Tibetan people living in Kathmandu. Prophylactic major controlling, horizontal and cross border transmission could be effective. CONCLUSIONS Three major genotypes of HBV in Nepal were found to be A, C and D. Despite being a low prevalence area, Nepal has a diversity of hepatitis B genotypes Keywords: genotypes; HBV; phylogenetic.
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Affiliation(s)
- D Paudel
- Mid-western regional police hospital, Nepalgunj, Nepal
| | - M N Aung
- Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan, and Boromarajonani College of Nursing, Nakhon Lampang, Lampang, Thailand
| | - P S Nguanmoo
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Thailand
| | - S Suvedi
- Nepalgunj Medical college, Nepalgunj, Nepal
| | - A Paudel
- Prawash medical college, Palpa, Nepal
| | - D Sharma
- Sechenkaruna Hospital, Baudha, Kathmandu, Nepal
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Paudel D, Aung MN, Sharma B, Aung TNN, Moolphate S. Intestinal parasitic infestation in combatants and their families: a hospital-based study in Mid-Western Regional Police Hospital, Nepal. Glob J Health Sci 2014; 6:9-15. [PMID: 24762341 PMCID: PMC4825450 DOI: 10.5539/gjhs.v6n3p9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 01/23/2014] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To find out the scenario of intestinal parasitic infestation in combatants and their families in the setting of Mid-Western Regional Police Hospital (MWRPH), Nepal. STUDY DESIGN Cross-sectional study. METHODS All 2005 patients presented with the complaint of abdominal pain, diarrhoea, frequent defecation, blood in stool, or black stool from August 2007 to February 2011 were offered a stool examination. About 10g of fresh stool was collected in a clean, dry bottle. Two slides from each specimen were examined applying light microscope in 10 and 40 uvf at Banke, Nepalgunj hospital laboratory. RESULT Among 2005 patients, 928 (46.28%) were infested with either helminths and/or protozoa. 96% were single infestation. The most common infestation was Ascaris lumbricoides (48.06%) and the second was hook worm (18.97%). Most common protozoal infestations were Entamoeba histolytica (12.92%) and Giardia lamblia (9.49%). Helminthic infestations peaked in cool months and protozoal infestations were rather steady throughout the year. CONCLUSION Very high parasitic infestation in least developed mid- western Nepal may need urgent public health intervention.
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Affiliation(s)
| | - Myo Nyein Aung
- Juntendo University Graduate School of Medicine, Japan; Boromarajonani College of Nursing, BCNLP, Thailand; Chaingmai Rajabhat University, Thailand.
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Aung MN, Yuasa M, Lorga T, Moolphate S, Fukuda H, Kitajima T, Yokokawa H, Minematsu K, Tanimura S, Hiratsuka Y, Ono K, Naunboonruang P, Thinuan P, Kawai S, Suya Y, Chumvicharana S, Marui E. Evidence-based new service package vs. routine service package for smoking cessation to prevent high risk patients from cardiovascular diseases (CVD): study protocol for randomized controlled trial. Trials 2013; 14:419. [PMID: 24308874 PMCID: PMC4028806 DOI: 10.1186/1745-6215-14-419] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 11/21/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking cessation is a high-priority intervention to prevent CVD events and deaths in developing countries. While several interventions to stop smoking have been proved successful, the question of how to increase their effectiveness and practicality in developing countries remains. In this study, a newly devised evidence-based smoking cessation service package will be compared with the existing service in a randomized controlled trial within the community setting of Thailand. METHOD/DESIGN This randomized control trial will recruit 440 current smokers at CVD risk because of being diabetic and/or hypertensive. Informed, consented participants will be randomly allocated into the new service-package arm and the routine service arm. The study will take place in the non-communicable disease clinics of the Maetha District Hospital, Lampang, northern Thailand. The new smoking-cessation service-package comprises (1) regular patient motivation and coaching from the same primary care nurse over a 3-month period; (2) monthly application of piCO + smokerlyzer to sustain motivation of smoker's quitting attempt and provide positive feedback over a 3-month period; (3) assistance by an assigned family member; (4) nicotine replacement chewing gum to relieve withdrawal symptoms. This new service will be compared with the traditional routine service comprising the 5A approach in a 1-year follow-up. Participants who consent to participate in the study but refuse to attempt quitting smoking will be allocated to the non-randomized arm, where they will be just followed up and monitored. Primary outcome of the study is smoking cessation rate at 1-year follow-up proven by breath analysis measuring carbomonoxide in parts per million in expired air. Secondary outcomes are smoking cessation rate at the 6-month follow-up, blood pressure and heart rate, CVD risk according to the Framingham general cardiovascular risk score, CVD events and deaths at the 12-month follow-up, and the cost-effectiveness of the health service packages. Intention-to-treat analysis will be followed. Factors influencing smoking cessation will be analyzed by the structure equation model. DISCUSSION This multicomponent intervention, accessible at primary healthcare clinics, and focusing on the individual as well as the family and social environment, is unique and expected to work effectively. TRIAL REGISTRATION Current Controlled Trials ISRCTN89315117.
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Affiliation(s)
- Myo Nyein Aung
- Department of Public Health, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
- Boromrajonani College of Nursing Nakhon Lampang (BCNLP), Lampang, Thailand
| | - Motoyuki Yuasa
- Department of Public Health, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Thaworn Lorga
- Boromrajonani College of Nursing Nakhon Lampang (BCNLP), Lampang, Thailand
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, Thailand
| | - Hiroshi Fukuda
- Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Tsutomu Kitajima
- Graduate School of International Cooperation Studies, Kyorin University, Hachioji, Japan
| | - Hirohide Yokokawa
- Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuo Minematsu
- Department of Public Health, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Susumu Tanimura
- Department of Public Health, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yoshimune Hiratsuka
- Department of Health and Welfare Services, National Institute of Public Health, Wako, Japan
| | - Koichi Ono
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan
| | | | - Payom Thinuan
- Boromrajonani College of Nursing Nakhon Lampang (BCNLP), Lampang, Thailand
| | - Sachio Kawai
- Department of Sport Medicine, Juntendo University School of Health and Sport Science, Inba, Japan
| | | | | | - Eiji Marui
- Department of Human Arts Sciences, University of Human Arts and Sciences, Saitama, Japan
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Aung MN, Leowattana W, Win KN, Tangpukdee N, Muangnoicharoen S. Chronic hepatitis B prognostic markers other than pre-treatment viral load predicted composite treatment outcome. J Infect Dev Ctries 2013; 7:541-9. [PMID: 23857389 DOI: 10.3855/jidc.2759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 08/16/2012] [Accepted: 09/06/2012] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Chronic hepatitis B (CHB) is a globally common infectious disease. Its clinical course is complicated. In Southeast Asia, nucleos(t)ide analogues (NA) are commonly used drugs for CHB treatment. Composite treatment outcome has often been used in CHB clinical practice, but rarely predicted epidemiologically. This study aimed to compare the composite treatment outcome between CHB patients with low and high treatment-naïve viral load, and to identify its predictors METHODOLOGY This retrospective cohort study followed up 95 CHB patients on NA treatment for a year. Composite treatment outcome was defined as undetectable HBV DNA level, ALT normalization and, HBeAg clearance in the case of HBeAg-positive patients. Multinomial logistic regression analysis was applied to analyze the significant treatment response predictors. RESULTS Complete composite treatment outcome was achieved by 52% of CHB patients with an initial viral load < 6.5 log 10 copies /ml, but 31% of those had an initial viral load ≥ log 6.5 log 10 copies /ml. Outcome was predicted by HBeAg negativity (adjusted relative risk ratio, aRRR = 11.1, 95 % confidence interval, CI 3-41.3) and ALT normalization within the sixth month of therapy (aRRR = 6.7, CI 1.8-24.9). An elevation of ALT to more than 1.5 times the normal value (40 IU/ml) can lead to an incomplete response on NA therapy (aRRR = 6.2, CI 1.5-26.6.) CONCLUSION Routine clinical markers other than pre-treatment viral load predicted composite CHB outcome on NA Therapy.
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Affiliation(s)
- Myo Nyein Aung
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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Lorga T, Aung MN, Naunboonruang P, Junlapeeya P, Payaprom A. Knowledge of communicable and noncommunicable diseases among Karen ethnic high school students in rural Thasongyang, the far northwest of Thailand. Int J Gen Med 2013; 6:519-26. [PMID: 23843701 PMCID: PMC3702227 DOI: 10.2147/ijgm.s44902] [Citation(s) in RCA: 9] [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] [Indexed: 01/19/2023] Open
Abstract
Background The double burden of communicable and noncommunicable diseases (NCD) is an increasing trend in low- and-middle income developing countries. Rural and minority populations are underserved and likely to be affected severely by these burdens. Knowledge among young people could provide immunity to such diseases within a community in the long term. In this study we aimed to assess the knowledge of several highly prevalent NCDs (diabetes, hypertension, and chronic obstructive pulmonary disease [COPD]) and several highly incident communicable diseases (malaria and diarrheal diseases) among Karen high school students in a rural district in far northwest of Thailand. The aim of the study is to explore information for devising life-course health education that will be strategically based in schools. Method A cross-sectional survey approved by the ethics committee of Boromarajonani College of Nursing Nakhon Lampang (BCNLP), Lampang, Thailand was conducted in Thasongyang, Tak province, from September 2011 to January 2012. Questionnaires for assessing knowledge regarding diabetes, hypertension, COPD, malaria, and diarrheal diseases were delivered to all 457 Karen high school students attending Thasongyang high school. A total of 371 students returned the questionnaires. Experts’ validation and split-half reliability assessment was applied to the instrument. Results Students’ main sources of health information were their teachers (62%), health care workers (60%), television (59%), and parents (54%). Familial risk factors of diabetes and hypertension were not known to more than two thirds of the students. Except obesity and physical inactivity, lifestyle-related risk factors were also not known to the students. Though living in a malaria-endemic area, many of the Karen students had poor knowledge about preventive behaviors. Half of the students could not give a correct answer about the malaria and hygienic practice, which might normally be traditionally relayed messages. Conclusion Health education and knowledge about common NCD and communicable diseases are yet to be prompted among the Karen students. A broader and more comprehensive school-based health education strategy for prevention of double burden diseases would benefit the rural minority population at the Thai-Myanmar border.
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Affiliation(s)
- Thaworn Lorga
- Boromarajonani College of Nursing Nakhon Lampang (BCNLP), Lampang, Thailand
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Aung MN, Moolphate S, Paudel D, Jayathunge Ph M, Duangrithi D, Wangdi K, Aung TNN, Lorga T, Higuchi K. Global evidence directing regional preventive strategies in Southeast Asia for fighting TB/HIV. J Infect Dev Ctries 2013; 7:191-202. [PMID: 23492996 DOI: 10.3855/jidc.2903] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Revised: 12/04/2012] [Accepted: 11/28/2012] [Indexed: 10/31/2022] Open
Abstract
Tuberculosis (TB) and human immunodeficiency virus (HIV) co-epidemics form a huge burden of disease in the Southeast Asia region. Five out of eleven nations in this region are high TB/HIV burden countries: Myanmar, Thailand, India, Indonesia and Nepal. The trends of TB incidence in these countries have been rising in recent years, in contrast to a falling global trend. Experts in the field of TB control and health service providers have been perplexed by the association of TB and HIV infections which causes a mosaic clinical presentation, a unique course with poor treatment outcomes including death. We conducted a review of contemporary evidence relating to TB/HIV control with the aims of assisting integrated health system responses in Southeast Asia and demystifying current evidence to facilitate translating it into practice.
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Affiliation(s)
- Myo Nyein Aung
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan.
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Kantipong P, Murakami K, Moolphate S, Aung MN, Yamada N. Causes of mortality among tuberculosis and HIV co-infected patients in Chiang Rai, Northern Thailand. HIV AIDS (Auckl) 2012; 4:159-68. [PMID: 23071410 PMCID: PMC3469094 DOI: 10.2147/hiv.s33535] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The case fatality rate in patients with tuberculosis (TB) associated with human immunodeficiency virus (HIV) has been particularly high in Chiang Rai, Northern Thailand. It was almost 50% before the introduction of antiretroviral therapy in the last decade, and was still at 28% in 2008, despite expanding access to antiretroviral therapy. Reviewing the causes of death may lead to further understanding of the timeline and natural history of TB-HIV coinfection, and in so doing help to devise an effective prevention strategy in Chiang Rai. In this study, we aimed to investigate the distribution of confirmed causes of death in patients coinfected with TB and HIV in Chiang Rai, describe the causes of such deaths along the timeline of TB treatment, and identify predictors of each cause of death. METHODS In this retrospective study, we reviewed the causes of death for 331 patients who died of TB-HIV coinfection at Chiang Rai Prachanukroh Hospital from 2005 to 2008. Causes of death were confirmed by reviewing medical records, vital registration, and the TB register in the province, as well as obtaining reconfirmation by two experienced HIV physicians. RESULTS The confirmed causes of death were TB (39%), acquired immune deficiency syndrome (AIDS)-related opportunistic infections other than TB (AOI) (29%), and other systemic diseases which were neither TB nor AIDS-related opportunistic infections (nonTB-nonAOI) (16%). The definitive cause could not be confirmed in the remaining 16% of deaths. After starting the TB treatment, deaths caused by TB occurred earlier compared with deaths caused by AOI, which occurred steadily throughout the course of TB treatment, whilst deaths caused by non-TB-nonAOI increased gradually in later months. Further analysis by multivariate multinomial regression analysis showed that deaths in the first month (adjusted odds ratio [aOR] 4.64, 95% confidence interval [CI] 2.49-8.63), CD4 count ≥ 200 cells/mm(3) (aOR 5.33, CI 1.05-26.10), non-category 1 TB treatment regimens (aOR 5.23, CI 1.04-9.77), and TB meningitis (aOR 3.27, CI 1.37-7.82) were significant predictors of confirmed TB deaths. Moreover, age over 45 years (aOR 3, CI 1.32-6.84) and admission as an inpatient were predictors of death caused by neither TB nor AIDS-related opportunistic infections (aOR 3.08, CI 1.39-6.80). Additional analysis showed that non-Thai patients (aOR 0.35, CI 0.12-0.99), those with an unknown CD4 count at TB diagnosis (aOR 0.16, CI 0.08-0.33), and those without an HIV diagnosis before TB treatment (aOR 0.32, CI 0.18-0.59) were less able to access antiretroviral therapy. CONCLUSION The timeline and predictors of causes of death may assist in devising an intervention strategy for further reduction of the TB-HIV case fatality rate.
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