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Biomedical subjects

S Wakai

Publications and source records attributed to S Wakai.

At least 19 recordsLinked to original sources

Magazine information on safety belt use for pregnant women and young children.

To assess the information on safety belt use for pregnant women and infants in maternity and baby magazines, we reviewed 2003 issues of the three top-selling monthly baby and maternity magazines. Articles on safety belt use during pregnancy and child safety seat (CSS) use for infants, and advertisements of the CSS, automobiles, or CSS-related products were examined for their informational content. Of the 9418 pages in the maternity magazines, 46 pages were on infants, 16 pages on pregnant women and 162 pages displayed advertisements. Of the 9750 pages in the baby magazines, 34 pages of articles addressed CSS use; no articles addressed the issue of pregnant women; 83 pages were advertisements. Although the magazines showed accurate information in general; its amount was not sufficient, and little specific information on appropriate use and selection of a CSS was seen. Some information was misleading and even incorrect: specifically related to when to start using a forward-facing seat, what products are attachable to the CSS, and the reuse of a CSS. Greater amounts and accuracy of safety information in these magazines would help pregnant women and parents acquire important safety knowledge that healthcare providers are falling short of providing in Japan.

Adult↗

Unintentional injuries among school adolescents in Kathmandu, Nepal: a descriptive study.

OBJECTIVE: To describe detailed mechanisms and activities at the time of unintentional injuries among adolescents in Kathmandu, Nepal. METHODS: A school-based study was conducted on 1557 students in grades 6-8 across 14 schools, using a self-administered questionnaire during August-September 2003. Mechanisms and activities were coded using the Nordic Medico Statistical Committee's classification. FINDINGS: Falls (65%) and cuts (63%) were the most common injuries, followed by transport-related injuries (36%) and burns (22%). In urban areas, falls (59%) were the most common injuries, followed by transport-related injuries (50%); in semi-urban areas, falls (66%) and cuts (65%) were the most common injuries, followed by transport-related injuries (34%). At the time of falls, boys were generally engaged in sports while girls were engaged in walking on streets or on stairs in houses, in both areas. Falls from trees among boys and falls from roofs among girls were also common in semi-urban areas. Cut injuries while processing food were common among boys and girls in both areas, whereas agricultural work was also a source of injury in semi-urban areas. Pedestrian injuries were common during transport among boys and girls in both areas; boys in semi-urban areas were almost equally likely to be injured during cycling. Burn injuries while cooking and serving food were more common among girls in semi-urban areas. CONCLUSION: Falls, cuts, transport-related injuries, and burn injuries were quite prevalent among adolescents in Kathmandu. The reported injury mechanisms and activities posing injury risks have implications for future interventions.

Adolescent↗

Use of rapid diagnostic tests for malaria in an emergency situation after the flood disaster in Mozambique.

OBJECTIVES: To determine how diagnosis of malaria may be improved by combining the use of rapid diagnostic tests (RDTs) for Plasmodium falciparum malaria with clinical diagnosis by the presence or history of fever compared with clinical diagnosis alone in emergency situations with flood-affected displaced populations in Mozambique. STUDY DESIGN: A cross-sectional study conducted at the emergency outpatient clinic in a village in the Chòkwè district of Gaza Province, 3 weeks after Cyclone Eline hit Mozambique in February 2000. METHODS: A hundred and thirty children aged less than 15 years with clinical malaria were selected for examination by RDT and fluorescent microscopy using acridine orange as a reference test. The diagnosis of clinical malaria was made by a history of fever in the last three days or axillary temperature above 37.0 degrees C at the time of attending the emergency outpatient clinic. Two positive predictive values were calculated; RDTs combined with clinical diagnosis and clinical diagnosis alone. RESULTS: Positive predictive values of RDTs combined with clinical diagnosis by the presence of fever or history of fever were 87.6% (92/105) (95% confidence interval (CI) 80.8-92.8) compared with 74.6% (97/130) (95% CI 66.2-81.8) for clinical diagnosis alone. Five patients were diagnosed false negative. CONCLUSION: RDTs combined with clinical diagnosis has sufficient positive predictive value to be used in emergency situations, while RDTs could result in increasing failure to treat when they are used for decisions of treatment compared with clinical diagnosis alone.

Adolescent↗

Nutritional status and associated factors in children aged 0-23 months in Granada, Nicaragua.

OBJECTIVES: Nicaragua is one of two low-income countries in the Latin Americas. The objectives of this study were to clarify the nutritional status of children aged 0-23 months and to identify the associated factors in rural Nicaragua. STUDY DESIGN AND METHODS: This was a cross-sectional study; a questionnaire survey was performed and anthropometric measurements were taken in Granada province, Nicaragua. RESULTS: Seven hundred and fifty-six mothers with at least one child aged 0-23 months took part in this study. The proportion of underweight children [weight-for-age Z-score <-2 standard deviations (SD)] was 10.3%, while 30.1% of children exhibited stunted growth (height-for-age Z-score <-2 SD) and 5.0% were wasted (weight-for-height Z-score <-2 SD). Mothers' illiteracy or lack of formal education [odds ratio (OR)=3.476, P<0.01], a history of respiratory infection (OR=1.821, P<0.05) and a birth weight below the median (<3000 g; OR=1.704, P<0.05) were identified as risk factors for stunted growth. Breastfeeding for more than 12 months (OR=2.031, P<0.01), absence of participation in child growth monitoring (OR=1.956, P<0.05) and female gender of the child (OR=1.884, P<0.05) were identified as risk factors for underweight. DISCUSSION: Despite the steady economic development in Nicaragua since 1990, child nutritional status has not improved as much as might be expected. The present study revealed that a mother's favourable sociodemographic characteristics and her active participation in health activities, such as child growth monitoring, can protect against child malnutrition, particularly against underweight. More attractive health education or antenatal care programmes might lead to substantial improvements in maternal and child health in this small, poor community.

Adult↗

Oral health status of vulnerable groups in a village of the Central Highlands, southern Vietnam.

OBJECTIVES: Oral health status of vulnerable people in developing countries tends to be given lower priority than other health issues. Consequently, few studies have examined the oral health status of the poor and minorities in developing countries. We aim to examine the dental caries and periodontal status, and explore the risk indicators of dental caries between two ethnic groups in rural villages in southern Vietnam. METHODS: We examined the caries status and its risk indicators of 150 participants (Co-Ho minority and Kinh majority) living in a hamlet of Dangphuong village in Vietnam. We also assessed periodontal status of the participants aged 14 and over by Community Periodontal Index. RESULTS: We first found that dental caries were highly prevalent among both the Co-Ho minority and Kinh majority groups. Second, the higher numbers of dental caries among children with primary teeth were associated with a higher frequency of consuming sweets. Third, most people (87%) aged 14 and over had periodontal problems. Finally, the Kinh majority tended to have more dental caries than Co-Ho among people aged less than 30. CONCLUSION: Oral health promotion should be considered as a part of the development programmes for vulnerable groups in Vietnam and other developing countries.

Adolescent↗

Herbal medicine use and quality of life among people living with HIV/AIDS in northeastern Thailand.

Many people living with HIV/AIDS (PHA) use herbal medicine as one of alternative therapies, where curative options are limited. This study aimed to examine the association between the herbal medicine use and quality of life (QOL) among PHA in northeastern Thailand. Participants were 132 HIV-positive Thai adults who attended the PHA's self-help group meetings from June to July 2002. Health-related QOL scores were measured by self-administered questionnaire from the Medical Outcomes Study-HIV Health Survey. Dimensions of physical function (PF) and mental health (MH) in QOL were assessed. Additional data were collected on herbal medicine use, socio-demographic, psychosocial and HIV-related characteristics. The herbal medicine users had significantly better MH scores than the non-users, while the herbal medicine use was not statistically associated with PF scores. When stratified, herbal medicine users with the following characteristics had significantly better MH scores than the non-users: female, widowed, having no income, reporting any HIV-related symptom, having no instrumental support or receiving subsidies. In conclusion, herbal medicine use was associated with better MH especially among socially vulnerable PHA. This study suggests that herbal medicine has a potential to improve the MH aspect of QOL among socially vulnerable PHA who cannot easily receive antiretroviral therapy in Thailand.

Adult↗

Traditional healers' roles on eye care services in Nepal.

AIM: To evaluate the traditional healer (TH) training programme carried out by Nepal Netra Jyoti Sangh, a non-governmental organisation in Nepal, by measuring the changes in knowledge and practices of trained THs in providing primary eye care services. METHODS: 103 trained THs practising in six districts of Nepal were interviewed with a semistructured questionnaire. Their knowledge about various illnesses and eye care practices were compared before and after the training. RESULTS: A significant change in the number of THs with accurate perceived knowledge about trachoma (28.2% v 70.9%, p<0.0001) and cataract (54.4% v 94.2%, p<0.0001) was found after the training. In total, 98 (95%) THs stopped using traditional eye medicines after receiving the training (p<0.0001). The referral practices of THs improved significantly after the training (15% v 100%, p<0.0001). After the training, 95% of the THs used an eye care kit to treat patients with red eyes and simple ocular trauma. CONCLUSION: The findings show that a TH training programme on primary eye care services convinced traditional healers to stop the use of traditional eye medicines and improve referral practices in Nepal.

Adult↗

Nutritional and mental health status of Afghan refugee children in Peshawar, Pakistan: a descriptive study.

The study sought to ascertain and describe the physical and mental health states of Afghan refugee children after the terrorist attack on September 11, 2001 in the US and the aerial bombing of Afghanistan that followed. A cross-sectional survey was carried out in four refugee camps in Peshawar, Pakistan from February to March 2002, and comparisons among camps were made. A total of 70 males (mean age SD = 9.81 +/- 1.98 years old) and 30 females (7.94 +/- 2.07) answered a self-developed questionnaire on demographic data, traumatic events experience, living environment in the camps, and physical and mental health, through interviews. Anthropometric measures were measured and physical symptoms including anaemia and edema were assessed. Severe malnutrition was not shown and there were no significant differences in most nutritional and physical states among the camps. Nevertheless, in the newer camps more children experienced war related traumatic events. Mental symptoms were prevalent in all camps, though the characteristics of the symptoms differed among the camps.

Afghanistan↗

Exploratory study on psychosocial impact of the severe acute respiratory syndrome (SARS) outbreak on Chinese students living in Japan.

The aim of this study is to explore the impact of the 2003 SARS outbreak on Chinese students living in Japan. A cross-sectional study was conducted using a semi-structured questionnaire. The participants were recruited at multiple locations at the University of Tokyo, Japan. The results showed approximately 60% (96/161) of the respondents felt an impact of SARS on college life; they had experienced SARS-related fear, worry, depression as well as social discrimination and had taken SARS prevention measures for daily protection in Japan during the epidemic. The magnitude of the impact was associated with socio-demographic factors, including their age, specialty, area of previous residence in China and length of stay in Japan. The findings suggest that the SARS outbreak had a psychosocial impact on the Chinese students living in Japan, even though none of them had SARS. Social support tailored for these foreign students should be provided during such a disease outbreak.

Adult↗

Geographical characterization of the triatomine infestations in north-central Guatemala.

In an entomological study in 2002, the degree of domestic and peridomestic infestation with triatomine bugs and the geographical distribution of such infestations were investigated in north-central Guatemala. The survey team searched for triatomines in houses constructed with mud walls or thatched roofs, in villages suspected of being infested. The level of infestation observed was lower than that seen in the same area and in eastern Guatemala, in a preliminary survey, 3 years earlier. Most of the infestations detected were of Triatoma dimidiata but even this species was found in <7% of the houses investigated. Infestations with Rhodnius prolixus or other potential vectors of Trypanosoma cruzi were much rarer. The generally low levels of infestation make the elimination of R. prolixus and the reduction of the domestic population of Tri. dimidiata feasible in the study area. The southern part of the study area had higher levels of domestic infestation and colonization than the north, and peridomestic infestation was highest in the south-west. Given such geographical variation in the pattern of infestation, it would seem wise to stratify the study region into areas of high, moderate and low-risk of human-triatomine contact, so that appropriate vector-control strategies can be targeted at the worst-affected areas. Regular entomological surveillance, ideally with community participation, is recommended. Analysis of the relationship between the geographical patterns of infestation and factors such as vegetation, altitude and vector migration would be useful.

Animals↗

Refugee participation in health relief services during the post-emergency phase in Tanzania.

INTRODUCTION: While community participation in health activities has been examined extensively after Alma-Ata, few studies have focused on beneficiary participation in health services in a humanitarian disaster relief programme. This research scrutinized refugee participation in encamped health services, explored its achievement, and identified the further needs of refugees in pursuit of enhanced health services in the camp. METHODS: The study was performed at Lugufu Camp, Tanzania, where a health information team (HIT) of Congolese refugees actively participated in health services. Structured questionnaires were used for this cross-sectional observational study, covering three types of respondents: i.e. (1) systematically selected refugee community members (n=576); (2) all HIT members (n=48); and all Tanzanian health staff in charge of preventive health (n=17). Additional information was also collected through focus group discussions. RESULTS: HIT refugees used their own health initiatives, which resulted in a growth of self-confidence. There was an evidence of benefits, especially in promoting health education, affirmed by an almost established consensus among the refugee community, Tanzanian health staff and HIT members themselves. However, refugee community members who did not know any HIT members had less positive health-seeking behaviours than those who knew one or more HIT members, thus showing a need for further dissemination of HIT services. CONCLUSIONS: Participation in the health services led the HIT refugees to regain the sense that they could contribute to solving peers' health problems with their own knowledge and services, and by working together as a team. Beneficiary participation is a dynamic process that heightened responsibility and health consciousness, along with a concomitant gain in power over their destiny.

Adult↗

Comparison of health-seeking behaviour between poor and better-off people after health sector reform in Cambodia.

This study compared health-seeking behaviour between poor and better-off people after health sector reform in Cambodia. The survey was conducted in the Prek Dach Health Centre coverage area, which is located in South-east Cambodia. The study population consisted of 257 housewives of reproductive age, selected at random. Data were collected through household surveys with a structured questionnaire. Data collected included socio-demographic information on the housewives, as well as episodes of illness of family members within 30 days prior to the survey. Two indicators, the floor area of living space and a rating scale on asset ownership, were used to identify poor and very poor people. When a family member became ill, subjects most often used home remedies as a first step, followed by self-medication. Subsequently, people used self-medication or the private health sector. Very poor people used the health centre more often than better-off people as a first step. For the second step, use of the health centre was also high among the poor compared with better-off people, although the difference was not statistically significant. Keeping the treatment fees low and abolishing informal fees maintained the affordability of health-centre services for the poor. However, this benefit diminished quickly with distance from the health centre. The significant difference between poor and better-off people disappeared for villages situated more than 2 km from the health centre. Thus, the health centre in the studied area was shown to be effective in providing primary health care to the economically disadvantaged, but only within a limited geographic area.

Adolescent↗

Obstacles to modern contraceptive use among married women in southern urban Maldives.

This study aimed to clarify the current state of, and factors associated with, modern contraceptive use among married women in the Maldives. A total of 205 women participated in interviews with structured questionnaires. Four sessions of FGIs were conducted to obtain in-depth information about the problems that they faced in using modern contraceptives. Both modern contraceptive users (MCUs) and those who were not modern contraceptive users (NMCUs) had a good knowledge of, and availability and accessibility to, contraceptives and social support for contraceptive use. NMCUs were more likely to have a husband who disapproved of modern contraceptive practice, to have difficulty communicating with their husband, to be afraid of side effects and to be dissatisfied with sexual sensation when using modern contraceptives. Moreover, NMCUs cited more perceived barriers against the use of modern contraceptives and preferred larger families than MCUs.

Adult↗

Anemia and iron deficiency among schoolchildren in the Aral Sea region, Kazakhstan.

The objectives of this study were to estimate the prevalence of anemia and iron deficiency among schoolchildren in the Aral Sea region of Kazakhstan and to determine the various factors associated with anemia in this population. We conducted a cross-sectional study of randomly selected schoolchildren. Blood samples were collected for measuring hemoglobin (Hb), serum ferritin (SF), total iron binding capacity (TIBC), and other hematological indices, and subjects were screened for anemia and iron deficiency. Associations between Hb concentration and SF, TIBC, anthropometric, and socioeconomic data were evaluated using regression analysis. The prevalence of anemia was 49.8 per cent although levels were mostly mild. Twenty-two per cent of the children were iron depleted (SF < 12 microg/l). Of the anemic children, 32.4 per cent were found to have iron deficiency anemia (anemia with SF < 12 microg/l). There were significant positive correlations between the levels of Hb and SF, but a negative correlation with serum TIBC. Age, mean corpuscular volume (MCV) and SF were found to be significantly related to Hb by stepwise multiple regression analysis. Multiple logistic regression analysis revealed that anemia was independently related to living district, education of father, and child's age. The results suggest that iron deficiency is an important determinant of anemia in this population; however, whole anemia cannot be solely explained by iron deficiency. Further studies are needed for consideration of micronutrients status, parasite infestation, hereditary disorders, and exposure to environmental pollutants.

Adolescent↗

Seatbelt legislation in Japan: high risk driver mortality and seatbelt use.

OBJECTIVES: To clarify why seatbelt legislation did not achieve the expected reduction in mortality in Japan. LOCATION AND BACKGROUND: Seatbelt legislation was enacted in Japan in September 1985 and penalties were introduced in November 1986. METHODS: The driver deaths per vehicle km traveled (D/VKT) were calculated to adjust for changes in traffic volume. Decreases in D/VKT were compared with the reduction expected after legislation. The association between percentage changes of driver D/VKT, seatbelt use rate, and seatbelt non-use rate were explored. Deaths of passengers, pedestrians, and cyclists were also examined. Mortality data were obtained from vital statistics, traffic volume figures from the Ministry of Land, Infrastructure, and Transport, and seatbelt use rates from the National Police Agency. RESULTS: Although the decrease in D/VKT after the law was enforced was larger than the absolute number of deaths, it was far less than predicted. The percentage decrease in seatbelt non-use rate showed the strongest correlation with the percentage decrease in driver mortality. Mortality did not increase among other road users after the law was enacted. CONCLUSION: Accurate evaluation of the effect of seatbelt legislation must take into account changes in traffic volume. The selective recruitment hypothesis-that high risk drivers were less responsive to seatbelt legislation-fits well with the findings. There was no conclusive evidence supporting risk compensation-that is, an increase in injuries among other road users.

Accidents, Traffic↗