ABSTRACT
Objective@#To identify individual characteristics related to the development of pulmonary tuberculosis (PTB) among residents in the Airin area (Airin), Osaka City, Japan.@*Methods@#We conducted a retrospective case-control study of individual characteristics potentially related to the development of PTB by comparing PTB patients and residents without tuberculosis (TB) in Airin. The following binominal data of characteristics were compared: age (<65 or >65); body mass index (BMI) (<18.5 or >18.5); diabetes mellitus (diagnosed or not diagnosed); smoking (currently smoking any amount or not smoking); and alcohol use (currently drinking any amount or not drinking).@*Results@#We compared the individual characteristics of 192 PTB patients notified from January 2015 to December 2018 and 190 residents of supportive houses who attended a health education programme from April 2016 to March 2018. Univariable analysis showed that the following characteristics were significantly related with PTB: BMI <18.5 (odds ratio [OR]: 6.54, 95% confidence interval [CI]: 3.58–11.97, P < 0.001) and current alcohol use (OR: 1.88; 95% CI: 1.24–2.85, P = 0.003). Multivariable analysis showed similar results: BMI <18.5 (adjusted odds ratio [aOR]: 6.90, 95% CI: 3.72–12.79, P < 0.001) and current alcohol use (aOR: 2.15, 95% CI: 1.36–3.42, P = 0.001).@*Discussion@#Undernutrition and alcohol use are individual characteristics associated with PTB among residents in Airin, Osaka City. To strengthen the TB control programme further, it is suggested to develop new programmes for primary prevention.
ABSTRACT
In Japan, tuberculosis (TB) control activities are conducted by public health centres (PHCs) and treatment support is provided by public health nurses (PHNs). This study describes the TB situation in the affected areas and assesses the effectiveness of Japan’s TB control efforts after the disaster.
ABSTRACT
The human immunodeficiency virus (HIV) epidemic and dual infection of tuberculosis (TB) and HIV are now altering the role of chest radiography (CR) in TB control. The role has been gaining increasing importance, especially as HIV-associated TB and childhood TB are less likely to show positive smears. However, CR with poor image quality can cause misdiagnoses or require repeated examinations, wasting economic resources and exposing patients to unnecessary radiation. In order to improve the image quality of CR, the Tuberculosis Coalition for Technical Assistance (TBCTA) developed an assessment tool for CR categorized on the basis of six factors as “excellent,” “good,” “fair,” and “poor.” With the aim of disseminating the assessment tool, five-day international training sessions were held in Cambodia and Kenya in 2009. This field report summarizes the international training activities and documents the findings after the trainings.<BR>A total of thirty-four participants from 14 countries were trained and assigned to conduct an assessment upon their return. The results from nine countries showed that the quality of CR ranged from 90% excellent or good in Bangladesh to over 90% fair or poor in Afghanistan. Of 69 health facilities, only 4 apply more than 120kV and above. This is one of the considerable factors behind the sub-optimal quality of CR in these countries.
ABSTRACT
<p><b>OBJECTIVE</b>To ascertain the extent of under-utilization and insufficiency or inappropriateness in provision of health services as one of the possible causes of high mortality from pediatric pneumonia in pilot areas in Vietnam.</p><p><b>METHOD</b>The household survey on morbidity and treatment of acute respiratory infections, simple cough, and cold and pneumonia, was conducted in two communities with 10% sampling of the child population.</p><p><b>RESULTS</b>Both under-treatment of "fast breathing", a proxy for pneumonia, and over-treatment of simple cough and cold with antimicrobials by health workers, mothers, and private practitioners were common.</p><p><b>CONCLUSIONS</b>A household survey on morbidity and treatment was found to be useful to clarify actual practices in the treatment of acute respiratory infections in the community, which cannot be obtained by mere interview with health workers or mothers. Since a change of knowledge did not automatically lead to change of practice, the training of health workers, health education of mothers and provision of antimicrobials at village health stations would not guarantee improved practice of health workers and mothers. Therefore, constant supervision for health workers, continued health education of mothers and involvement of private practitioners are needed to improve the situation.</p>
ABSTRACT
Objective: To ascertain the extent of under-utilization and insufficiency or inappropriateness in provision of health services as one of the possible causes of high mortality from pediatric pneumonia in pilot areas in Vietnam. Method: The household survey on morbidity and treatment of acute respiratory infections, simple cough, and cold and pneumonia, was conducted in two communities with 10% sampling of the child population. Results: Both under-treatment of “fast breathing”, a proxy for pneumonia, and over-treatment of simple cough and cold with antimicrobials by health workers, mothers, and private practitioners were common. Conclusions: A household survey on morbidity and treatment was found to be useful to clarify actual practices in the treatment of acute respiratory infections in the community, which cannot be obtained by mere interview with health workers or mothers. Since a change of knowledge did not automatically lead to change of practice, the training of health workers, health education of mothers and provision of antimicrobials at village health stations would not guarantee improved practice of health workers and mothers. Therefore, constant supervision for health workers, continued health education of mothers and involvement of private practitioners are needed to improve the situation.