Association between household solid fuel use and tuberculosis: cross-sectional data from the Mongolian National Tuberculosis Prevalence Survey

BACKGROUND@#Tuberculosis (TB) and indoor air pollution (IAP) are equally critical public health issues in the developing world. Mongolia is experiencing the double burden of TB and IAP due to solid fuel combustion. However, no study has assessed the relationship between household solid fuel use and TB in Mongolia. The present study aimed to assess the association between household solid fuel use and TB based on data from the Mongolian National Tuberculosis Prevalence Survey (MNTP Survey).@*METHOD@#The MNTP Survey was a nationally representative population-based cross-sectional survey targeting households in Mongolia from 2014 to 2015, with the aim of evaluating the prevalence of TB. The survey adopted a multistage cluster sampling design in accordance with the World Health Organization prevalence survey guidelines. Clusters with at least 500 residents were selected by random sampling. A sample size of 98 clusters with 54,100 participants was estimated to be required for the survey, and 41,450 participants were included in the final analysis of the present study. A structured questionnaire was used to collect information on environmental and individual factors related to TB. Physical examination, chest X-ray, and sputum examinations were also performed to diagnose TB.@*RESULTS@#The use of solid fuels for heating (adjusted odds ratio (aOR): 1.5; 95% confidence interval (CI): 1.1-2.1), male gender (aOR: 2.2; 95% CI: 1.6-3.2), divorced or widowed (aOR: 2.6; 95% CI: 1.7-3.8), daily smoker (aOR: 1.8; 95% CI: 1.3-2.5), contact with an active TB case (aOR: 1.7; 95% CI: 1.2-2.3), being underweight (aOR: 3.7; 95% CI: 2.4-5.7), and previous history of TB (aOR: 4.3; 95% CI: 3.0-6.1) were significantly associated with bacteriologically confirmed TB after adjusting for confounding variables.@*CONCLUSION@#The use of solid fuels for heating was significantly associated with active TB in Mongolian adults. Increased public awareness is needed on the use of household solid fuels, a source of IAP.

Trunk-to-peripheral fat ratio predicts a subsequent blood pressure in normal-weight pubertal boys: a 3-year follow-up of the Kitakata Kids Health Study

BACKGROUND@#Limited evidence exists regarding the relationship between central-to-peripheral fat ratio measured by dual-energy X-ray absorptiometry (DXA) and subsequent cardiometabolic risk in both pediatric and adult populations.@*METHODS@#The present cohort study investigated the relationship between DXA-measured body fat distribution and cardiometabolic parameters. The source population was 275 4th-6th graders (aged 9.6-12.6 years) in the northeast region of Japan (Shiokawa area in Kitakata). A 3-year follow-up was conducted to obtain complete information from 155 normal-weight children (87 boys and 68 girls). Normal-weight children were identified using sex- and age-specific international cut-offs for body mass index (BMI) based on adult BMI values of 25 kg/m and 18.5 kg/m, respectively. Body fat distribution was assessed using the trunk-to-appendicular fat ratio (TAR) and trunk-to-leg fat ratio (TLR) measured by DXA.@*RESULTS@#In boys, systolic blood pressure (SBP) at follow-up showed a significant relationship with TAR at baseline after adjusting for age, height, pubic hair appearance, SBP, and whole body fat at baseline (β = 0.24, P < 0.05), and SBP also showed a significant relationship with TLR after adjusting for confounding factors including whole body fat (β = 0.25, P < 0.05). In girls, there were no significant relationships between blood pressure and TAR/TLR.@*CONCLUSION@#Body fat distribution in normal-weight boys predicted subsequent blood pressure levels in adolescence. The relationship between fat distribution and blood pressure was independent of fat volume.

Coal burning-derived SO and traffic-derived NO are associated with persistent cough and current wheezing symptoms among schoolchildren in Ulaanbaatar, Mongolia

BACKGROUND@#Children in Ulaanbaatar are exposed to air pollution, but few epidemiological studies have been conducted on the effects of environmental risk factors on children's health. Also, no studies have yet examined the prevalence of respiratory symptoms in children in suburban areas, where air quality-monitoring stations have not yet been installed. This cross-sectional study evaluated the associations between outdoor air pollution and respiratory symptoms among schoolchildren in urban and suburban districts of Ulaanbaatar.@*METHODS@#The ATS-DLD-78 C questionnaire was used to investigate the respiratory symptoms of schoolchildren aged 6-12 years (n = 1190) who lived in one of three urban districts or a suburban district of Ulaanbaatar. In each district, the outdoor concentrations of nitrogen dioxide (NO) and sulfur dioxide (SO) were measured at two sites (at ≤100 m and > 100 m from the nearest major road) in the 2-year period from 2015 to 2016. The associations between health outcomes and exposure to air pollutants were estimated using the multinomial logistic regression method.@*RESULTS@#The outdoor concentration of SO was significantly associated with persistent cough symptom (OR = 1.12, 95% CI 1.04-1.22). Furthermore, the outdoor concentration of NO was significantly associated with the current wheezing symptom (OR = 1.33, 95% CI 1.01-1.75) among children in urban and suburban.@*CONCLUSIONS@#The prevalence of persistent cough symptom was markedly high among the schoolchildren in urban/suburban districts of Ulaanbaatar. Overall, the increases in the prevalence of respiratory symptoms among children might be associated with ambient air pollution in Ulaanbaatar.

The First Case in Japan of Severe Human Leptospirosis Imported from Vietnam

Leptospirosis is a worldwide zoonosis and common in tropical and subtropical areas with high rainfall. It should be noted as an imported infectious disease although it is sporadic in Japan. Some imported cases already have been reported in Japan and these cases occurred mainly in Southeast Asia. The case discussed in this article is the first reported Japanese case infected in Vietnam. Four days after returning back to Japan after a two-week stay in the mountain area near Hue, in the middle part of Vietnam, the patient suddenly experienced chills, a high fever, sore throat, gastrocnemius pain, and headache. Conjunctival jaundice, renal function disorder, and proteinuria were observed on the third day of onset. Significant increase in antibody titers against serovar Australis and Autumnalis strains was observed in paired serum samples by microscopic agglutination test (MAT). Consequently we recognized this case as a diagnosis of severe leptospirosis (Weil’s disease). Finally, renal function disorder did not deteriorate further, and then the patient recovered after the tenth day of onset with the administration of antibiotics and supportive care without sequelae. We experienced the first imported Japanese case of severe human leptospirosis infection from Vietnam that was successfully treated with ceftriaxone and minocycline.

Effect of dietary protamine on lipid metabolism in rats

Protamine has been widely used as a pharmaceutical product and natural food preservative. However, few studies have been conducted to assess the beneficial function of dietary protamine. This study examined the effects of dietary salmon protamine on serum and liver lipid levels and the expression levels of genes encoding proteins involved in lipid homeostasis in the liver of rats. Groups of male Wistar rats were fed AIN93G diet containing 2% or 5% protamine. After 4 weeks of feeding these diets, markedly decreased serum and liver cholesterol (CHOL) and triacylglycerol levels were noted. Increased activity of liver carnitine palmitoyltransferase-2 and acyl-CoA oxidase, which are key enzymes of fatty acid beta-oxidation in the mitochondria and peroxisomes, was found in rats fed on protamine. Furthermore, rats fed protamine showed enhanced fecal excretion of CHOL and bile acid and increased liver mRNA expression levels of ATP-binding cassette (ABC) G5 and ABCG8, which form heterodimers and play a major role in the secretion of CHOL into bile. The decrease in triacylglycerol levels in protamine-fed rats was due to the enhancement of liver beta-oxidation. Furthermore, rats fed protamine exhibited decreased CHOL levels through the suppression of CHOL and bile acid absorption and the enhancement of CHOL secretion into bile. These results suggest that dietary protamine has beneficial effects that may aid in the prevention of lifestyle-related diseases such as hyperlipidemia and atherosclerosis.

A METHOD FOR BLOOD EXAMINATIONS IN OVERSEAS MOBILE CLINICS: CLINICAL APPLICATION IN THE RURAL AREAS OF LAO PDR

We conducted an overseas mobile clinic in Lao PDR and examined the results of biochemical tests and blood examinations. For the biochemical tests, we used a method involving plasma skimming film and filter paper, called “plasma separation plate.” In this study, we report the usefulness of the plasma separation plate, which is a newly developed method for the screening of biochemical tests in Japan. We were able to apply this method in a mobile clinic in Lao PDR. The quantitative concentration of plasma from blood collected from pricked fingers was measured by this method. Using the plasma skimming film and filter paper, the non-cell components in the blood were separated, and a quantity of the plasma was adsorbed by filter paper. Neither elaborate equipment nor electricity was required. The results of our test data indicated that few inhabitants suffered from adult diseases for which we were screening. We concluded, therefore, that this method is suitable for use in mobile clinics in the rural areas of developing countries.