Parental decision-making on human papillomavirus vaccination for daughters in Japan.

BACKGROUND: In June 2013, the fear of adverse events compelled the government to withdraw its recommendation of the Human papillomavirus (HPV) vaccine. Since then, the rate of vaccination among Japanese girls has dropped dramatically. OBJECTIVE: This study aims to assess how the Japanese government's policy change against HPV vaccination influenced the degree to which parents in remote areas in Japan accepted the vaccine for their daughters, and to analyze related factors. METHODS: A self-administered questionnaire was distributed to parents with daughters attending secondary schools or high schools in two remote areas of the country. RESULTS: Out of 700 eligible parents, 246 (35%) responded. The percentage of parents in the "accept group" (those whose daughters had already been vaccinated or those who intended to have their daughters vaccinated) dropped from 54% before the government withdrew its HPV vaccine recommendation to only 4.5% after the withdrawal (1.5% of whom intended to vaccinate and 3% of whom had already had their daughters vaccinated). Vaccine acceptance was higher in parents who were employed as healthcare workers, had been educated through to the completion of high school, had good levels of knowledge about cervical cancer and the HPV vaccine, had low perceived barriers against the HPV vaccine, and received high levels of social support. CONCLUSION: The acceptance of HPV vaccination among parents was low overall. Higher acceptance may be possible if the government restores its recommendation and healthcare providers disseminate appropriate information about the HPV vaccination and cervical cancer.

Factors associated with pneumococcal vaccination in elderly people: a cross-sectional study among elderly club members in Miyakonojo City, Japan.

BACKGROUND: Pneumonia is the third leading cause of death in Japan. All elderly people aged 65 years or older are recommended to receive a pneumococcal vaccine. A subsidy for part of the cost of routine pneumococcal vaccination in this age group was introduced in 2014. Factors related to vaccination behavior among elderly adults have not been well reported. The purpose of this study was to investigate factors associated with vaccine uptake among elderly people in Japan. METHODS: We conducted a cross-sectional study, using a self-administered questionnaire among elderly club members aged 65 years or older in one city of Japan in April 2017. The participants were selected from among all elderly club members in the study area. Variables extracted from the questionnaire were analyzed using logistic regression analysis. RESULTS: A total of 208 elderly club members participated in the study. The mean age (± SD) was 77.2 (± 5.3) years. The pneumococcal vaccination rate was 53.2%. Logistic regression analysis revealed three variables that had a significant association with pneumococcal vaccination: a recommendation for vaccination from medical personnel (aOR 8.42, 95% CI 3.59-19.72, p <  0.001), receiving influenza vaccination in any of the previous three seasons (aOR 3.94, 95% CI 1.70-9.13, p = 0.001), and perception of the severity of pneumonia (aOR 1.23, 95% CI 1.03-1.48, p = 0.026). CONCLUSIONS: Although the pneumococcal vaccination rate in this study was increased compared with previous reports, almost half of study participants had not yet received vaccination. Our findings could be helpful for developing vaccination strategies to increase the vaccine coverage in the elderly population.

Factors influencing preventive behaviors for dengue infection among housewives in Colombo, Sri Lanka.

Dengue is an infectious disease prevalent in Sri Lanka. Some factors may influence preventive behaviors. This cross-sectional study aimed to determine the knowledge, attitude, and preventive behaviors associated with dengue and analyzed the factors influencing preventive behaviors among housewives in Colombo, Sri Lanka. The analytical study was designed, and data were collected using a structured questionnaire. The χ(2) test and binary logistic regression were used to analyze data. The mean age of housewives was 39.41 years, 91% were married, 52% were Buddhist, and 46.5% had a family monthly income of 15 000 to 25 000 rupees. The knowledge of dengue preventive behaviors was 69.2%. The majority (91.5%) had a positive attitude toward dengue prevention. Only 39.3% used a mosquito net, and 89.3% had water storage container covers. Overall, 58.5% were knowledgeable about preventive measures. Age, religion, family income, education, knowledge, and attitude were associated with preventive behaviors. These findings are useful for dengue control in Colombo.

Comparison of contact patterns relevant for transmission of respiratory pathogens in Thailand and The Netherlands using respondent-driven sampling.

Understanding infection dynamics of respiratory diseases requires the identification and quantification of behavioural, social and environmental factors that permit the transmission of these infections between humans. Little empirical information is available about contact patterns within real-world social networks, let alone on differences in these contact networks between populations that differ considerably on a socio-cultural level. Here we compared contact network data that were collected in The Netherlands and Thailand using a similar online respondent-driven method. By asking participants to recruit contact persons we studied network links relevant for the transmission of respiratory infections. We studied correlations between recruiter and recruited contacts to investigate mixing patterns in the observed social network components. In both countries, mixing patterns were assortative by demographic variables and random by total numbers of contacts. However, in Thailand participants reported overall more contacts which resulted in higher effective contact rates. Our findings provide new insights on numbers of contacts and mixing patterns in two different populations. These data could be used to improve parameterisation of mathematical models used to design control strategies. Although the spread of infections through populations depends on more factors, found similarities suggest that spread may be similar in The Netherlands and Thailand.

Online respondent-driven sampling for studying contact patterns relevant for the spread of close-contact pathogens: a pilot study in Thailand.

BACKGROUND: Information on social interactions is needed to understand the spread of airborne infections through a population. Previous studies mostly collected egocentric information of independent respondents with self-reported information about contacts. Respondent-driven sampling (RDS) is a sampling technique allowing respondents to recruit contacts from their social network. We explored the feasibility of webRDS for studying contact patterns relevant for the spread of respiratory pathogens. MATERIALS AND METHODS: We developed a webRDS system for facilitating and tracking recruitment by Facebook and email. One-day diary surveys were conducted by applying webRDS among a convenience sample of Thai students. Students were asked to record numbers of contacts at different settings and self-reported influenza-like-illness symptoms, and to recruit four contacts whom they had met in the previous week. Contacts were asked to do the same to create a network tree of socially connected individuals. Correlations between linked individuals were analysed to investigate assortativity within networks. RESULTS: We reached up to 6 waves of contacts of initial respondents, using only non-material incentives. Forty-four (23.0%) of the initially approached students recruited one or more contacts. In total 257 persons participated, of which 168 (65.4%) were recruited by others. Facebook was the most popular recruitment option (45.1%). Strong assortative mixing was seen by age, gender and education, indicating a tendency of respondents to connect to contacts with similar characteristics. Random mixing was seen by reported number of daily contacts. CONCLUSIONS: Despite methodological challenges (e.g. clustering among respondents and their contacts), applying RDS provides new insights in mixing patterns relevant for close-contact infections in real-world networks. Such information increases our knowledge of the transmission of respiratory infections within populations and can be used to improve existing modelling approaches. It is worthwhile to further develop and explore webRDS for the detection of clusters of respiratory symptoms in social networks.

Dengue hemorrhagic fever knowledge, perception, and preventive behavior among secondary school students in Bangkok.

OBJECTIVE: To explore dengue hemorrhagic fever (DHF) knowledge, perception, and preventive behavior among secondary school students in Nong-Kheam, Bangkok, Thailand. MATERIAL AND METHOD: A cross-sectional descriptive study was conducted with 300 students between 12 and 16 years old currently attending secondary schools in the Bangkok metropolitan areas using self-administered questionnaires. Data were subsequently summarized using descriptive statistics. RESULTS: Only 18.0% of students had a good level of overall knowledge of DHF but more than half had a good level of perception of DHF The results also revealed that only 4.7% of students had a good level of preventive behavior and 75.6% required improvement. CONCLUSION: The levels of knowledge, perception, and preventive behavior were low. Health education programs should be continued and intensified with emphasis on improving the knowledge of students on prevention and control practices.

Clinical features and differences between child and adult dengue infections in Rayong Province, southeast Thailand.

A retrospective study was conducted among patients with dengue infection admitted to Rayong Hospital during September 2004-September 2005. Data were collected from medical charts and outpatient records created when the patients came to the hospital. Of the patients diagnosed with dengue, only 301 who met the WHO criteria for dengue fever and DHF/DSS were selected. The study cohort was comprised of 147 children (76 males, 71 females) and 154 adults (71 males, 83 females), with an overall mean age of 17.6 years. Some adult clinical symptoms were different from the children. Headache and myalgia were more common among adults (p < 0.05), but cough, vomiting, abdominal pain, and rash were more common among children (p < 0.05). Among the major bleeding symptoms, epistaxis (nasal bleeding) was more common in children (p = 0.012) and gum bleeding was more common in adults (p < 0.001). Myalgia was more likely in less severe grades of infection. Adults showed some different clinical manifestations of dengue infection from children. It is necessary for health personnel to take these differences into consideration when seeing probable cases of dengue infection.

Duplex PCR-hybridization based detection of pathogenic Leptospira in environmental water samples obtained from endemic areas in northeast region of Thailand.

Leptospirosis, a major health problem worldwide, is known to be endemic in the northeastern part of Thailand with the risk of infection by exposure to pathogenic Leptospira in contaminated aquatic environment. A method based on PCR-hybridization detection of pathogenic Leptospira in water was established. The method included filtration of water sample through membrane filters of two pore sizes, DNA extraction from filters using a guanidine thiocyanate extraction method, a duplex-PCR assay with two primer pairs, and hybridization with a synthetic LipL32 DNA probe. The duplex-PCR allowed detection of two products of 279 bp for LipL32 gene and 430 bp for 16S rRNA gene. In water samples artificially seeded with serovar bratislava, at least 10(3) cells could be analyzed by PCR-agarose gel electrophoresis and 1-10 cells by PCR-Southern blot hybridization. The protocol was applied to the detection of pathogenic Leptospira in environmental waters collected from endemic areas in the northeast region of Thailand. Of 100 water samples analyzed, 23 samples were positive for pathogenic Leptospira with PCR performed with Southern blot hybridization only, but none was detected by PCR-agarose gel-electrophoresis. However, PCR performed with the chemiluminescent LipL32 probe using the Fluorescein ULS labeling facilitated the detection of low numbers of pathogenic Leptospira in water. This method should prove useful for monitoring of pathogenic Leptospira pollution in environmental waters, and has the potential to become a valuable tool to the surveillance of leptospirosis in endemic areas, thus leading to enhanced public health protection.

An enrichment broth culture-duplex PCR combination assay for the rapid detection of enterotoxigenic Clostridium perfringens in fecal specimens.

An enrichment broth culture-duplex PCR combination assay was devised to identify Clostridium perfringens directly from fecal samples. The method consists of a combination of short enrichment of samples in selective media, DNA isolation, and performing duplex PCR using two pairs of primers which identify C. perfringens strains that harbor the virulence enterotoxin gene. Comparison of two selective enrichment media and two incubation temperatures showed that the reinforced clostridial medium with neomycin was better than the fluid thioglycollate medium with neomycin (p<0.001); and incubation at 37 degrees C vs 45 degrees C showed no statistically significant difference (p=0.238). The optimal short time for pre-enrichment culture was 4 hours. The developed assay was applied to detect phospholipase C (plc) and enterotoxin (cpe) genes for C. perfringens in feces inoculated artificially with enterotoxigenic C. perfringens. The method could detect both gene products in samples inoculated with a minimum of 10(4) CFU per ml. When the method was applied to detect enterotoxigenic C. perfringens in 198 diarrhea patients, C. perfringens was found in 121 samples; 7 out of 121 samples were positive for both plc and cpe (prevalence of 5.8%). These results indicate that the developed assay was a suitable method for the rapid and specific detection of enterotoxigenic C. perfringens directly in fecal specimens of diarrhea patients, which will assist epidemiological investigations of food poisoning outbreaks and quality control of food products.

Typing of dengue viruses in clinical specimens from central Thailand.

Typing of dengue viruses was done for clinical specimens from a total of 136 patients (children under 15-years-old) suspected of having dengue virus infections and who had been admitted to Pathum Thani Provincial Hospital during the period May 1999 to April 2000. Altogether, 44 strains were isolated (isolation rate: 32.4%), consisting of 18 DEN-1, 18 DEN-2, 7 DEN-3 and 1 DEN-4. The isolation rate decreased according to the number of days after the onset of disease, from day 4 to day 8.