An analysis of factors contributing to household transmission of COVID-19-using data from active epidemiological investigations performed in the Setagaya ward of Tokyo, Japan.

An active epidemiological investigation of COVID-19 cases in the Setagaya ward of Tokyo revealed that household transmission was the main route of infection spread. This study aimed to identify the factors affecting household transmission in patients diagnosed with COVID-19 and their cohabitants, during the wild type virus (December 2020) and alpha variant epidemic (May 2021). Index case factors significantly associated with household transmission for both wild type (WT) and alpha variant (AV), were at least 3 days from onset to diagnosis (WT: risk ratio [RR] 1.44, 95% confidence interval [CI] 1.16-1.79/AV: RR 1.66, CI 1.32-2.08), and a household size of three or more people (WT: RR 1.37, CI 1.10-1.72/AV: RR 1.29, CI 1.05-1.59). There were also significant differences in age ≥ 65 (RR 2.39, CI 1.26-4.54) and symptomatic at diagnosis (RR 3.05, CI 1.22-7.63) in index cases of WT. Among cohabitants, factors associated with household transmission for both strains were being the spouse/partner of the index case (WT: RR 1.68, CI 1.21-1.82/AV: RR 1.97, CI 1.59-2.43) and at least 3 days from onset to diagnosis of the index case (WT: RR 1.48, CI 1.34-2.10/ AV: RR 1.86, CI1.52-2.28). Early diagnosis and isolation are effective for preventing household transmission.

Disparity in the Burden of Caring for Older Persons between Families Living in Housing Estates and Traditional Communities in Thailand.

Thailand's rapid population aging and reliance on family-based long-term care requires research into disparities in family caregiver burden. Since the type of residence matters to the caregiving outcome, this research aimed to examine the difference in caregiver burden between residents of private housing estates and traditional village communities. This cross-sectional study was conducted with 1276 family caregivers of community-dwelling Thai older adults, in Chiang Mai province, Thailand. The caregiver burden was examined using the Caregiver Burden Inventory (CBI), and the care recipients' dependency status was examined using Barthel's Activity of Daily Living (ADL). Descriptive analysis, multivariate analysis of variance test, and multiple logistic regression analysis were performed. Family caregivers living in a traditional village community were 1.607 times more likely to experience emotional burden (adj. OR 1.607, 95% CI: 1.049, 2.462) and 2.743 times more likely to experience overall caregiver burden (adj. OR: 1.163, 95% CI: 1.163, 6.471) compared to those in the private housing estate group. Our findings showed significant differences in caregiver burden based on residential area, contributing with insights to evidence-based policies, interventions, and programs to minimize disparities and promote family caregivers' health and well-being.

Prevalence and social determinants of depression: A cross-sectional survey of Myanmar migrant workers in Chiang Mai, Northern Thailand.

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.

Association Between Dietary Habits and Type 2 Diabetes Mellitus in Thai Adults: A Case-Control Study.

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.

Exploring the contribution of Japan's experience in addressing rapid aging in Asia: Focus on dementia care.

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.

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.

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.

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.

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.

Roles of Social Protection to Promote Health Service Coverage among Vulnerable People toward Achieving Universal Health Coverage: A Literature Review of International Organizations.

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.

COVID-19 Phobia among Korean, Chinese, and Japanese students: An international comparative study.

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.

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.

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.

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.

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.

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.

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/.

Characteristics and Treatment Outcomes among Migrants with Pulmonary Tuberculosis: A Retrospective Cohort Study in Japan, 2009-2018.

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.

Determinants of Health-Related Quality of Life Among Community-Dwelling Thai Older Adults in Chiang Mai, Northern Thailand.

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.

Depression and Associated Factors among Community-Dwelling Thai Older Adults in Northern Thailand: The Relationship between History of Fall and Geriatric Depression.

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.

Digitally Inclusive, Healthy Aging Communities (DIHAC): A Cross-Cultural Study in Japan, Republic of Korea, Singapore, and Thailand.

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.

Comparison of the Causes of Death Identified Using Automated Verbal Autopsy and Complete Autopsy among Brought-in-Dead Cases at a Tertiary Hospital in Sub-Sahara Africa.

BACKGROUND: Over one-third of deaths recorded at health facilities in Zambia are brought in dead (BID) and the causes of death (CODs) are not fully analyzed. The use of automated verbal autopsy (VA) has reportedly determined the CODs of more BID cases than the death notification form issued by the hospital. However, the validity of automated VA is yet to be fully investigated. OBJECTIVES: To compare the CODs identified by automated VA with those by complete autopsy to examine the validity of a VA tool. METHODS: The study site was the tertiary hospital in the capital city of Zambia. From September 2019 to January 2020, all BID cases aged 13 years and older brought to the hospital during the daytime on weekdays were enrolled in this study. External COD cases were excluded. The deceased's relatives were interviewed using the 2016 World Health Organization VA questionnaire. The data were analyzed using InterVA, an automated VA tool, to determine the CODs, which were compared with the results of complete autopsies. RESULTS: A total of 63 cases were included. The CODs of 50 BID cases were determined by both InterVA and complete autopsies. The positive predictive value of InterVA was 22%. InterVA determined the CODs correctly in 100% cases of maternal CODs, 27.5% cases of noncommunicable disease CODs, and 5.3% cases of communicable disease CODs. Using the three broader disease groups, 56.0% cases were classified in the same groups by both methods. CONCLUSION: While the positive predictive value was low, more than half of the cases were categorized into the same broader categories. However, there are several limitations in this study, including small sample size. More research is required to investigate the factors leading to discrepancies between the CODs determined by both methods to optimize the use of automated VA in Zambia.

Prevalence and Risk Factors for Hypertension among Myanmar Migrant Workers in Thailand.

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.

Age-Friendly Environment and Community-Based Social Innovation in Japan: A Mixed-Method Study.

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. 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. A quantitative study applied the World Health Organization (WHO) framework of 20 age-friendly environmental factors with analysis applying a structural equation model. A qualitative study applied focus group meetings and in-depth interviews to conduct a thematic analysis of Japanese community residents' activities according to the WHO scope of CBSI for healthy aging. 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 aging. 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 coronavirus disease 2019 pandemic as those are the paths leading to healthy aging communities and quality of older residents' life. The lessons learned 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.

Association between Dietary Habits and Type 2 Diabetes Mellitus in Yangon, Myanmar: A Case-Control Study.

In Myanmar, the escalating prevalence of type 2 diabetes mellitus (T2DM) and impaired glucose tolerance among adults was recently reported, with the highest prevalence in the Yangon Region. The aim of the present study was to identify the risk factors in dietary habits and their relationship with T2DM in urban Myanmar residents. We conducted a case-control study recruiting 300 individuals aged 25-74 years living in the Yangon Region, consisting of 150 newly diagnosed cases attending a diabetes clinic, and 150 controls, who were community residents and free of diabetes. The case group had a significantly higher consumption of noodles, fish, beans, fermented food and pickles, dried food, topping seasonings, and non-dairy milk products than the control group, whereas they had a lower vegetable intake (more than three servings/day) and fruit intake (more than three servings/day) than the control group. Furthermore, the case group exhibited a higher frequency of some dietary behaviors than the control group, such as (1) having meals with family, (2) skipping breakfast, and (3) eating out. The final model showed that topping seasonings (adjusted odds ratio (aOR) 11.23, 95% confidence interval (CI) 3.08-40.90), more than three servings/day of vegetable intake (aOR 0.18, 95% CI 0.05-0.67), and having meals with family (aOR 2.23, 95% CI 1.05-4.71) were associated with diabetes. The study suggests that Myanmar's characteristic dietary culture of topping their meals with salty seasonings and sauces and eating multiple dishes together as a family are risk factors associated with T2DM. Our findings may contribute recommendations and opportunities for the primary prevention of T2DM in urban Myanmar.