Disaster and public health emergency health data collection and management: A scoping review.

OBJECTIVE: The World Health Organization (WHO) developed the Emergency Medical Team (EMT) Minimum Data Set (MDS) to provide a structured, data-based approach to health data collection and management during disasters and public health emergencies. Given recent creation of the EMT MDS, we conducted a scoping review to gauge current practices surrounding health data collection and sharing in emergent settings. DESIGN: An English-based scoping review of PubMed and Embase databases of publications before June 28, 2021. MAIN OUTCOME MEASURES: The review aimed to identify facilitators and barriers to the implementation of the WHO-standardized health data collection systems in the context of disasters and public health emergencies; characterize best practices regarding implementation of an MDS to improve health data collection capacity in differing settings; and highlight internationally accepted, standardized tools or methods for setting up essential public health data for disaster response. RESULTS: A total of 8,038 citations from PubMed and Embase were imported into Covidence with 46 duplicates removed. Among these, 7,992 citations underwent title screening and abstract review, with 161 articles proceeding to full-text article review where an additional 109 articles were excluded. Fifty-two citations were included in final data abstraction. CONCLUSIONS: Findings revealed a range of critical operational, structural, and functional insights of relevance to implementation of the EMT MDS. The literature identified facilitators and barriers to collecting and storing disaster-based datasets, gaps in standardization of data collection resulting in poor data quality during the transition from the acute to post-acute phase, and best practices in the collection of EMT MDS.

Outbreak of Salmonella Braenderup infection originating in boxed lunches in Japan in 2008.

There have been only 2 reports of a large-scale foodborne outbreak arising from Salmonella enterica serotype Braenderup infection worldwide. On August 9, 2008, an outbreak originating in boxed lunches occurred in Okayama, Japan. We conducted a cohort study of 786 people who received boxed lunches from a particular catering company and collected 644 questionnaires (response rate:82%). Cases were defined as those presenting with diarrhea (≧4 times in 24h) or fever (≧38℃) between 12 am on August 8 and 12 am on August 14. We identified 176 cases (women/men:39/137);younger children (aged＜10 years) appeared to more frequently suffer severe symptoms. Three food items were significantly associated with higher risk of illness;tamagotoji (soft egg with mixed vegetables and meat) (relative risk (RR):11.74, 95% confidence interval (CI):2.98-46.24), pork cooked in soy sauce (RR:3.17, 95% CI:1.24-8.10), and vinegared food (RR:4.13, 95% CI:1.60-10.63). Among them, only the RR of tamagotoji was higher when we employed a stricter case definition. Salmonella Braenderup was isolated from 5 of 9 sampled cases and 6 food handlers. It is likely that unpasteurized liquid eggs contaminated by Salmonella Braenderup and used in tamagotoji caused this outbreak.

[Baseline survey on physician practice and attitude in recommending partner HIV testing].

OBJECTIVES: We studied physician partner testing (PT) practice and obstacles against PT in the clinical settings in Japan. METHODS: Subjects were 513 physicians identified at HIV/AIDS sentinel hospitals. The questionnaire included demographics, current practices, factors for facilitating PT, experience in finding new HIV cases through PT, and information channels for PT. RESULTS: Of physicians interviewed, 66% did PT for all HIV cases, with 37% finding 185 new HIV cases through PT. Physicians reported too little time for PT, together with a lack of legal authorization and standardized educational material. Of those interviewed, 78% did PT orally. CONCLUSIONS: Detecting new HIV cases showed the effectiveness of PT in identifying and diagnosing HIV cases as early as possible in Japan. To expand PT legal authorization, standardized practices, and educational material all require development.

A Feasibility Evaluation of an Employee-led Brief Health Promotion Program to Promote Lifestyle Change in the Workplace.

BACKGROUND: In Japan, lifestyle-related diseases are a major issue. It is necessary to support employees in making lifestyle changes. As a result, this study intended to test and evaluate the feasibility of a brief lifestyle change program led by employees in the workplace. METHODS: A 2-group before-and-after test design was used, with employees from a plant in Japan as participants. Intervention was carried out by healthcare specialists for the Standard Intervention Group, while employees who previously received the same intervention performed it for the Employee-run Group. Data were collected twice with a questionnaire, provided in the first and last program sessions. The conditions of the participants during the intervention were compared. RESULTS: Of all the participants, 96 were in the Standard Intervention Group and 365 were in the Employee-run Group. The mean age did not differ significantly between the 2 groups. There was a significantly higher ratio of men and night shift workers in the Employee-run Group. Although a significantly smaller proportion of participants set shared behavioral goals for 3 people or self-monitored their lifestyle habits in the Employee-run Group, the lifestyle habits of self-checking, physical measurement, and other items for set goals did not differ. CONCLUSIONS: Participants in the Employee-run group completed components of the program to the same extent as those in the Standard Intervention Group, suggesting that this program is feasible. However, as the participation rate was lower in some components, improvements to the program and workbook are needed to make those components easier to complete.

Factors affecting appropriate management of patients with sexually transmitted infections in Japan.

Physicians should educate patients with sexually transmitted infections (STIs) on measures to prevent reinfection and should also undertake human immunodeficiency virus (HIV) testing after diagnosis of STIs. These preventive measures are important, but it is not known to what extent these procedures are followed in Japan. We conducted a cross-sectional study to investigate the proportion of patients with STIs who received appropriate management from physicians, namely recommendation of HIV testing, encouragement of condom use and examination and/or treatment of sexual partners, to elucidate the factors affecting institution of each measure. From a mailshot of 566 physicians, 409 (72.3%) responded, with 176 diagnosing an STI in 967 patients. The proportions applying the 3 measures were low (recommendation of HIV testing:27.0;encouragement of condom use:64.8%;examination of sexual partners:17.5%), and were related to the sex of the patients and numbers of patients diagnosed by the physicians. Female patients received better care than male patients, particularly with respect to recommendation of HIV testing (odds ratio:2.82). Physicians who diagnosed more than 20 STI patients tended not to provide appropriate management. These findings suggest the necessity for better physician management of patients for effective prevention of STIs.

[Testing services for sexually transmitted infections in Japan, public funding for HIV testing compared to public funding for other STI testing].

HIV and other STIs testing services of public funded setting have not been integrated in Japan. Public health centers and other public funded testing sites provide free anonymous HIV test. This has been playing an important role to confirm almost half of asymptomatic patients. Early diagnosis is an essential intervention for personal health, and critical for preventative strategies of public health. However, the role of public health centers and other public funded testing sites are very limited for other STIs. The symptomatic patients visit private clinic/hospital for diagnosis and treatment, but it is difficult for asymptomatic person to visit such medical facilities. The prevalence of genital chlamydia in young women in Japan remains very high compared to other developed countries. So, I think public funding of testing for genital chlamydia and other asymptomatic STIs should be expanded and integrated with HIV testing programs in Japan. Recently, there is the problem of the shortage of OB/GY doctors and clinics. This might influence the accessibilities of STIs testing and treatment opportunities for women. This is a new problem of STI testing in Japan.

Current state and need for improvement of system for antibody testing and counseling for HIV infection at public health centers in Japan.

BACKGROUND: Public Health Centers (PHCs) throughout Japan have been playing a role in preventing HIV in Japan. The number of HIV seropositive persons and AIDS patients is increasing from year to year in Japan. METHODS: A survey regarding the HIV antibody test was sent out to 594 PHCs between January 1997 and December 2001. The response rate was 73.9%. In order to assess the HIV testing system at PHCs, Pearson's correlation coefficient, an analysis of variance (ANOVA) and multiple regression analysis were used. RESULTS: There was a difference in the demand for HIV antibody tests according to area. The change in number of HIV antibody tests per 100,000 persons was high in metropolitan areas during the 5-year period. It was influenced by two factors; population density and ratio of daytime population to nighttime population. Rate of examinees who did not return to receive their test results was influenced by the area where the PHC was located. CONCLUSIONS: PHCs need to establish an HIV testing system which reflects the characteristics of the area and meets the needs of people who want to get tested.

Nosocomial Serratia marcescens outbreak in Osaka, Japan, from 1999 to 2000.

OBJECTIVES: To investigate and control an outbreak of bloodstream infections (BSIs) caused by Serratia marcescens and to identify risk factors for respiratory colonization or infection with S. marcescens. DESIGN: Epidemiologic investigation, including review of medical and laboratory records, procedural investigations, pulsed-field gel electrophoresis (PFGE) typing of environmental and patient isolates, statistical study, and recommendation of control measures. PATIENTS AND SETTING: All patients admitted to a 380-bed, secondary-care hospital in Osaka Prefecture, Japan, from July 1999 through June 2000 (study period). RESULTS: Seventy-one patients were colonized or infected with S. marcescens; 3 patients who developed primary BSIs on the same ward within 5 days in June 2000 had isolates with indistinguishable PFGE patterns and indwelling intravenous catheters for more than 5 days. On multivariate analysis, among 36 case-patients with positive sputum specimens and 95 control-patients, being bedridden (odds ratio [OR], 15.91; 95% confidence interval [CI95], 4.17-60.77), receiving mechanical ventilation (OR, 7.86; CI95, 2.27-27.16), being older than 80 years (OR, 3.12; CI95, 1.05-9.27), and receiving oral cleaning care (OR, 3.10; CI95, 1-9.58) were significant risk factors. S. marcescens was isolated from the fluid tanks of three nebulizers and a liquid soap dispenser. The hospital did not have written infection control standards, and many infection control practices were found to be inadequate (eg, respiratory equipment was used without disinfection between patients). CONCLUSIONS: Poor hospital hygiene and the lack of standard infection control measures contributed to infections hospital-wide. Recommendations to the hospital included adoption of written infection control policies.