Seroprevalence for severe fever with thrombocytopenia syndrome virus among the residents of Miyazaki, Japan: An epidemiological study.

INTRODUCTION: Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease caused by the SFTS virus (SFTSV). The Miyazaki Prefecture has the highest number of SFTS cases in Japan and requires countermeasures for prevention. In this study, we aimed to conduct an epidemiological survey in Miyazaki Prefecture to determine the exposure conditions of SFTSV by measuring the seroprevalence among residents of Miyazaki and to evaluate the factors that influence the endemicity of SFTS. METHODS: The survey was conducted between June 2014 and April 2019 in all 26 municipalities in Miyazaki Prefecture. SFTSV antibodies were detected using an enzyme-linked immunosorbent assay in the blood samples of 6013 residents (3184 men and 2829 women). A questionnaire-based survey of the living environment was also conducted. RESULTS: Multiple logistic regression analysis revealed that age and occupation were significant factors related to the proportion of participants with an optical density (OD) value > 0.2 and a seroprevalence of 0.9 % (54/6013). Seven seropositive individuals (0.1 %) with an OD value of >0.4 were identified (three men and four women, aged 54-69 years), and all were asymptomatic. One participant had a higher OD than the positive control. CONCLUSION: Although SFTS is endemic in Miyazaki Prefecture, Japan, its seroprevalence is relatively low. Since some risk areas in Miyazaki prefecture have been identified, it is important to enhance awareness of SFTS in residences and reduce contact with ticks, especially in high-risk areas.

Association between lithium in tap water and suicide mortality rates in Miyazaki Prefecture.

BACKGROUND: Most studies have reported that suicide mortality rates are negatively associated with lithium levels in tap water; however, a few studies showed either no association or a positive association. Thus, the association between suicide mortality and lithium levels in tap water remains controversial. To clarify the association, our study evaluated the association between lithium levels in tap water and suicide mortality rates in Miyazaki Prefecture of Japan, after adjusting for confounding factors. METHODS: We measured lithium levels in tap water across the 26 municipalities of Miyazaki Prefecture in Japan. We examined the standardized mortality ratio (SMR) for suicide in each municipality and used the data as the average suicide SMRs over 5 years (2009-2013). Weighted least-squares regression analysis, adjusted for the size of each municipality's population, was used to investigate the association between lithium levels in tap water and suicide SMRs. In addition to a crude model, in an adjusted model, potential confounding factors (proportion of elderly people, proportion of one-person households, annual marriage rate, annual mean income, unemployment rate, the density of medical doctors per 100,000 people, annual total rainfall, and proportion of people with a college education or higher) were added as covariates. RESULTS: We showed that male and female suicide SMRs were not associated with lithium levels in tap water in Miyazaki Prefecture. After adjusting for confounders, male suicide SMRs were significantly and positively associated with the proportion of elderly people in the population and annual total rainfall, and female suicide SMRs were associated with the proportion of elderly people in the population. CONCLUSIONS: No association between lithium levels in tap water and suicide mortality rates was found in Miyazaki Prefecture.

PER1 rs3027188 Polymorphism and its Association with the Risk of Colorectal Cancer in the Japanese Population.

Colorectal cancer(CRC)accounted for the largest number of new cases of cancer in 2018. CRC is caused by a multifactorial disease process including disruption of the circadian rhythm. Period 1(PER1),as one of the circadian genes,has a role in the cell cycle as well as influence on the cancer process. In this research,we investigate the association of PER1(rs3027188) polymorphism and susceptibility to CRC in conjunction with gender and smoking status. This research was a case-control study in the Japanese population which included 121 CRC patients and 197 noncancerous clinical controls. Genomic deoxyribonucleic acid(DNA)was extracted from peripheral blood lymphocytes. The analysis to detect single-nucleotide polymorphisms( SNPs)in PER1(rs3027188)used polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). Overall,there was no significant association between PER1(rs3027188)and CRC. When stratified by gender and smoking status,the results indicated that,compared with the C/C genotype,the G/G genotype among females was significantly less common in the cancer cases than in the controls(adjusted ORs: 0.19[95%CI: 0.04-0.95]). A significant association was found between the G allele of PER1(rs3027188)and reduced risk of CRC in females,while smoking had no association with PER1(rs3027188)in CRC.

Peripheral neuropathy induced by drinking water contaminated with low-dose arsenic in Myanmar.

BACKGROUND: More than 140 million people drink arsenic-contaminated groundwater. It is unknown how much arsenic exposure is necessary to cause neurological impairment. Here, we evaluate the relationship between neurological impairments and the arsenic concentration in drinking water (ACDW). PARTICIPANTS AND METHODS: A cross-sectional study design was employed. We performed medical examinations of 1867 residents in seven villages in the Thabaung township in Myanmar. Medical examinations consisted of interviews regarding subjective neurological symptoms and objective neurological examinations of sensory disturbances. For subjective neurological symptoms, we ascertained the presence or absence of defects in smell, vision, taste, and hearing; the feeling of weakness; and chronic numbness or pain. For objective sensory disturbances, we examined defects in pain sensation, vibration sensation, and two-point discrimination. We analyzed the relationship between the subjective symptoms, objective sensory disturbances, and ACDW. RESULTS: Residents with ACDW ≥ 10 parts per billion (ppb) had experienced a "feeling of weakness" and "chronic numbness or pain" significantly more often than those with ACDW < 10 ppb. Residents with ACDW ≥ 50 ppb had three types of sensory disturbances significantly more often than those with ACDW < 50 ppb. In children, there was no significant association between symptoms or signs and ACDW. CONCLUSION: Subjective symptoms, probably due to peripheral neuropathy, occurred at very low ACDW (around 10 ppb). Objective peripheral nerve disturbances of both small and large fibers occurred at low ACDW (> 50 ppb). These data suggest a threshold for the occurrence of peripheral neuropathy due to arsenic exposure, and indicate that the arsenic concentration in drinking water should be less than 10 ppb to ensure human health.

Determinants of immunization status among 12- to 23-month-old children in Indonesia (2008-2013): a multilevel analysis.

BACKGROUND: Immunization is one of the most cost-effective public health interventions to prevent children from contracting vaccine-preventable diseases. Indonesia launched the Expanded Program for Immunization (EPI) in 1977. However, immunization coverage remains far below the United Nations International Children's Emergency Fund (UNICEF) and World Health Organization (WHO) target of 80%. This study aims to investigate the determinants of complete immunization status among children aged 12-23 months in Indonesia. METHODS: We used three waves of the Indonesian National Socioeconomic Survey (2008, 2011, and 2013) and national village censuses from the same years. Multilevel logistic regression was used to conduct the analysis. RESULTS: The number of immunized children increased from 47.48% in 2008 to 61.83% in 2013. The presence of health professionals, having an older mother, and having more educated mothers were associated with a higher probability of a child's receiving full immunization. Increasing the numbers of hospitals, village health posts, and health workers was positively associated with children receiving full immunization. The MOR (median odds ratio) showed that children's likelihood of receiving complete immunization varied significantly among districts. CONCLUSIONS: Both household- and district-level determinants were found to be associated with childhood immunization status. Policy makers may take these determinants into account to increase immunization coverage in Indonesia.

XPC intron11 C/A polymorphism as a risk factor for prostate cancer.

OBJECTIVES: DNA repair genes play an important role in protection against environmental and endogenous DNA damage, and constitute the first line of defense against cancer. Xeroderma pigmentosum complementation group C (XPC) is involved in the damage recognition step during nucleotide excision repair. The relationship between XPC intron11 C/A polymorphism and cancer risk has not been widely studied. Hence, this study evaluated the relationship between the XPC intron11 C/A polymorphism and prostate cancer risk. MATERIALS AND METHODS: This hospital-based cohort consisted of 152 patients with prostate cancer and 142 male controls. The XPC intron11 C/A genotype was determined using the PCR-RFLP method. Medical, occupational, and cigarette-smoking history was obtained from each participant using questionnaires. RESULTS: Logistic regression analysis revealed that compared to controls, the frequencies of the A/A and C/A genotypes were significantly higher than those of the C/C genotype in cancer patients (OR = 2.03, 95% confidence interval (CI) 1.03-3.98 and OR = 1.91, 95% CI 1.13-3.24, respectively). We also found that the frequency of the A/A genotype was significantly higher in cancer cases than in controls among non-smokers (OR = 7.7, 95% CI 1.38-42.88, compared to the C/C genotype). CONCLUSION: We found that the XPC intron11 C/A polymorphism was associated with an increased risk of prostate cancer. Among non-smokers, the A/A genotype was significantly more prevalent in prostate cancer patients than in controls.

Quantitative effects of a declaration of a state of emergency on foot-and-mouth disease.

OBJECTIVES: The law in Japan requires the declaration of a state of emergency and implementation of countermeasures for an epidemic of a new infectious disease. However, because a state of emergency has never been declared in Japan, its effects remain unknown. The required countermeasures are similar to those implemented in the foot-and-mouth disease epidemic in Miyazaki in 2010. This study aimed to quantitatively estimate the effect of the declaration in 2010 and investigate the nature of the epidemic based on the day on which the declaration took effect. METHODS: Only publicly available data were used. Data for farms in the most affected town were analyzed. A modified susceptible-infected-recovered model was used to estimate the effect and for the simulation. Another model was used to estimate the effective reproduction number. RESULTS: After the declaration, the intra-bovine transmission rate decreased by 18.1 %, and there were few days when the effective reproduction number was >1.0. A few weeks delay in the declaration significantly increased the possibility of epidemic, number of farms at peak, and final infection scale. CONCLUSIONS: Based on the substantial decrease in the transmission rate after the declaration of a state of emergency in 2010, a future declaration will have a similar effect for a new infectious disease even though a direct extrapolation is not valid. Although a declaration should be carefully considered owing to the potential socioeconomic effects, it is essential to prepare for the implementation given that a delay of only a few weeks should be acceptable.

Shift-work disorder and sleep-related environmental factors in the manufacturing industry.

The aim of this study was to examine the relationship between shift-work disorder (SWD) and environmental and somatic factors related to falling asleep among rapidly rotating shift workers in a manufacturing industry.A total of 556 male workers were recruited to complete a self-administered questionnaire regarding age, shift work experience, lifestyle, and family structure; the Epworth sleepiness scale (ESS); the Pittsburgh sleep quality index (PSQI); and the Horne and Ostberg questionnaire, a questionnaire for environmental and somatic factors related to falling asleep. We classified workers according to having SWD or not, and compared workers with SWD with those without this disorder in terms of all items covered in the aforementioned questionnaires. A total of 208 workers (62.8%) working rapidly rotating shifts were diagnosed with SWD. The ESS and PSQI scores and scores for environmental and somatic factors were significantly higher in workers with SWD than in those without this disorder. The ESS scores and scores for environmental and somatic factors were also associated with SWD in the logistic regression analyses. We suggest that susceptibility to SWD in the manufacturing industry may be associated with environmental and somatic factors related to falling asleep.

The genotype of the transporter associated with antigen processing gene affects susceptibility to colorectal cancer in Japanese.

OBJECTIVE: Although colorectal cancer (CRC) is one of the most frequent malignancies in Japan, the associated genetic factors remain to be elucidated. Functional loss of the transporter associated with antigen processing (TAP) 1 gene induces carcinogenesis. We investigated whether single nucleotide polymorphisms (SNPs) in the TAP1 gene (rs735883) are associated with susceptibility to CRC in a Japanese population. METHODS: The study participants were 143 cases and 243 clinical controls. After extracting DNA from their peripheral blood cells, genotyping was conducted by the polymerase chain reaction-restriction fragment length polymorphism method. RESULTS: Participants with a mutated allele had an increased risk for CRC. The adjusted odds ratios for the C/T, T/T, and the mutation type (C/T + T/T) compared to that of wild type (C/C) were 2.27 [95 % confidence interval (CI), 1.43-3.67], 1.95 (95 % CI, 0.88-4.30), and 2.22 (95 % CI, 1.42-3.55), respectively. Furthermore, a significant trend in the rate of cases was observed with an increasing number of mutated alleles (P for trend = 0.0068). CONCLUSIONS: The genotype of the TAP1 gene is associated with susceptibility to CRC.

Transporter Associated With Antigen Processing (TAP) 1 Gene Polymorphisms and Risks of Urothelial Cell Carcinoma Among the Japanese Population.

Urothelial cell carcinoma is one of the costliest types of cancer because of its recurrence, lengthy course of therapy, and tendency to lead to further complications. Gene polymorphisms are one of many factors that are thought to cause the carcinogenesis of urothelial cell carcinoma. Two single-nucleotide polymorphisms (SNPs) of the transporter associated with antigen processing (TAP) 1 gene and their relationship with the risks of urothelial cell carcinoma in the Japanese population were examined in this study by using polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP) for genotyping and statistical analysis. The adjusted odd ratios with 95% confidence interval (CI) of the mutant types (A/G+G/G) in females for the I333V and D637G polymorphisms are 2.28 (1.11-4.66) and 2.50 (1.21-5.17), respectively. The findings showed that females with the (A/G+G/G) genotype are more likely to develop urothelial cell carcinoma than those with the A/A genotype. Any correlation between smoking and gene polymorphism was absent. Results indicate that TAP1 gene polymorphisms and the risk of urothelial cell carcinoma are related in females.

Epidemiological Study of Metastatic Brain Tumors in Miyazaki Prefecture: A Regional 10-year Survey in Southern Japan.

Advances in cancer treatment have improved the survival of patients with cancer, with a concomitant increase in the proportion of patients with metastatic brain tumors (MBTs). In this study, we used cancer registries established in Japan after 2016 and available patient data by organ in order to conduct an accurate epidemiological study. To the best of our knowledge, this is the first study to report on the detailed epidemiological data on MBT at the prefectural level in Japan using the Miyazaki Brain Tumor Database and Miyazaki Cancer Registry. This study included 425 new cases of MBTs diagnosed in Miyazaki Prefecture from 2007 to 2016. As per our findings, the most frequent primary tumor in Miyazaki Prefecture was found to be in the lung (49.4%), followed by colon/rectum/anus (9.4%) and breast (8.5%). Among patients with MBTs, 59.1% were males, a number closely similar to that of Japan, as shown in the Japanese Brain Tumor Registry (55.5%). The median age at diagnosis was 68 and 63 years in Miyazaki Prefecture and Japan, respectively. Although more patients were symptomatic in Miyazaki Prefecture than in Japan (88.5% vs. 15.5%), fewer patients opted for surgery (33.6% vs. 61.9%), probably because of their advanced age at diagnosis. As per the findings of this study, the annual incidence rate of new MBTs (i.e., ratio of the number of new cancer registrations to that of new MBT patients in Miyazaki Prefecture) was at 0.41%. The number of tumor sites in MBTs was independent of the total number of cancers per organ. Considering the expansion of cancer registries worldwide, including those on brain tumors, further epidemiological analysis of MBTs is deemed warranted.

The Relationship Between CTLA-4 (-318 C/T) Polymorphism and Urothelial Cancer Carcinogenesis in Japanese Patients.

Background Urothelial cancer is one of the most common types of urinary system cancer and there are several factors that can influence its growth. One of the most prominent factors among these is genetics. The Cytotoxic T-Lymphocyte Antigen-4 (CTLA-4) gene is suspected to be a susceptibility gene in urothelial carcinoma. The aim of this study is to investigate polymorphism in the CTLA-4 gene (CTLA-4 -318 C/T) and whether it is associated with urothelial cancer. Methods The study population consisted of 253 cases and 272 controls. In this case-control study, DNA was extracted from peripheral blood cells, and the CTLA-4 -318C/T genotypes were detected using polymerase chain reaction-restriction fragment length polymorphism. Results C/T (adjusted OR (aOR) 3.37; 95%CI: 1.98-5.74) genotype, C/T + T/T (aOR 3.25; 95%CI: 1.96-5.39) genotype, and T allele (aOR 2.94 95%CI: 1.87-4.62) all indicated they are significant risk factors for urothelial cancer, with the effects of polymorphism being higher in the nonsmoker group than in the smoker group. Furthermore, the association between polymorphism and urothelial cancer carcinogenesis was similar among men and women. Conclusions This is the first study examining the association between CTLA-4 -318C/T polymorphism and urothelial carcinoma in Japanese patients. A significant association between CTLA-4 -318C/T polymorphism and urothelial cancer among Japanese patients was detected in this study. This supports the development of research on polymorphisms in urothelial cancer and is an important root of immunoreactions in cancer. We believe this study will be beneficial to clarify the relationship between CTLA-4 polymorphism and urothelial cancer.

The Relationship Between PD-1(rs2227981) and PD-L1(rs2890658) Polymorphisms and Urothelial Cell Carcinoma.

Background Urothelial cell carcinoma, which is believed to develop from the urothelium (transitional epithelium), is the most common aggressive tumor and accounts for the ten most prevalent cancers in the world. The risk factors for urothelial cell carcinoma are aging, smoking, gender, and genetic alternations. Programmed cell death1 (PD-1) has been widely described as a negative regulator of T-cells by sending inhibitory signals to the T-cell. Through PD-1 binding with PD-L1 (ligand for PD-1), an inhibitory signal is propagated to the T cell. The polymorphisms of PD-1 and PD-L1 lead to an efficient T-cell response and affect an anti-tumor reaction. The polymorphisms of PD-1 and PD-L1 could also affect the carcinogenesis of human cancer, including urothelial cell carcinoma. Therefore, in this study, we evaluated the relation between PD-1(rs2227981) and PD-L1(rs2890658) polymorphisms and the carcinogenesis of urothelial cell carcinoma. Materials and methods This study was conducted using 211 healthy controls and 256 cases of urothelial cell carcinoma among the Japanese population. The DNA samples were extracted from the peripheral white blood cells of each subject. The genotype was detected by using the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method. Results C/T (Adjusted OR 1.55, 95% CI:1.02-2.35) and C/T+T/T (OR 1.46, 95% CI:1.01-2.12) genotypes of PD-1 rs2227981 were significant and risk factors for urothelial cancer. Male with A/A genotype in PD-L1 and CT genotype in PD-1 has a significant higher risk factor compared with other genotypes (Adjusted OR 1.83, 95% CI:1.05-3.21). Conclusions and discussion We found that C/T(PD-1) and "A/A (PD-L1) and C/T(PD-1)" were predominant in urothelial cell carcinoma cases. This indicates that C/T(PD-1) and "A/A (PD-L1) and C/T(PD-1)" genotypes could increase susceptibility to urothelial cell carcinoma. However, since our findings indicated that the effects of PD-1 and PD-L1 polymorphisms included discrepancies, additional research will be needed to evaluate the relationship between human cancer and PD-1 and PD-L1 polymorphisms. This is the first study that seeks to find the relation between PD-1(rs2227981) and PD-L1(rs2890658) polymorphisms concerning urothelial cell carcinoma among the Japanese population.

Socio-Demographic, Health, and Transport-Related Factors Affecting the COVID-19 Outbreak in Myanmar: A Cross-Sectional Study.

Introduction The coronavirus disease 2019 (COVID-19) pandemic is a worldwide threat in many aspects, making developing countries with scarce primary health care and medical services more vulnerable. Evaluation of the relationship between the COVID-19 pandemic, sociodemographic variables, and medical services provides useful information to take countermeasures to stop the infection spread and could mitigate the damage. Therefore, this study investigated the relationship between the spread of COVID-19 and sociodemographic variables, medical services, and the transportation system in Myanmar. Methodology This study was a cross-sectional study and was conducted using data on COVID-19 cases from August 20, 2020 to January 31, 2021 in Myanmar. We evaluated the association between the COVID-19 cases and 13 independent variables that were sociodemographic, medical services, and transportation system factors using simple linear regression analysis and multiple linear regression analysis in three phases (increasing (from August 20th to October 10th), stable (from October 11st to December 4th) and decreasing phases (from December 5th to January 31st)) on the infection timeline. Results It was found that the population density was parallelly associated with COVID-19 cases. On the other hand, among the medical services factors, the number of doctors was parallelly associated with COVID-19 cases and the number of nurses was inversely related to COVID-19 cases. Conclusions The result indicated that a high population density area was a risk factor for the increase of COVID-19 cases. This supported the worldwide countermeasures to deal with the spread of the infection, such as social distancing, banning large gatherings, working from home, and implementing quarantine procedures for suspected individuals to reduce person-to-person contact. Finally, at least in Myanmar, employing a large number of nurses could reduce the emergence of new COVID-19 cases. We believe that our study can make valuable contributions to tackling future epidemics like COVID-19 not only in Myanmar but also in other developing countries. This article was previously presented as an abstract at the 91st conference of The Japanese Society for Hygiene (JSH ) on March 08, 2021.

PER3 polymorphisms and their association with prostate cancer risk in Japanese men.

INTRODUCTION: Prostate cancer (PCa) is one of the most common cancers affecting men globally. Although PER3 has been suggested as a risk factor for cancer development, there are few reports elucidating the relationship between PER3 and PCa. We investigated the association between PER3 polymorphisms (rs2640908 and VNTR) and susceptibility to PCa in the Japanese population. METHODS: Eighty three patients with PCa and 122 controls participated in this study. We analyzed rs2640908 and VNTR polymorphisms by using PCR-Restriction Fragment Length Polymorphism (PCR-RFLP). RESULTS: Compared to the C/C genotype with the rs2640908 polymorphism, the T/T (OR: 0.35, 95% CI: 0.15-0.81, P = 0.02) and C/T + T/T (OR: 0.46, 95% CI: 0.24-0.88, P = 0.02) genotypes had a significantly lower risk of PCa. TT (OR: 0.29, 95% CI: 0.10-0.77, P = 0.02) and CT + TT (OR: 0.47, 95% CI: 0.23-0.97, P = 0.04) also had significant protection against PCa in the smoker group. Significantly, we observed an association between smoking and rs2640908 polymorphism in this study. However, no association between the VNTR polymorphisms and PCa was detected. CONCLUSIONS: Our results suggest that PER3 rs2640908 polymorphisms influence an individual's susceptibility to PCa.

[Predicting spread of new pandemic swine-origin influenza A (H1N1) in local mid-size city: evaluation of hospital bed shortage and effectiveness of vaccination].

OBJECTIVES: On April 24th, 2009, a new swine-origin influenza A (H1N1) was first reported in Mexico. Japan confirmed cases of the flu on May 9th, and the pandemic in Japan has become full-scale. The Ministry of Health, Labor and Welfare of Japan announced that the first peak of this pandemic was predicted to occur in October, 2009. Therefore, it is most important to predict the progress of this pandemic to be able to use medical resources effectively in Japan. METHODS: We used a modified susceptible-exposed-infected-recovered (SEIR) model to calculate the number of infected people and hospital bed shortage during this pandemic. In this model, available medical resources were investigated on the basis of four vaccination scenarios. RESULTS: Our model showed that it would take a further six months for the pandemic to peak than was predicted by the Ministry of Health, Labor and Welfare of Japan. Without vaccination, at the peak of the pandemic 23,689 out of 400,000 people would be infected and the hospital bed shortage would reach 7,349 in total. CONCLUSIONS: We suggest that mathematical models are strong tools to predict the spread of infectious diseases. According to our model, it is possible to prevent hospital bed shortage by vaccination.

Genetic polymorphisms and oral cancer.

Oral cancer, a disease associated with major morbidity and mortality, represents a significant worldwide health problem. It is clear that the major etiological factors for oral cancer are tobacco and alcohol exposure. It has been shown that metabolic activation is associated with cancer susceptibility. Various carcinogens and carcinogenic precursors, such as benzopyrene and nitrosamine, have been identified in tobacco smoke, and those are activated or detoxified by two types of metabolic enzymes, phase I and phase II. There are some polymorphisms for these enzyme genes, the functions of which are modified by the types of polymorphisms. On the other hand, there are some genes besides these enzyme genes related to cancer susceptibility. In this review, we discuss the relationships between polymorphisms concerned with oral cancer. Although there are many reports on the polymorphisms related to oral cancer, the results of these reports are controversial. Further studies are needed to evaluate the interactions between carcinogens and the genetic polymorphisms.

Trends, Spatial Disparities, and Social Determinants of DTP3 Immunization Status in Indonesia 2004-2016.

Although 91% of 12-23-month-old children in Indonesia received at least one immunization in 2013, only 76% completed DTP3 immunization. This percentage is below the UNICEF and WHO recommended standards. Thus, this study aims to investigate trends, spatial disparities, and social determinants related to low coverage of DTP3 immunization in Indonesia. Using a multilevel approach, we analyzed data from 305,090 12-23-month-old children living across approximately 500 districts in Indonesia to study demand and supply factors determining DTP3 immunization status. We examined unique, nationally representative data from the National Socioeconomic Survey (Survei Sosial Ekonomi Nasional or Susenas) and Village Potential Census (Potensi Desa or Podes) from 2004 to 2016. The percentage of children receiving complete DTP3 immunization increased from 37.8% in 2004 to 75.9% in 2016. Primarily income, parity status, and education, showed influence on DTP3 coverage. Among individual-level factors, the presence of a professional birth attendant was the most influential factor. At the district level, the factors varied. Low progress in DTP3 immunization status in Indonesia is due to huge disparities across the country's islands, in the density of health services, and in household socioeconomic status.

Rutin supplementation in the diet has protective effects against toxicant-induced hippocampal injury by suppression of microglial activation and pro-inflammatory cytokines: protective effect of rutin against toxicant-induced hippocampal injury.

AIMS: Rutin is one of the flavonoids that has many beneficial effects on the health. Previously, we showed that rutin has a protective effect on trimethyltin (TMT)-induced memory dysfunction in rats. The aim of this study was to investigate the protective effects of rutin on TMT-induced hippocampal injury and the time course profiles of these effects in rats. METHODS: Four-week-old male Sprague-Dawley (SD) rats were fed chow with or without rutin (0.75%) during the experimental period and were administered with a single dose of TMT (8.5 mg/kg b.w., p.o.) or vehicle at 6 weeks of age. The rats were sacrificed 5, 10, or 20 days after the TMT administration and then histological and molecular examinations of the hippocampus were performed. RESULTS: Rutin supplementation suppressed the TMT-induced decrease in the number of hippocampal pyramidal neurons 20 days after TMT administration. The TMT-induced up-regulation of the mRNA expression levels of reactive microglia marker and pro-inflammatory cytokines were reversed by rutin supplementation 10 or 20 days after the TMT administration. CONCLUSIONS: These results suggested that the neuroprotective effect of rutin on TMT-induced spatial memory impairment could be attributable to its inhibitory effect against microglial activation and its role in synapse formation via neurotrophic factors in the hippocampus.

Estimation of the effective reproduction number of influenza based on weekly reports in Miyazaki Prefecture.

In Japan, as part of surveillance for seasonal influenza, the number of patients per influenza sentinel site is counted on a weekly basis. Currently, reference values are set for the weekly reported number of influenza cases per sentinel, and pre-epidemic and epidemic warnings are issued based on these values. In this study, we examined the association between these reference values and the effective reproduction number (Rt) using surveillance data for Miyazaki Prefecture collected from 2010 to 2011. There are nine public health centre jurisdictions in this prefecture, and Rt exceeded 1.0 at the time when pre-epidemic warnings were issued in almost all the jurisdictions. Thus, it was indicated that the validity of the reference value was also high for influenza transmission. However, our results indicated the presence of secondary epidemic caused by infections originating both from other jurisdictions and inner jurisdictions, and it is occasionally not possible to evaluate the end of an epidemic in a jurisdiction using only the reference value of termination. It is necessary to establish new methods after considering the situation in the surrounding jurisdictions for more detailed epidemic predictions.