Assessment of fever screening at airports in detecting domestic passengers infected with SARS-CoV-2, 2020-2022, Okinawa prefecture, Japan.

BACKGROUND: While airport screening measures for COVID-19 infected passengers at international airports worldwide have been greatly relaxed, observational studies evaluating fever screening alone at airports remain scarce. The purpose of this study is to retrospectively assess the effectiveness of fever screening at airports in preventing the influx of COVID-19 infected persons. METHODS: We conducted a retrospective epidemiological analysis of fever screening implemented at 9 airports in Okinawa Prefecture from May 2020 to March 2022. The number of passengers covered during the same period was 9,003,616 arriving at 9 airports in Okinawa Prefecture and 5,712,983 departing passengers at Naha Airport. The capture rate was defined as the proportion of reported COVID-19 cases who would have passed through airport screening to the number of suspected cases through fever screening at the airport, and this calculation used passengers arriving at Naha Airport and surveillance data collected by Okinawa Prefecture between May 2020 and March 2021. RESULTS: From May 2020 to March 2021, 4.09 million people were reported to pass through airports in Okinawa. During the same period, at least 122 people with COVID-19 infection arrived at the airports in Okinawa, but only a 10 suspected cases were detected; therefore, the capture rate is estimated to be up to 8.2% (95% CI: 4.00-14.56%). Our result of a fever screening rate is 0.0002% (95%CI: 0.0003-0.0006%) (10 suspected cases /2,971,198 arriving passengers). The refusal rate of passengers detected by thermography who did not respond to temperature measurements was 0.70% (95% CI: 0.19-1.78%) (4 passengers/572 passengers). CONCLUSIONS: This study revealed that airport screening based on thermography alone missed over 90% of COVID-19 infected cases, indicating that thermography screening may be ineffective as a border control measure. The fact that only 10 febrile cases were detected after screening approximately 3 million passengers suggests the need to introduce measures targeting asymptomatic infections, especially with long incubation periods. Therefore, other countermeasures, e.g. preboarding RT-PCR testing, are highly recommended during an epidemic satisfying World Health Organization (WHO) Public Health Emergency of International Concern (PHEIC) criteria with pathogen characteristics similar or exceeding SARS-CoV-2, especially when traveling to rural cities with limited medical resources.

Impact of eHealth education to reduce anemia among school-going adolescent girls in rural Bangladesh: Study protocol of a randomized controlled trial.

Adolescent girls are highly vulnerable to developing anemia due to reproductive immaturity, poor personal hygiene, and lack of nutritional intake and health education in rural Bangladesh. Digital health technology is a promising tool to overcome barriers and provide appropriate health guidelines. We aim to evaluate eHealth education's impact and changes in adolescent girls' knowledge, attitude, and practice regarding anemia. A 1:1 parallel randomized control trial was conducted among school-going adolescent girls in rural Bangladesh. A total of 138 anemic (mild and moderate) participants were enrolled. We randomized schools to reduce the health education bias through a simple coin toss technique, then allocated participants to the intervention group (n = 69) and control group (n = 69) by stratified random sampling technique. The intervention group received two online counseling sessions and 8-month eHealth education through mobile phone calls and short message service regarding anemia. The control group received the usual care. The primary endpoint changes the anemic level through changing knowledge, healthy lifestyle behavior, and an iron-rich food dietary plan. Per-protocol analysis will utilize to compare the control and intervention groups using SPSS software. Descriptive statistics (frequencies, percentages, mean, SD) will be employed, and continuous variables will be compared using the t-test/Mann-Whitney test. Two-way analysis of variance will assess outcome variables at baseline, 4 months, and 8 months. The 8-month intervention is designed from May 2022 to February 2023. Participants' age range of 10-14 years was 60.9% in the intervention group and 56.5% in the control group. Among the participants, 89.9% and 88.4% were mild anemic; 11.11 (SD ± 0.80) and 11.06 (SD ± 0.96) were mean hemoglobin in the intervention and control groups, respectively. eHealth education is expected to be an effective way to increase knowledge and healthy behavioral change, which can reduce the anemia burden among adolescent girls.

Quantifying the Effects of Medical Examination and Possible Risk Factors against the Incidence of Cervical Cancer in a Low Human Papillomavirus Vaccination Coverage: An Ecological Study in Japan.

Cervical cancer (CC) is one of the most common gynecological malignancies in females, mainly caused by human papillomavirus (HPV). In countries with lower HPV vaccine coverage, such as Japan, medical examination may play a key role in decreasing CC incidence. This study aimed to quantify the effect of medical examination on cervical cancer (CC) incidence in Japan, considering the effects of possible risk factors. By collecting Japan's Prefectural data on CC incidence (2013-2017), incidence of sexually transmitted diseases (STDs; Chlamydia, Herpes, Condyloma, and Gonorrhea; 1993-2012), screening and detailed examination rate against CC (2013-2016), smoking rate (2001-2013), economic status (disposable income and economic surplus; 2014-2015), and education status (2015), we analyzed associations among them using Pearson's correlation coefficients. Additionally, assuming that the incidence of STDs reflects the frequency of risky sexual behavior at the co-infection point with HPV, we constructed generalized linear models to predict CC incidence, taking a 5-20-year time-lag between incidences of STDs and the CC incidence. Against CC incidence, Chlamydia in females and Gonorrhea in males with a 15-year time-lag showed positive associations, while Condyloma in both genders with a 15-year time-lag, screening rate, economic status, and smoking rate showed negative associations. An increase in screening test rate by 10% was estimated to decrease CC incidence by 9.6%. This means that screening tests decrease CC incidence effectively, but not drastically, suggesting the need for additional countermeasures for CC prevention.

Health Literacy and Health Behavior: Associated Factors in Surabaya High School Students, Indonesia.

(1) Background: The health behavior (HB) of adolescents develops in the school or family setting and plays an important role in their future health status. Health literacy (HL) has been identified as an important factor in modifying health behavior in addition to socioeconomic factors. health-promoting school (HPS) programs also have a significant role in providing students with the means of learning the importance of knowledge, behavior, and skills for a healthy lifestyle. (2) Method: This study aims to identify the association between HB, HL measured in comprehensive health literacy (CHL) and functional health literacy (FHL), HPS programs, and socioeconomic factors among high school students in Surabaya, Indonesia. A cross-sectional study was conducted, and 1066 students were evaluated as respondents. (3) Result: The results of multivariate analyses showed that following factors were associated with better health behavior: female, better academic performance, higher grade, higher father's education, lower allowance, and better CHL and FHL. The strongest association for HB was gender. CHL was especially associated with handwashing, physical activity, and drug abuse. FHL was associated with smoking and drug abuse. The implementation of HPS programs did not reach an optimum level and only influenced physical activity. (4) Conclusions: The findings confirm that CHL and FHL have a significant association with several HBs. HB intervention in the HPS program is recommended to incorporate the CHL and FHL for a better health impact.