On Ishigaki Island, Plasmodium falciparum and Plasmodium vivax epidemics occurred in 1945-1946 and were successfully suppressed. The epidemic re-emerged in 1949 because many settlers immigrated to the former endemic areas, but it terminated in 1961. The present study aimed at predicting an outbreak of a new epidemic based on the situation in which P. falciparum malaria patients stay on Ishigaki Island and also examined the re-emergence of the P. falciparum epidemic in 1951-1960 to determine the reliability of the model.
A stochastic transmission model of P. falciparum was constructed to detect a small number of infected persons. The seasonal fluctuation of the Anopheles minimus population obtained by observational data and meteorological data through statistical processing was introduced into the model.
Simulations were carried out to predict the risk of a new epidemic with scenarios in which the attribute of index patient, visiting season, and reduced inoculation rates of An. minimus were assumed. When an infected person visited the island in summer, a small number of patients with primary infections derived from the index patient appeared for all 1,000-iterations. On the other hand, when an infected person visited the island in winter, few or no patients with primary infections appeared for any of the 1,000-iterations because of the low mosquito density. In realistic conditions, the simulation results showed that there was little possibility of the occurrence of P. falciparum infection.

Objective：The aim of this study was to examine the efficacy and safety of hochuekkito to address reduced activities of daily living (ADL), nutritional status, and immunity in patients with severe conditions, represented by a functional independence measure (FIM) total score of ≤ 40.

Methods：Thirty-one patients who were undergoing rehabilitation for hemiplegia after cerebrovascular disease were randomized into 2 groups：those treated with hochuekkito (TJ-41 group) and those treated without hochuekkito (control group). Their conditions were observed for 24 weeks, focusing on items such as ADL and incidence of inflammatory complications.

Results：The FIM total score markedly improved after treatment in both groups, but the changes in the score between admission and discharge were similar between the two groups. The incidence of inflammatory complications was significantly lower in the TJ-41 group (P = 0.049). Among the patients with a motor FIM score of ≤ 20, those in the TJ-41 group showed a tendency of increase in total lymphocyte count after treatment. No adverse drug reactions were observed during the study period.

Conclusion：These results suggest that hochuekkito is effective in reducing the incidence of inflammatory complications in patients undergoing rehabilitation for cerebrovascular or other diseases.