1.The status of malaria before and after distribution of ITNs from 1999 to 2006 in two districts of Khammouanne Province, Lao P.D.R
Boualam Khamlome ; Hideaki Eto ; Toshihiro Mita ; Miki Sakurai ; Takayuki Saito ; Ataru Tsuzuki ; Jun Kobayashi ; Samlane Phompida ; Takatoshi Kobayakawa
Tropical Medicine and Health 2007;35(4):343-350
In 1999, an insecticide-treated net (ITN) distribution project was started in several malaria-endemic villages in Lao P.D.R., namely Vientiane, Bolikhamxay and Khammouanne Provinces. After the completion of the project, it was found that the ITNs were effective for malaria control based on the analysis of the slide positivity rate for malaria parasites between 1999 and 2000 [6]. We conducted malariometric, entomological and KAP surveys in 2005-06 to confirm the status of malaria and to determine the effectiveness of ITNs in three different socioepidemiological areas (near city, rural and remote), represented by the Xebangfay and Boualapha districts, Khammouanne Province.
A marked decrease in the annual malaria incidence and slide positivity rate was noted from 1999 to 2006 in the two districts. The malaria prevalence was significantly reduced in near city areas (5.6%-10.7% in 1999 to 0% in 2005-06) and rural areas (21.4%-50.9% in 1999 to 0%-1% in 2005-06). Twelve positive cases were recorded in remote areas (3.4 - 7.7% in 2006).
The illiteracy rate was significantly higher among the respondents in the remote (83.9%) than among those in the near city (32.7%) and rural (54%) areas. In all areas, more than 50% of the villagers indicated that they were not aware of malaria. Similarly, about 60% of the respondents were found to have incorrect knowledge concerning malaria transmission. In remote, 40.9% of the respondents were aware of the methods to prevent malaria infection and 49.5% used mosquito nets throughout the year, rates significantly lower than the corresponding rates in near city and rural. The density of persons per net in remote (3.1-5.9) was considerably higher than that in near city (1.8-2.1) and rural (1.2-2.7). Malaria vector mosquitoes, such as An. minimus and An. nivipes were collected by human-baited adult collection, and cow-baited and CDC light traps. The results of the analysis suggested that the lower the number of persons per net the more effective the reduction of malaria morbidity in these areas. It is imperative that ITN distribution and health education regarding malaria be strengthened, especially in remote, but also in other areas.
2.High Infant Mortality Presumably Due to Thiamine Deficiency in Lao PDR
Hiroyuki NAKANO ; Sumiko OMOTE ; Takayuki SAITO ; Kumiko SHINOHARA ; Tomoko SAITO ; Daisaku URABE ; Nobuko TAKAOKA ; Mieko KIMURA ; Miki SAKURAI ; Yoshitake SATAKE
Journal of International Health 2008;23(1):33-42
Introduction
During the course of primary health care activities in Khammouane province of Lao PDR by non- profit organization, international support and partnership for health, an exceedingly high infant mortality rate was recognized in some villages. As thiamine deficiency was strongly suspected for the main cause of the high mortality, the household survey with an emphasis on nutritional aspect and the measurement of thiamine level in the blood of mothers as well as their breast-milk were carried out for the confirmation.
Methods
The survey was conducted at Sibounhouane sub-district (Group 1) with the highest infant mortality and Hatkhamhieng sub-district (Group 2) with the lowest mortality. Fifty families of the two groups, each consisting of randomly selected 25 families with less than one year old infant(s) were interviewed by using prepared questionnaire. The body weight of both mother and infant was measured and blood and milk were taken from the mother.
Results
The ethnic minorities of the group 1 consisted of Lao Lum (44%) and Lao Theung (56%), whereas only Lao Lum in the group 2. The economical indicators and the mother's educational level in the group 1 were inferior to those in the group 2. There was no significant difference in the methods of preparing staple glutinous rice, likely to flux thiamine and intake of thiaminases between the two groups. High infant mortality rate was documented in the group 1 whose clinical symptoms were mostly consistent with those of infantile beriberi. The concentration of thiamine in the blood and milk of mothers in both groups were considerably lower and significant reduction of thiamine level was observed in the group 1 than the group 2. Nevertheless, both groups of those infants tended to be inadequately fed with the foods except for breast-milk during their early infantile phase.
Conclusions
The low concentration of thiamine in the blood and milk of mothers was strongly suggestive that infantile beriberi due to thiamine deficiency was the principal cause of the infant mortality in the study region. We hereby surmise that thiamine deficiency could be extensively prevalent in Lao PDR than the currently studied areas because of their traditional preparing methods of staple dietary rice, postpartum food taboos and intake of thiaminases. For the prevention of infant death due to severe thiamine deficiency, necessary measures including the exchange of information among the institutions concerned, adequate thiamine supplementation and nutritional counseling have to be urgently adopted.
3.Effects of different microhabitas on growth and four kinds of volatile oil components of Atractylodes lancea.
Yan ZHANG ; Sakurai MIKI ; Guang YANG ; Xiu-ji TAKEDA ; Mei-lan CHEN ; Shou-dong ZHU ; Ling WANG ; Lan-ping GUO
China Journal of Chinese Materia Medica 2015;40(21):4142-4148
To investigate the suitable site environment for Atractylodes lancea, field trials in different niches was carried out, and the seedling growth, biomass and volatile oil components in different microhabitas was studied. The study found that the survival rate, plant height, volatile oil content of those which growing under the bamboo were significantly higher than those exposed in the open field. The survival rate understory was (76 ± 15.1) %, plant height understory was (77 ± 14. 8) cm and the summation of the four kinds of volatile oil content understory reached up to 4.09%; The same evaluation values of these indicators of the four faces in the open field respectively: survival rate is 30%, plant height was (77 ± 14.8) cm and the summation of the four kinds of volatile oil content was 2.24%. But, the yield of the understory (41 ± 22.3) g was significantly lower than those four faces in the open field (104.5 g) on the contrary. For the four open field towards, the yield of the east facing, which organic matter and other nutritional conditions were better than others, was significantly higher than those in the other facings. A. lancea was found to be an anti-poor and shading-like or growing in east facing slope herb through the correlation analysis of light, temperature, soil and leaf nutrients with seedling growth, biomass and volatile oil components. It also reminds us that the understory herb with high survival rate, low incidence, low management costs, and high medicinal ingredients, although it's production is not so high, but it can be improved by increased organic fertilizer. So the ecological planting patterns which can intercropping herbs with the forest was proposed.
Atractylodes
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chemistry
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growth & development
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metabolism
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Drugs, Chinese Herbal
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chemistry
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metabolism
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Molecular Structure
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Oils, Volatile
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chemistry
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metabolism
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Seedlings
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chemistry
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growth & development
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metabolism
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Soil
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chemistry
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Temperature
4.Evaluation by Students’ Self-assessment of a Curriculum for Fifth-year Pharmacy Students to Integrate Basic Science and Clinical Knowledge
Miki YAMASHITA ; Hidehiko SAKURAI ; Seiichi FURUTA ; Ainari KONDA ; Toru HAYAKAWA
Japanese Journal of Social Pharmacy 2018;37(2):140-146
The core curriculum of the pharmacy education model was revised in 2013 based on the “Basic competencies required of a pharmacist” that should be developed by graduation. Specific behavioral objectives to acquire include competency in “The ability to implement pharmacotherapeutic management”, which involves gaining the ability to understand patient information, prescription design and proposal, as well as pharmacotherapeutic assessment. In order to improve this ability, it is necessary for students to acquire basic knowledge about pathology, pharmacology, and pharmacotherapy and to integrate and apply this knowledge to patients in practice. We introduced an integrated program called “Integrated Clinical Pharmacy” for fifth-year students at Hokkaido Pharmaceutical University. In this program, students take an objective test on the basic knowledge of pathology, pharmacology, and pharmacotherapy and learn how to design pharmaceutical care plans using individual patient cases. A self-evaluation questionnaire survey about the ability to develop care plan was conducted on students who completed the program. Based on the objective test and self-evaluation questionnaire results, we studied whether basic knowledge was fully established and whether the ability to utilize this knowledge was acquired through this program. We found that although the ability to select an individual component of care plan did improve, this ability wasn’t correlated with the degree of basic knowledge, and performance in summarizing care plan did not improve. These results suggested that it is necessary to understand the connection between components of the care plan and strategies to focus on improving the ability to integrate basic knowledge.
5.Evaluation by Students’ Self-assessment of a Curriculum for Fifth-year Pharmacy Students to Integrate Basic Science and Clinical Knowledge
Miki YAMASHITA ; Hidehiko SAKURAI ; Seiichi FURUTA ; Ainari KONDA ; Toru HAYAKAWA
Japanese Journal of Social Pharmacy 2018;37(2):140-146
The core curriculum of the pharmacy education model was revised in 2013 based on the “Basic competencies required of a pharmacist” that should be developed by graduation. Specific behavioral objectives to acquire include competency in “The ability to implement pharmacotherapeutic management”, which involves gaining the ability to understand patient information, prescription design and proposal, as well as pharmacotherapeutic assessment. In order to improve this ability, it is necessary for students to acquire basic knowledge about pathology, pharmacology, and pharmacotherapy and to integrate and apply this knowledge to patients in practice. We introduced an integrated program called “Integrated Clinical Pharmacy” for fifth-year students at Hokkaido Pharmaceutical University. In this program, students take an objective test on the basic knowledge of pathology, pharmacology, and pharmacotherapy and learn how to design pharmaceutical care plans using individual patient cases. A self-evaluation questionnaire survey about the ability to develop care plan was conducted on students who completed the program. Based on the objective test and self-evaluation questionnaire results, we studied whether basic knowledge was fully established and whether the ability to utilize this knowledge was acquired through this program. We found that although the ability to select an individual component of care plan did improve, this ability wasn’t correlated with the degree of basic knowledge, and performance in summarizing care plan did not improve. These results suggested that it is necessary to understand the connection between components of the care plan and strategies to focus on improving the ability to integrate basic knowledge.
6.Empirical Study on Promotion of Appropriate Pharmacotherapy in Patients with Seasonal Allergic Rhinitis
Hidehiko SAKURAI ; Ayamo NAGAI ; Miki YAMASHITA ; Keiko KISHIMOTO ; Reiko MIZUTANI
Japanese Journal of Social Pharmacy 2023;42(2):89-98
The prevalence of seasonal allergic rhinitis (hereinafter “hay fever”) is increasing annually. While self-medication with over-the-counter (OTC) drugs is growing, some hay fever patients also use OTC drugs alongside medical visits. Issues arising from co-administration, such as excessive dosing and reduced quality of life (QOL) due to drowsiness, have been highlighted. However, no research has investigated the factors contributing to the concomitant use of prescribed and OTC drugs. Therefore, this study examined the following three patient groups: those using only prescribed drugs, those using only OTC drugs, and those using a combination of both. Initial analyses compared adherence, overuse extent, QOL (as measured by the Japanese Rhino-conjunctivitis Quality of Life Questionnaire [JRQLQ]), treatment satisfaction, lifestyle habits, and health literacy (as measured by the Communicative and Critical Health Literacy Scale [CCHL]) among the groups. Subsequently, a multinomial logistic regression analysis focusing on combination users identified factors associated with co-administration. The results revealed that combination users exhibited lifestyle issues and lower QOL compared to those using prescribed or OTC drugs only, although differences in CCHL were not significant. Furthermore, co-administration was linked to social life-related JRQLQ and excessive usage during symptom onset. In conclusion, patients with hay fever should avoid the concurrent use of prescribed and OTC drugs. Co-administration may not necessarily improve symptoms and might even lead to overuse risks. Thus, patients should be guided to consult medical professionals before purchasing OTC drugs, and lifestyle improvements should be emphasized as well.