1.Difference of sociodemographic characteristics among the disabled population in Cambodia: a cross-sectional study of the demographic and health survey data
Kanika KEP ; Yurie KOBASHI ; Erica Jynn Abarca Lopez ; Masaharu TSUBOKURA ; Manabu OKAWADA
Journal of Rural Medicine 2022;17(2):79-84
Objective: There is an urgent need to raise awareness of the significance of the social security system for vulnerable populations in developing countries and identify the widening disparities among people with disabilities. This study determined the sociodemographic characteristics of people with disabilities in Cambodia.Materials and Methods: This was a cross-sectional study. Data from the Cambodia Demographic and Health Survey were used to determine the association between disability and sociodemographic characteristics such as age, gender, number of family members, residence (rural/urban), and economic status.Results: The results showed that the proportion of people with disabilities greatly increased with age. The rural-urban residence difference affected the disability proportion in univariate analysis; however, the effect was not significant after adjusting for covariables in multivariate analysis. The odds of having a disability were 0.85 times lower for the high economic status group than for the low economic status group.Conclusion: Raising awareness to expand the capacity of social support for older adults with disabilities, especially those who do not receive care from their families, may be an urgent issue in Cambodia. Therefore, a well-designed and disease-specific study is required. This study was the first to determine the sociodemographic disparities among people with disabilities in Cambodia.
2.Vulnerable groups and protective habits associated with the number of symptoms caused by pesticide application in Kratie, Cambodia: a cross-sectional questionnaire study
Yurie KOBASHI ; Lihorn SROU ; Masaharu TSUBOKURA ; Yoshitaka NISHIKAWA ; Ngy LAYMITHUNA ; Songhy HOK ; Manabu OKAWADA
Journal of Rural Medicine 2022;17(4):214-220
Objective: The present study aimed to identify pesticide poisoning symptoms and related protective habits to effectively prevent pesticide poisoning among farmworkers in Kratie, Cambodia, where pesticide poisoning is an urgent public health problem.Materials and Methods: This cross-sectional study based on a questionnaire survey analyzing social demographics, number of symptoms, and protective behavior regarding pesticide application was conducted in Kratie Province from January 25 to 31, 2021. In total, 210 farmworkers completed the survey. The effects of social demographics and pesticide-protective behavioral scores on the number of symptoms were investigated using multivariable regression analysis.Results: The observed number of symptoms was 1.16 times higher among women (P=0.004), increased with the duration of work, and decreased with age. In addition, we identified five significant pesticide-protective behaviors: 1) preparing using gloves, 2) using protective equipment, 3) avoiding wiping sweat, 4) avoiding leaking, and 5) resting when feeling ill. Pesticide-protective behaviors tended to decrease with the duration of working years in the low-education group (B=−0.04, SE=0.01), whereas no association was observed in the high-education group (B=0.01, SE=0.01).Conclusion: Pesticide-protective behaviors significantly correlated with fewer symptoms. The female and aging groups required continuous special education or instructions for implementing pesticide-protective actions, especially the aforementioned five protective actions.
3.The disparity of utilization rate among specific groups for a rapid spreading telehealth application called LEBER during the COVID-19 state of emergency in Japan
Yurie KOBASHI ; Masaki OGUNI ; Masaharu TSUBOKURA ; Naoki KANDA ; Naomi ITO ; Shunichiro ITO
Journal of Rural Medicine 2023;18(4):233-240
Objectives: The purpose of this research is to describe the social demographics and chief complaints of users of a free medical consultation application in Ibaraki Prefecture, where a free medical consultation application was released.Methods: The present study included users of a telehealth application in Ibaraki Prefecture between April 9 and May 17, 2020, during the state of emergency. User background characteristics were descriptively analyzed to clarify individual factors with the potential to act as barriers to equally using innovative solutions. Additionally, the age and consultation time distribution by sex were examined for those who used the application for COVID-19 and non-COVID-19 issues.Results: Most of the participants were in their thirties. Moreover, 72% were female, with most being in their thirties (86%) and the least being in their sixties (45%). The number of consultations was concentrated between 6 p.m. and 10 p.m., with the least between 1 a.m. and 5 a.m. The telehealth application users were mainly females in their thirties and forties.Conclusions: To prevent the widening of health disparities due to the rapid introduction of telehealth, further research is required to identify why the use of the application did not spread beyond the aforementioned user groups.
4.Health disparity toward noncommunicable diseases among residents in rural Cambodia: a descriptive study
Yurie KOBASHI ; Hong CHHAY ; Thyryfong SAVAT ; Manabu OKAWADA ; Masaharu TSUBOKURA ; Yushifumi HAYASHI
Journal of Rural Medicine 2020;15(4):212-216
Objective: Regional disparities in health services is a crucial problem in Cambodia. Particularly, a number of NCD risk factors are more common among the rural poor. Fortunately, 80% of NCDs are preventable and cost-effective interventions exist. Therefore, health care needs assessments regarding NCDs in poor rural areas are vital. The object of this pilot study was to identify health care needs regarding NCDs among residents in poor rural areas in Cambodia.Materials and Methods: A medical health check-up and questionnaire survey were conducted with 208 rural residents who participated in a free health check-up and doctor consultation in Kaoh Peam Reang.Results: One hundred sixteen (55.8%) females were included in the total sample size of 208 participants; the majority (52.9%) were between 35 and 65 years of age. Twenty-five participants (12%) were current smokers, and 44 (21%) were current alcohol drinkers. Eighty (38.5%) participants had hypertension and 44 participants (21.2%) had a body mass index over 25. Alcohol drinking and smoking habits were more common among men. The five most frequent medical complaints were headache (18.3%), lower back pain (14.4%), foot and hand pain (13.9%), joint pain (10.1%), and difficulty breathing (10.1%).Conclusions: The medical need for doctor consultations regarding chronic disease and chronic pain might be higher in poor rural areas in Cambodia.
5.Japanese anesthesiologists’ knowledge of the cost of medicines and their attitudes toward cost containment: a cross-sectional survey
Arika HARA ; Yurie KOBASHI ; Maki HANAOKA ; Varanate NUENGSIGKAPIAN ; Yuzo SHIMAZU ; Masaharu TSUBOKURA ; Hirotoshi YAMAMOTO
Journal of Rural Medicine 2022;17(3):131-136
Objectives: This study surveyed Japanese anesthesiologists’ knowledge of the cost of medicine and their attitudes toward cost containment to determine how these factors may affect their choice of medication and provide insight into reducing healthcare expenditures.Materials and Methods: In this cross-sectional study, Japanese anesthesiologists’ knowledge of medicine prices and their attitudes toward cost containment were surveyed to identify barriers in lowering the cost of anesthesia. The proportion of participants who correctly guessed the cost of the five most frequently used types of drugs within 25% of the actual price was determined, and their attitudes regarding drug prices and barriers to achieving cost containment were analyzed.Results: In total, responses to 60 questionnaires were analyzed. The proportion of participants correctly guessing the price within 25% of the actual price for each of the five drug categories, including neuromuscular blocking agents, inhaled anesthetics, intravenous anesthetics, opioids, and neuromuscular blockade reversal agents, was 30% (n=18), 18.3% (n=11), 6.67% (n=4), 30.0% (n=18), and 63.3% (n=38), respectively. Participants believed they had adequate access to information on prices, that the cost of a product influenced their decisions regarding product use, and that more information about cost might change their use of the drugs but did not believe that they had adequate knowledge about product prices.Conclusion: The proportion of participants with acceptable price estimates is small. Educating anesthesiologists about the cost of anesthetic agents may be required to encourage cost-containing behaviors. This study is the first survey to assess Japanese anesthologists’ knowledge of the cost of medicines.
6.Surgical symptomatic knowledge among medical staff and community health workers in rural Cambodia: a descriptive study for workforce improvement
Yurie KOBASHI ; Kazato SAEKI ; Masaharu TSUBOKURA ; Lihorn SROU ; Tiny PRUM ; Norifumi KURATANI ; Tomohiro ISHII ; Kayako SAKISAKA
Journal of Rural Medicine 2020;15(2):57-62
Objective: The surgical workforce needs to at least double by 2030. To increase the workforce, training for non-physician healthcare professionals and community health workers (CHWs) in rural areas is promising to decrease the numbers of untreated surgical patients. Nevertheless, few studies have been conducted on surgical activities of non-physician healthcare professionals and CHWs in rural Cambodia. We sought to measure the level of knowledge of surgical symptoms, and identify factors associated with it. A questionnaire survey was administered to people in rural areas of Kratie Province to determine their knowledge of surgical symptoms, and to strengthen the surgical workforce among medical staff and CHWs.Patient/Materials and Methods: To evaluate the knowledge of surgical symptoms among medical staff and CHWs, a self-reported questionnaire was administered to medical staff, CHWs, and villagers in a rural area of Kratie province, Cambodia. The rating score of the number of correct answers among medical staff, CHWs, and villagers was set as the primary outcome.Results: A total of 91 participants, including 31 medical staff, 24 CHWs, and 36 villagers, completed the survey. The median scores for knowledge of symptoms indicative of surgery were 8 (7–8) [median (interquartile range)] in medical staff, 8 (7–8.5) in CHWs, and 8.5 (8–9) in villagers. There was no significant difference in the scores of surgical symptoms among each of the occupational groups. The group of people who recognized low subjective knowledge of surgical symptom by themselves had significantly higher objective score of knowledge of surgical symptom.Conclusion: Knowledge of surgical symptoms among medical staff and CHWs was inadequate. To at least double the surgical workforce by 2030 successfully, accurate evaluation and improvement of surgical symptomatic knowledge among medical staff in rural areas is crucial.