Objective: We examined sociobehavioural factors associated with SARS-CoV-2 infection and estimated COVID-19 vaccine effectiveness against symptomatic SARS-CoV-2 infection in the Philippines. Such studies are limited in low- and middle-income countries, especially in Asia and the Pacific. Methods: A case-control study was conducted in two hospitals in Manila, Philippines, from March 2022 to June 2023. Sociobehavioural factors and vaccination history were collected. PCR-positive individuals were cases, while PCR-negative individuals were controls. Adjusted odds ratios (aORs) were calculated to examine associations between sociobehavioural factors/vaccination and medically attended SARS-CoV-2 infection. Results: The analysis included 2489 individuals (574 positive cases, 23.1%; 1915 controls, 76.9%; median age [interquartile range]: 35 [27–51] years). Although education and household income were not associated with infection, being a health-care worker was (aOR: 1.45; 95% confidence interval [CI]: 1.03–2.06). The odds of infection were higher among individuals who attended gatherings of five or more people compared to those who attended smaller gatherings (aOR: 2.58; 95% CI: 1.14–5.83). Absolute vaccine effectiveness for vaccination status was not estimated due to a high risk of bias, for example, unascertained prior infection. Moderate relative vaccine effectiveness for the first booster (32%; 95% CI: -120–79) and the second booster (48%; 95% CI: -23–78) were observed (both with wide CI), albeit with a waning trend after half a year. Discussion: The higher odds of infection among health-care workers emphasize the importance of infection prevention and control measures. Moderate relative vaccine effectiveness with a waning trend reiterates the need for more efficacious vaccines against symptomatic infection caused by circulating variants and with longer duration of protection.

roblem: Once COVID-19 vaccines were rolled out, there was a need to monitor real-world vaccine effectiveness to accumulate evidence to inform policy and risk communication. This was especially true in Japan and the Philippines, given historical issues that affected vaccine confidence. Context: Neither country had public health surveillance that could be enhanced to evaluate vaccine effectiveness or readily available national vaccination databases. Action: Study groups were established in multiple health-care facilities in each country to assess vaccine effectiveness against both symptomatic infection and severe disease. Outcome: In Japan, multiple study reports were published in Japanese on the website of the National Institute of Infectious Diseases and presented at the national government’s advisory board. Nationwide media coverage facilitated transparency and increased the confidence of the government and the public in the vaccination programme. In the Philippines, the launch of the study was delayed so as to align the research plan with the interests of various stakeholders and to obtain institutional review board approval. Ultimately, the studies were successfully initiated and completed. Discussion: There were four main challenges in conducting our studies: finding health-care facilities for data collection; obtaining exposure (vaccination) data; identifying epidemiological biases and confounders; and informing policy and risk communication in a timely manner. Preparedness during inter-emergency/epidemic/pandemic periods to rapidly evaluate relevant interventions such as vaccination is critical and should include the following considerations: (1) the establishment and maintenance of prospective data collection platforms, ideally under public health surveillance (if not, clinical research networks or linked databases); (2) uniform and practical protocols considering biases and confounders; and (3) communication with stakeholders including institutional review boards.

The purpose of this study was to clarify the relationship between quality of motion and motor ability in early childhood, as well as the moderating effects of grade and gender. A total of 133 preschoolers (3- to 5-year-old class) were evaluated for quality of motion and motor ability using the “Athletic Aptitude Test II” developed by the Japan Sports Association to assess the fundamental movements of running, jumping, and throwing. Two observers evaluated quality of motion based on movies taken by tablet. The relationship between quality of motion and motor ability was determined using multiple regression analysis. In addition, we clarified the influence of grade and gender on the relationship between quality of motor and motor ability using moderation analysis. A significant relationship was found between quality of motion and motor ability for all movements. Grade moderated the relationship between the quality of running motion and the results of the 25-m run. Gender moderated the relationship between the quality of the throwing motion and the results of softball throwing. These results suggest an association between quality of motion and motor ability in early childhood, and show that improving quality of motion improves motor ability.

The purpose of this study was to clarify the number of types and frequencies of fundamental movement patterns (FMP) during Soccer Kids Program (SKP) recommended by the Japan Football Association for preschool children, and to clarify the relationship between FMP and Moderate to Vigorous Physical Activity (MVPA; ≥3 METs). The participants were 12 children (six boys and six girls). The SKP was conducted for 50 minutes with video recording, and researchers counted the number of FMP during SKP by replaying the video. The FMP during SKP was classified into three movement categories: stability (eight types), locomotion (eight types), and manipulation (18 types). The participants wore a triaxial accelerometer (Active Style Pro, OMRON) on their waist during SKP and measured their activity (intensity and step) every ten seconds. Partial correlation analysis was performed on the relationship between MVPA and FMP using age in months and gender as covariates. MVPA during SKP was 24.3±5.0 minutes (48.7%), which was considerably more than in previous studies. Total number of FMP during SKP was 637.8±183.5 (stability: 27.8±12.4, locomotion: 399.7±156.6, manipulation: 210.3±48.4) and the mean number of types of FMP was 14.6±2.0 types. The FMP was confirmed in all three categories. There were significant correlations between MVPA and the total FMP (r = 0.72), the number of stability (r = 0.83), and the types of FMP (r = 0.69). This study suggested that an association between MVPA and FMP (total FMP, total stability, and type of FMP) in SKP.

BACKGROUND: Among former Olympic-level athletes, engagement in different sport disciplines has been associated with mortality risk in subsequent years. However, limited evidence is available on whether engagement in different sport disciplines at a young age is associated with locomotive syndrome (LS) risk later in life. This study examined the relationship between engagement in different sport disciplines during university years and LS risk in older age among former university athletes. METHODS: Participants were 274 middle-aged and 294 older men alumni who graduated from a school of physical education in Japan. LS risk was defined as answering "yes" to any of the Loco-check questions. Data on university sports club membership were collected using questionnaires. University clubs were classified into three groups of cardiovascular intensity (low, moderate, high), following the classification system of sport disciplines by the American College of Cardiology. This classification considers the static and dynamic components of an activity, which correspond to the estimated percent of maximal voluntary contraction reached and maximal oxygen uptake achieved, respectively. University clubs were grouped based on the risk of bodily collision (no, yes) and extent of physical contact (low, moderate, high). Relationships between engagement in different sport disciplines and LS risk were analyzed using Cox proportional hazards models, and adjusted for age, height, weight, joint disease, habitual exercise, and smoking and drinking status. RESULTS: Adjusted hazard ratios and 95% confidence intervals associated with the low, moderate, and high cardiovascular intensity sports were 1.00 (reference), 0.48 (0.22-1.06, P = 0.070), and 0.44 (0.20-0.97, P = 0.042) in older men, respectively; however, there was no significant association between these parameters among middle-aged men. Engagement in sports associated with physical contact and collision did not affect LS risk in either group. CONCLUSIONS Engagement in sports associated with high cardiovascular intensity during university years may reduce the risk of LS in later life. Encouraging young people to participate in such activities might help reduce LS prevalence among older populations.
Adult ; Aged ; Aged, 80 and over ; Athletes/statistics & numerical data* ; Exercise ; Geriatric Assessment ; Humans ; Japan/epidemiology* ; Locomotion ; Male ; Middle Aged ; Mobility Limitation ; Motor Disorders/etiology* ; Postural Balance ; Prevalence ; Proportional Hazards Models ; Risk Factors ; Sports/statistics & numerical data* ; Syndrome ; Young Adult

Background: Febrile neutropenia (FN) remains an important complication in pediatric cancer patients. The present study compared the efficacy of meropenem (MEPM) and piperacillin/tazobactam (PIPC/TAZ) with or without intravenous immunoglobulin (IVIG) as second-line therapy for FN in pediatric patients. Methods: As first-line treatment for FN, 394 episodes in 99 patients were randomly assigned to receive PIPC/TAZ (360 mg/kg/day, maximum 18 g/day) or MEPM (120 mg/ kg/day, maximum 3 g/day). Eighty-four episodes in 42 patients were judged as failures, and, thus, were enrolled for second-line treatment. In second-line treatment, antibiotics were switched to MEPM or PIPC/TAZ, and episodes were further randomized for treatment with or without concomitant IVIG at 100 mg/kg/day (maximum 5 g/day) for 3 consecutive days. Results: The total success rate of second-line treatment was 50.0% (52.0% in PIPC/ TAZ and 47.2% in MEPM with or without IVIG, P=0.826). The success rates of patients treated with (IVIG+ group) and without IVIG (IVIG− group) were 53.8 and 46.7%, respectively (P=0.662). In the IVIG+ group, the success rate of patients younger than 8 years old was 78.6%, which was significantly higher than that of those aged 8 years and older (40.0%, P=0.043). Conclusion PIPC/TAZ and MEPM were equally effective as second-line treatment. Concomitant IVIG was also effective, particularly in patients younger than 8 years.

The study aimed to assess a self-reported questionnaire about physical activity (PA) from the Health Behaviour in School-aged Children (HBSC) using triaxial accelerometer as a criterion. Elementary school boys (N=292) and girls (N=313) in the fourth grade and higher completed the questionnaire and wore an accelerometer for at least 10 h/day for at least 4 days. The phi coefficients of the chi-square test 2-way tables (active/inactive as measured using the HBSC questionnaire × achievement/non-achievement of the recommended 60-min moderate to vigorous PA [MVPA] as measured using the accelerometer) were 0.25 (P<0.001), 0.17 (P=0.009), and 0.08 (P=0.217) for all children, boys, and girls, respectively. The sensitivity and specificity in boys were 82% (95% confidence interval [CI]=78-86%) and 34% (95%CI=26-41%) respectively, while the those of girls were 52% (95%CI=40-63%), 57% (95%CI=55-60%). The positive predictive value in boys was 70% (95%CI=66-73%) and negative predictive value in girls was 83% (95%CI=79-87%). The independent t-test showed that moderate PA (MPA), vigorous PA (VPA), and MVPA min/day of active children were significantly higher than those of inactive children (range of Cohen’s d=0.38 to 0.71). Area under the curve (AUC) of the VPA (AUC = 0.60–0.73) in girls was significantly higher than that of the MPA (AUC = 0.52–0.65) and MVPA (AUC = 0.54–0.67). Our results supported that the HBSC self-reported questionnaire has acceptable, but limited agreement for assessing achievement/non-achievement of the MVPA recommendation, and could estimate the differences in the MPA, VPA, and MVPA min/day of children.

A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges.

A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges.