1.Prevalence and Risk Factors of Hypertension without Controlled Drug Treatment in Three Regions: A Study of Japanese Rural Populations
Yoshito Momose ; Hiroshi Une ; Masato Hayashi ; Naoharu Takeyama
Journal of Rural Medicine 2008;4(2):64-71
Background: Little information has been collected on the prevalence of hypertension in different rural parts of Japan, using similar methods for sample selection and based on similar diagnostic criteria, and epidemiological studies are urgently needed in each Japanese rural county to determine the baseline against which future trends in risk factor levels can be assessed in order to be able to plan appropriate preventive strategies. Objective: To study the prevalence and its relationship to risk factors of hypertension without controlled drug treatment in rural populations. Materials and Methods: Three cross-sectional surveys were conducted in the Akita (north), Gifu (middle) and Fukuoka (south) regions during 2004-2005 using study subjects (n=1778) aged 40-79 years who participated in a health check-up program. Blood pressure was measured by a trained nurse. Information concerning their history of hypertension and lifestyle was obtained by self-administered questionnaires. Results: When comparing the three regions, the prevalence of hypertension (≥140/90 mmHg) without controlled drug treatment demonstrated a significant difference among males (16.8%, 22.1% and 12.7% in Akita, Gifu and Fukuoka, respectively; p<0.05). However, no significant difference was seen among females (14.4%, 16.0% and 16.5% in Akita, Gifu and Fukuoka, respectively). According to a multivariate logistic regression analysis for these two groups in each of the three regions, the odds ratio (OR) showed that obesity (body mass index≥25 kg/m2) was strongly associated with the Hypertensive (-) group among females in two regions (ORs of 2.32 for both Akita and Fukuoka). Physical inactivity (average daily physical activity energy expenditure<300 kcal), alcohol drinking (alcohol intake≥44 g/day and/or frequency of drinking≥5 days/week), cigarette smoking (Brinkman index≥400) and a stressful lifestyle were not significantly associated with the Hypertensive (-) group among these rural populations. Conclusions: Therefore, hypertension in females in rural Japan may be controlled by a reduction in body weight.
Hypertension induced by pregnancy
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Risk Factors
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Japanese language
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Prevalence aspects
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Three
2.The prevalence of HIV infection in women attending antenatal clinics in Fiji.
Charles H Washington ; Lauren M Singer ; Tauta McCaig ; Lisi Tikoduadua ; Sophaganine T Ali ; James Fong ; Jiko Luveni ; Thane O Kyaw-Myint ; Stuart Watson ; Fiona Russell
Papua and New Guinea medical journal 2008;51(1-2):56-59
HIV (human immunodeficiency virus) is an increasing concern in the South Pacific. We estimate, based on reported figures, that the prevalence of HIV infection in women attending antenatal clinics in Fiji in 2003 was 0.04%. The number of children born to HIV-positive mothers is small, though perinatal transmission appears to be high. Fiji's preliminary strategies for prevention of perinatal transmission have been significant, but require ongoing support and implementation.
Fiji
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Prevalence aspects
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Human Females
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HIV Infections
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HIV
3.Intestinal microsporidiosis: A new entity in Malaysia?
A.H. Rukman ; O. Malina ; M.I. Noorhayati * ; M. Marlyn ** ; A. Wan Omar ; A.M. Roslaini ; Z. Ngah ; M. Norhayati *
Malaysian Journal of Medicine and Health Sciences 2008;4(2):11-24
Intestinal microsporidia is an emerging human disease caused by microsporidia. A study was conducted to determine the prevalence of microsporidia in patients with gastro-intestinal symptoms and to examine the clinical manifestations associated with intestinal microsporidiosis. A descriptive cross-sectional study using a well-structured questionnaire; a review of medical records was also undertaken. Positive stool samples were defined as presence of one or more pinkish-violet ovoid structures with a belt-like stripe under high power field (100x) using modified gram-chromotrope stain (MGC). A total of 353 faecal specimens of patients was examined and 100 patients were found to have positive stool samples for microsporidia. The overall prevalence of microsporidia was 28.3%. Acute and chronic diarrhoea were seen in 49.0% and 36.0% patients, respectively. The commonest clinical presentations were diarrhoea (85.0%) with 83.0% of patients having loose or watery stools, vomiting (75.0%), foul-smelling stools (60.0%), nausea (59.0%) and cramping abdominal pain (39.0%). The least common symptoms were fever (15.0%), mucous in stool (5.0%) and blood in stool (4.0%). This study concludes that the prevalence of microsporidia is still high (28.3%) and the majority of patients (93.0%) are symptomatic; the most common gastro-intestinal symptom is diarrhoea with loose or watery stools. Hence, it is recommended that a stool screening for microsporidia be done in selected patients presented with gastrointestinal symptoms.
Feces
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symptoms <1>
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Prevalence aspects
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Intestinal microsporidiosis
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Clinical
4.Prevalence of Metabolic Syndrome in Rural Community as Defined by the Japanese Association of Internal Medicine and the Ministry of Health, Labor and Welfare
Limei LI ; Li WANG ; Masayuki YAMASAKI ; Mamiko IWAMOTO ; Rumi IKENISHI ; Toshimi YONEYAMA ; Kuninori SHIWAKU
Journal of the Japanese Association of Rural Medicine 2007;56(5):703-713
Recently, people are interested in visceral obesity and metabolic syndrome (MS). The Japanese Ministry of Health, Labor and Welfare has decided to introduce a new MS screening system and health promotion guidance on the prevention of type 2 diabetes mellitus (diabetes) and cardiovascular disease from 2008. We analyzed the prevalence of MS and estimated the number of candidates for MS in a rural community based on the new criteria provided by the Japanese Association of Internal Medicine and the Ministry of Health, Labor and Welfare. Data obtained from 393 males and 526 females aged over 20 years were studied for the prevalence of MS and diabetes. The prevalence of MS was 14% for males and 6% for females. It was a remarkable lower prevalence than the reported prevalence in urban communities. We calculated again the prevalence of MS with the exclusion of diabetes, because diabetes was usually preceded by MS. The prevalence of diabetes and MS was 10% and 10% for males and 8% and 6% for females, respectively. Diabetes increased with age, but MS prevailed among younger people aged 20-59 years. We think that countermeasures against MS should be taken targeted on younger people, and those against diabetes on elder people. We also estimated the member of people with MS using the Ministry of Health, Labor and Welfare criteria. In 2012, the health organizations, both public and private, will be providing service to 3,470 thousand adults with MS and encouragement to 3,950 thousand adults to have a motivation for healthy lifestyle.
Morphine Sulfate
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Prevalence aspects
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Diabetes
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Labor (Childbirth)
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Health
5.The epidemiology of malaria in the Papua New Guinea highlands: 6. Simbai and Bundi, Madang Province.
Ivo Mueller ; Simon Yala ; Moses Ousari ; Julius Kundi ; Rex Ivivi ; Gerard Saleu ; Albert Sie ; John C Reeder
Papua and New Guinea medical journal 2007;50(3-4):123-33
Although predominantly a lowland province, Madang also includes highland areas such as Simbai and Bundi along the northern highland fringe. While the malaria situation in the coastal lowlands has been studied in great detail, the current malaria situation in the highland fringe communities has not been studied in depth since the 1960s. A series of recent malariological surveys found that the malaria situation has changed little over the last 40 years in both Simbai and Bundi. In the Simbai area there is little malaria transmission in villages above 1400 m, with a prevalence rate (PR) of 2.5-4.2%. Below 1400 m, however, there is moderate to high transmission (PR 8.6-24.7%) with surprisingly little difference in prevalence rates between survey villages, despite large differences in altitude. Prevalence rates of malaria infection were low in all Bundi villages (2.5-8.5%) with most infections occurring in adolescents and adults, which indicates limited acquisition of effective immunity to malaria and the possibility that many infections are acquired when travelling to the highly malarious lowlands area. Based on spleen rates the lower Simbai area would be regarded as mesoendemic, and the upper Simbai and Bundi areas as hypoendemic. Only in the lower Simbai area is malaria a major cause of febrile illness. However, in all areas village mean haemoglobin (Hb) levels were highly correlated with the prevalence of malaria infections, while concurrent parasitaemia reduced individual Hb levels by 1.3 g/dl (CI95 [1.0-1.5], p < 0.001) and significantly increased the risk for moderate-to-severe anaemia (Hb < 8 g/dl) (adjusted odds ratio 5.6, CI95 [3.6-8.6], p < 0.001). Based on the survey results, areas of different malaria epidemiology are delineated and options for control in each area are discussed.
Malaria
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Study of epidemiology
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Prevalence aspects
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Hemoglobin
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L
6.The epidemiology of malaria in the Papua New Guinea highlands: 5. Aseki, Menyamya and Wau-Bulolo, Morobe Province.
Ivo Mueller ; Albert Sie ; Moses Ousari ; Jonah Iga ; Simon Yala ; Rex Ivivi ; John C Reeder
Papua and New Guinea medical journal 2007;50(3-4):111-22
Although not strictly a highlands province, Morobe encompasses large highlands areas, the most important being Aseki, Menyamya and Wau-Bulolo. A series of rapid malaria surveys conducted in both the wet and dry seasons found malaria to be clearly endemic in areas below 1400 m in Menyamya and Wau-Bulolo, with overall prevalence rates in the wet season (25.5%, range: 9.1%-39.2%) greatly exceeding those in the dry season (8.3%, range: 2.4%-22.8%; p < 0.001). In the wet season surveys Plasmodium falciparum was the clearly predominant species, accounting for 63% of all infections. P. vivax increased in frequency in the dry season (from 27% to 46%, p < 0.001), while P. falciparum and P. malariae decreased. In line with past surveys a low prevalence of malaria was found in the Aseki area. Malaria was found to be the main source of febrile illness in the wet season with at least 60% of measured or reported fever associated with parasitaemia. Other causes of febrile illness dominated in the dry. In villages with parasite prevalence rates < 20% mean haemoglobin levels and prevalence of severe anaemia were strongly correlated with overall parasite prevalence. In addition concurrent malarial infections were associated with a strong reduction of individual haemoglobin levels (-1.2 g/dl) and there was increased risk of moderate-to-severe anaemia with concurrent malaria. Malarial infections are thus the most significant cause of febrile illness and anaemia in the highlands fringe populations in Morobe. As a consequence all villages below 1500-1600 m in Morobe Province should be included in malaria control activities.
Malaria
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Seasons
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Prevalence aspects
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Fever
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upper case pea
7.Obesity among schoolchildren in Kuala Selangor: a cross-sectional study.
Ghazali Sumarni Mohd ; K Muhammad Amir ; S Ibrahim Md ; I Mohd Rodi ; M G Izzuna Mudla ; Idris Nurziyana
Tropical biomedicine 2006;23(2):148-54
Childhood obesity is an established problem in many countries and emerging in others. Epidemiological data on obesity in children is essential in order to plan public health policy and services. A study was conducted to determine the prevalence of obesity in schoolchildren in the fifth grade of elementary school (10-12 years old) in the district of Kuala Selangor. Ten schools of which five are in urban and five in rural areas were selected consisting of 699 eleven year old schoolchildren from the three major ethnic groups. Using international cut-off points for obesity, we report an overall prevalence of obesity of 7.2%. Prevalence of obesity in urban children is 7.2% whereas in rural children it is 7.0 %. Analysed by gender, there were 8.9% obese boys and 5.3% obese girls. Among the 3 major ethnic groups, the Malays had the highest prevalence of obesity at 9.3% followed by the Chinese with 6.6% while among Indians 3.0%. The data obtained from this study suggests that obesity in Kuala Selangor children is a cause for concern in urban and rural areas.
Obesity
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seconds
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Child
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Prevalence aspects
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rural area
8.Occurrence of Sleep-Disordered Breathing (SDB) in Examinees of Thorough Medical Checkup
Akemi TAKAMIZAWA ; Mitsuyo OKADA ; Toshio SHIMIZU ; Miyuki HAYASHI ; Junko KOMATSU
Journal of the Japanese Association of Rural Medicine 2005;54(6):879-886
The estimated prevalence of sleep-disordered breathing (SDB) with an apnea-hypopnea index (AHI) of 5 or higher was 24 percent for men, and 4 percent of men in the middle-aged work force meet the minimal diagnostic criteria for the sleep apnea syndrome (SAS) (SDB with daytime hypersomnolence). However, there are few published data about this problem in our country.A random sample of 208 men 30 to 76 years old who were staying overnight for a complete physical examination were the subjects of this study. A portable sleep data acquisition device was used to determine the frequency of episodes of apnea and hypa-pnea in them. The prevalence of SDB was worked out and the clinical significance was discussed.The estimated prevalence of SDB was 76.4 percent and that of SAS was 12.5 percent. Compared with subjects with lower AHI values, those with higher levels of SDB and AHI included a significantly large number of individuals of advanced age and with hypertension, although their body mass index, Epworth sleepiness scale, and values of total cholesterol and triglycerides were not significantly high.These data revealed a remarkable high incidence of SDB in our country and suggested an association of SDB with risk factors of cardio-vascular events. We need a regular screening for sleep disorders by polysomnography or the portable device at least.
percent
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Prevalence aspects
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Sleep Apnea Syndromes
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Male population group
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SAS
9.Skin prick test reactivity to common airborne pollens and molds in allergic rhinitis patients.
The Medical journal of Malaysia 2005;60(2):194-200
Allergic rhinitis is the single most common chronic allergic disease affecting an estimated four million people in Malaysia. House dust mites, grass pollens and fungal spores play has been identified to play a major role in the pathogenesis of allergic rhinitis. However, sensitization to pollen and spores in Malaysia is not well documented. On the basis of the results of an aerobiological survey of the common mold spores and pollens in the Klang Valley, twelve local extracts of molds and two local extracts of grass pollens were prepared by the Institute for Medical Research for this study. The study evaluated the prevalence of skin prick test (SPT) reactivity to the extracts of those airborne molds and pollens in allergic rhinitis patients in the Klang Valley. A total of 85 allergic rhinitis patients were recruited. All molds and grass pollens extracts tested, elicited positive response to SPT. Among the molds extracts, Fusarium was observed to have the highest prevalence of SPT reactivity (23.5%), followed by Aspergillus flavum (21.2%), Dreselera orysae (18.8%), Alternaria sp (17.6%), Curvularis eragrostidis (17.6%), Penicillium oxa (16.5%), Pestolotriopsis gtuepini (16.5%), Rhizopphus arrhi (16.5%), Aspergilluls nigus (15.3%). Penicillium choy (12.9%), Aspergillus fumigatus (11.8%), and Cladosporium sp (4.7%). In the grass pollen, the SPT reactivity to Ischaemum and Enilia is 14.1% and 5.9% respectively. However, the prevalence of SPT reactivity was not influenced by the age, sex, ethnicity, symptomatology and concurrent allergic condition. We have documented the prevalence of skin prick test reactivity to common molds and grass pollens in the Klang valley, which is comparable to the neighboring countries. Its prevalence in our allergic rhinitis patients suggests that it has a role in pathogenesis of allergic diseases. A larger representative sample involving multi-centric centers in Malaysia should be encouraged in the near future.
Mold, NOS
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Allergic rhinitis, NOS
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Prevalence aspects
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Malaysia
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Pathogenesis
10.The epidemiology of malaria in the Papua New Guinea highlands: 3. Simbu Province.
Ivo Mueller ; Julius Kundi ; Steve Bjorge ; Pioto Namuigi ; Gerard Saleu ; Ian D Riley ; John C Reeder
Papua and New Guinea medical journal 2004;47(3-4):159-73
Two very distinct malaria zones can be found within Simbu Province. The north of the province is characterized by the absence or very low level of local malaria transmission, but there is a considerable risk of epidemics prevalent in the lower-lying parts. During non-epidemic periods, parasite prevalence was usually under 5%, with similar frequencies for Plasmodium falciparum and P. vivax (47% each), and malaria was an only minor source of febrile illness. During epidemics, however, 13-36% of people were infected, predominantly with P. falciparum (64%), and high levels of severe morbidity were present. In south Simbu malaria is clearly endemic with an overall prevalence of 35%, combined with a strong age-dependence of infections, low haemoglobin levels, high rates of enlarged spleen and moderate to severe anaemia (haemoglobin level < 7.5 g/dl) in children. The malaria epidemiology in south Simbu is thus more similar to the lowlands than to other highlands areas. Epidemic prevention, surveillance and response in the north, and bednet distribution and strengthening of curative services in the south, are therefore the priorities for malaria control in Simbu Province.
Malaria
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Study of epidemiology
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upper case pea
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Prevalence aspects
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epidemic aspects


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