著者
Fumiko Kagiura Ryota Matsuyama Dai Watanabe Yuuki Tsuchihashi Kazuhiko Kanou Takuri Takahashi Yusuke Matsui Masayuki Kakehashi Tomimasa Sunagawa Takuma Shirasaka
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.33, no.5, pp.256-261, 2023-05-05 (Released:2023-05-05)
参考文献数
29
被引用文献数
1

Background: The CD4 cell count of patients during diagnosis and distribution of CD4 cell counts in the patient population are important to understand infection-diagnosis interval and incidence rate of human immunodeficiency virus (HIV) infection, respectively. However, this information has not been published in Japan. This study aimed to describe the change in CD4 cell count trends and clarify the change in patients’ characteristics in association with the CD4 cell count information.Methods: A descriptive study was conducted to analyze the medical records of patients with HIV who visited one of the largest acquired immunodeficiency syndrome (AIDS) core hospitals in western Japan. The basic characteristics, CD4 cell counts, viral loads, and diagnosis-treatment intervals between the first (2003–2010) and second (2011–2017) halves of the study duration were compared.Results: The distribution of CD4 cell counts significantly changed between 2003–2010 and 2011–2017 (χ2 = 20.42, P < 0.001). The proportion of CD4 cell count <200 cells/mm3 increased (38.8% in 2003 to 45.9% in 2017), whereas CD4 cell count ≥500 cells/mm3 decreased (19.4% in 2003 to 12.2% in 2017). Moreover, the distributions of age groups, history of HIV screening test, patient outcomes, HIV viral load, and diagnosis-treatment interval also significantly changed (χ2 = 25.55, P < 0.001; χ2 = 8.37, P = 0.015; χ2 = 6.07, P = 0.014; χ2 = 13.36, P = 0.020; χ2 = 173.76, P < 0.001, respectively).Conclusion: This study demonstrated the fundamental trends of the HIV epidemic in Osaka, Japan between 2003–2010 and 2011–2017 and indicated that the incidence rate of HIV was decreasing in Japan.
著者
HIROSHI NISHIURA MASAYUKI KAKEHASHI
出版者
Japanese Society of Tropical Medicine
雑誌
Tropical Medicine and Health (ISSN:13488945)
巻号頁・発行日
vol.33, no.3, pp.127-132, 2005 (Released:2005-12-03)
参考文献数
32
被引用文献数
1 1

To estimate the time-dependent transmission potential of primary pneumonic plague (PPP), we analyzed historical records from six outbreaks. Based on contact investigation information (source of infection information) of three outbreaks, we generalized the probability density function of the serial interval with a Gamma distribution using maximum likelihood estimations. Furthermore, we used a likelihood-based approach to estimate effective reproduction numbers at time t, Rt, incorporating records from the remaining three outbreaks by assuming independence within unknown contact networks. According to our estimates, the Rt of PPP during the initial phases of each epidemic were roughly in the order of 1.3 (95% confidence interval (CI): 0.0-4.3) in Oakland, 1.4 (0.0-4.6) in Rangoon and 6.5 (0.0-16.0) in Ecuador. The expected values of Rt were shown to slightly exceed unity, even in latter stages. While declining trends in Rt were observed in Oakland and Ecuador, no such trend was observed in Rangoon. The findings suggest that the three outbreaks investigated could have been accompanied by demographic stochasticity. The statistical usefulness of the transformation procedure, even with a small number of recorded cases available, was demonstrated, and the expected responses to bioterrorism using Yersinia pestis were discussed.