著者
Shuhei Nomura Marisa Nishio Sarah Krull Abe Akifumi Eguchi Manami Inoue Motoi Suzuki Masahiro Hashizume
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20230235, (Released:2023-10-21)
参考文献数
23
被引用文献数
1

IntroductionThe Covid-19 pandemic has significantly impacted end-of-life decisions for cancer patients in Japan, with disparities existing between preferred and actual care settings. Our study investigates the potential shifts in cancer death locations during the pandemic and if there were excess cancer deaths.MethodsUtilizing national mortality data from the Ministry of Health, Labour, and Welfare from January 2012 to February 2023, we identified cancer deaths using ICD-10 codes. We assessed death locations, including medical institutions, nursing facilities, and homes. The Farrington algorithm was employed to estimate expected death counts, and the differences between observed and expected counts were denoted as excess deaths.ResultsFrom January 2018 to February 2023, there was consistently increase in the weekly observed cancer deaths. The presence of a definitive excess during the pandemic period remains uncertain. The percentage of deaths in medical institutions declined from 83.3% to 70.1% , while home deaths increased from 12.1% to 22.9%. Between April 2020 and February 2023, deaths in medical institutions frequently fell below the 95% prediction lower limit. Home deaths consistently exceeded the 95% prediction upper limit, with significant excess deaths reported annually.ConclusionOur study found a shift in cancer death locations from medical institutions to homes in Japan during the COVID-19 pandemic. Our study did not confirm an overall increase in cancer deaths during this period. As with global trends, the profound shift from hospitals to homes in Japan calls for a comprehensive exploration to grasp the pandemic's multifaceted impact on end-of-life cancer care decisions.
著者
Ayu Kasamatsu Kazuhiko Kanou Munehisa Fukusumi Yuzo Arima Shun Omori Haruna Nakamura Tetsuro Sato Yusuke Serizawa Asuka Takeda Hiroyuki Fujikura Chiaki Ikenoue Shingo Nishiki Yoshihiro Fujiya Takeshi Arashiro Takuri Takahashi Tomoe Shimada Motoi Suzuki Tomimasa Sunagawa
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20230025, (Released:2023-06-17)
参考文献数
21

Background: Little is known about the trends of imported infectious diseases among travelers to non-endemic countries during the COVID-19 pandemic. This article aimed to describe those among travelers to Japan.Methods: This is a descriptive study based on national surveillance data. Imported infectious disease cases were defined as those with a reported overseas source of infection among 15 diseases pre-selected based on the probability and impact of importation. The number of notified cases from April 2016 to March 2021 were described by disease and time of diagnosis. The relative ratio and absolute difference in case counts—both by number and per arrival—were calculated by disease comparing those from the pandemic period (April 2020–March 2021) to the pre-pandemic period (April 2016–March 2020).Results: A total of 3524 imported infectious disease cases were diagnosed during the study period, including 3439 cases before and 85 cases during the pandemic. The proportionate distribution of diseases changed but notification counts of all 15 diseases decreased during the pandemic. Accounting for arrivals, however, seven diseases showed a two-fold or greater increase, with a notable absolute increase per million arrivals for amebiasis (60.1; 95%CI, 41.5–78.7), malaria (21.7; 10.5–33.0), and typhoid fever (9.3; 1.9–16.8).Conclusion: The epidemiology of imported infectious diseases changed during the pandemic. While the number of imported infectious disease cases decreased, the number of cases per arrivals increased considerably both in relative and absolute terms for several diseases of public health and clinical importance.
著者
Yuuki Tsuchihashi Yuzo Arima Takuri Takahashi Kazuhiko Kanou Yusuke Kobayashi Tomimasa Sunagawa Motoi Suzuki
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20200519, (Released:2021-05-29)
参考文献数
40
被引用文献数
6

BackgroundNotifications of novel coronavirus infections increased in early 2020 in Japan. We described characteristics of novel coronavirus infection cases and analyzed risk factors for severe outcomes.MethodsCases were persons with laboratory-confirmed novel coronavirus infection reported under national surveillance between January and March 2020. Clinical characteristics were described, and factors associated with severe outcomes (intensive care unit [ICU] admission, invasive ventilation/death) were analyzed using Poisson regression.ResultsAmong the 516 cases analyzed, median age was 60 years (range: 1–97 years) and 285 (55%) were male. Common symptoms/signs were fever (375/475, 79%), cough (353/465, 76%), and pneumonia (245/387, 63%). Ten (2%) cases died. Of the 348 cases with data, 50 (14%) required invasive ventilation. Adjusted for each other, male gender and 1-year increase in age were associated with ICU admission (risk ratio (RR) 4.18; 95% confidence interval (CI), 1.69–10.32 and RR 1.05; 95%CI, 1.03–1.08, respectively) and invasive ventilation/death (RR 2.79; 95%CI, 1.49–5.21 and RR 1.06; 95%CI, 1.04–1.08). Diabetes, dyslipidemia, hyperuricemia, and lung diseases were also associated with severe outcomes. Of the 80 cases asymptomatic at hospitalization, 40 developed symptoms and five of them >70 years of age required invasive ventilation.ConclusionsThe early stage of the novel coronavirus epidemic in Japan disproportionately affected the elderly. Older age, male gender, and underlying conditions were associated with severe outcomes. Notably, some elderly case-patients who were asymptomatic at diagnosis and promptly hospitalized still went on to develop severe disease, indicating the importance of careful monitoring of certain populations.