Objective　This study aims to estimate the impact of maternal and child health professional consultation and development of support plans during pregnancy on trust in community health professionals (trust) and awareness of sources of public/private institutional support (awareness) in the postpartum period.

Methods　A web-based panel survey was conducted in July-August 2021 and January-February 2022, targeting women who were pregnant during the 2021 survey and 0-5 months postpartum in 2022. We collected information about consultation opportunities and development of a support plan during pregnancy, trust and recognition, demographic characteristics, employment status, and pregnancy- and childbirth-related variables. First, logistic regression analysis was conducted by setting trust and recognition during postpartum as outcomes. Exposure variables were the consultation opportunities and development of a support plan during the pregnancy period. Second, we added the presence of a comprehensive support center for raising children, the financial index of the municipality of residence, the per capita child welfare expenditure, and the number of nurses at the comprehensive support center for maternal and child health to the analytical model as overall level of municipal support in order to check the robustness of our results.

Results　Responses were obtained from pregnant women across Japan. Of the 616 respondents included in the analysis, 74.0% had opportunities for consultation, 23.7% made support plans, 69.8% trusted local maternal and child health professionals, and 63.6% recognized public/private institutional support as places for help-seeking. Logistic regression analysis showed that trust and recognition were higher among those who had opportunities to consult and had created a support plan compared to those who did not. With regard to trust, for those who had opportunities to consult, the odds ratio (OR) was 2.05 (95% confidence interval [95% CI] 1.37-3.07), and for those who developed a support plan, the OR was 2.25 (95% CI 1.41-3.60). As for recognition, the OR was 1.46 (95% CI 0.98-2.16) if given the opportunity for consultation. For development of a support plan, the OR was 3.05 (95% CI 1.94-4.80). These results did not change even after adjusting for municipal finances and the level of support for pregnant women in general.

Conclusions　Consultation opportunities and developing support plans during pregnancy increased trust and recognition in the postpartum period while municipal finances or overall support for child rearing were not associated with these outcomes, thus suggesting the importance of engagement with professionals during pregnancy.

Objectives　In response to the steady rise in the number of cases of mpox in nonendemic countries, starting with an outbreak in the United Kingdom in May 2022, the World Health Organization declared a public health emergency of international concern on July 23, 2022. As of November 13, 2022, seven cases of mpox have been reported in Japan.

Methods　A community engagement approach was applied to prevent the spread of mpox in Japan.

Results　A tripartite partnership between academia, community, and government (ACG) was established to promote multisectoral communication between vulnerable communities, medical personnel involved in diagnosis and treatment, public health specialists at public health centers, epidemiologists at the National Institute of Infectious Diseases (NIID), and government and public administration. Through information sharing, this ACG partnership can translate accurate information into effective infection control measures.

Conclusion　By developing and maintaining the ACG partnership, an environment will be created that allows an immediate response to future public health crises affecting vulnerable communities. This Practice Report describes the process of establishing an ACG partnership.

Objective　Coronavirus disease 2019 (COVID-19) became a global public health threat, and local public health centers in Japan implemented an infectious disease response to support patients. The response was subsequently modified to meet the needs for each of the five waves of infection. The study aim was to analyze the characteristics and courses of the disease in patients with COVID-19 at a single public health center. The study period included the first through fifth waves of the disease.

Methods　We utilized a descriptive epidemiological design in this study and data of patients with COVID-19 from one administrative district in Tokyo, Japan. We analyzed age, gender, nationality, symptoms at diagnosis, the route of infection, the recovery environment, and associated morbidity intervals, including case fatality rate, days from symptom onset to diagnosis, days from diagnosis to hospitalization, and recovery time for each of the first through fifth waves.

Results　From February 2020 to November 2021, 11,252 patients were diagnosed with COVID-19. Specifically, in the first wave, 151 patients were diagnosed, followed by 803 in the second wave, 2,406 in the third wave, 1,480 in the fourth wave, and 6,412 in the fifth wave. Hospitalization was the primary recovery environment during the first wave, while home recovery became the primary approach from the third wave onward. The case fatality rate was highest during the first wave, likely because of limited testing and treatment options for severe cases. The median time from onset to diagnosis was seven days in the first wave, significantly longer than for the other waves. The median time from diagnosis to hospitalization was one day in the first through fourth waves but three days in the fifth wave. The extension of this interval suggests that hospitalization was delayed in this wave as the number of severe patients increased rapidly, likely because of the novel COVID-19 variant.

Conclusion　This study of patients testing positive for COVID-19 provides valuable insights into the characteristics and courses of the pandemic within this district. These findings can inform regarding the development of effective strategies to manage the ongoing COVID-19 pandemic and other future emerging infectious diseases.

　Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH), Vol. 70 (2023) No. 12 pp.817-827