Objective : To study the life style of the homeless living along the riverside, to assess their physical and mental health status, and to clarify the changes in their health status.Subjects : 155 homeless living in tents along the Sumida-River.Methods : The initial survey was conducted from July through December 2000, asking about the personal traits, life style, physical health status, subjective symptoms and mental health status (The General Health Questionnaire : GHQ-28). The follow-up survey was conducted in October and November, 2002. The presence of each subject, as well as his health status were confirmed.Results : According to the initial survey, the GHQ total score distribution of 86 male subjects indicated two peaks : that of a lower score group (mean : 2.7), and of a higher score group (mean : 10.7) suggesting a mildly neurotic condition. A higher score group a greater more number of subjective symptoms than the lower score group (Mann-Whitney test, p < 0.001). A significant correlation was found between the GHQ scores and the number of subjective symptoms (Spearman's rank correlation : 0.51, p<0.001) . Logistic regression analysis revealed that odds ratio of the number of subjective symptoms for neurotic condition was 1.95 (95% Confidence Interval : 1.203-3.162).The follow-up study showed that 40% of the homeless men had left the riverside, and most of them due to health-related problems. Regarding the termination of living along the riverside, univariate analysis of logistic regression model revealed that odds ratio of the number having disease was 3.18 (95% Confidence Interval : 1.316-7.669), and odds ratio of GHQ total score was 1.15 (95% Confidence Interval : 1.028-1.297).Conclusion : The number of disease of the individual homeless and the aggravated mental health status were contributing factors to the termination of living along the riverside.
Objective : To estimate the prevalence of Sick House Syndrome (SHS) in Tokyo metropolitan area with knowledge and attitudes regarding SHS.Subjects and Methods : Telephone survey by Random Digit Dialing methods was conducted in 2002. People living in the Tokyo metropolitan area aged 20 years or over were asked about their symptoms of SHS, their knowledge and coping behavior regarding SHS.Results : The number of respondents was 299 (the response rate was 24.8%).1) 76.6% of the respondents answered they knew about SHS.2) Among eight major SHS related symptoms, 42.1% of the respondents experienced at least one symptom during the past one year before the survey.3) The most frequently cited places where the respondents experienced the worsening of symptoms were their homes, public facilities, and workplaces, and 54.8% experienced relief of symptoms when getting out.4) In 41.3%, the symptoms varied according to the season.5) We defined SHS as (1) having experienced one or more symptoms among eight major SHS related symptoms, (2) symptoms which ameliorated when moving outdoors, and (3) symptoms unrelated to seasonal change. The prevalence of SHS was 14.0%.6) Among SHS patients, 11.9% visited physician's office, and 9.5% used OTC medicine.Conclusions : Our survey results revealed that SHS was well known. The prevalence of SHS in the Tokyo metropolitan area was 14.0%. A few SHS patients used medical services suggesting that SHS was recognized as a mild QOL disease. Further studies should reveal the validity of the disease definition based on subjective symptoms, incidence, natural course and regional difference of the disease.
Since the World Health Organization (WHO) set the global goal of leprosy elimination in 2000, many countries have successfully achieved elimination. Indonesia has achieved elimination at a national level, but several provinces and areas still have a high prevalence rate. South Sulawesi is one of 6 provinces on Sulawesi Island, and 5 of these provinces still have many leprosy patients with a prevalence rate of more than 1.1 per 10, 000 population and new cases are detected every year. The leprosy control program has not been successful in reducing the prevalence of this disease and 22 out of 27 regencies have, on average, a prevalence rate of 2.3 cases per 10, 000 population, of which child cases account for more than 5%, indicating that there are many more leprosy cases in the community. The leprosy control program has been helped by the multi drug therapy (MDT) regimen based on the WHO recommendation and several research studies carried out in the area. However, we as yet do not have a clear idea how to eliminate leprosy in South Sulawesi and further research is required.