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In This Issue WPSWestern Pacific Surveillance and ResponseR Journal Volume 10, Number 4, 2019, Pages 1–50 p-ISSN: 2094-7321 e-ISSN: 2094-7313 ©WHO IN THIS ISSUE Original Research Case-control study of risk factors for incident syphilis infection among men who have sex with men in Tokyo, Japan 1 M Ishikane, Y Arima, I Itoda, T Yamagishi, T Takahashi, T Matsui, T Sunagawa, M Ohnishi, K Oishi Field epidemiology training programmes in the Asia-Pacific: what is the best practice for supervision? 9 O Forbes, S Davis, A Dyda, A Rosewell, S Williams, M Kirk, MC Roces, MC Lim-Quizon, K Viney Meteorological factors associated with hand, foot and mouth disease in a Central Highlands province in Viet Nam: an ecological study 18 Pham HV, Phan UTN, Pham ANQ Screening for latent tuberculosis infection by an Aboriginal Community Controlled Health Service, New South Wales, Australia, 2015 24 H Visser, M Passey, E Walke, S Devlin Spatial distribution of tuberculosis in a rural region of Western Province, Papua New Guinea 31 T Diefenbach-Elstob, V Guernier-Cambert, B Gula, R Dowi, D Pelowa, W Pomat, C Rush, D Plummer, E McBryde, J Warner Gap in measles vaccination coverage among children aged 9 months to 10 years in Ho Chi Minh City, Viet Nam 39 Western Pacific Surveillance and Response Hoang QC, Ho XN, Pham VH, Nguyen LKH, Phan TL, A Mounts, Tran Minh NN Open access journal with continuous publication Regional Analysis Western Pacific Surveillance and Response (WPSAR) is Diphtheria diagnostic capacity in the an open access journal dedicated to the surveillance of and Western Pacific Region 46 response to public health events. The goal of the journal S Gurung, A Trindall, L Reeve, A Efstratiou, V Grabovac is to create a platform for timely information sharing both within our region and globally to enhance surveillance and response activities. WPSAR is a continuous publication which means articles will be published online as soon as they have completed the review and editing process. Every three months articles will be batched for a print issue. It is a publication managed by the World Health Organization Regional Office for the Western Pacific. Copyright notice Rights and permissions © World Health Organization 2019. Some rights reserved. p-ISSN: 2094-7321 EDITORIAL TEAM e-ISSN: 2094-7313 Masaya Kato The articles in this publication are published by the World Health Organization and contain contributions by individual acting Executive Editor authors. The articles are available under the Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO http:// creativecommons.org/licenses/by/3.0/igo/legalcode), which Anna Drexler permits unrestricted use, distribution and reproduction in any Coordinating Editor medium, provided the original work is properly cited. In any use of these articles, there should be no suggestion that WHO endorses any specific organization, products or services. The Roxanne Andaya use of the WHO logo is not permitted. Antonio Perez Attribution: please cite the articles as follows: [Author names]. Don Rivada [Article title]. Western Pac Surveill Response J. [Year]; [Volume] Editorial Assistant ([Issue]). [doi number]. License: Creative Commons BY 3.0 IGO Associate Editors The World Health Organization does not necessarily own each component of the content contained within these articles and Rabindra Abeyasinghe does not therefore warrant that the use of any third-party-owned individual component or part contained in the articles will not James Heffelfinger infringe on the rights of those third parties. The risk of claims Chin-Kei Lee resulting from such infringement rests solely with you. If you wish to re-use a component of the articles attributed to a third Nobuyuki Nishikiori party, it is your responsibility to determine whether permission is needed for that re-use and to obtain permission from the Heather Papowitz copyright owner. Examples of components can include, but are Boris Pavlin not limited to, tables, figures or images. Any mediation relating to disputes arising under this license shall be conducted in accordance with the WIPO Mediation Rules (www.wipo.int/amc/en/mediation/rules). Any inquiries should be addressed to [email protected]. Disclaimer The designations employed and the presentation of the information in this publication do not imply the expression of any To contact us: opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or Western Pacific Surveillance and Response boundaries. World Health Organization Office for the Western Pacific Region The mention of specific companies or of certain manufacturers' United Nations Avenue products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a 1000 Manila, Philippines similar nature that are not mentioned. Errors and omissions [email protected] excepted, the names of proprietary products are distinguished by https://ojs.wpro.who.int/ initial capital letters. OriginalArticle Research type Case-control study of risk factors for incident syphilis infection among men who have sex with men in Tokyo, Japan Masahiro Ishikane,a,b,c Yuzo Arima,d Ichiro Itoda,e Takuya Yamagishi,d Takuri Takahashi,d Tamano Matsui,d Tomimasa Sunagawa,d Makoto Ohnishif and Kazunori Oishid Correspondence to Yuzo Arima (email: [email protected]) Introduction: In Japan, syphilis notifications have increased. Men who have sex with men (MSM) in Tokyo have contributed substantially to the increase in syphilis notifications. We thus aimed to determine the correlates of incident syphilis among them. Methods: MSM who attended a Tokyo clinic that serves sexual minorities were recruited in a case-control study in 2015. A case was seropositive for primary/secondary/asymptomatic syphilis at enrolment visit and seronegative at prior visit or had oral ulcers positive for Treponema pallidum DNA at enrolment. For each case, two controls seronegative at enrolment and prior visit were selected. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated to assess for correlates of case status. Results: Among 35 cases, the median age was 37 (range = 21–63) years and was similar to the 71 controls. Among HIV-positive participants (26 cases and 67 controls), cases were independently associated with higher frequency of anal or oral sex (OR = 3.4; 95% CI = 1.4–8.6; increase per category from < 1/month, ≥ 1/month but < 1/week, to ≥ 1/ week) and no or inconsistent condom use during anal or oral sex (OR = 3.0; 95% CI = 1.1–8.3; increase per category from using every time, occasionally, to never), adjusted for residency and time between visits. Discussion: Modifiable behaviours were associated with incident syphilis, and dissemination of prevention messages are needed. yphilis, a nationally notifiable infectious disease Recent studies among MSM have reported that in Japan, has seen a considerable rise in the factors associated with syphilis were low educational Snumber of notifications,1,2 similar to many other attainment, sex with casual partners without a condom countries globally,3,4 including within the Western and coinfection with other sexually transmitted infections Pacific Region.5–7 In Japan, while more recent increases (STIs).10–13 Using mobile phone applications and the in syphilis have been among heterosexual men and Internet to seek partners has also been reported as a women,8 during 2013–2014, this increase was potential risk factor for STIs, including syphilis, among predominantly associated with men who have sex with MSM.14–16 While these and other practices have been men (MSM).1,2 The number of notifications among MSM suggested as possible contributors to the recent rise of remained high through 2018. Notably, both the absolute syphilis notifications in Japan, very few studies have number of reported MSM and heterosexual syphilis evaluated potential predictors for syphilis acquisition cases and the notification rate per population have in Japan. Recently, there was a cohort study analysing been highest in Tokyo (4 cases per 100 000 persons- the risk factors of incident syphilis infection among HIV- years during 2012–2016), contributing one third of the positive MSM in Japan,17 but behavioural factors were national cases.8,9 not assessed. To better understand the syphilis outbreak a Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan. b Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan. c Department of Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan. d Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan. e Shirakaba Clinic, Tokyo, Japan. f Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan. Submitted: 13 January 2019; Published: 9 December 2019 doi: 10.5365/wpsar.2019.10.1.003 https://ojs.wpro.who.int/ WPSAR Vol 10, No 4, 2019 | doi: 10.5365/wpsar.2019.10.1.003 1 Syphilis case-control study in Japan Ishikane et al among MSM in Tokyo, we conducted a clinic-based case- positive for T. pallidum DNA (polA/TpN47 genes) by poly- control study based on a self-administered questionnaire merase chain reaction (PCR)20,21 at the enrolment visit to assess the potential risk factors, including modifiable (PCR method available on a limited basis for research). behavioural factors, for incident syphilis. We excluded late stage and neurosyphilis cases because they likely would not reflect recent infection, and sexual MATERIALS AND METHODS activity within the recent six months would not be caus- ally related to such infections. Study design and setting Control subjects We conducted a case-control study at Shirakaba Clinic, a clinic that serves sexual minority populations. The clinic A control was defined as an eligible subject without evi- is located in the urban area of Tokyo, and most of the dence of recent syphilis infection.
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