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Introducing Ecohealth education in a Teacher Training Institute in Lao PDR: a case study

Tomokawa S, Asakura T, Keosada N, Bouasangthong V, Souvanhxay V, Navamal P, Kanyasan K, Miyake K, Kokudo S, Watanabe R, Soukhavong S, Thalangsy K, Moji K.
Health Promot Int. 2021 Aug 24;36(3):895-904. doi: 10.1093/heapro/daaa100.

This paper argues the effectiveness of Ecohealth education for improving the quality of health and environmental education and for achieving sustainable development in developing countries. To illustrate the need for Ecohealth education, we review the transitions in health education, environmental education and Education for Sustainable Development (ESD) in various developing countries. Moreover, we discuss issues relating to these disciplines and consider the possible roles that Ecohealth education can play. Then, drawing on a case study conducted in Lao PDR, we propose a concrete example of the teaching content of Ecohealth education. We conclude that Ecohealth education can embody the concepts of ESD with respect to health and environmental issues, and thus can contribute to improvements in the quality of health and environmental education, and of ESD. In addition, we propose the following five actions for implementing Ecohealth education in developing countries: (i) promote research based on the approaches of public health and anthropology, and develop teaching materials that use the research results, (ii) empower school-aged children, (iii) encourage the active involvement and sharing of problems among communities, (iv) strengthen participatory teaching and learning methodology and (v) build a training system and train relevant teachers.

Lessons on health promotion from Japanese early childhood development

Miyake K, Tomokawa S, Asakura T.
Pediatr Int. 2021 Jan;63(1):22-36. doi: 10.1111/ped.14400.

The present study discussed the potential application of health-related Early childhood development (ECD) practices in Japan for developing countries by reviewing an outline of Japanese ECD, along with a case study describing practices in ECD facilities in Japan. We identified four main points: (i) distinct legal grounds including a legal basis for allocating health specialists; (ii) outlines of activities based on national standards and flexible practices at the facility level; (iii) teachers' attitudes that respect children's initiative, and explicit and independent activities embedded in children's daily lives that reflect the child's developmental status; and (iv) various useful practices to enhance the effect of health-related activities, such as cooperation with parents, lesson study and hoiku- (teachers) conference. As these practices are based on the Japanese context, it is essential to consider both the Japanese context and potential risks of transplanting such concepts, to enable optimum use of these lessons in other countries.

Has the double burden of malnutrition reached pupils in rural Western Kenya?

Rie Takeuchi Doris W Njomo Sammy M Njenga Sachi Tomokawa Alex Mutua Haruki Kazama Walema Barnette Takeshi Akiyama Takashi Asakura Yasuhiko Kamiya Jun Kobayashi
Pediatrics International 2021. Doi: 10.1111/ped.14729

Factors influencing school re-entry among adolescents in Kenya

Hanae Henzan, Rie Takeuchi, Sammy M. Njenga, Ernesto R. Gregorio Jr., Yoshio Ichinose, Daisuke Nonaka, Jun Kobayashi
Pediatrics International 2021. Doi: 10.1111/ped.14866

Urgent need to strengthen school health in Asia and the Pacific Islands

Jun Kobayashi, Rie Takeuchi, Yuko Toyama, Ernesto R. Gregorio Jr., Hamsu Kadriyan, Crystal Amiel M. Estrada, Makoto Motomura, Norie Wake, Kyoko Yamada, Ryuji Ishikawa, Minoru Takakura
Pediatrics International 2021. Doi: 10.1111/ped.14921

Perspectives of sustainable global school health promotion in Asia and Africa

Jun Kobayashi, Kenzo Takahashi
Pediatrics International 2021. Doi: 10.1111/ped.14867

Recommendations for the urgent need to vaccinate school-aged and adolescent children against COVID-19 in the Asia–Pacific region

Jun Kobayashi, Rie Takeuchi, Fumiko Shibuya, Yuki Murata, Kenzo Takahashi

Tropical Medicine and Health 49: 74. 2021. Doi: 10.1186/s41182-021-00365-5

“Reverse innovation” and “child rights” in further school health promotion

Jun Kobayashi, Kenzo Takahashi
Pediatrics International 2021. Doi: 10.1111/ped.15002

Quantitative or qualitative? Both types of research matter for establishing a voice from field evidence

Kenzo Takahashi, Jun Kobayashi
Pediatrics International 2021. doi: 10.1111/ped.14988


Participation of children in school health in Japan

Tomokawa S, Miyake K, Takeuchi R, Kokudo S, Asakura T.
Pediatr Int. 2020 Dec;62(12):1332-1338. doi: 10.1111/ped.14347.

This study examined ways in which Japan's school health system involves children, and factors enabling child participation in this system. It also suggests strategies to promote child participation in school health in developing countries. We identified the following four factors that enable child participation in school health in Japan: (i) having an explicit legal basis for participatory activities at the national level; (ii) having clear notification, in relevant administrative documents at the prefectural and municipal levels, of the necessity for children's voluntary participation; (iii) establishing a system for teachers to provide support for participatory activities at the school level, and (iv) having a shared understanding among stakeholders about the pedagogical importance of participatory activities in school health. To promote child participation in school health activities in developing countries, it is necessary to describe clearly the importance, benefits, impacts, and purposes of child participation in relevant legal and administrative documents at relevant administrative levels. Schools should also ensure that stakeholders have a common understanding of the educational benefits of child participation considering the cultural context of each country. It is helpful to conduct appropriate training for teachers to enable them to facilitate child participation.

Implementation of Kenyan comprehensive school health program: improvement and association with students' academic attainment

Akiyama T, Njenga SM, Njomo DW, Takeuchi R, Kazama H, Mutua A, Walema B, Tomokawa S, Estrada CAM, Henzan H, Asakura T, Shimada M, Ichinose Y, Kamiya Y, Kaneko S, Kobayashi J.
Health Promot Int. 2020 Dec 1;35(6):1441-1461. doi: 10.1093/heapro/daaa005.

This study aimed to clarify the improvement of school health during the project years and the association between school health and students' academic attainment. Primary schools in Mbita sub-county were selected as study sites. We assessed 44 schools' scores on a school health checklist developed from the Kenyan Comprehensive School Health Program, the students' mean score on the Kenya Certificate of Primary Education (KCPE), and absenteeism during the project years (2013-16). The mean school health checklist score (n = 44 schools) was 135.6 in 2013, 169.9 in 2014, 158.2 in 2015 and 181.3 in 2016. The difference of the mean score between 2013 and 2016 was significant. In addition, correlation analysis showed a significant association between mean KCPE score in the project years and school health checklist score (Pearson's coefficient was 0.43, p = 0.004). The results of this study suggest improvements of school health by the implementation of the Kenyan Comprehensive School Health Program and students' academic attainment.

Examining the appropriateness and reliability of the strategy of the Kenyan Comprehensive School Health Program

Tomokawa S, Asakura T, Njenga SM, Njomo DW, Takeuch R, Akiyama T, Kazama H, Mutua A, Barnett W, Henzan H, Shimada M, Ichinose Y, Kamiya Y, Kaneko S, Miyake K, Kobayashi J.
Glob Health Promot. 2020 Dec 1;27(4):78-87. doi: 10.1177/1757975920917976.

The Kenyan government established the Kenyan Comprehensive School Health Program (KCSHP) on the basis of Kenyan National School Health Policy. A KCSHP pilot project was carried out in eight primary schools in Mbita Sub-County of Homa Bay County in the Nyanza Region from 2012 to 2017. This pilot project provided health facilities and support for evaluation with a school health checklist, and organized teacher training on health education, a child health club, and school-based health check-ups. The present study aimed to examine the appropriateness and reliability of the strategy of the second KCSHP pilot project in Kenya. We analyzed data from self-administered questionnaires targeted at pupils in seventh-grade in the eight primary schools. The questionnaire consisted of questions on health-related knowledge, attitudes and practices, self-evaluated physical and mental health status, self-awareness of health control, subjective happiness, recognition on the importance of learning about health in school, absenteeism, and sense of school belongingness. The project contributed to improving health-related knowledge, attitudes and practices, self-evaluated health status, sense of school belongingness, recognition on the importance of learning about health in school, self-awareness of health control, and absenteeism. On the contrary, subjective happiness did not improve significantly.

Reliability and Validity of the Center for Epidemiologic Studies Depression (CES-D) Scale for Adolescents in Lao PDR

Tomokawa S, Asakura T, Keosada N, Bouasangthong V, Souvanhxay V, Kanyasan K, Miyake K, Soukhavong S, Thalangsy K, Moji K.
Psychology. 2020 Nov 17;11(11):1646-1660. doi: 10.4236/psych.2020.1111104.

This study aimed to develop a Laotian adolescent version of the Center for Epidemiologic Studies Depression Scale (CES-D), determine its reliability and validity, and examine its factorial properties. The study targeted 7554 students in lower secondary schools and teacher training colleges in Lao PDR. Self-administered questionnaires were distributed and collected from 2012 to 2014. Exploratory factor analysis was performed in three age groups using the weighted least square mean and variance adjusted estimation with robust maximum likelihood methods. The factor structure for each age group was the same; therefore, data from the full sample were analyzed further. The model was then tested by confirmatory factor analysis. A 2-factor model was determined as a common model among the age groups by using paralleled analysis. We determined a best-fitting structure comprising two factors: “Negative affect” and “Positive affect”. The Cronbach’s alpha was 0.81. “Effort” items loaded on the “Somatic and retarded activity” factor in the original model but loaded on the “Positive affect” factor in the adolescent model. “Depressed affect,” “Somatic and retarded activity,” and “Interpersonal” items were combined into the “Negative affect” factor in the adolescent model.

Undokai and sports events in the Japanese school system

Akiyama T.
Pediatr Int. 2020 Nov;62(11):1230-1233. doi: 10.1111/ped.14332.

Japanese schools hold annual sports events in which all pupils participate. These events include activities such as walking, running, and swimming competitions.We analyzed literature on school sports events in Japan. In addition to the physical education classes, which are part of the curriculum, Japanese schools hold annual sports events in which all pupils participate. These school events include activities such as walking, running, swimming, and ball game competitions, skiing, and climbing. School sports events offer participants an opportunity for holistic education as well as cultivating a variety of virtues such as cooperation, a sense of solidarity, teamwork, and responsibility. A popular sports event held countrywide is undokai. Undokai has a style that is unique to Japan. They usually take one day and include individual and group competitions. The pupils participate in a variety of activities including a foot race, relay race, group gymnastics, and group activities. The undokai is an important event in both the school and its surrounding community. The potential benefit of undokai is often considered in terms of social capital. However, the competitive nature of undokai may generate negative feelings in the children who participate. Further research on the potential of sports events such as undokai is necessary.

From Effective school-based preventive interventions for alcohol use in Africa: a systematic review

Tomokawa S, Miyake K, Akiyama T, Makino Y, Nishio A, Kobayashi J, Jimba M, Ayi I, Njenga SM, Asakura T.
Afr Health Sci. 2020 Sep;20(3):1397-1406. doi: 10.4314/ahs.v20i3.45.

We aimed to identify effective school-based alcohol use prevention interventions in Africa. Four of 2797 papers met our eligibility criteria. All reported interventions targeted secondary school students in South Africa and were incorporated in the school curriculum. The interventions comprised multi-component activities with participatory and peer educational methods, and applied modified programs originally developed in the US. However, intervention effects were inconsistent among studies, although the interventions tended to have a positive effect on non-drinkers at baseline, with stronger effects in girls. Interventions had positive effects on students that were non-drinkers at baseline, especially girls. Although we could not find robust evidence that school-based interventions changed attitudes, frequency/quantity of drinking, and intentions to use alcohol, one intervention showed an increase in students' alcohol refusal self-efficacy.

From historical experiences to global outcome: Lessons learned from school health in Japan

Takahashi K, Eto T.
Pediatr Int. 2020 Sep;62(9):1017-1018. doi: 10.1111/ped.14355.

School health promotion in South-East Asia by Japan and partners

Estrada CAM, Gregorio Jr ER, Kanyasan K, Hun J, Tomokawa S, Dumlao MC, Kobayashi J.
Pediatr Int. 2020 Sep;62(9):1029-1038. doi: 10.1111/ped.14284.

School health promotion in South-East Asia has developed rapidly in recent years, and Japan has been one of the significant contributors to the reinforcement of school health promotion in the region. Starting from the Hashimoto Initiative on global parasite control, Japan advocated for international partnerships with several agencies for the development of school health programs in South-East Asia. Through a strengthened collaboration with international organizations, countries such as the Lao PDR, Cambodia, the Philippines, and Thailand have created and implemented school health programs on nutrition, sanitation, and deworming, among others. In addition to school health program formulation and implementation, the expanded network in South-East Asia led to more capable school health personnel, with many workers in the education and health sectors benefitting from the training programs jointly held by collaborating organizations.

Sustainable human resource training system for promoting school health in Japan

Tomokawa S, Miyake K, Asakura T.
Pediatr Int. 2020 Aug;62(8):891-898. doi: 10.1111/ped.14292.

This paper reviewed the structure of human resources and relevant training systems for school health in Japan and identified current strengths and challenges. Our review identified seven key points: (i) a legal basis for the allocation of human resources to schools; (ii) established training systems for school health human resources; (iii) uniformity and quality of teacher training curricula; (iv) establishment of teacher-training institutions; (v) education centers in every prefecture; (vi) allocation of supervisors for Yogo teachers to every prefectural and municipal education board; and (vii) various study group activities at the district and school levels. Based on these results, we proposed some useful ideas for developing human resources to promote school health in countries outside Japan, especially for developing countries. First, it is necessary to clarify the required competencies for school health among school staff and establish teacher-training systems based on the required competencies in each country. It is also necessary to consider possible collaboration with existing community health workers, such as doctors, nurses, midwives, nutritionists, and community health workers by providing short-term training on school health. Second, it is important to train and assign specialists to teacher-training institutions that can provide education and conduct research on school health. Third, it is helpful to enhance the functions of in-service training at the prefectural or district level and introduce lesson study on school health.

Compulsory educational mental health support system in Japan

Nishio A, Kakimoto M, Horita R, Yamamoto M.
Pediatr Int. 2020 May;62(5):529-534. doi: 10.1111/ped.14205.

The purpose of this article is to show the mental health support system and its historical transition in Japan. In general, Japanese schools have a Yogo teacher (a school nurse) who works full time, as well as three types of mental health specialists who work part time: school counselors, advisors, and social workers. The regularity of visits from the three types of specialists depends on schools and regions. In general, school counselors visit schools more often than do other specialists, for approximately 4 h per week. The other specialists either visit the schools rarely or not at all because they are sometimes not hired. The strengths of the Japanese system included much provision of psychological consultations and a small budget compared to Western countries. Almost all school counselors are clinical psychologists with master's degrees who are skillful at handling students' mental problems. Moreover, they are capable of providing intensive psychological counseling in school settings in Japan. The weakness is that there is no specialist available who supports students' academic or school life. General teachers take on the role of the Western countries' "school counselors." There are also few specialists who can be approached for social support compared to Western countries.

School-based interventions to promote adolescent health: A systematic review in low- and middle-income countries of WHO Western Pacific Region

Xu T, Tomokawa S, Gregorio Jr ER, Mannava P, Nagai M, Sobel H.
PLoS One. 2020 Mar 5;15(3):e0230046. doi: 10.1371/journal.pone.0230046.

There is an urgent need to identify effective school-based interventions and facilitating factors for successful implementation in adolescent health in WPRO. Most of the studies used knowledge, attitudes and behaviours as outcome measures. A few also included changes in the school policy and physical environment as outcome measures while only one used BMI, waist circumference and quality of life as their outcome measures. The topics in these studies included: AIDS, sexual and reproductive health, de-worming, nutrition, obesity, tobacco use, and suicide. Some interventions were reported to be successful in improving knowledge, attitudes and behaviours, but their impact and scale were limited. The interventions used by the different studies varied from those that addressed a single action area (e.g. developing personal skills) or a combination of action areas in health promotion, e.g. developing a health policy, creating a supportive environment and developing personal skills. No intervention study was found on other important issues such as screening, counseling and developing safe and nurturing school environments. Only eight school-based health interventions were conducted in the Region. This study found that school-based interventions were effective in changing knowledge, attitudes, behaviors, healthy policies and environment. Moreover, it was clarified that policy support, involving multiple stakeholders, incorporating existing curriculum, student participation as crucial factors for successful implementation.

Current situation and comparison of school mental health in ASEAN countries

Nishio A, Kakimoto M, Bermardo TMS, Kobayashi J.
Pediatr Int.
2020 Apr;62(4):438-443. doi: 10.1111/ped.14137.

School-based mental health interventions are considered to have potential for the promotion of mental health in developing countries. We held a workshop to discuss the promotion of mental health in schools in southeast Asian countries. This review report aimed to summarize the current situation of school mental health in Association of Southeast Asian Nations (ASEAN) countries as reported by their representatives in this workshop. To summarize the current situation of ASEAN countries in relation to school mental health, we qualitatively analyzed the content of the discussions from four perspectives: (i) laws and regulations: (ii) mental health services; (iii) teacher training on mental health; (iv) mental health education for students. With regard to school mental health laws and regulations, this report could not provide clear conclusions because the laws were reported through the personal understanding of the public officers. Our results show that mental health services in schools are centered on professionals such as guidance counselors, although the coverage varied among the different ASEAN countries. Only Singapore conducted mental health training for teachers in a comprehensive way, and the number of people who were actually trained in other countries was very limited. Cambodia, Malaysia, Myanmar, Philippines, Singapore, and Thailand included mental health education for students in health education or life skills subjects.

Expert Consensus on the Essential Preventive Knowledge of Tuberculosis for High School Students, Kathmandu, Nepal

Gopali RS, Maharjan B, Kigawa M.
Biomed J Sci & Tech Res. 2020 Mar 5;26(2):19849-19857. doi: 10.26717/BJSTR.2020.26.004332

School students play an important role in the prevention of TB at all levels of community. However, there is no consensus on essential preventive messages to be taught to the students. This study aims to develop consensus on essential information about preventive measures of TB. It is qualitative research using three-round Delphi techniques among TB experts to develop agreement on essential preventive measures to prevent TB and verify their level of agreement. The essential knowledge to prevent TB is information about causative agent, DOTS process and its importance, sign and symptoms, national strategic plans, and psychosocial counseling. Nearly 91% of the experts agree that information about causative agent of TB is most essential to be informed to the students. Delphi method is an effective tool to develop consensus. The results can be used for developing the IEC materials focusing school students and the communities.

保育者の健康に関する活動の自己評価及び 「健康」保育者効力感とそれらに関連する要因の検討

三宅公洋, 友川幸, 友川礼, 朝倉隆司
日本健康教育学会誌 2020;28(4): 287-298. doi: 10.11260/kenkokyoiku.28.



Is there a gap between health education content and practice toward schistosomiasis prevention among schoolchildren along the shores of Lake Victoria in Kenya?

Takeuchi R, Njenga SM, Ichinose Y, Kaneko S, Estrada CAM, Kobayashi J.
PLoS Negl Trop Dis.
2019 Aug 19;13(8):e0007572. doi: 10.1371/journal.pntd.0007572.

Despite provision of preventive measures against schistosomiasis such as mass drug administration (MDA), the prevalence of Schistosoma mansoni remains high in communities living near Lake Victoria. This study aimed to analyse the status of schistosomiasis, including its prevalence, health education, knowledge, attitudes, and practices (KAP) among pupils, and water use in schools in Mbita situated along the shores of Lake Victoria. The prevalence of S. mansoni was 56% and 36% in 2015 and 2016, respectively. 60-70% of pupils chose a correct answer for the mode of transmission. More than 70% of pupils answered that bathing in Lake Victoria causes Schistosoma infection; however, more than 70% of pupils bathed in Lake Victoria sometimes or every day. According to the science textbook, "avoiding contact with contaminated water" is the way to prevent schistosomiasis; however, 66% of schools asked pupils to bring water from Lake Victoria. The prevalence of S. mansoni among pupils remains high. Schoolchildren are taught to avoid contact with contaminated water but are often asked to fetch water from the lake. From the school health viewpoint, health education that reflects the social and cultural context of the community in the contents and teaching methods are needed. In addition to this, provision of sanitation infrastructure is needed. A comprehensive and innovative approach which harmonises central and local governments and other stakeholders, as well as community is important to prevent schistosomiasis.

Suicidal ideation, suicidal behaviors, and attitudes towards suicide of adolescents enrolled in the Alternative Learning System in Manila, Philippines-a mixed methods study

Estrada CAM, Nonaka D, Gregorio ER Jr, Leynes CR, Del Castillo RT, Hernandez PMR, Hayakawa T, Kobayashi J.
Trop Med Health.
2019 Mar 29;47:22. doi: 10.1186/s41182-019-0149-6.

This study aimed to document suicidal ideation and behaviors among adolescent learners enrolled in the Alternative Learning System (ALS) in Manila, Philippines. Non-specific active thoughts were the most common type of lifetime suicidal ideation (40.9%) while passive ideation was the most common in the past month (13.5%). Aborted suicide attempt was the most frequent behavior in both lifetime (16.4%) and in the past month (4.7%). Non-fatal suicide attempt in the past month was 2.3%, reaching 12.9% for the entire lifetime. Age, sex, education, and attitudes towards suicide were significantly associated with suicidal ideation or behavior. Thematic analysis showed five themes: (1) fostering belongingness, (2) securing learners’ safety, (3) teaching philosophy, (4) teacher and learner beliefs towards suicidal behavior, and (5) availability of school-offered and community-based services. Suicidal ideation and behaviors are prevalent among adolescent ALS learners. This study also showed a significant difference in attitudes towards suicide and sociodemographic characteristics between learners with and without suicidal ideation behaviors. It also suggests that the school psychosocial environment, through social norms and learner-teacher interactions, can potentially prevent progression of suicidal ideation to behavior, influence help-seeking, and promote mental health among learners.

Knowledge, attitudes, and practices of public secondary school teachers on Zika Virus Disease: A basis for the development of evidence-based Zika educational materials for schools in the Philippines

Gregorio ER Jr, Medina JRC, Lomboy MFTC, Talaga ADP, Hernandez PMR, Kodama M, Kobayashi J.
PLoS One.
2019 Mar 28;14(3):e0214515. doi: 10.1371/journal.pone.0214515.

This study aimed to assess the knowledge, attitudes, and practices of public secondary school teachers on ZIKV Disease. Out of the 609 respondents, 87.3% reported that their main source of information about ZIKV is tri-media, which includes television, print, and radio. Only half of the participants identified vector control as a preventive strategy. Moreover, only 54% admitted to have cleaned their water containers or water sources within the last week. Only a few identified mother-to-child (23%) and sexual intercourse (8%) as other means of transmission. Half (49.8%) of the respondents felt that it is possible to acquire ZIKV in their community, while 90% perceived that a private doctor (90%) or a public hospital (88%) can effectively treat the disease. Perceived stigma is high at 50%. This study showed there was good knowledge among teachers on vector transmission of ZIKV but poor knowledge on other aspects of the disease. Also, there was a low level of perceived susceptibility and severity of ZIKV which can be explained by the absence of a personal encounter with a Zika patient and the low number of cases in the Philippines. Half of the respondents said that they cleaned the possible mosquito breeding sites within the last week, followed by those who cleaned their water source more than a week ago (19%). None of the socio-demographic characteristics is significantly associated with respondents’ knowledge on Zika. Only income and location of residence were found to be significantly associated with attitudes towards Zika. These findings call for a comprehensive training program that includes development of teaching materials for public secondary school teachers on ZIKV Disease based from this study.


友川幸, 三宅公洋, 岡崎良子
2019 May 25; 20: 9-19.

School health and nutrition program implementation, impact, and challenges in schools of Nepal: stakeholders' perceptions

Shrestha RM, Ghimire M, Shakya P, Ayer R, Dhital R, Jimba M.
Trop Med Health.
2019 May 14;47:32. doi: 10.1186/s41182-019-0159-4.

We conducted a qualitative study to explore (1) the School Health and Nutrition (SHN) program implementation, (2) its impact, and (3) challenges in Nepal. We categorized interview data into three broad themes: (1) SHN program implementation, (2) its impact, and (3) challenges during implementation. Almost all the key informants appreciated the program for its positive impact on students, schools, and communities. The positive impacts included improved students’ health and school environment and enhanced community awareness. However, the key impediments in implementing the program included a lack of coordination between stakeholders, lack of resources, limited training opportunities, and doubts regarding the sustainability of the program. This study provided a deeper understanding of the linkage between the SHN program implementation, impact, and challenges in Nepal. Despite the challenges, all the stakeholders acknowledged that the SHN program had positive impacts on students, schools, and communities. Our findings highlighted that stakeholders from all tiers should coordinate, collaborate, and continue their efforts to effectively implement and expand the program nationwide. Awareness campaigns and advocacy for the program are indispensable to pull more resources from relevant stakeholders.

Religious education can contribute to adolescent mental health in school settings

Estrada CAM, Lomboy MFTC, Gregorio Jr ER, Amalia E, Leynes CR, Quizon RR, Kobayashi J.
Int J Ment Health.
2019 Apr 26;13:28. doi: 10.1186/s13033-019-0286-7.

This paper aims to discuss the importance of religious education in promoting mental health. Religious education can be instrumental to improving adolescent mental health. Specifically, it can: (1) help develop healthier reaction to stimuli through the internalization of religious morality; (2) reinforce religious coping mechanisms which reduce the impact of stresses, enhance coping skills, and promote a less risky lifestyle; (3) increase awareness regarding religious beliefs and practices and their influence on the individual, the family, and the community; and finally, (4) promote connectedness which can enhance self-esteem and well-being. However, negative health outcomes such as discrimination and social isolation can also develop, especially among religious or gender minority groups. It is important to reflect on the crucial role of religious education on adolescent mental health. School-based mental health education and promotion strategies can maximize the benefits of religious education by putting emphasis on effective implementation of religious education to positively influence adolescent mental health.


関谷大輝, 依田健志, 清水裕子, 熊谷信弘
2019 Mar; 19(2): 69-90.

Oral health behavior of children and guardians' beliefs about children's dental caries in Vientiane, Lao People's Democratic Republic (Lao PDR)

Phanthavong S, Nonaka D, Phonaphone T, Kanda K, Sombouaphan P, Wake N, Sayavong S, Nakasone T, Phongsavath K, Arasaki A.
PLoS One.
2019 Jan 25;14(1):e0211257. doi: 10.1371/journal.pone.0211257.

This study aimed to describe children's oral health behavior and its association with childhood dental caries, as well as to assess associations between children's tooth-brushing behavior and guardians' beliefs in an urban area of Lao PDR, using Health Belief Model (HBM). A mixed-effects logistic regression model assessed the association between dental caries and children's oral health behavior and between children's tooth-brushing behavior and guardians' beliefs. Data from 1161 of 1304 (89.0%) children registered at the schools were used. The prevalence of dental caries was 82%. Children who brushed their teeth ≥ twice/day were significantly less likely to have dental caries than those brushing once or seldom (OR: 0.64, 95% CI: 0.45 to 0.91). The number of children who brushed twice daily also significantly increased with the increased level of guardians' self-efficacy (OR: 2.14, 95% CI: 1.91 to 2.41). In conclusion, childhood dental caries was associated with daily tooth brushing. Children's tooth-brushing behavior was associated with guardians' self-efficacy in making their children brush twice daily.

Virologic failure in HIV-positive adolescents with perfect adherence in Uganda: a cross-sectional study

Natukunda J, Kirabira P, Ong KIC, Shibanuma A, Jimba M.
Trop Med Health.
2019 Jan 17;47:8. doi: 10.1186/s41182-019-0135-z.

This study aimed to identify the factors associated with viral load suppression among HIV-positive adolescents (10-19 years) receiving antiretroviral therapy (ART) in Uganda. We analyzed the data of 200 adolescents meeting the inclusion criteria. Viral suppression was high among adolescents with good adherence > 95% (adjusted odds ratio [AOR] 2.73, 95% confidence interval [95% CI, 1.09 to 6.82). However, 71% of all adolescents who did not achieve viral suppression were also sufficiently adherent (adherence > 95%). Regardless of adherence status, other risk factors for viral suppression at the multivariate level included having a history of treatment failure (AOR 0.26, 95% CI, 0.09 to 0.77), religion (being Anglican [AOR 0.19, 95% CI, 0.06 to 0.62] or Muslim [AOR 0.17, 95% CI, 0.05 to 0.55]), and having been prayed for (AOR 0.38, 95% CI, 0.15 to 0.96). More than 70% of adolescents who experienced virologic failure were sufficiently adherent (adherence > 95). Adolescents who had unsuppressed viral loads in their initial viral load were more likely to experience virologic failure upon a repeat viral load regardless of their adherence level or change of regimen. The study also shows that strong religious beliefs exist among adolescents. Healthcare provider training in psychological counseling, regular and strict monitoring of adolescent outcomes should be prioritized to facilitate early identification and management of drug resistance through timely switching of treatment regimens to more robust combinations.

Quality of public school toilets and the frequency of changing sanitary napkins among students in public secondary schools in the City of Manila, Philippines

Katsuno C, Gregorio Jr ER, Lomboy MFTC, Nonaka D, Hernandez PMR, Estrada CAM, Pimentel JMT, Bernadas RMGC, Kobayashi J.
Trop Med Health.
2019 Jan 11;47:5. doi: 10.1186/s41182-018-0131-8.

The present study aimed to assess the association between the quality of school toilets and the frequency of changing sanitary napkins in school toilet among Filipino students. No significant association was found both between toilet quality and the outcome. Although the association was not significant, the odds ratio (OR) of “sanitary bin is available in toilet” was 2.54 compared to “sanitary bin is not available in toilet.” The results of multivariate analysis showed that participants who reported stronger perceived behavioral control or stronger subjective norm were significantly more likely to change sanitary napkins, compared to those with lower perceived control score or lower subjective norm score, respectively (adjusted OR 2.29, 95% confidence interval 1.24 to 4.25; adjusted OR 2.63, 95% confidence interval 1.45 to 4.76). The present study showed that the quality of school toilets was not associated with the frequency of changing sanitary napkins among the studied population. However, it does not mean that the cause-effect relationship was rejected. Further studies involving more schools are necessary to confirm this relationship. Improving subjective norm and perceived behavior control might improve menstrual hygiene behavior.

The effect of youths as change agents on cardiovascular disease risk factors among adult neighbours: a cluster randomised controlled trial in Sri Lanka


Chandraratne N, Yamaguchi M, Indrawansa S, Gunawardena N, Kuwahara K, Islam Z, Kawasaki Y, Mizoue T, Samarasinghe D.
BMC Public Health.
2019 Jul 8;19(1):893. doi: 10.1186/s12889-019-7142-1.

The objective of this study was to investigate the effect of an intervention with youth on cardiovascular disease risk factors of community adults. Of 512 participants at baseline, 483 completed the final assessment after the intervention. Regarding primary outcomes, the intervention group showed a significantly greater decrease in body weight after intervention than the control group. The mean (95% confidence interval) difference of body weight change for intervention versus control group was − 2.83 kg (− 3.31, − 2.35). There was no statistically significant difference in blood pressure between the two groups. Turning to the secondary outcomes, in diet, the intervention group had a higher probability of consuming at least one serving/day of fruits (p = 0.02) and a lower probability of consuming snacks twice/day or more (p < 0.001) than the control group. An intervention employing youths as change agents was effective in lowering body weight among community adults in Sri Lanka.


清水裕子, 山口舞, 山本麻理奈, 上原星奈, 依田健志, 楠川富子, テアリス ブン, タイ ソックヘン.
2019; 23(1): 59-70. doi: 10.34390/njku.23.1_59



Addressing challenges in children's mental health in disaster-affected areas in Japan and the Philippines - highlights of the training program by the National Center for Global Health and Medicine

Usami M, Lomboy MF, Satake N, Estrada CAM, Kodama M, Gregorio Jr ER, Suzuki Y, Uytico RB, Molon MP, Harada I, Yamamoto K, Inazaki K, Ushijima H, Leynes C, Kobayashi J, Quizon RR, Hayakawa T.
BMC Proc.
2018 Dec 19;12(Suppl 14):65. doi: 10.1186/s12919-018-0159-0

Natural disasters such as earthquakes, typhoons, floods, and volcanic eruptions frequently occur in Republic of Philippines and mental health care for children affected by these natural disasters is a major public health concern. The National Center for Global Health and Medicine (NCGM) conducted a training program for children’s mental health in disaster-affected areas in Japan and the Philippines in June, October, and December, 2017.
The training program enabled key stakeholders to describe the current situation of mental health in Japan and the Philippines, to identify mental health challenges common to disaster-affected areas in both countries, and to propose short- and long-term plans and recommendations. The training program is expected to address the mental health needs of children in disaster-affected areas through a responsive community-based support network.

Implementation of disaster risk reduction and management policies in a school setting in Lao PDR: a case study

Kanyasan K, Nonaka D, Chatouphonexay A, Hernandez PM, Kounnavong S, Kobayashi J.
Trop Med Health.
2018 Dec 12;46:42. doi: 10.1186/s41182-018-0124-7.

This study aimed to clarify the present situation to inform better implementation strategies on disaster risk reduction and management in a school setting focused on fire disasters in Lao PDR. Three themes emerged: policy content and dissemination, factors which affect policy implementation, and impacts of policy implementation facilitating factors include effective coordination and ownership among the national DMC members for scaling up disaster risk reduction (DRR) activities, and strong support from the central government. Barriers include unclear provisions in the national legislation, unclear mandates especially on leading the program, poor monitoring system, insufficient human resources, and lack of public-private partnerships. All the study schools conducted DRR classes and designated a disaster assembly point. More than 80% of the students correctly answered items on fire response. The policy was widely disseminated and implemented in all levels across sectors among the study sites except for some rural areas. Although there is a lack of national legislation and clear mandates, strong leadership, and ownership of the implementers facilitated policy implementation. All the study schools conducted fire prevention activities. Most students knew how to appropriately respond to fire. A comprehensive school-based DRR program would be beneficial in improving student knowledge and practices on DRR.


杉田映理,国際開発学事典,国際開発学会編,2018年11月,494-495,ISBN 978-4-621-30340-5


国際開発学事典,国際開発学会編,2018年11月,500-501, ISBN 978-4-621-30340-5

Youth sports activity and young people’s well-being after a disaster: a trial with the Mastery Approach to Coaching (MAC) in the Philippines

Akiyama T, Gregorio Jr ER, Kobayashi J.
BMC Res Notes.
2018 Oct 22;11(1):747. doi: 10.1186/s13104-018-3860-1.

Sports activities is broadly utilized to support well-being of youth after a disaster or conflict. However, scientific validation of programs have not been conducted. The Mastery Approach to Coaching (MAC) is a coaching-education program on sports activities. The MAC reported to have a positive effect on youngsters’ self-esteem. As self-esteem is generally known to be beneficial for mental status, we tested the effect of a MAC program on students’ self-esteem in a disaster-affected area: Leyte, Philippines. All schools were encouraged to involve students in volleyball from January to February 2015. In January 2015, MAC workshop was conducted in the intervention school before the sports activity. A total of 293 students completed the questionnaires. The intervention school (n = 51) showed a significant change in self-esteem, with the mean score increasing from 20.2 to 21.1 (p = 0.02). Neither school in the control group showed the significant change. The result showed the feasibility and a positive effect of sports activity with the MAC. However, further investigation should be conducted.

Preliminary Study of the Reliability and Validity of the Center for Epidemiologic Studies Depression Scale in Lao PDR

Tomokawa S, Asakura T, Keosada N, Miyake K, Khamheang U, Moji K.
2018 Sep 17;9(10):2396-2410. doi: 10.4236/psych.2018.910137

This study aimed to develop a Laotian version of the the Center for Epidemiologic Studies Depression Scale (CES-D), investigate the reliability and validity of the Laotian CES-D, and examine its factorial properties. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted to determine the structure of the Laotian CES-D. We tested whether the Laotian CES-D differed from a single factor model of the 20-item CES-D, and from Radloff’s original four-factor solution.
CFA results indicated that neither the single factor model nor the four-factor solution was a good fit for a Laotian sample. EFA was conducted to determine a Laotian-specific model, which was tested using CFA. Next, we determined a best fit structure comprising three factors: “Sadness/loneliness”, “Psychosomatic symptoms”, and “Lack of positive affect”.
This Laotian CES-D model showed high reliability (alpha = 0.81). “Dislike” items loaded on the “Sadness/loneliness” factor in the Laotian model. Items indicating depressive feelings, somatic complaints, and interpersonal relationships were combined into one factor (“Sadness/loneliness”) in the Laotian model. Moreover, items indicating depressive feelings and somatic complaints were combined into the “Psychosomatic symptoms” factor in the Laotian model.

Key factors for school health policy implementation in Thailand

Tomokawa S, Kaewviset S, Saito J, Akiyama T, Waikugul J, Okada K, Kobayashi J, Jimba M.
Health Educ Res.
2018 Apr 1;33(2):186-195. doi: 10.1093/her/cyy008

This case study aimed to identify factors that have influenced the implementation of National School Health Policy (NSHP) in Thailand. This study showed that NSHP was well-disseminated and implemented at whole country. We identified seven positive factors influencing NSHP implementation, namely matching with ongoing educational strategy, competition and encouragement by an awarding system, sustainable human capacity building at school level, participation of multiple stakeholders, sufficient understanding and acceptance of school health concepts, sharing information and collaboration among schools in the same clusters and functional fund raising activities. In addition, we identified three negative factors, namely lack of institutional sustainability, vague role of provincial officers and diverse health problems among Thai children. The government should clarify the role of provincial level and set up institutionalized capacity-building system as measures to strengthen monitoring and evaluation activities.

Systematic review of school tobacco prevention programs in African countries from 2000 to 2016

Nishio A, Saito J, Tomokawa S, Kobayashi J, Makino Y, Akiyama T, Miyake K, Yamamoto M.
PLoS One.
2018 Feb 6;13(2):e0192489. doi: 10.1371/journal.pone.0192489.

The current study systematically reviewed relevant literature to examine the effects of tobacco prevention programs in African countries. Six articles were selected. Four were conducted in South Africa and two were performed in Nigeria. All RCTs studies showed no significant change of smoking-rate by the intervention. The effectiveness of intervention was observed only in some sub-group. The cohort studies showed school-based interventions may be effective in improving knowledge and attitudes about smoking. However, they reported no significant change of smoking-rate by the intervention.

Psychological well-being and adherence to antiretroviral therapy among adolescents living with HIV in Zambia

Okawa S, Kabaghe SM, Mwiya M, Kikuchi K, Jimba M, Kankasa C, Ishikawa N.
AIDS Care.
2018 Jan 18;30(5):634-642. doi: 10.1080/09540121.2018.1425364.

This study aimed at addressing this gap by examining adolescents’ depressive symptoms and antiretroviral therapy (ART) adherence. We measured depressive symptoms using the short form of the Center for Epidemiologic Studies Depression Scale, and self-reported three-day adherence to ART. We performed logistic regression analysis to identify factors associated with depressive symptoms and non-adherence to ART. For qualitative data, we examined challenges over ART adherence using thematic analysis. Out of 190 adolescents, 25.3% showed high scores of depressive symptoms. Factors associated with depressive symptoms were unsatisfactory relationships with family unsatisfactory relationships with health workers and experience of stigma. Of all participants, 94.2% were taking ART, but 28.3% were non-adherent. Factors associated with non-adherence to ART were loss of a mother and lack of basic knowledge about HIV. Qualitative data identified the following challenges to ART adherence: management of medication, physical reactions to medicine, and psychosocial distress. The evidence suggests that depressive symptoms and non-adherence to ART were priority issues in late adolescence in Zambia. Health workers should be aware of these issues, and the care and treatment services should be tailored to respond to age-specific needs.


Roles of children and their parents in the reduction of radiation risk after the 2011 Fukushima Daiichi Nuclear Power Plant accident

Fujimura MS, Komasa Y, Kimura S, Shibanuma A, Kitamura A, Jimba M.
PLoS One. 2017 Dec 13;12(12):e0188906. doi: 10.1371/journal.pone.0188906

The resulting tsunami at the largest recorded earthquake on March 11 in 2011 caused massive damage to the Fukushima Nuclear Power Plant reactors, and the surrounding environment was contaminated with radioactive materials. This study was conducted to assess the effects of lifestyle and attitude factors on external radiation exposure among Fukushima residents. Having a cautious attitude towards radiation and being aware of exposure risks proved to be significant in the reduction of external radiation dose.

Caring for perinatally HIV-infected children: call for mental care for the children and the caregivers. AIDS Care.

Kikuchi K, Poudel KC, Rwibasira JM, Majyambere A, Mutabazi V, Nyonsenga SP, Muhayimpundu R, Jimba M.
AIDS Care. 2017;29:10, 1280-1286, doi:10.1080/09540121.2017.1307917

Antiretroviral therapy has dramatically improved the survival rate of perinatally HIV-infected children. Caregivers play an important role in children's daily care and caregiver mental health may relate to children's mental health. Accordingly, the present study examined the associations between depression of caregivers and that of perinatally HIV-infected children in Kigali, Rwanda. Mental health needs to be addressed to improve quality of life of perinatally HIV-infected children. Caregiver's depression was positively associated with children's depressive symptoms. 

Inclusive Education in Association of Southeast Asian Nations (ASEAN): Literature Review from 1995-2015.

Nishio A, Tomokawa S, Kobayashi J, Mizoue T, Horita R, Yamamoto M.
School Health. 2017;13:20-9. doi: 10.20812/jash.SH_087

There are 93-150 million children with disabilities worldwide, and they are mostly excluded from education. However, research concerning inclusive education (IE) among Association of Southeast Asian Nations (ASEAN) has not been thoroughly examined. Hence, in this study, a literature review was conducted to determine the status of the inclusion of children with disabilities among ASEAN members. Interest in IE is growing rapidly in ASEAN countries; nevertheless, their collective IE-related research output has a disparity among the countries.

Adolescents' Experiences and Their Suggestions for HIV Serostatus Disclosure in Zambia: A Mixed-Methods Study.

Okawa S, Mwanza-Kabaghe S, Mwiya M, Kikuchi K, Jimba M, Kankasa C
Front Public Health. 2017 Dec 15;5:326. doi: 10.3389/fpubh.2017.00326. PMID: 29326914; PMCID: PMC5736526.

This study aimed to examine the setting of HIV serostatus disclosure for adolescents, its impacts on them, and their suggestions on the best practice of HIV disclosure. Despite initial emotional distress experienced after the disclosure, knowing one's own HIV serostatus was found to be a crucial turning point for adolescents to improve motivation for self-care. HIV serostatus disclosure to adolescents requires follow-up support involving parents/primary caregivers, health workers, and peers.

Improving feeding and growth of HIV-positive children through nutrition training of frontline health workers in Tanga, Tanzania.

Sunguya BF, Mlunde LB, Urassa DP, Poudel KC, Ubuguyu OS, Mkopi NP, Leyna GH, Kessy AT, Nanishi K, Shibanuma A, Yasuoka J, Jimba M
BMC Pediatr. 2017 Apr 4;17(1):94. doi: 10.1186/s12887-017-0840-x. PMID: 28376725; PMCID: PMC5379502

Nutrition training can boost competence of health workers to improve children's feeding practices. We aimed to examine the efficacy of a nutrition training intervention to improve midlevel providers' (MLPs) nutrition knowledge and feeding practices and the nutrition statuses of HIV-positive children in Tanga, Tanzania. Nutrition training improved nutrition knowledge among MLPs caring for HIV-positive children attending CTCs in Tanga, Tanzania.


依田健志, 宮本 賢作, 土居譲治, 依田春奈, 岡部悠吾, 神田かなえ, 鈴木裕美, 野村美加, 清水裕子, 平尾智弘
地域環境保健福祉研究. 201;20(1), 47-52

地方都市の中山間地域における子育てと子育て支援の特徴 : 市街地との比較からみえる「地域の見守りとゆるやかなつながり」

西朋子, 三宅公洋, 友川幸.
信州大学教育学部研究論集 2017;11: 69-83



月経はどのように捉えられ経験されるのか: 月経対処が開発アジェンダになる中で、ウガンダの事例から考える

東洋大学大学院紀要 2016; 53:1-16 doi: 10.14890/jasca.2015.0_G17

「持続可能な開発目標(Sustainable Development Goals: SDGs)」においても月経対処の必要性が示唆されており、月経衛生への対処をMHM(Menstrual Hygiene Management)と呼ぶ略称も開発業界では定着をしはじめている。本稿では、ウガンダの農村部の女子中学生が月経をどのように捉え、経験しているか、公立中学校に通う女子生徒を主な対象者として聞き取り調査した結果を一事例として報告している。そこから、月経をめぐる多くのタブーが存在する一方、48%の女子生徒たちが、十分知識を得る機会がない実態が浮かびあがってくる。また月経用品の取り扱いについても、いろいろな懸念を抱いていることが理解できた。

Food-choice motives of adolescents in Jakarta, Indonesia: the roles of gender and family income. Public Health Nutrition 

Maulida R, Nanishi K, Green J, Shibanuma A, Jimba M.
Public Health Nutrition 2016;19(15), 2760-276 doi:10.1017/S136898001600094X

The aims of the present study were to assess the reliability and validity of the Food Choice Questionnaire (FCQ) and to determine the factors associated with food-choice motives in public junior-high-school students in Jakarta, Indonesia. While its factor structure differed from those found in previous studies of adults, the FCQ can provide reliable measures of food-choice motives among these adolescents.

Undernutrition Among Infants and Children in Nepal: Maternal Health Services and Their Roles to Prevent it.

Pokhrel K, Nanishi K, Poudel KC, Pokhrel KG, Tiwari K, Jimba M.
Matern Child Health J. 2016 Oct;20(10):2037-49. doi: 10.1007/s10995-016-2023-z. PMID: 27236701.

This study examined the association of ANC or PNC attendance with IYCF and child nutrition status. Methods A cross-sectional study was performed on 400 mother-child pairs in rural Nepal. Children tended to be underweight and stunted if their mothers did not receive any PNC. Absence of ANC and PNC were associated with poor IYCF, underweight, and stunting in children.

A School Health Project Can Uplift the Health Status of School Children in Nepal.

Shrestha RM, Miyaguchi M, Shibanuma A, Khanal A, Yasuoka J, Jimba M.
PLoS One. 2016 Nov 3;11(11):e0166001. doi: 10.1371/journal.pone.0166001. PMID: 27812190; PMCID: PMC5094771.

School health is effective in helping students achieve health literacy, enhance their health-related behaviors, and thereby improve their health status. We determined the association of the school health and nutrition (SHN) project activities on students' a) health knowledge, b) hygiene practices, and c) health outcomes, one year after the project completion. Students in the SHN project group were more likely to have better health outcomes compared to those in the comparison group, even after one year of the project completion.

The effectiveness of a nationwide universal coverage campaign of insecticide-treated bed nets on childhood malaria in Malawi.

Zamawe CO, Nakamura K, Shibanuma A, Jimba M.
Malaria Journal. 2016;15(1) 505. doi: 10.1186/s12936-016-1550-9

Although the universal coverage campaign of insecticide-treated mosquito bed nets (ITNs) has been associated with improved malaria outcomes. Thus, this study examined the effects of the campaign on malaria morbidity among children in Malawi. The universal coverage campaign of ITNs was not associated with a reduced burden of malaria among children in Malawi. This was likely due to increased insecticide resistance, inconsistent use of bed nets and under-utilization of other methods of malaria control.

School-based intervention to enable school children to act as change agents on weight, physical activity and diet of their mothers: a cluster randomized controlled trial.

Gunawardena N, Kurotani K, Indrawansa S, Nonaka D, Mizoue T, Samarasinghe D.
International Journal of Behavioral Nutrition and Physical Activity. 2016;13:45. doi: 10.1186/s12966-016-0369-7

School health promotion has been shown to improve the lifestyle of students, but it remains unclear whether school-based programs can influence family health. The objective of this study was to examine the effect of the child-initiated intervention on weight, physical activity and dietary habit of their mothers. A program to motivate students to act as change agents of family’s lifestyle was effective in decreasing weight and increasing physical activity of their mothers.

Asymptomatic malaria, growth status, and anemia among children in Lao People’s Democratic Republic: a cross-sectional study.

Akiyama T, Pongvongsa T, Phrommala S, Taniguchi T, Inamine Y, Takeuchi R, Watanabe T, Nishimoto F, Moji K, Kano S, Watanabe H , Kobayashi J.
Malaria Journal, 2016;15:499. doi:10.1186/s12936-016-1548-3

This study investigated the relationship between asymptomatic malaria, growth status, and the prevalence of anemia among children aged 120 months old or younger in rural villages in Lao PDR. These results suggest a significant association between asymptomatic malaria and anemia in children. Furthermore, stunted children were more likely to have lower Hb levels and to be infected with asymptomatic malaria than children without stunting.


友川幸, 新井優貴.
教育保健研. 2016; 18:91-94


長田光司, 友川幸.
日本学校保健研究. 2016; 58:33-38.



公衆衛生. 2016; 80(7):519-512. doi:10.11477/mf.1401208470



山口 乃生子, Poudel Krishna C, 神馬 征峰.
日本ハンセン病学会雑誌. 2016;85(2) 65-68. doi. 10.5025/hansen.85.65

Leprosy is a chronic infectious disease that has an impact on the Health-Related Quality of Life (HRQOL) of sufferers as well as their children. To date, no study has investigated the effects of parental leprosy on the well-being of adolescent children. A cross-sectional study was conducted in the Lalitpur and Kathmandu districts of Nepal. Adolescents with leprosy-affected parents had higher levels of depressive symptoms, lower levels of self-esteem, and lower HRQOL compared with adolescents whose parents were unaffected by leprosy


The ecosystem approach to health is a promising strategy in international development: lessons from Japan and Laos

Asakura T, Mallee H, Tomokawa S, Moji K, Kobayashi J.
Global Health. 2015 Feb 16;11:3. doi: 10.1186/s12992-015-0093-0. PMID: 25880569; PMCID: PMC4340288.

This article presents a brief case study of Japan’s development assistance to Laos, and its environmental and health implications, as an illustration of the ecohealth approach. We highlight three implications of the ecohealth perspective.

Patterns of trematode infections of Opisthorchis viverrini (Opisthorchiidae) and Haplorchis taichui (Heterophyidae) in human populations from two villages in Savannakhet Province, Lao PDR.

Sato M, Pongvongsa T, Sanguankiat S, Yoonuan T, Kobayashi J, Boupha B, Nishimoto F, Moji K, Sato MO, Waikagul J.
J Helminthol. 2015 Jul;89(4):439-45. doi: 10.1017/S0022149X14000261. Epub 2014 Apr 17. PMID: 24739959.

This study analyzed the patterns of infections of O. viverrini and H. taichui in Lahanam and Thakhamlien villages (Savannakhet Province, Lao PDR), in two cross-sectional investigations. Our findings indicated that fish-borne trematode infections were more prevalent among adults. Fish, common intermediate hosts, were acquired in the study area for analysis. If people who work in rice fields limit the species of fish they consume, or avoid consuming raw fish during the month of November, they may reduce their risk of O. viverrini infection.


Better learning in schools to improve attitudes toward abstinence and intentions for safer sex among adolescents in urban Nepal.

Shrestha RM, Otsuka K, Poudel KC, Yasuoka J, Lamichhane M, Jimba M.
BMC Public Health 2013;13, 244. doi:10.1186/1471-2458-13-244

This study thus had two main objectives: (1) to assess students’ evaluation of school-based sex education, and (2) to examine the associations between students’ evaluations of school-based sex education and their (a) attitudes toward abstinence and (b) intentions for safer sex. Our results suggest that students’ needs and expectations regarding HIV and sexual health education are not being met through their schools.

Mental health status among Burmese adolescent students who stay in boarding houses in Thailand: a cross sectional study.

Akiyama T, Win T, Maung C, Ray P, Sakisaka K, Tanabe A, Kobayashi J, Jimba M.
BMC Public Health 2013;13 (337): doi:10.1186/1471-2458-13-337

This study investigated mental health status and its relationship with perceived social support among such students. Many students residing in boarding houses suffered from poor mental health in Thailand’s Tak province. The number of traumatic experiences reported was higher than expected. Furthermore, these traumatic experiences were associated with poorer mental health status.

tLimited potential of school textbooks to prevent tobacco use among students grade 1–9 across multiple developing countries: a content analysis study.

Saito J, Nonaka D, Mizoue T, Kobayashi J, Jayatilleke AC, Shrestha S, Kikuchi K, Haque SE, Yi S, Ayi I, Jimba M.
BMJ Open. 2013;Feb 21;3(2):e002340. doi: 10.1136/bmjopen-2012-002340. PMID: 23430601; PMCID: PMC3586112.

To evaluate the content of school textbooks as a tool to prevent tobacco use in developing countries. A rather limited number of school textbooks in developing countries contained descriptions of prevention of tobacco use, but they did not fully cover the core components for tobacco use prevention.


teA call for parental monitoring to improve condom use among secondary school students in Dares Salaam, Tanzania.

Mlunde LB, Poudel KC, Sunguya BF, Mbwambo JK, Yasuoka J, Otsuka K, Ubuguyu O, Jimba M. BMC Public Health. 2012;12(1):1061. doi: 0.1186/1471-2458-12-1061

we conducted this study to examine the magnitude of risky sexual behaviors and the association of parental monitoring and parental communication with condom use at last sexual intercourse among secondary school students in Dar es Salaam, Tanzania. A high level of parental monitoring is associated with more consistent condom use among male students in Dar es Salaam, Tanzania -- many of whom have engaged in high-risk sexual behaviors in the past one year.

Risk factors for Opisthorchis viverrini infection among school children in Lao PDR.

Tomokawa S, Kobayashi T, Pongvongsa T, Nisaygnang B, Kaneda E, Honda S, Moji K, Boupha B.
Southeast Asian J Trop Med Public Health. 2012 May;43(3):574-85. PMID: 23077836.

A matched-pair case-control study was conducted to identify factors associated with Opisthorchis viverrini infection among primary schoolchildren to develop preventive education. To prevent infections it is necessary to prevent the fish from becoming infected and to avoid eating raw fish. Education should focus on the children and their guardians to promote better eating habits.

High risk of ART non-adherence and delay of ART initiation among HIV positive double orphans in Kigali, Rwanda.

Kikuchi K, Poudel KC, Muganda J, Majyambere A, Otsuka K, Sato T, Mutabazi V, Nyonsenga SP, Muhayimpundu R, Jimba M, Yasuoka J.
PLoS One. 2012;7(7):e41998. doi: 10.1371/journal.pone.0041998. Epub 2012 Jul 30. PMID: 22860043; PMCID: PMC3408396.

To reduce HIV/AIDS related mortality of children, adherence to antiretroviral treatment (ART) is critical in the treatment of HIV positive children. The aims of this study were to assess the ART adherence and identify whether different orphan status was associated with the child's adherence. Double orphans were at highest risk of ART non-adherence and especially those who had a sibling as a caregiver had high risk. Double orphans need more attention to the promote child's adherence to ART.


Application of the child-to-child strategy to change health awareness and behavior among school children and community dwellers in Sri Lanka

Kobayashi H, Yuasa M, Mizoue T, Samarasinghe D.
Journal of International Health 2011; 26(4): 315-321.

The project was aimed at prevention of chronic and lifestyle-related diseases among adults through school children's activities. Major interventions such as workshops and regular publication of newsletters including the results of the workshops were implemented in the Southern Province of Sri Lanka. The trial suggested that school children have the potential not only to improve their own health but also to help their parents and the broader community adopt a healthier lifestyle. 

Content analysis of school textbooks on health topics: a systematic review.

Nomoto M, Nonaka D, Mizoue T, Kobayashi J, Jimba M.
Biosci Trends. 2011;5(2):61-8. doi: 10.5582/bst.2011.v5.2.61. PMID: 21572249.

The objective of this study was to review the findings of analytical studies about the contents of textbooks used in elementary, junior high, or high schools. The findings of reviewed studies can be summarized as follows: some current school textbooks provide insufficient content and contain inaccurate or out-of-date health information.

HiRisk vs. protective factors for substance use among adolescents in Cambodia.

Yi S, Poudel KC, Yasuoka J, Palmer PH, Yi S, Jimba M.
Journal of Substance Use 2011:16:14-26. doi.10.3109/14659890903531261.

The aim of this study is to examine the effects of risk and protective factors in multiple domains on adolescent substance use in Cambodia. Substance use remained significantly associated with risk factors including depression, peer delinquency, family-violence, victimization, and community-violence witnessing. It also remained significantly associated with some socio-demographic characteristics such as higher school grade, older age, and male gender.


Yamaguchi N, Poudel KC, Poudel-Tandukar K, Shakya D, Ravens-Sieberer U, Jimba M. Reliability and validity of a Nepalese version of the Kiddo-KINDL in adolescents. Biosci Trends 2010 Aug;4(4):178-185.

Yi S, Poudel KC, Yasuoka J, Palmer PH, Yi S, Jimba M. Role of risk and protective factors in risky sexual behavior among high school students in Cambodia. BMC Public Health 2010 Aug 12;10:477.

Yanagisawa S, Poudel KC, Jimba M. Sibling caregiving among children orphaned by AIDS: synthesis of recent studies for policy implications. Health Policy 2010 Dec;98(2-3):121-130.

Ayi I, Nonaka D, Adjovu JK, Hanafusa S, Jimba M, Bosompem KM, et al. School-based participatory health education for malaria control in Ghana: engaging children as health messengers. Malar J. 2010 Apr; 18; 9:98.

Yoshimura N, Jimba M, Poudel KC, Chanthavisouk C, Iwamoto A, Phommasack B, et al. Health promoting schools in urban, semi-urban and rural Lao PDR. Health.Promot.Int. 2009 Jun;24(2):166-176.

Jimba M. Poudel-Tandukar K, Poudel KC. School and community health project: Part 1: a community development and health project in Nepal. JMAJ 2008; 51: 225-234.

Nonaka D, Kobayashi J, Jimba M, Vilaysouk B, Tsukamoto K, Kano S, et al. Malaria education from school to community in Oudomxay province, Lao PDR. Parasitol.Int. 2008 Mar; 57(1):76-82.Iriyama S, Nakahara S, Jimba M, Ichikawa M, Wakai S. AIDS health beliefs and intention for sexual abstinence among male adolescent students in Kathmandu, Nepal: a test of perceived severity and susceptibility. Public Health 2007 Jan;121(1):64-72.

Iriyama S, Nakahara S, Jimba M, Ichikawa M, Wakai S. AIDS health beliefs and intention for sexual abstinence among male adolescent students in Kathmandu, Nepal: a test of perceived severity and susceptibility. Public Health 2007 Jan;121(1):64-72.

Jimba M, Aitken IW, Joshi AB, Ohashi T, Poudyal AK, Wakai S. A challenge for monitoring iodine deficiency disorders in rural Nepal. Trop Doct 2007 Apr;37(2):106-107.

Poudel-Tandukar K, Nakahara S, Ichikawa M, Poudel KC, Jimba M. Risk perception, road behavior, and pedestrian injury among adolescent students in Kathmandu, Nepal. Inj Prev 2007 Aug;13(4):258-263.

Takeuchi T, Nozaki S, Crump A. Past Japanese successes show the way to accomplish future goals. Trends Parasitol. 2007 Jun;23(6):260-267.

Kojima S, Aoki Y, Ohta N, Tateno S, Takeuchi T. School-health-based parasite control initiatives: extending successful Japanese policies to Asia and Africa. Trends Parasitol. 2007 Feb;23(2):54-57.

Kobayashi J, Jimba M, Okabayashi H, Singhasivanon P, Waikagul J. Beyond deworming: the promotion of school-health-based interventions by Japan. Trends Parasitol. 2007 Jan;23(1):25-29.

Okabayashi H, Thongthien P, Singhasvanon P, Waikagul J, Looareesuwan S, Jimba M, et al. Keys to success for a school-based malaria control program in primary schools in Thailand. Parasitol.Int. 2006 Jun;55(2):121-126.

Kojima S, Takeuchi T. Global parasite control initiative of Japan (Hashimoto Initiative). Parasitol.Int. 2006;55 Suppl:S293-6.

Poudyal AK, Jimba M, Silwal RC, Murakami I, Sherchand JB, Wakai S. Targeting newly enrolled low-age school children for the control of the intestinal helminth infection in rural Nepal. Trop Doct 2006 Jan;36(1):16-19.

Joshi AB, Banjara MR, Bhatta LR, Rikimaru T, Jimba M. Assessment of IDD problem by estimation of urinary iodine among school children. Nepal Med Coll J 2006 Jun;8(2):111-114.

Kojima S, Looareesuwan S, Singhasivanon P, Takeuchi T. The Asian center of international parasite control (ACIPAC): five years of achievement. I. Introduction. Southeast Asian J.Trop.Med.Public Health 2005;36 Suppl 3:1-12.

Waikagul J, Singhasivanon P, Supavej S, Rojekittikhun W, Suphadtanaphongs W, Leemingswat S, et al. The Asian Center of International Parasite Control (ACIPAC): five years of achievement. II. ACIPAC human resources development. Southeast Asian J.Trop.Med.Public Health 2005;36 Suppl 3:13-16.

Joongsuksuntigul P, Thongthien P, Sirichotiratana N, Okabayashi H, Jimba M. The Asian Center of International Parasite Control (ACIPAC): five years of achievement. III. School health for parasite control in Thailand: a review and current model activities. Southeast Asian J.Trop.Med.Public Health 2005;36 Suppl 3:17-27.

Kabayashi J, Socheat D, Phommasack B, Tun A, Nga NH. The Asian Center of International Parasite Control (ACIPAC): five years of achievement. IV. Activities in partner countries (Cambodia, Lao PDR, Myanmar and Vietnam): small scale pilot project (SSPP) and other impacts. Southeast Asian J.Trop.Med.Public Health 2005;36 Suppl 3:28-40.

The Asian Center of International Parasite Control (ACIPAC): five years of achievement. V. Evaluation of the ACIPAC project. Southeast Asian J.Trop.Med.Public Health 2005;36 Suppl 3:41-73.

Jimba M, Wakai S. School health in rural Nepal: why and how? Southeast Asian J Trop Med Public Health 2005 Jan;36(1):237-239.

Zheng G, Jimba M, Wakai S. Exploratory study on psychosocial impact of the severe acute respiratory syndrome (SARS) outbreak on Chinese students living in Japan. Asia Pac J Public Health 2005;17(2):124-129.

Kobayashi J, Phompida S, Toma T, Looareensuwan S, Toma H, Miyagi I. The effectiveness of impregnated bed net in malaria control in Laos. Acta Trop. 2004 Feb;89(3):299-308.

Tsukamoto K. Preventive Behaviours among health promoting primary school children under soil-transmitted helminthiasis control program in Nakhon Si Thammarat province, Thailand. A thesis for the degree master of primary health care management, Faculty of Graduate Studies, Mahidol University. 2004. Full-text

Tomono N, Anantaphruti MT, Jongsuksuntigul P, Thongthien P, Leerapan P, Silapharatsamee Y, et al. Risk factors of helminthiases among schoolchildren in southern Thailand. Southeast Asian J.Trop.Med.Public Health 2003 Jun;34(2):264-268.

Luong TV. De-worming school children and hygiene intervention. Int.J.Environ.Health Res. 2003 Jun;13 Suppl 1:S153-9.

Brooker S, Singhasivanon P, Waikagul J, Supavej S, Kojima S, Takeuchi T, et al. Mapping soil-transmitted helminths in Southeast Asia and implications for parasite control. Southeast Asian J.Trop.Med.Public Health 2003 Mar;34(1):24-36.

Anantaphruti MT, Jongsuksuntigul P, Imsomboon T, Nagai N, Muennoo C, Saguankiat S, et al. School-based helminthiases control: I. A baseline study of soil-transmitted helminthiases in Nakhon Si Thammarat Province, Thailand. Southeast Asian J.Trop.Med.Public Health 2002; 33 Suppl 3:113-119.

Son DT, Yasuoka J, Poudel KC, Otsuka K, Jimba M. Massively multiplayer online role-playing games (MMORPG): association between its addiction, self-control and mental disorders among young people in Vietnam. Int J Soc Psychiatry. in press.