Okumura Junko
Institute of Tropical Medicine, Nagasaki, Japan.
School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan.
Trop Med Health. 2021 May 13;49(1):38. doi: 10.1186/s41182-021-00324-0.
Although the scale of the coronavirus disease (COVID-19) pandemic was relatively small in Japan compared with the rest of the world, the polarisation of areas into high- and low-COVID-19-incidence areas was observed among the 47 prefectures. The aims of this study were not only identifying the factors associated with the polarised COVID-19 pandemic in Japan but also discussing effective preventive measures.
This was an ecological study using online survey data which was cross-sectionally conducted by the author. A total of 6000 respondents who resided in 10 low- and 10 high-COVID-19 incidence prefectures, with a wide gap in terms of COVID-19 incidence, in Japan were recruited. Data on COVID-19 cases and geodemographic information were obtained from official government sites. Statistical analyses were conducted to compare variables between the two areas and age groups.
This study revealed that that age influenced people's behaviours and perceptions, except one behaviour of 'wearing facemasks'. The major factors significantly associated with the cumulative number of COVID-19 cases per 100,000 people were 'commuting by private automobile' (adjusted odds ratio [AOR], 0.444; 95% confidence interval [CI], 0.394-0.501), 'commuting by public transportation' (AOR, 6.813; 95% CI, 5.567-8.336), 'washing hands' (AOR, 1.233; 95% CI, 1.005-1.511), 'opening windows regularly' (AOR, 1.248; 95% CI, 1.104-1.412), 'avoiding crowded places (AOR, 0.757; 95% CI, 0.641-0.893), 'non-scheduled visits to drinking places' (AOR, 1.212; 95% CI, 1.054-1.392) and 'perceived risk of contracting COVID-19' (AOR, 1.380; 95% CI, 1.180-1.612). These factors were strongly associated with age groups.
Effective preventive measures for COVID-19 transmission can be developed by understanding the characteristics of populated areas, such as public transportation infrastructure and younger people's movements and behaviours in relation to the population age structure to contain the current epidemic and protect the most vulnerable elderly people.
尽管与世界其他地区相比，日本冠状病毒病（COVID-19）大流行的规模相对较小，但在其47个都道府县中，仍观察到COVID-19高发病区和低发病区的两极分化。本研究的目的不仅是确定与日本COVID-19大流行两极分化相关的因素，还讨论有效的预防措施。
这是一项生态学研究，使用作者进行的横断面在线调查数据。总共招募了6000名居住在日本10个COVID-19低发病都道府县和10个高发病都道府县的受访者，这些地区在COVID-19发病率方面存在很大差距。COVID-19病例数据和地理人口信息来自政府官方网站。进行统计分析以比较两个地区和年龄组之间的变量。
本研究表明，年龄会影响人们的行为和认知，但“戴口罩”这一行为除外。与每10万人中COVID-19病例累计数显著相关的主要因素包括“乘坐私家车通勤”（调整后的优势比[AOR]，0.444；95%置信区间[CI]，0.394 - 0.501）、“乘坐公共交通工具通勤”（AOR，6.813；95% CI，5.567 - 8.336）、“洗手”（AOR，1.233；95% CI，1.005 - 1.511）、“定期开窗”（AOR，1.248；95% CI，1.104 - 1.412）、“避免前往拥挤场所”（AOR，0.757；95% CI，0.641 - 0.893）、“不定期前往饮酒场所”（AOR，1.212；95% CI，1.054 - 1.392）以及“感知感染COVID-19的风险”（AOR，1.380；95% CI，1.180 - 1.612）。这些因素与年龄组密切相关。
通过了解人口密集地区的特征，如公共交通基础设施以及年轻人与人口年龄结构相关的活动和行为，可制定有效的COVID-19传播预防措施，以控制当前疫情并保护最脆弱的老年人。
