Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan.
Front Public Health. 2022 Jul 29;10:921966. doi: 10.3389/fpubh.2022.921966. eCollection 2022.
The COVID-19 pandemic has resulted in treatment interruption for chronic diseases. The scale of COVID-19 in Japan has varied greatly in terms of the scale of infection and the speed of spread depending on the region. This study aimed to examine the relationship between local infection level and treatment interruption among Japanese workers.
Cross-sectional internet survey was conducted from December 22 to 26, 2020. Of 33,302 participants, 9,510 (5,392 males and 4,118 females) who responded that they required regular treatment were included in the analysis. The infection level in each participant's prefecture of residence was assessed based on the incidence rate (per 1,000 population) and the number of people infected. Age-sex and multivariate adjusted odds ratios (ORs) of regional infection levels associated with treatment interruption were estimated by multilevel logistic models, nested by prefecture of residence. The multivariate model was adjusted for sex, age, marital status, equivalent household income, educational level, occupation, self-rated health status and anxiety.
The ORs of treatment interruption for the lowest and highest levels of infection in the region were 1.32 [95 % confidence interval (CI) were 1.09-1.59] for the overall morbidity rate (per 1,000) and 1.34 (95 % CI 1.10-1.63) for the overall number of people infected. Higher local infection levels were linked to a greater number of workers experiencing treatment interruption.
Higher local infection levels were linked to more workers experiencing treatment interruption. Our results suggest that apart from individual characteristics such as socioeconomic and health status, treatment interruption during the pandemic is also subject to contextual effects related to regional infection levels. Preventing community spread of COVID-19 may thus protect individuals from indirect effects of the pandemic, such as treatment interruption.
COVID-19 大流行导致慢性病治疗中断。日本 COVID-19 的规模在感染规模和传播速度方面因地区而异。本研究旨在研究日本工人中当地感染水平与治疗中断之间的关系。
于 2020 年 12 月 22 日至 26 日进行了横断面互联网调查。在 33302 名参与者中，有 9510 名（5392 名男性和 4118 名女性）回应需要定期治疗，被纳入分析。根据每个参与者所在县的发病率（每千人）和感染人数来评估当地的感染水平。通过多层次逻辑模型，嵌套按县居住的方式，估计与治疗中断相关的地区感染水平的年龄-性别和多变量调整比值比（OR）。多变量模型调整了性别、年龄、婚姻状况、等效家庭收入、教育水平、职业、自我评估的健康状况和焦虑。
对于该地区感染率最低和最高的治疗中断的 OR 分别为总发病率（每千人）的 1.32（95%可信区间为 1.09-1.59）和总感染人数的 1.34（95%可信区间为 1.10-1.63）。较高的当地感染水平与更多的工人经历治疗中断有关。
较高的当地感染水平与更多的工人经历治疗中断有关。我们的结果表明，除了个人特征（如社会经济和健康状况）外，大流行期间的治疗中断还受到与地区感染水平相关的背景效应的影响。因此，预防 COVID-19 在社区中的传播可能会保护个人免受大流行的间接影响，例如治疗中断。
