Mitsuaki MATSUI

Basic information

Kobe University · Graduate School of Health Sciences · 教授

Research keywordsmaternal health surveys・genital trichomoniasis・antenatal care・anemia in pregnancy・healthcare worker preparedness・intrapartum practice・maternal and newborn health・survey methodology

Research fieldsToxicology・保健システム・母性保健

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Recent publications

Diagnostic accuracy of an antigen-based point-of-care test versus nucleic acid amplification testing for genital trichomoniasis among pregnant women attending antenatal care facilities in Zambia.2023 · BACKGROUND: Infection with Trichomonas vaginalis (TV) is the most prevalent curable sexually transmitted infection (STI) globally and is associated with prelabour rupture of membranes, preterm delivery, and low birthweight. Point-of-care (POC) testing for TV during pregnancy may facilitate rapid antenatal case detection and treatment. This study, part of the World Health Organization's global ProSPeRo study, aimed to evaluate the performance of OSOM® Trichomonas Rapid Test, an antigen-based POC test, against a reference nucleic acid amplification test (NAAT) among pregnant women in Zambia. We also assessed the operational characteristics and patient acceptability of the POC test, within the context of WHO's target product profiles for STI POC tests. METHODS: We enrolled pregnant women attending four health centres in Nchelenge, Zambia, for antenatal care between 15 February and 26 May 2023. Vaginal swabs for the TV POC test and a reference NAAT (Aptima® Trichomonas vaginalis assay) were obtained. POC test results were read independently by two study staff members. Study staff filled a questionnaire on the operational characteristics of the POC test, and participants were asked about their willingness to wait for results. RESULTS: Paired POC and reference test samples were collected from 1,015 participants. Overall, 23.0% (233/1015) tested positive for TV by NAAT, and 15.3% (155/1015) tested positive by the POC test, with three inconclusive results. The overall sensitivity and specificity of the POC test were 66.4% (95% confidence intervals [CI] 57.7-74.1%) and 99.6% (95% CI: 98.8-99.9%), respectively. Sensitivity was higher among those with TV-associated symptoms compared to those without (83.6% versus 60.4%, relative ratio 1.39, 95% CI 1.14-1.68). Inter-rater agreement was 99.7% (Cohen's Kappa 0.989). The study staff (n = 14) found the test easy to use and interpret, with most staff (12/14) reporting results were available within 25 min. CONCLUSION: Overall, the TV POC test showed lower sensitivity than WHO's 85% target, but exceeded the 99% specificity target. Among symptomatic pregnant women, sensitivity nearly reached the WHO target. The assay was user-friendly, required minimal training, and delivered results quickly. Further studies are needed to determine the optimal antenatal settings for this technology. TRIAL REGISTRATION: PACTR202302766902029.
Anaemia prevalence and risk factors among nonpregnant and pregnant women of reproductive age in Ghana: an analysis of the Ghana demographic and health survey data.2022 · BACKGROUND: Despite extensive global and national efforts to reduce anaemia, it remains a major public health concern among Women of Reproductive Age (WRA). However, community-based studies that compare the prevalence and risk factors of anaemia using nationally representative samples are limited in Ghana. This study examines and compares anaemia prevalence and associated risk factors between nonpregnant and pregnant WRA in Ghana. METHODS: This study utilized cross-sectional data from the 2022 Ghana Demographic and Health Survey (GDHS). A total of 15,014 WRA were recruited, of whom 7,557 were screened for anaemia including 7004 nonpregnant and 553 pregnant women. Anaemia was defined as haemoglobin levels below 12 g/dL for nonpregnant and below 11 g/dL for pregnant women. Pearson chi-square and Fisher's exact tests were used to compare anaemia prevalence across groups. Poisson regressions were applied to identify risk factors for anaemia. All analyses were conducted using Stata version SE.18. RESULTS: The prevalence of anaemia was 40.4% among nonpregnant women and 51.4% among pregnant women. Aside from self-reported health status and toilet facilities being significant determinants for nonpregnant women, common factors affecting both groups included parity, BMI, wealth status, and geographic zone. Multiparous women had a higher risk of anaemia, with nonpregnant and pregnant women experiencing 23% and 43% increased risk, respectively. Underweight nonpregnant women had an 11% higher risk, while overweight pregnant women had a 34% lower risk of anaemia. In terms of wealth, women in the poorest quintile had a significantly higher risk of anaemia 36% among nonpregnant women (APR: 1.36, 95% CI 1.01-1.83, p = 0.049) and 32% among pregnant women (APR: 1.32, 95% CI 1.01-1.76, p = 0.049). Additionally, women residing in the northern zone had a higher anaemia risk compared to those in the southern zone. Among nonpregnant women, those reporting poor health status had a 51% increased risk of anaemia, while those with improved toilet facilities had a 10% lower risk (APR: 0.90, 95% CI 0.83-0.96, p = 0.004). CONCLUSIONS: The prevalence of anaemia, particularly among pregnant women, remains high in Ghana and constitutes a significant public health threat. Addressing this issue requires holistic and tailored public health strategies that improve access to healthcare, nutrition, sanitation, and economic equity.
A Consensus-Based Checklist for Reporting of Survey Studies (CROSS).2021 · 2021年04月, Journal of general internal medicine, 36(10) (10), 3179 - 3187, 英語, 国際誌
Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic.2020 · INTRODUCTION: The COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the pandemic on services and health outcomes. The objective of this study was to prospectively document experiences of frontline maternal and newborn healthcare providers. METHODS: We conducted a global, cross-sectional study of maternal and newborn health professionals via an online survey disseminated through professional networks and social media in 12 languages. Information was collected between 24 March and 10 April 2020 on respondents' background, preparedness for and response to COVID-19 and their experience during the pandemic. An optional module sought information on adaptations to 17 care processes. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregating by low-income and middle-income countries (LMICs) and high-income countries (HICs). RESULTS: We analysed responses from 714 maternal and newborn health professionals. Only one-third received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, 47% of participants in LMICs and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based practices. CONCLUSIONS: Substantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information-sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations and support rapid development of effective responses.

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Mitsuaki MATSUI松井三明