1 Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Science, Goto, JapanDepartment of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Japan yamanashi@nagasaki-u.ac.jp.
2 Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Sakamoto, Japan.
3 Nagasaki Goto Central Hospital, Yoshikugi, Goto, Nagasaki, Japan.
4 Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Science, Goto, Japan.
5 Department of Rheumatology, Nagasaki University Hospital, Sakamoto, Japan.
6 Department of Neurology and Strokology, Nagasaki University Hospital, Sakamoto, Japan.
7 Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Science, Goto, JapanDepartment of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Sakamoto, Japan.