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BACKGROUND: The proportion of intense tropical cyclones is expected to increase in a changing climate. However, there is currently no consistent and comprehensive assessment of infectious disease risk following tropical cyclone exposure across countries and over decades. We aimed to explore the tropical cyclone-associated hospitalisation risks and burden for cause-specific infectious diseases on a multi-country scale. METHODS: Hospitalisation records for infectious diseases were collected from six countries and territories (Canada, South Korea, New Zealand, Taiwan, Thailand, and Viet Nam) during various periods between 2000 and 2019. The days with tropical cyclone-associated maximum sustained windspeeds of 34 knots or higher derived from a parametric wind field model were considered as tropical cyclone exposure days. The association of monthly infectious diseases hospitalisations and tropical cyclone exposure days was first examined at location level using a distributed lag non-linear quasi-Poisson regression model, and then pooled using a random-effects meta-analysis. The tropical cyclone-attributable number and fraction of infectious disease hospitalisations were also calculated. FINDINGS: Overall, 2·2 million people who were hospitalised for infectious diseases in 179 locations that had at least one tropical cyclone exposure day in the six countries and territories were included in the analysis. The elevated hospitalisation risks for infectious diseases associated with tropical cyclones tended to dissipate 2 months after the tropical cyclone exposure. Overall, each additional tropical cyclone day was associated with a 9% (cumulative relative risk 1·09 [95% CI 1·05-1·14]) increase in hospitalisations for all-cause infectious diseases, 13% (1·13 [1·05-1·21]) for intestinal infectious diseases, 14% (1·14 [1·05-1·23]) for sepsis, and 22% (1·22 [1·03-1·46]) for dengue during the 2 months after a tropical cyclone. Associations of tropical cyclones with hospitalisations for tuberculosis and malaria were not significant. In total, 0·72% (95% CI 0·40-1·01) of the hospitalisations for all-cause infectious diseases, 0·33% (0·15-0·49) for intestinal infectious diseases, 1·31% (0·57-1·95) for sepsis, and 0·63% (0·10-1·04) for dengue were attributable to tropical cyclone exposures. The attributable burdens were higher among young populations (aged ≤19 years) and male individuals compared with their counterparts, especially for intestinal infectious diseases. The heterogeneous spatiotemporal pattern was further revealed at the country and territory level-tropical cyclone-attributable fractions showed a decreasing trend in South Korea during the study period but an increasing trend in Viet Nam, Taiwan, and New Zealand. INTERPRETATION: Tropical cyclones were associated with persistent elevated hospitalisation risks of infectious diseases (particularly sepsis and intestinal infectious diseases). Targeted interventions should be formulated for different populations, regions, and causes of infectious diseases based on evidence on tropical cyclone epidemiology to respond to the increasing risk and burden. FUNDING: Australian Research Council, Australian National Health, and Medical Research Council.
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Enfermedades Transmisibles , Tormentas Ciclónicas , Hospitalización , Humanos , Hospitalización/estadística & datos numéricos , Enfermedades Transmisibles/epidemiología , Nueva Zelanda/epidemiología , Vietnam/epidemiología , República de Corea/epidemiología , Taiwán/epidemiología , Canadá/epidemiología , Tailandia/epidemiologíaRESUMEN
This concurrent qualitative study was carried out with the main objective to determine wildlife beliefs, taboos, usages, health perceptions, and practices among ten ethnic groups in four communities in Tak and Mae Hong Son provinces of Thailand from November 2020 to January 2021. We also gathered comprehensive information on study respondents' knowledge related to potential risk behaviors that could lead to zoonotic disease transmission and infection. Furthermore, we intended to use the study's findings to develop communication strategies and health literacy improvement interventions for mitigating risky behaviors, with a focus on ethnic groups and particular individuals who live in close proximity to forests and wildlife, to prevent future pandemics. Sixty-five respondents were purposively selected based on their extensive knowledge, active participation in local cultural contexts, beliefs, and exposure to wildlife contact or consuming game animals. Twenty (30.8%) participated in in-depth interviews (IDIs), while 45 (69.2%) participated in eight focused group discussions (FGDs). The results revealed that the characteristics of wildlife contact are similar and distinct based on their beliefs and taboos among various ethnic groups and study locations, which are influenced by cultural backgrounds and traditions. Although some ethnic groups do not have explicit restrictions on the consumption of wildlife, others adhere to specific beliefs and taboos that forbid the consumption or killing of specific wild animals. These beliefs frequently correspond with conservation initiatives, thereby facilitating the preservation of threatened species. The study also revealed a lack of appropriate health knowledge, perceptions, and practices regarding wildlife contact and consumption. As a result, it is recommended that public health officials and local governments develop and execute communication and education initiatives. These campaigns should aim to increase health literacy and promote safe handling, preparation, and cooking practices to reduce the risk of zoonotic disease transmission and infection effectively. Moreover, it is necessary to design and implement wildlife conservation education and outreach activities. The programs should promote environmental stewardship while considering the cultural contexts, beliefs, and practices of various ethnic groups. The activities should involve diverse stakeholders, including local leaders, religious influencers, community members, schoolteachers, students, health professionals, village health volunteers, and civil society organizations.
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Animales Salvajes , Etnicidad , Conocimientos, Actitudes y Práctica en Salud , Investigación Cualitativa , Tabú , Humanos , Tailandia/etnología , Animales , Masculino , Etnicidad/estadística & datos numéricos , Etnicidad/psicología , Femenino , Adulto , Persona de Mediana Edad , Zoonosis/prevención & control , Grupos Focales , Adulto JovenRESUMEN
Background: Amidst the COVID-19 pandemic, the learning pattern of medical students shifted from onsite to online. This transition may contribute to what has been called "Zoom fatigue." This study aimed to evaluate the prevalence of Zoom fatigue related to online learning, identify associated factors of Zoom fatigue, and explore its correlation with depression among medical students during the COVID-19 pandemic. Methods: This cross-sectional study was conducted among 1st to 6th-year Thai medical students. The online survey was administered using a demographic and health behavior questionnaire, the Patient Health Questionnaire-9 (PHQ-9), and the Thai version of the Zoom Exhaustion & Fatigue Scale (ZEF-T). Results: Among the 386 participating students, 221 (57%) were female, with a mean age of 20.6 years. The prevalence of high Zoom fatigue was 9.6%. In the multivariable regression analysis, a lower academic year and a higher number of online learning sessions were significant predictors of Zoom fatigue (p < 0.001), while regular exercise emerged as a protective factor (p = 0.009). The prevalence of depressive disorder was 61.9%, and a significant correlation was found between having a depressive disorder and experiencing Zoom fatigue (p = 0.004). Conclusion: Zoom fatigue among medical students was correlated with depression. Consequently, medical students experiencing Zoom fatigue should undergo further assessment for depression. It is crucial to closely monitor medical students in lower academic years with a high number of online sessions for signs of Zoom fatigue. Additionally, implementing strategies, such as reducing the frequency of online sessions and promoting regular exercise, may help alleviate the symptoms.
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COVID-19 , Depresión , Fatiga , Estudiantes de Medicina , Humanos , Femenino , Tailandia/epidemiología , Masculino , Estudios Transversales , Depresión/epidemiología , Prevalencia , Adulto Joven , Fatiga/epidemiología , COVID-19/epidemiología , COVID-19/psicología , Educación a Distancia , Encuestas y Cuestionarios , Adulto , SARS-CoV-2 , AdolescenteRESUMEN
BACKGROUND: Helminths are a major global health issue, impacting health, educational, and socioeconomic outcomes. Infections, often starting in childhood, are linked to anemia, malnutrition, cognitive deficit, and in chronic cases of Opisthorchis viverrini (OV), cholangiocarcinoma. The main control strategy for helminth infection is mass drug administration; however, this does not prevent reinfection. As such, prevention strategies are needed. The "Magic Glasses" is a school-based cartoon health education package that has demonstrated success in improving knowledge, attitudes, and practices (KAP) surrounding soil-transmitted helminths (STH) in China and the Philippines. This study is designed to assess the acceptability and impact of the 2 new versions of the Magic Glasses targeting STH and OV designed for the Lower Mekong audience in Cambodia, Lao People's Democratic Republic (PDR), and Thailand. OBJECTIVE: The objective of this study is to evaluate the acceptability of the "Magic Glasses Lower Mekong" and "Magic Glasses Opisthorchiasis" education packages among schoolchildren in the Lower Mekong Basin, and the impact of these education packages on students' KAP surrounding STH and OV, respectively. METHODS: Schoolchildren will be recruited into a cluster randomized controlled trial with intervention and control arms in rural schools in Cambodia, Lao PDR, and Thailand. Schoolchildren's initial acceptability of the intervention will be evaluated using an adapted questionnaire. Sustained acceptability will be assessed at 9-month follow-up through focus group discussions with students and interviews with teachers. Impact will be evaluated by KAP questionnaires on STH and OV. KAP questionnaires will be administered to children at baseline and at follow-up. Indirect impact on parents' KAP of OV and STH will be assessed through focus group discussions at follow-up. RESULTS: The trial is in progress in Lao PDR and Thailand and is expected to commence in Cambodia in January 2024. The results of the study are expected to be available 18 months from the start of recruitment. We hypothesize that participants enrolled in the intervention arm of the study will have higher KAP scores for STH and OV, compared with the participants in the control arm at follow-up. We expect that students will have initial and sustained acceptability of these intervention packages. CONCLUSIONS: This trial will examine the acceptability of the "Magic Glasses Opisthorchiasis" and "Magic Glasses Lower Mekong" interventions and provide evidence on the effectiveness of the "Magic Glasses" on KAP related to OV and STH among schoolchildren in the Lower Mekong Basin. Study results will provide insight on acceptability and impact indicators and inform a scaling up protocol for the "Magic Glasses" education packages in Cambodia, Lao PDR, and Thailand. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12623000271606; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385315&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55290.
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Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Opistorquiasis , Humanos , Niño , Opistorquiasis/prevención & control , Opistorquiasis/epidemiología , Opistorquiasis/psicología , Cambodia/epidemiología , Laos/epidemiología , Educación en Salud/métodos , Tailandia/epidemiología , Femenino , Masculino , Adolescente , Estudiantes/psicología , Helmintiasis/prevención & control , Helmintiasis/epidemiología , Animales , Dibujos Animados como AsuntoRESUMEN
OBJECTIVE: Microsporidial stromal keratitis (MSK) is an uncommon disease. Only several case series have been reported. We aimed to describe the clinical manifestations, histopathology and treatment outcomes of MSK. METHODS AND ANALYSIS: Retrospective data of MSK diagnosed between January 2009 and December 2020 at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand were retrieved. The diagnosis was made based on corneal scraping, corneal biopsy and corneal button histopathology findings. Detailed clinical characteristics, histopathological findings and treatment outcomes were reviewed and analysed. RESULTS: 21 patients with MSK with a mean age of 63.8 years (SD 12.2) had an indolent disease onset with a median of 9 months (IQR 2.2-12.0). Five patients (23.8%) experienced ocular traumas. Herpes stromal keratitis was the most common preliminary diagnosis (33.3%), followed by non-specific ulcers and fungal keratitis. The most common corneal finding was multifocal grey-white lesions with anterior to mid-stromal infiltration and fluffy borders (66.7%). Pathogens were identified by modified trichrome staining of corneal scrapings in 11 of 14 cases (78.6%). Histopathological examination showed positive Ziehl-Neelsen staining in 17 of 19 cases (89.5%). All patients received surgical treatment, with 18 receiving therapeutic penetrating keratoplasty (TPK), 2 undergoing deep anterior lamellar keratoplasty and 1 undergoing femtosecond laser-assisted anterior lamellar keratoplasty. The overall cure rate was 76.2% after the first surgery and 95.2% after the second surgery. CONCLUSION: MSK can be easily underdiagnosed. Clues to diagnosis included a history of chronic refractory stromal infiltration and typical corneal findings of deep stromal infiltration, without epithelial defects. TPK is the preferred treatment for MSK.
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Sustancia Propia , Infecciones Fúngicas del Ojo , Queratitis , Microscopía Confocal , Microsporidiosis , Humanos , Estudios Retrospectivos , Masculino , Persona de Mediana Edad , Femenino , Infecciones Fúngicas del Ojo/patología , Infecciones Fúngicas del Ojo/microbiología , Infecciones Fúngicas del Ojo/terapia , Infecciones Fúngicas del Ojo/diagnóstico , Microsporidiosis/patología , Microsporidiosis/cirugía , Sustancia Propia/patología , Sustancia Propia/microbiología , Sustancia Propia/cirugía , Anciano , Queratitis/microbiología , Queratitis/patología , Queratitis/diagnóstico , Queratitis/terapia , Antifúngicos/uso terapéutico , Resultado del Tratamiento , Adulto , Trasplante de Córnea , Tailandia/epidemiología , BiopsiaRESUMEN
From Darwin through Wittgenstein to contemporary scientific investigations, it has been argued humans tend to view facial expressions through a mentalistic lens. According to this view, when looking at someone's expressive face, we see emotion and are unable to describe the face in behavioral terms, i.e., name the details of facial movements. At the same time, however, a growing body of work shows cultures in fact differ in the degree of importance they attribute to mental states and willingness to discuss them. Is this variation reflected in the linguistic coding of facial expressions? To explore this, we conducted two facial expression naming tasks targeting mental states and facial movements with speakers of Maniq (Austroasiatic, Thailand) and Polish (Indo-European, Poland), representing highly diverse linguistic and cultural settings. We found that, while Polish speakers conformed with the predicted orientation towards mental states, this did not hold for Maniq speakers. The Maniq were instead oriented towards behavioral aspects of faces, naming them more frequently, more precisely, and with higher consensus, compared to the Polish. These differences are carved into the Maniq and Polish lexicons, suggesting diverse cultures exhibit differential specialization in verbalizing expressive faces.
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Expresión Facial , Humanos , Masculino , Femenino , Adulto , Polonia , Tailandia , Emociones/fisiología , Cultura , Adulto Joven , LenguajeRESUMEN
BACKGROUND: Sleep-disordered breathing (SDB) and allergic rhinitis (AR) are common problems that can lead to worsening quality of life (QOL) in children with these conditions. There is scarce evidence on the QOL of children with SDB outside of the hospital setting with inconsistent evidence on the association of AR and QOL concerning the SDB in children. Thus, the primary objective of this study is to determine the QOL concerning the SDB of elementary school students by using OSA-18. We also aim to provide the relationship of allergic rhinitis to the QOL. METHODS: A cross-sectional study was conducted on all elementary school students, aged 6-12 years, from 10 elementary schools. The QOL of all participants was evaluated by the Thai version of the caregiver-administered OSA-18 questionnaire. The simple and multiple linear regression models were used to determine the effect of allergic rhinitis on the OSA-18 total scores. RESULTS: A total of 3,053 children were included in the final analysis, 50.1% male. At least a moderate impact on QOL from SDB was observed in 9.4% of the population. Children with AR had significantly higher mean total OSA- 18 scores than the children without AR (47.5 ± 15.0 VS 38.5 ± 13.1, p < 0.001). After the adjustment for age, gender, body mass index, household income, and history of asthma, the point estimate of the adjusted beta regression coefficient on the OSA-18 total score in children with AR was 7.82 (95% CI: 6.00-9.65, p < 0.001). Significant associations were observed between AR and all domains except for emotional distress. CONCLUSIONS: A substantial number of elementary school children had at least a moderate impact on the QOL from SDB, especially those with AR. Thus, effective screening of SDB in children with AR should be done to improve the QOL of these children.
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Calidad de Vida , Rinitis Alérgica , Síndromes de la Apnea del Sueño , Estudiantes , Humanos , Masculino , Femenino , Niño , Tailandia/epidemiología , Rinitis Alérgica/epidemiología , Síndromes de la Apnea del Sueño/epidemiología , Síndromes de la Apnea del Sueño/psicología , Estudios Transversales , Encuestas y Cuestionarios , Estudiantes/psicología , Instituciones AcadémicasRESUMEN
AIMS: This study aims to compare the trends in the quality of hospital care for WHO's three disease groups pre-, during, and post-COVID-19 pandemic peak in Thailand. METHODS: The study utilized existing hospital admission data from the Thai Health Information Portal (THIP) database, covering the period from 2017 to 2022. We categorized WHO's three disease groups: poverty-related, noncommunicable, and injury groups using the International Classification of Diseases (ICD)-10 of initial admission of patients, and we analyzed three major outcomes: prolonged (≥ 90th percentile) length of stay (LOS), hospital mortality, and readmission pre-, during, and post-COVID-19 pandemic peak. Relative weight (RW) of hospital reimbursements was used as a surrogate measure of the severity of the diseases. RESULTS: The average prolonged LOS of patients with poverty disease pre-, during, and post-COVID-19 pandemic peak were 7.1%, 10.8%, 9.05%, respectively. Respective hospital mortality rates were 5.02%, 6.22%, 6.05% and readmission were 6.98/1,000, 6.16/1,000, 5.43/1,000, respectively. For non-communicable diseases, the respective proportions in the prolonged LOS were 9.0%, 9.12%, and 7.58%, with respective hospital mortality being 10.65%, 8.86%, 6.62%, and readmissions were 17.79/1,000, 13.94/1,000, 13.19/1,000, respectively. The respective prolonged LOS for injuries were 8.75%, 8.55%, 8.25%. Meanwhile, respective hospital mortality were 4.95%, 4.05%, 3.20%, and readmissions were 1.99/1,000, 1.60/1,000, 1.48/1,000, respectively. The RW analysis reveals diverse impacts on resource utilization and costs. Most poverty-related and noncommunicable diseases indicate increased resource requirements and associated costs, except for HIV/AIDS and diabetes mellitus, showing mixed trends. In injuries, road traffic accidents consistently decrease resource needs and costs, but suicide cases show mixed trends. CONCLUSIONS: COVID-19 had a more serious impact, especially prolonged LOS and hospital mortality for poverty-related diseases more than noncommunicable diseases and injuries.
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COVID-19 , Mortalidad Hospitalaria , Tiempo de Internación , Enfermedades no Transmisibles , Readmisión del Paciente , Pobreza , Humanos , COVID-19/mortalidad , COVID-19/epidemiología , COVID-19/economía , Tailandia/epidemiología , Enfermedades no Transmisibles/mortalidad , Enfermedades no Transmisibles/epidemiología , Enfermedades no Transmisibles/economía , Readmisión del Paciente/estadística & datos numéricos , Mortalidad Hospitalaria/tendencias , Masculino , Femenino , Heridas y Lesiones/mortalidad , Heridas y Lesiones/economía , Heridas y Lesiones/epidemiología , Persona de Mediana Edad , Adulto , Anciano , SARS-CoV-2 , PandemiasRESUMEN
BACKGROUND: Streptococcus mutans is studied for its acidogenic and aciduric characteristics, notably its biofilm formation in the presence of sucrose, toward its role in the caries process. Variations in both genotype and phenotype have been reported among clinical isolates of S. mutans. This study aimed to examine genotypic and phenotypic characteristics of S. mutans obtained from Thai children with varying caries statuses. METHODS: We determined the presence of S. mutans and caries status in 395 children aged 3-4 years. From 325 children carrying S. mutans, we selected 90 with different caries statuses-caries-free (CF; n = 30), low severity of caries (LC; n = 30), or high severity of caries (HC; n = 30). Three isolates of S. mutans were taken from each child, thus, a total of 270 isolates were obtained. Multilocus sequence typing (MLST) was used to genotype the isolates and assess their clonal relationships. The properties, including biofilm formation, collagen binding, and acid production and tolerance were also evaluated. RESULTS: Children with carious lesions showed a higher detection rate and number of S. mutans in saliva than those without caries. S. mutans from individuals with HC status showed the lowest biofilm formation ability, while this group had the highest detection rate of collagen-binding isolates. There was no difference in acid production or tolerance by caries status. Genotyping by MLST did not reveal any clone of S. mutans specific to CF status. This result remained even when we included MLST data from the open-access PubMLST database. MLST did identify clones containing only strains from caries-affected hosts, but tests of their phenotypic properties did not reveal any differences between S. mutans from these clones and clones that were from both caries-free and caries-affected children. CONCLUSIONS: The clonal relationships of S. mutans indicated by MLST were not associated with the status of dental caries in the host.
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Biopelículas , Caries Dental , Genotipo , Tipificación de Secuencias Multilocus , Fenotipo , Saliva , Streptococcus mutans , Humanos , Streptococcus mutans/genética , Streptococcus mutans/aislamiento & purificación , Caries Dental/microbiología , Preescolar , Tailandia , Biopelículas/crecimiento & desarrollo , Saliva/microbiología , Femenino , Masculino , Índice CPO , Pueblos del Sudeste AsiáticoRESUMEN
Fall is the leading cause of disability and mortality due to unintentional injury in older adults. The aim of this study was to determine the prevalence and risk factors associated with knee pain, fear of falling, and quality of life among community-dwelling older adults in Northern Thailand. A cross-sectional study was conducted among older adults aged 60 and over. A total of 369 participants were enrolled from April to May 2024. Oxford knee score, a short version of the Falls Efficacy Scale International (FES-I) and World Health Organization quality of life-BREF-Thai, was measured. The results showed that the mean age was 69.4 years and 47 (12.7%) had a history of falls in the previous year. The prevalence of fear of falling was 39.3% for low, 22.5% for moderate, and 38.2% for high concern. Age, marital status, alcohol, history of falls, hypertension, arthritis, and osteoporosis were associated with fear of falling. After adjusting to age, gender, body mass index, education, marital status, smoking, alcohol, history of falls, and chronic disease, osteoarthritis of the knee was positively associated with increasing fear of falling (ß: 0.361; p<0.001), while quality of life was negatively associated with fear of falling (ß: -0.064; p<0.011). In conclusion, the identified determinants of fear of falling among the elderly indicated the need for fear of falling prevention programs targeting not only individual lifestyles but also chronic diseases. This study provides useful information that might help to develop and adopt effective policies for fear of falling control in Thailand.
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Accidentes por Caídas , Miedo , Vida Independiente , Calidad de Vida , Humanos , Accidentes por Caídas/prevención & control , Tailandia/epidemiología , Anciano , Masculino , Calidad de Vida/psicología , Femenino , Miedo/psicología , Estudios Transversales , Vida Independiente/psicología , Persona de Mediana Edad , Factores de Riesgo , Prevalencia , Anciano de 80 o más Años , Artralgia/psicología , Artralgia/epidemiologíaRESUMEN
The association between self-assessed cold threshold (CT) and thermal insulation of clothing (Icl) was analysed in 283 poultry workers in Thailand. The mean CT was 13.5 °C (range - 28-29) and the mean Icl was 1.23 clo (range 0.35-2.21). The adjusted CT remained unchanged at low Icls (0.35 through 1.25 clo) but was estimated to increase by 14.8 °C at high Icls (1.25 through 2.21 clo). Overall, CT was higher by 2.4 °C (95% confidence interval [CI] 0.3-3.8) at high (≥ 1.25 clo) than that at low (< 1.25 clo) Icl, but this difference was modified by personal and work-related factors. The difference was 2.6 °C (CI 0.5-4.6) for older (30-57 y) compared to younger (18-29 y) participants, with an excess of 7.3 °C (CI 5.6-9.0) for low vs high educated participants, 2.6 °C (CI 0.5-4.8) for those doing heavy vs light work, 7.4 °C (CI 3.7-11.0) for alcohol consumers vs others, and 3.4 °C (CI 0.6-6.3) for smokers vs non-smokers. The differences were independent of personal characteristics and worksite physical conditions and were interpreted as increased cold sensitivity among subgroups with lesser stamina and poorer health. Sensitive worker subgroups should be identified, and their need for cold protection should be reviewed.
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Frío , Aves de Corral , Humanos , Adulto , Animales , Masculino , Persona de Mediana Edad , Femenino , Tailandia , Adulto Joven , Adolescente , Exposición Profesional/efectos adversos , Autoevaluación (Psicología) , Vestuario , Ropa de ProtecciónRESUMEN
BACKGROUND: Pregnant women are more likely to have a higher severity of illness after being infected with coronavirus disease 2019 compared with the general population, particularly in the hyperinflammatory phase. However, immunomodulatory drugs are contraindicated and have been associated with an increased risk of fetal abnormalities. Therefore, we are reporting our experience with the use of HA330 hemoperfusion in combination with standard therapy in severe to critical coronavirus disease 2019 cases among pregnant patients. CASE PRESENTATION: From January 2020 to December 2021, four pregnant Thai women were treated with hemoperfusion using a cytokine adsorptive technique. The patients' ages ranged from 21 to 36 years old, and their gestational ages at the time of admission ranged from 18 to 38 weeks. Two patients required intubation. Extracorporeal blood purification with an adsorptive cartridge (HA330®, Jafron, China) was applied as an adjunctive strategy to standard therapy approximately one week after the onset of symptoms, and most patients received three sessions of hemoperfusion. The baseline C-reactive protein level was greater than 80 mg/dL. The results showed that hemoperfusion could decrease the C-reactive protein level by approximately 80% and improve oxygenation. The newborns were delivered by Cesarean section without complications. Neither mortality nor serious adverse events related to hemoperfusion occurred. CONCLUSION: This report may help ensure the use of the hemoperfusion strategy in pregnant patients during a cytokine storm. However, a larger cohort is needed to confirm its safety and efficacy.
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COVID-19 , Hemoperfusión , Complicaciones Infecciosas del Embarazo , SARS-CoV-2 , Humanos , Femenino , Embarazo , Hemoperfusión/métodos , COVID-19/terapia , COVID-19/complicaciones , Adulto , Complicaciones Infecciosas del Embarazo/terapia , Adulto Joven , Tailandia , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Cesárea , Recién NacidoRESUMEN
Rabies is a neglected disease primarily related to dog-mediated transmission to humans. Accurate dog demographic and dynamic data are essential for effectively planning and evaluating population management strategies when designing interventions to prevent rabies. However, in Thailand, longitudinal survey data regarding dog population size are scarce. A school-based participatory research (SBPR) approach was conducted to survey owned dogs for one year in four high-risk provinces (Chiang Rai, Surin, Chonburi, and Songkhla) of Thailand, aiming to understand dog population dynamics and raise awareness about rabies. 'Pupify' mobile application was developed to collect data on dog population and observe the long-term population dynamics in this study. At the end of the data collection period, telephone interviews were conducted to gain insight into contextual perceptions and awareness regarding both animal and human rabies, as well as the social responsibility of dog owners in disease prevention and control. Among 303 high school students who registered in our study, 218 students reported at least one update of their dog information throughout the one-year period. Of 322 owned dogs from our survey, the updates of dog status over one year showed approximately 7.5 newborns per 100-dog-year, while deaths and missing dogs were 6.2 and 2.7 per 100-dog-year, respectively. The male to female ratio was approximately 1.8:1. Twenty-three students (10%) voluntarily participated and were interviewed in the qualitative study. The levels of rabies awareness and precautions among high-school students were relatively low. The high dropout rate of the survey was due to discontinuity in communication between the researcher and the students over the year. In conclusion, this study focused on using the SBPR approach via mobile application to collect data informing dog population dynamics and raising awareness regarding rabies in Thailand Other engaging platforms (e.g. Facebook, Instagram, Twitter, and other popular applications) is necessary to enhance communication and engagement, thereby sustaining and maintaining data collection. Further health education on rabies vaccination and animal-care practices via social media platforms would be highly beneficial. For sustainable disease control, engaging communities to raise awareness of rabies and increase dog owners' understanding of their responsibilities should be encouraged.
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Enfermedades de los Perros , Conocimientos, Actitudes y Práctica en Salud , Dinámica Poblacional , Rabia , Perros , Rabia/prevención & control , Rabia/epidemiología , Rabia/veterinaria , Animales , Tailandia/epidemiología , Humanos , Masculino , Femenino , Enfermedades de los Perros/prevención & control , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/virología , Instituciones Académicas , Adolescente , Investigación Participativa Basada en la Comunidad , Estudiantes/psicología , Encuestas y CuestionariosRESUMEN
Rasch analysis was employed to investigate the psychometric properties of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and its shorter versions (EUROHIS-QOL-8 and WHOQOL-5) within the context of patients undergoing warfarin in Thailand. A group of 260 patients were recruited from three public hospitals and tasked with completing the WHOQOL-BREF questionnaire. Rasch analysis showed that the WHOQOL-BREF, structured into four-domain subtests, achieved a commendable fit to the Rasch model (χ2[16] = 12.26, p = 0.73), met the criterion of unidimensionality (7.31% significant t-tests; lower bound confidence interval, 4.66), and demonstrated satisfactory reliability (PSI = 0.87). The adoption of a subtest approach facilitated an acceptable fit to the Rasch model for each domain of the WHOQOL-BREF, except for the social domain. However, the presence of local dependency of the three-item social domain was detected, so the reliability was not reported. The WHOQOL-5 proved to be unidimensional, fitting the Rasch model acceptably, and had satisfactory reliability. Conversely, the EUROHIS-QOL-8 presented local dependency; thus, reliability was not reported. Consequently, the WHOQOL-BREF in its four-domain subtests is recommended for pre- and post-HRQoL measurements, whereas the WHOQOL-5 can effectively measure HRQoL levels in between-group analyses.
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Psicometría , Calidad de Vida , Warfarina , Humanos , Warfarina/uso terapéutico , Tailandia , Psicometría/métodos , Femenino , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Anciano , Reproducibilidad de los Resultados , Anticoagulantes/uso terapéutico , Organización Mundial de la Salud , Adulto , Pueblos del Sudeste AsiáticoRESUMEN
The gut microbiota metabolite trimethylamine-N-oxide (TMAO)-derived from dietary phosphatidylcholine-is mechanistically linked to cardiovascular disease (CVD) and increased cardiovascular risk. This study examined the relationship between fasting plasma TMAO levels and 5-year all-cause mortality in a cohort of patients at high risk of cardiovascular events (CORE-Thailand Registry). Of the 134 patients, 123 (92%) had established cardiovascular disease, and 11 (8%) had multiple risk factors. Fasting plasma TMAO levels were measured using nuclear magnetic resonance spectroscopy. Within this prospective cohort study, the median TMAO was 3.81 µM [interquartile range (IQR) 2.89-5.50 µM], with a mean age of 65 ± 11 years; 61% were men, and 39.6% had type II diabetes. Among 134 patients, 65 (49%) were identified as the high-TMAO group (≥ 3.8 µM), and 69 (51%) were identified as the low-TMAO group (< 3.8 µM). After a median follow-up of 58.8 months, the high-TMAO group was associated with a 2.88-fold increased mortality risk. Following adjustment for traditional risk factors, high-sensitivity cardiac troponin-T, estimated glomerular filtration rate, angiotensin-converting enzyme (ACEI), or angiotensin-receptor blocker (ARB) use, the high-TMAO group remained predictive of 5-year all-cause mortality risk (the high-TMAO vs. the low-TMAO group, adjusted hazard ratio 2.73, 95% CI 1.13-6.54; P = 0.025). Among Thai patients at high risk of cardiovascular events, increased plasma TMAO levels portended greater long-term mortality risk.
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Enfermedades Cardiovasculares , Microbioma Gastrointestinal , Metilaminas , Humanos , Metilaminas/sangre , Metilaminas/metabolismo , Masculino , Femenino , Anciano , Enfermedades Cardiovasculares/mortalidad , Persona de Mediana Edad , Tailandia/epidemiología , Estudios Prospectivos , Factores de RiesgoRESUMEN
Cervical cancer is a leading cause of gynecological malignancies and cancer-related deaths among women worldwide. This study investigates the anti-cancer activity of Thua Nao, a Thai fermented soybean, against HeLa cervical carcinoma cells, and explores its underlying mechanisms. Our findings reveal that the ethyl acetate fraction of Thua Nao (TN-EA) exhibits strong anti-cancer potential against HeLa cells. High-performance liquid chromatography (HPLC) analysis identified genistein and daidzein as the major isoflavones in TN-EA responsible for its anti-cancer activity. TN-EA and genistein reduced cell proliferation and induced G2/M phase arrest, while daidzein induced G1 arrest. These responses were associated with the downregulation of cell cycle regulators, including Cyclin B1, cycle 25C (Cdc25C), and phosphorylated cyclin-dependent kinase 1 (CDK-1), and the upregulation of the cell cycle inhibitor p21. Moreover, TN-EA and its active isoflavones promoted apoptosis in HeLa cells through the intrinsic pathway, evidenced by increased levels of cleaved Poly (ADP-ribose) polymerase (PARP) and caspase-3, loss of mitochondrial membrane potential, and the downregulation of anti-apoptotic proteins B-cell leukemia/lymphoma 2 (Bcl-2), B-cell lymphoma-extra-large (Bcl-xL), cellular inhibitor of apoptosis proteins 1 (cIAP), and survivin. Additionally, TN-EA and its active isoflavones effectively reduced cell invasion and migration by downregulating extracellular matrix degradation enzymes, including Membrane type 1-matrix metalloproteinase (MT1-MMP), urokinase-type plasminogen activator (uPA), and urokinase-type plasminogen activator receptor (uPAR), and reduced the levels of the mesenchymal marker N-cadherin. At the molecular level, TN-EA suppressed STAT3 activation via the regulation of JNK and Erk1/2 signaling pathways, leading to reduced proliferation and invasion of HeLa cells.
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Apoptosis , Proliferación Celular , Glycine max , Isoflavonas , Neoplasias del Cuello Uterino , Humanos , Células HeLa , Isoflavonas/farmacología , Femenino , Neoplasias del Cuello Uterino/metabolismo , Glycine max/química , Proliferación Celular/efectos de los fármacos , Apoptosis/efectos de los fármacos , Fermentación , Tailandia , Extractos Vegetales/farmacología , Extractos Vegetales/química , Pueblos del Sudeste AsiáticoRESUMEN
BACKGROUND: Most real-world data on CGRP mAbs have been published from high-income countries such as the USA, Western countries, Japan, Korea, and Singapore. However, data from low- and middle-income countries in Southeast Asia is lacking. This is the first real-world study from Thailand to describe the efficacy of CGRP mAbs therapy in migraine patients and to analyze the response trends between episodic migraine and chronic migraine. METHODS: We conducted a single-center, real-world retrospective chart review study with an observation period of 6 months after CGRP mAbs initiation. We aim to compare treatment responses to CGRP mAbs between EM and CM patients. RESULTS: A total of 47 Thai patients were enrolled (median [IQR] age 37.2 [28.6-50.4] years; 85.1%F, 44.7% EM; 70.2% galcanezumab). There was no difference in baseline characteristics and migraine disability assessment (MIDAS) between EM and CM. The overall ≥ 30%, ≥ 50%, and ≥ 70% monthly migraine day reduction rates at 6 months were 89.0%, 71.6%, and 58.5% with higher responders in EM. There was a significant decrease in monthly headache days (MHDs) over time (adjusted ß = -0.42, p < 0.001) and a significant decrease in MIDAS score over time after the initiation of CGRP mAbs (adjusted ß = -1.12, p = 0.003). However, there were no differences between the two diagnoses. There was no significant decrease in the number of abortive medication pills used over time after the initiation of CGRP mAbs. CM had a significantly steeper trend compared to those with EM. CONCLUSION: The first real-world study in Thailand demonstrated that CGRP mAbs therapy had efficacy for migraine treatment, as evidenced by a reduction in MHDs, decreased disability, and reduced use of abortive medications. Additionally, the response pattern to CGRP mAbs therapy was similar between EM and CM in terms of MHDs reduction and MIDAS score improvement.
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Trastornos Migrañosos , Humanos , Femenino , Masculino , Tailandia , Adulto , Persona de Mediana Edad , Trastornos Migrañosos/tratamiento farmacológico , Estudios Retrospectivos , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Péptido Relacionado con Gen de Calcitonina/antagonistas & inhibidores , Péptido Relacionado con Gen de Calcitonina/inmunología , Países en DesarrolloRESUMEN
Thailand introduced a two-dose regimen of bivalent HPV vaccines for Grade 5 schoolgirls, approximately 11 years old, initially piloted in Ayutthaya province in 2014, and nationwide under the National Immunization Program (NIP) in 2017. This cross-sectional, case-control study evaluated the vaccine effectiveness in schoolgirls 7 years after a two-dose administration. Between May and June 2023, 211 grade 12 female students from Ayutthaya, who received the two-dose bivalent HPV vaccine CERVARIXâ (HPV types 16 and 18), and 376 grade 12 students from Nakhon Pathom who did not receive the HPV vaccine, were enrolled. HPV infection was detected by testing for HPV DNA in the first-void urine samples using real-time PCR (Cobas® 4800 and AnyplexTM HPV28). The study found that the HPV vaccine 100% effective against high-risk HPV (HR-HPV) types included in the vaccine (16, 18) and 32.8% effective against other HR-HPV types not included in the vaccine. Our findings indicated that the bivalent HPV vaccine does not provide cross-protection against non-vaccine HPV types. Prioritizing vaccines with the highest coverage of HR-HPV types, such as the nonavalent HPV vaccine, is crucial to effectively prevent a broader range of HR-HPV infections under the NIP.
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Programas de Inmunización , Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Humanos , Vacunas contra Papillomavirus/administración & dosificación , Vacunas contra Papillomavirus/inmunología , Femenino , Infecciones por Papillomavirus/prevención & control , Tailandia , Estudios Transversales , Niño , Estudios de Casos y Controles , Eficacia de las Vacunas , Vacunación , Estudiantes , ADN Viral , Adolescente , Pueblos del Sudeste AsiáticoRESUMEN
This study employs a mathematical model to analyze and forecast the severe outbreak of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), focusing on the socio-economic ramifications within the Thai population and among foreign tourists. Specifically, the model examines the impact of the disease on various population groups, including susceptible (S), exposed (E), infected (I), quarantined (Q), and recovered (R) individuals among tourists visiting the country. The stability theory of differential equations is utilized to validate the mathematical model. This involves assessing the stability of both the disease-free equilibrium and the endemic equilibrium using the basic reproduction number. Emphasis is placed on local stability, the positivity of solutions, and the invariant regions of solutions. Additionally, a sensitivity analysis of the model is conducted. The computation of the basic reproduction number (R0) reveals that the disease-free equilibrium is locally asymptotically stable when R0 is less than 1, whereas the endemic equilibrium is locally asymptotically stable when R0 exceeds 1. Notably, both equilibriums are globally asymptotically stable under the same conditions. Through numerical simulations, the study concludes that the outcome of COVID-19 is most sensitive to reductions in transmission rates. Furthermore, the sensitivity of the model to all parameters is thoroughly considered, informing strategies for disease control through various intervention measures.
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Número Básico de Reproducción , COVID-19 , SARS-CoV-2 , COVID-19/epidemiología , COVID-19/transmisión , COVID-19/virología , Humanos , Tailandia/epidemiología , SARS-CoV-2/aislamiento & purificación , Modelos Teóricos , Viaje , Cuarentena , Turismo , EpidemiasRESUMEN
BACKGROUND: Nutritional supplements for sports and exercise (NSSE) can facilitate the exogenous replenishment of the body. This study provides the first extensive overview of NSSE research through bibliometric and visual analyses. METHODS: We searched the Web of Science Core Collection database for literature related to "NSSE" from 1st January 2000 to 8th March 2024. A total of 1744 articles were included. CiteSpace, VOSviewer, and Bibliometrix R package software were used to analyze the data. RESULTS: Research in the NSSE can be divided into steady growth, exponential growth, fluctuating stage, and surge stages. The United States is the most active country in this field. In recent years, the leading countries have been Croatia, Colombia, Slovenia, Chile, Egypt, China, and Thailand. The Australian Institute of Sports is the top research institution in terms of number of publications. Burke, LM from Australia published the most articles. Research in this area has primarily been published in Nutrients in Switzerland. The study population mainly consisted of men, and postmenopausal women were the main focus of the female group. Coronary heart and cardiovascular diseases continue to dominate research. CONCLUSION: Research on the NSSE is developing rapidly, with an annual growth trend. Insulin resistance, sports nutrition, inflammation, alpha-linolenic acid, limb strength performance, female sex, and gut microbiota are the focus of the current research and trends for future research. Future research should focus on improving the scientific training system for athletes and quality of training and life for the general public.