Prevalence, detection and control of hypertension in Thai population of a central rural community.

Epidemiolagical survey of hypertension was carried out on 2,374 villagers, aged 15 years and above, residing in Bang-Pa-in district, Ayutthaya province. The overall prevalence of hypertension was 11.3 per cent. The prevalence rate of pure systolic hypertension rose with age up to elderly; whereas the prevalence rate of diastolic hypertension increased with age up to late middle age, then declined in the elderly. Regarding the detection of hypertension, only 41.6 per cent of the cases were previously detected. And only 30.1 per cent of the cases were under current treatment. Females had a greater proportion of previously detected and currently treated cases than males. Among those currently treated hypertensive patients, 50.5 per cent went to see a physician, 29.5 per cent went to the local health centers; the rest sought the services of local quacks, traditional healers and drug stores. It yielded only 24.7 per cent of the treated cases whose BP were under control. Since the people prefer seeking help from local personnel, the role of community health personnel should be strengthened to bring more effective control of the disease.

Salmonella and Shigella carrier rates and environmental sanitation in a rural district, Central Thailand.

The study of Salmonella and Shigella carrier rates were carried out in two Tambol (sub districts). Klongjik, Kanon-Laung and Amphur (district) Bang-Pa-In. The carrier rates of Salmonella and Shigella were 3.3% and 0.8% respectively. Most Salmonella strains were sensitive to the antibiotics commonly used; only 6.4% and 3.2% were resistant to tetracycline and neomycin. All Shigella isolated were resistant to chloramphenicol and 75% to tetracycline. One fourth of the families defecated in the river or canal or went to the field and one third disposed the garbage into the river or canal. This contaminated water was used for drinking by 62.7% of all families and only 28.1% treated the water by boiling. The disease vectors bothering the villagers were rats 58.8%, flies and cockroaches which served as important vehicles for cross contamination. The prevalence rate of diarrhoeal disease in the villages was 1933 per 100,000 and presented as the morbidity rate of this disease in the district hospital, only 355 to 363 per 100,000 in 1979 and 1980. Health care for diarrhoeal diseases in these villages were 61% by self-medication, 36% using the village healer and only 3% went to the district hospital. The effective means to eliminate transient and chronic carriers of Shigella and Salmonella typhi may be very important but other means of prevention of diarrhoeal diseases of typhoid fever are through the sanitary disposal of human excreta and the development of safe water supply should be emphasized.