Association of high sensitivity C-reactive protein concentrations and metabolic syndrome among Thai adults.

Background: Limited information is available regarding associations of metabolic syndrome with C-reactive protein (CRP) concentrations among Asian populations. Objective: Investigate the association of high sensitivity CRP (hsCRP) concentrations and metabolic syndrome among Thai adults. Methods: This cross-sectional study was comprised of 467 Thai participants (209 men and 258 women) receiving annual health check-up. Spearman’s rank correlation coefficients were used to assess the associations between metabolic parameters (age, waist circumference, blood pressure, triglycerides, HDL-C, fasting plasma glucose, fasting insulin and uric acid) with hsCRP concentrations for men and women, respectively. Multivariable logistic regression procedures were used to estimate the risk (odds ratios (OR), and 95% confidence intervals (CI) of metabolic syndrome according to low, moderate, and high hsCRP concentrations (<1.0, 1.0-3.0, and >3.0 mg/L, respectively). Results: Measures of adiposity and fasting insulin were positively and significantly correlated with hsCRP concentrations among women with and without metabolic syndrome. Similar associations were observed among men without metabolic syndrome. After controlling for confounders, moderately elevated hsCRP concentrations were associated with a 2.38-fold increased risk of metabolic syndrome (OR=2.38, 95%CI=1.20-4.72) among men. Men with high hsCRP concentrations had a 5.45-fold increased risk of metabolic syndrome (OR=5.45, 95%CI=2.24- 13.27) when compared with those who had low hsCRP concentrations. The corresponding OR for women with moderately elevated and high hsCRP concentrations were 4.92 (OR=4.92, 95%CI=2.34-10.35) and 11.93 (OR=11.93, 95%CI=5.54-25.72), respectively. Conclusions: These findings are consistent with the literature suggesting a role of hsCRP as a biomarker for metabolic syndrome.

Prevalence of metabolic syndrome among professional and office workers in Bangkok, Thailand.

OBJECTIVE: To estimate the prevalence of metabolic syndrome (MetS) among Thai professional and office workers and to compare the prevalence with other populations. MATERIAL AND METHOD: The authors conducted a cross-sectional study of 1,339 professional and office workers (535 men and 804 women) who participated in the annual health examinations at the Mobile Health Checkup Unit of King Chulalongkorn Memorial Hospital in Bangkok, Thailand during the period of August through December 2001. MetS was defined using the modified NCEP ATP III criteria. Chi-square tests were used to evaluate differences in distribution of covariates for affected and unaffected patients. RESULTS: The prevalence of MetS among Thai professional and office workers was 15.2% and approximately 3 times more common among men than women (25.8% vs. 8.2%). Men and women with MetS were older (p < 0.05) and were less well-educated (p < 0.05) than those without MetS. The three most common metabolic abnormalities in men were high blood pressure (45.0%), BMI > or = 25 kg/m2 (40.7%) and hypertriglyceridemia (38.7%). Among women, high blood pressure (22.8%), BMI > or = 25 kg/m2 (20.9%) and low HDL-Cholesterol (18.4%) were the most common metabolic abnormalities noted. CONCLUSION: The prevalence of MetS in this cohort of Thai professional and office workers was as high as those observed in developed countries. These findings emphasize the urgent need to develop strategies for the detection, treatment, and prevention of MetS. Such efforts will contribute to attenuating the incidence of cardiovascular disease and diabetes.

Influenza vaccination among the elderly in Bangkok.

This study aimed to determine the effectiveness of influenza vaccinations among the elderly in Bangkok in reducing influenza-like illness (ILI) and influenza-related complications. Using a non-randomized, controlled, prospective methodology, healthy, active people aged 60 years or more, living in the Bangkok Metropolitan Administration (BMA) area, were studied. The two study cohorts comprised 519 persons in the vaccinated group and 520 in the non-vaccinated group. The outcome under study was influenza-like illness (ILI), as reported by the study volunteers. The two groups were comparable for most socio-demographic characteristics, except for gender, level of education, marital status, and smoking habit. The age range was 60-88 years (mean: 68 years). Females outnumbered males in both groups, with ratio of female to male of 2.6:1 and 1.9:1 in the vaccinated and non-vaccinated groups, respectively. The top three co-morbidities among these groups were hypertension, diabetes mellitus, and heart disease, in that order. Only 1% of the volunteers reported lung disease as co-morbidity. During the 12-month study period, a total of 107 volunteers reported ILI in both groups, with 38 persons in the vaccinated group and 69 persons in the non-vaccinated group. There were 46 ILI episodes in the vaccinated group, and 86 in the non-vaccinated group, for a total of 132 episodes. The incidence rates rates of influenza in this population, therefore, were 8.9% for the vaccinated and 16.9% for the non-vaccinated groups; with a reduction in the rate of reported ILI and doctor visits of 8%. Vaccine effectiveness was rated at 47.6%, crude risk ratio at 1.9 (1.33-2.75), and adjusted risk ratio at 1.92 (95% CI: 1.25-2.95), after adjustment for gender, marital status, education, and smoking habit. No complications due to ILI were observed in this population during the study period. Hospitalizations during this period were due to non-ILI related causes, such as cancer and accident.

Factors associated with compliance among tuberculosis patients in Thailand.

BACKGROUND: Tuberculosis (TB) is a major health problem in developing countries. There are so many factors which influence the cure rate and one of them is compliance. However in developing countries like Thailand, there is little information about the factors that can predict the compliance within TB patients. OBJECTIVES: To study the level of compliance and associated factors among tuberculosis patients in Thailand. DESIGN: A cross-sectional descriptive study. SETTING: Three levels of health care facilities in the 4 regions of Thailand (Zonal TB Centers, Provincial Hospitals and District Hospitals), excluding Bangkok. PARTICIPANTS: A total of 487 adult newly diagnosed TB patients with positive sputum smear at the study location and they were interviewed by trained health personnel with structured questionnaires. MAIN OUTCOME MEASURES: Level of compliance classified into excellent (punctuality), good (missing < or =2 consecutive weeks) and poor (missing >2 consecutive weeks). The socio-economic variables were studied as the independent variables. RESULTS: About 70% (342 out of 487)of the TB patients were males. Mean (SD) of age was 47.2 (16.65) years and ranged from 15 to 84 years. The excellent compliance rate of the TB patients was 65.7% (95% CI: 61.5-69.6%) while good and poor compliance were 22.8% and 11.5%, respectively. Using Chi-square test of association, the finding showed that the type of treatment (DOT and SS), gender, working, experience of contacting TB patient, perception in health status, attitude, knowledge and social support were significantly associated with the compliance (p < .05). Binary logistic regression (Excellent vs. Good and Poor) were used to adjust the confounding factors. Females were more likely to have excellent compliance than males (adjusted OR = 1.87, 95% CI: 1.17-2.99, p = .009). Patients having perception of fair health status was 2.26 times more to have excellent compliance (95% CI: 1.45-3.53, p < .001). CONCLUSION: Compliance is one of the potential factors to increase the cure rate in TB patients. Finding the significant factors will pave the way to improve the effective treatment of tuberculosis.

Cost analysis of different types of tuberculosis patient at tuberculosis centers in Thailand.

Tuberculosis (TB) has recently re-emerged as a major public health problem in Thailand. As a consequence of the HIV epidemic in the country, the TB burden has been rising in terms of both morbidity, and mortality which have tremendous socioeconomic impact. However, a study of the cost of various anti-TB drugs in Thailand has never been conducted. A specific aim of this study was to compare the total provider costs of delivering services to different types of TB patient in four zonal TB centers located in the east, northeast, north, and south of Thailand. This aim was accomplished by calculating the unit costs of TB treatment services at these TB centers during the year 1996-1997. All units of the zonal TB centers were classified into 5 cost-center categories: treatment units, laboratory units, radiology units, pharmaceutical units, and administrative/supportive units. The results showed that the average total provider cost of multidrug resistant TB (MDR TB) patients was 89,735.49 baht which was the highest of any type of patient and was 17 times higher than the cost of smear-negative TB cases; this finding was attributed to the high cost of anti-TB drugs for MDR TB cases (65,870 baht), some 95 times higher than the cost for smear-negative cases. Total provider costs were highest in the northeastern region TB centers and lowest in the southern centers for every type of TB patient: smear-negative TB cases (7.727 baht vs 3.916 baht). newly smear positive TB cases (12,539 baht vs 7.020 baht), TB with AIDS cases (15,108 baht vs 8,369 baht). re-treatment TB cases (16,679 baht vs 9,696 baht), and MDR TB cases (102.330 baht vs 82,933 baht). The information from this study may be useful when reviewing the role, function, and cost structure of each TB center in Thailand in order to establish a strategic plan for effective TB control.