Evaluation of Salt Iodization at Consumption Level in North-Eastern Thailand.

Objectives: Iodine deficiency disorder (IDD) is an important health problem in Thailand, especially in northern and north-eastern regions. Since the introduction of iodized salt in 1960s many control programs have been implemented judging the effectiveness at community level. Concerns have been expressed regarding public health information and quality control of manufactured iodinefortified salt (mandatory: 20- 40 ppm). This study assessed the iodine content in Thai table salts. Methods: Salt samples (n=438) from endemic areas in north-eastern Thailand including eleven districts from three different provinces were collected either by asking school children to bring salt used for home cooking or with the help of local health volunteers during home visits. Salt analysis was conducted by using a portable photometer for quantitative iodine determination (iCheckTMiExTM IODINE). Results: Median iodine concentration was 7.0 ppm (IQR 0.0-32.9) being highest in district 2 and district 6 (51.9 ppm, IQR 24.4-82.7 and 36.6 ppm, IQR 32.0-49.1, respectively). Samples from province A (5.4 ppm, IQR 0.0-31.2) contained significantly less iodine than from province B and province C (20.6 ppm, IQR 5.7-34.4 and 26.3 ppm, IQR 5.9-34.7, respectively; p<0.001). 137 salt samples (31.3%) were not fortified, 24.4% were fortified at levels < 20 ppm and 30.1% were sufficiently fortified (20- 40 ppm); 14.2% were fortified above 40 ppm. Conclusions: Analysis revealed high variability in iodine content between and within different provinces. The results show that IDD programs need to address quality control at factory, retail and household levels.

Development of quality of life instrument for urban poor in the northeast of Thailand.

BACKGROUND: Measuring the quality of life is important for evaluation and prediction of life and social care needs. To evaluate Quality of Life (QOL) in an urban poor population in northeast of Thailand, the Urban Poor Quality of Life (UPQOL) instrument was developed OBJECTIVE: To develop an initial instrument to measure urban poor QOL. MATERIAL AND METHOD: The development was started with literature review and investigated in urban poor communities. The results were transformed into the items required to build a structured questionnaire. Five hundred twenty three subjects, representatives of urban poor, were selected to test this instrument. Descriptive statistics described feature of items and the samples, exploratory factor analysis conducted the items score, and confirmatory factor analysis conducted the construct validity. RESULTS: The result found that the UPQOL instrument consisted of nine domains (education, income and employment, environment, health, infrastructure, security and safety, shelter and housing, civil society and political, and human rights domains) with egien value rank from 1.5 to 4.2 and 61 items with the factor loading rank from 0.41 to 0.82. The internal consistency was 0.92. The correlation between items to domain ranged from 0.30 to 0.72 and domains to overall QOL ranged from 0.27 to 0.84. Confirmatory factor analysis showed that the structure fit all domains well. Domains and overall structure were good with CFI (> 0.95). The internal consistency value ranged from 0.73-0.93. UPQOL scores were able to discriminate groups of subjects with differences levels of QOL. CONCLUSION: The UPQOL instrument is conceptually valid. The results support good validity and reliability. It forms the basis for future testing and application in other settings.

Experience with a self-administered device for cervical cancer screening by Thai women with different educational backgrounds.

Background: This descriptive study was carried out to test the acceptability of a self-administered device for cervical cancer screening and assess certain risk factors in relation to the cancer in two districts of Khon Kaen province in Northeast Thailand. Methods: A total of 354 women from the villages were selected (including 143 teachers from secondary and primary schools; 24 health officers from the rural health centres, and 37 nurses from the University Hospital, Khon Kaen University). The Kato device was introduced and used by the women, who were then asked to give their opinion on its usage. Results: The Kato device was generally well accepted by the women. However, many of those with a higher educational background were more sceptical towards the device than their counterparts from the villages. Conclusions: A suitable approach to strengthen the control of cervical cancer in the rural areas of Thailand might be to introduce the Kato device as an integral part of primary health care. The introduction of the device should go along with health education on the importance of avoiding infection with the papilloma viruses. This message should be transmitted to both females and males.