Perceptions of Physical Activity among Older Adults in Rural Communities Southern Thailand

@#Thailand promotes the regular engagement of physical activity (PA) among its older population to gain health benefits. However, the majority of this group does not achieve sufficient levels of PA to meet the minimum guidelines recommended by Thailand’s National Health Policy. This study explores how older Thai adults living in rural community context, southern Thailand perceive participation in PA along with the barriers that enable them to participate regularly in PA. Methods: Five focus group discussions were investigated consisting of older members living in Muslim and Buddhist communities in southern Thailand. Thematic analysis was used to analyse the data. Results: All older participants were aware of the health benefits of PA. Forty - three considered themselves to be active as part of their daily activities. The kinds of PA they practised were based on local lifestyles and individual convenience. Biological, psychological, social and environmental factors were revealed as motivations and barriers regarding consistent PA. Conclusion: This paper provides a conceptual understanding about the perceptions of PA among older people living in rural communities of southern Thailand. The findings have implications for health care professional who care for older groups. The provision of needs and supports related to their backgrounds and lifestyles could reduce barriers and increase accessible resources to achieve effective levels. The information should be valuable to those interested in designing suitable interventions to increase participation in PA.

Morphometric analysis of sand fly (Diptera: Psychodidae: Phlebotominae), Sergentomyia anodontis Quate and Fairchild, 1961, populations in caves of southern Thailand

To determine the morphological characteristics of variations in populations of female adult sand fly, Sergentomyia anodontis Quate and Fairchild, 1961 in caves in southern Thailand using morphometric analysis. Methods: A total of 107 female Sergentomyia anodontis were isolated from 651 sand flies captured by CDC light traps overnight in caves in Surat Thani, Nakhon Si Thammarat, Satun and Songkhla provinces from February to December 2017. Measurement of 23 external and internal morphological characteristics was conducted. Data were tested with preliminary statistics (Kolmogorov-Smirnov test, Levene's test and Box's test of equality of covariance matrices) and by one-way ANOVA or Kruskal-Wallis test. Measurements were analyzed using canonical discriminant analysis. Results: There were 11 morphological characteristics with high variability while two characteristics exhibited low variation. The sand fly populations from Nakhon Si Thammarat, Satun and Songkhla provinces were very similar but were separate from that in Surat Thani province based on canonical discriminant analysis data. This indicates that the morphological variation founding is a result of the diversity of habitats in each population and the geographic features of caves in each area, such as their altitude above sea level. Conclusions: There is a certain variation in the morphology of Sergentomyia anodontis sand flies at the population level which may be used for future classification of sand flies.

Morphometric analysis of sand fly (Diptera: Psychodidae: Phlebotominae), Sergentomyia anodontis Quate and Fairchild, 1961, populations in caves of southern Thailand

To determine the morphological characteristics of variations in populations of female adult sand fly, Sergentomyia anodontis Quate and Fairchild, 1961 in caves in southern Thailand using morphometric analysis. Methods: A total of 107 female Sergentomyia anodontis were isolated from 651 sand flies captured by CDC light traps overnight in caves in Surat Thani, Nakhon Si Thammarat, Satun and Songkhla provinces from February to December 2017. Measurement of 23 external and internal morphological characteristics was conducted. Data were tested with preliminary statistics (Kolmogorov-Smirnov test, Levene's test and Box's test of equality of covariance matrices) and by one-way ANOVA or Kruskal-Wallis test. Measurements were analyzed using canonical discriminant analysis. Results: There were 11 morphological characteristics with high variability while two characteristics exhibited low variation. The sand fly populations from Nakhon Si Thammarat, Satun and Songkhla provinces were very similar but were separate from that in Surat Thani province based on canonical discriminant analysis data. This indicates that the morphological variation founding is a result of the diversity of habitats in each population and the geographic features of caves in each area, such as their altitude above sea level. Conclusions: There is a certain variation in the morphology of Sergentomyia anodontis sand flies at the population level which may be used for future classification of sand flies.

Molecular Surveillance of Pfkelch13 and Pfmdr1 Mutations in Plasmodium falciparum Isolates from Southern Thailand

Artemisinin-based combination therapy (ACT) resistance is widespread throughout the Greater Mekong Subregion. This raises concern over the antimalarial treatment in Thailand since it shares borders with Cambodia, Laos, and Myanmar where high ACT failure rates were reported. It is crucial to have information about the spread of ACT resistance for efficient planning and treatment. This study was to identify the molecular markers for antimalarial drug resistance: Pfkelch13 and Pfmdr1 mutations from 5 provinces of southern Thailand, from 2012 to 2017, of which 2 provinces on the Thai- Myanmar border (Chumphon and Ranong), one on Thai-Malaysia border (Yala) and 2 from non-border provinces (Phang Nga and Surat Thani). The results showed that C580Y mutation of Pfkelch13 was found mainly in the province on the Thai-Myanmar border. No mutations in the PfKelch13 gene were found in Surat Thani and Yala. The Pfmdr1 gene isolated from the Thai-Malaysia border was a different pattern from those found in other areas (100% N86Y) whereas wild type strain was present in Phang Nga. Our study indicated that the molecular markers of artemisinin resistance were spread in the provinces bordering along the Thai-Myanmar, and the pattern of Pfmdr1 mutations from the areas along the international border of Thailand differed from those of the non-border provinces. The information of the molecular markers from this study highlighted the recent spread of artemisinin resistant parasites from the endemic area, and the data will be useful for optimizing antimalarial treatment based on regional differences.

High prevalence of undernutrition among preschool children in Pattani Province, southern Thailand

@#Introduction: Malnutrition is one of the leading causes of childhood death. In the southern provinces of Thailand that are encountering a civil conflict, the extent of malnutrition among young children has not been adequately reported. Methods: A cross-sectional study was undertaken to assess the nutritional status of children aged 2-5 years enrolled in early childhood development centres (ECDC) in Pattani Province. A total of 112 ECDCs were randomly selected and 871 children who met the inclusion criteria were recruited. Anthropometric measurements were taken and nutritional status determined according to World Health Organization (2006) growth standards. Statistical analyses of nutritional indicators, namely wasting, stunting, underweight and Composite Index of Anthropometric Failure (CIAF) across sociodemographic variables were carried out. Binary logistic regression models, based on the different nutritional indicators, were used to determine the relationships between undernutrition status and associated factors. Results: Prevalence of wasting (7.7%), stunting (19.6%) and underweight (16.8%) were determined. Based on CIAF, 27.4% of the children were undernourished. Logistic regression odds showed that prevalence of all forms of undernutrition was statistically independent of sex and place of residence. Religion was associated with all four indicators of undernutrition. Stunting was associated with child’s age and religion, while underweight and CIAF were associated with the child’s age, religion and mother’s occupation. Conclusion: Prevalence of undernutrition was estimated to be high in comparison with the national average figure. The study findings highlighted the need for more effective nutrition promotion activities to alleviate undernutrition problems among young children in Pattani Province.

Characteristics, clinical outcomes and factors influencing mortality of patients with melioidosis in southern Thailand: A 10-year retrospective study

OBJECTIVE@#To study characteristics, clinical outcomes and factors influencing mortality of patients afflicted with melioidosis.@*METHODS@#We retrospectively analyzed 134 patients, with a microbiologically-confirmed diagnosis of melioidosis, during the period from January 2002 to June 2011 at Songklanagarind Hospital, a tertiary care hospital in southern Thailand.@*RESULTS@#The prevalence of melioidosis among admitted patients was 36.8 per 100000 in patients. The median age was 49 years and they were predominantly male. The most common underlying disease was diabetes mellitus (47.01%). The majority of cases (50%) had localized infection. The rates of multifocal, bacteremic, and disseminated infections were 12.7%, 23.1%, and 14.2%, respectively. The lungs were the most common organ afflicted, resulting in infection (24.63%). Splenic abscess as well as liver abscess accounted for 20.90% and 19.40%, respectively. A total of one eighth of the patients had septic shock at presentation. The overall mortality rate was 8.96%. The factors influencing mortality were pneumonia, septic shock, a positive blood culture for Burkholderia pseudomallei, superimposing with nosocomial infection and inappropriate antibiotic administration.@*CONCLUSIONS@#Melioidosis is not uncommon in southern Thailand. The mortality of patients with pneumonia, bacteremia and septic shock is relatively high. Appropriate antibiotics, initially, will improve outcomes.

Characteristics, clinical outcomes and factors influencing mortality of patients with melioidosis in southern Thailand: A 10-year retrospective study

Objective: To study characteristics, clinical outcomes and factors influencing mortality of patients afflicted with melioidosis. Methods: We retrospectively analyzed 134 patients, with a microbiologically-confirmed diagnosis of melioidosis, during the period from January 2002 to June 2011 at Songklanagarind Hospital, a tertiary care hospital in southern Thailand. Results: The prevalence of melioidosis among admitted patients was 36.8 per 100. 000 in patients. The median age was 49 years and they were predominantly male. The most common underlying disease was diabetes mellitus (47.01%). The majority of cases (50%) had localized infection. The rates of multifocal, bacteremic, and disseminated infections were 12.7%, 23.1%, and 14.2%, respectively. The lungs were the most common organ afflicted, resulting in infection (24.63%). Splenic abscess as well as liver abscess accounted for 20.90% and 19.40%, respectively. A total of one eighth of the patients had septic shock at presentation. The overall mortality rate was 8.96%. The factors influencing mortality were pneumonia, septic shock, a positive blood culture for Burkholderia pseudomallei, superimposing with nosocomial infection and inappropriate antibiotic administration. Conclusions: Melioidosis is not uncommon in southern Thailand. The mortality of patients with pneumonia, bacteremia and septic shock is relatively high. Appropriate antibiotics, initially, will improve outcomes.

Changes in the psychosocial aspects of child-bearing teenage girls in southern Thailand from pre-pregnancy to postpartum through interviews / 国際保健医療

<b>Objective</b><BR>  This study aims to describe the changes in the psychosocial aspects of women from southern Thai who gave birth during their teenage years and also considers support from the maternal care perspective.<BR><b>Methods</b><BR>  The present study adopted a qualitative descriptive method. Nine postpartum southern Thai women were interviewed about changes in their lives and their psychological conditions from pregnancy to postpartum. The data was codified, categorized by similar codes, and then analyzed.<BR><b>Results and Discussion</b><BR>  The participant’s average age was 16.8 years, of whom seven were primiparas and two were multiparas. Among them, four had not completed compulsory education. All pregnancies were unplanned, and the participants exhibited low rates of sex education. They could not exercise effective self-management with respect to health during pregnancy. One birth was premature and of the nine newborns, five had low birth weights. The participants were raised in poor families and had an “inferiority complex” due to the same. They could not successfully build personal relationships; “school life was not fun, and was interrupted.” With a “purposeless life following withdrawal from school,” they found a romantic partner and became pregnant. After confirmation of their pregnancy, each became upset and found themselves in a state of psychological crisis. After confessing to their parents and after being encouraged by them to get married, they experienced major changes toward “relief at being acknowledged of their circumstances and a positive awareness toward childbirth.” After childbirth, they experienced “growing affection toward their child” and “positive feelings about child care.” We also heard discussions about “a positive view toward school to find employment.”<BR>  In spite of the fact that the area concerned was equipped with medical facilities and administrative-level maternal and child healthcare systems, the participants did not receive guidance regarding education and consultation or guidance on reproductive health within the community. Participants were inexperienced, and their ability to access the available social resources remained low. Proactive outreach regarding the ability to participate in the community is necessary in preventing unwanted teenage pregnancies and also for life after childbirth. Especially, comprehensive education about reproductive health needs to be provided by the community for those who have left school before completing compulsory education. Training for peer supporters and assistance by networking with local residents along with promoting the formation of teenage childcare groups are deemed necessary.