A comparison of effectiveness of sex estimation from the calcaneus and talus in a Thai population / Comparación de la efectividad de la estimación del sexo a partir del calcáneo y el talus en una población tailandesa

SUMMARY: Sex estimation is an important aspect of skeletal identification. In addition, previous studies have found that the sex estimation of each race is different. Thus, it is necessary to develop discriminant function equations for the estimation of sex for the Thai population. This study aims to investigate the relationship between width, length and height of the calcaneus and talus with regards to sex and compare the effectiveness of sex estimation between the calcaneus alone, the talus alone, and between both the calcaneus and talus. A total of 200 individuals (100 males and 100 females) were used in this study; ages ranged from 19 to 94 years. Thirteen variables of calcaneus and ten variables of talus were measured. The authors created discriminant function equations for the estimation of sex and tested the efficiency of the equations obtained by using a test group of 40 individuals (20 males and 20 females). By analyzing the mean values of the variables in the calcaneus and the talus, it was shown that males were significantly different from females (p0.05). A stepwise method was used to create 6 equations for sex estimation. The equations were categorized from between the calcaneus alone, the talus alone, and between both the calcaneus and the talus, providing a sex estimation accuracy of between 88.5 and 93.0 %. Using the test group, it was shown that discriminant function equations from the calcaneus alone, the talus alone, and the calcaneus and the talus together, can estimate sex at a high level of accuracy. Sex estimation accuracy was greater than 85 % in all equations. Therefore, the discriminant function equations from the calcaneus alone, the talus alone, and between both the calcaneus and the talus, from this study can be applied to the Thai population.

La estimación del sexo es un aspecto importante de la identificación esquelética. Estudios previos han encontrado que la estimación del sexo de cada raza es diferente. Por lo tanto, es necesario desarrollar ecuaciones de funciones discriminantes para la estimación del sexo de la población tailandesa. Este estudio tuvo como objetivo investigar la relación entre el ancho, el largo y la altura de los huesos calcáneo y talus con respecto al sexo y comparar la efectividad de la estimación del sexo entre el calcáneo solo, el talus solo y entre el calcáneo y el talus. Se utilizaron un total de 200 huesos de individuos adultos (100 hombres y 100 mujeres), cuyas edades oscilaron entre 19 y 94 años. Se midieron trece variables del calcáneo y diez variables del talus. Los autores crearon ecuaciones de funciones discriminantes para la estimación del sexo y probaron la eficiencia de ellas usando un grupo de prueba de huesos de 40 individuos (20 hombres y 20 mujeres). Al analizar los valores medios de las variables en el calcáneo y el talus, se demostró que los huesos de los hombres eran significativamente diferentes al de las mujeres (p0.05). Se utilizó un método paso a paso para crear 6 ecuaciones para la estimación del sexo. Las ecuaciones se clasificaron entre el calcáneo solo, el talus solo y entre el calcáneo y el talus, lo que proporcionó una precisión de estimación del sexo de entre 88,5 y 93,0 %. Usando el grupo de prueba, se demostró que las ecuaciones de funciones discriminantes del calcáneo solo, el talus solo y el calcáneo y el talus juntos pueden estimar el sexo con un alto nivel de precisión. La precisión de la estimación del sexo fue superior al 85 % en todas las ecuaciones. Por lo tanto, las ecuaciones de la función discriminante del calcáneo solo, el talus solo y entre el calcáneo y el talus de este estudio se pueden aplicar a la población tailandesa.

Molecular detection of oral Trichomonas tenax in periodontal disease patients by polymerase chain reaction -based 18S rRNA gene

@#Trichomonas tenax, an oral flagellated protozoon found in humans, potentially associated with the inflammation of periodontal tissues and decreased immunity that causes the tissue damage and tooth loss from chronic infection. Currently, there is a lack of data regarding the prevalence of T. tenax infection in Thailand. Therefore, this study aimed to measure prevalence of T. tenax in periodontal disease patients by using polymerase chain reaction (PCR) to amplify the 18S ribosomal RNA (18S rRNA) gene and to determine the factors associated with the presence of this protozoan. A cross-sectional descriptive study was conducted among 230 patients with periodontal disease, who visited the oral health center of Suranaree University of Technology Hospital, Thailand from 2021 to 2022. Dental plaque specimens were collected and examined to identify the presence of T. tenax using the PCR-based 18S rRNA gene. The occurrence of factors associated with T. tenax infection was analyzed by the chi-square test and binary logistic regression. The prevalence of T. tenax infection was 13.48% (31/230), in patients, including 96.77% (30/31) and 3.23% (1/31) in periodontitis and gingivitis patients, respectively. The presence of T. tenax was associated with periodontal disease (p<0.001) and the Periodontal Screening and Record (PSR) index (p=0.001). The significant risk factors for T. tenax infection were periodontitis (ORadj=239.89, 95% CI=23.801-2417.746), no-underlying disease (ORadj=0.31, 95% CI=0.099–0.942), and male sex (ORadj=0.25, 95% CI=0.062-0.981). Dentists should be concerned about this oral protozoan in periodontitis patients. Furthermore, epidemiologic studies of T. tenax are still needed to investigate the mechanism of pathogenesis from T. tenax infection.

Molecular detection of filarial nematode from Culicoides biting midges (Diptera: Ceratopogonidae) in northeastern Thailand

@#Culicoides Latreille biting midges are important blood feeding insects. Many species are pests and vectors of the disease causing agents including viruses, protozoa and filarial nematodes which can be transmitted to humans and other animals. However, knowledge of the role of Culicoides as vectors of filarial nematodes is limited, particular in Thailand, where at least 100 species of the genus Culicoides have been reported. In this study, a molecular approach using the 12S rRNA gene sequence was used to detecting the filarial nematode in four common biting midge species, C. actoni Smith, C. oxystoma Kieffer, C. peregrinus Kieffer and C. mahasarakhamense Pramual, Jomkumsing, Piraonapicha & Jumpato in animal shelters from northeastern Thailand. A total of 1,721 specimens were used for molecular screening. An unidentified Onchocercidae sp. was detected in a specimen of C. mahasarakhamense collected from Maha Sarakham province. This filarial species shows 93% sequence similarity with an unidentified Onchocercidae sp. isolated from Culex mosquitoes. Phylogenetic analyses revealed that Onchocercidae sp. from C. mahasarakhamense formed a clade with strong bootstrap support (100%) with filarial species detected in birds. Thus, it is very likely that the Onchocercidae sp. found in this study employes birds as vertebrate hosts which agrees with feeding behavior of C. mahasarakhamense which is known to feed on chicken. Further study is requiring to examine whether this biting midge species is a competent vector of this Onchocercidae sp.

Oral parasitic protozoan Entamoeba gingivalis in periodontal disease patients, northeastern Thailand

@#Entamoeba gingivalis is present in the oral cavity of humans and is associated with periodontal disease. Consequently, this study aimed to comprehensively investigate the E. gingivalis infection and the associated risk factors among individuals suffering from periodontal conditions. A cross-sectional descriptive study was carried out within a cohort of periodontal patients. Dental plaque specimens were meticulously collected and subsequently subjected to thorough examination using the polymerase chain reaction (PCR)-based technique targeting the small subunit ribosomal RNA (SrRNA) gene of the organism. The occurrence of risk factors for E. gingivalis infection was analyzed by the chi-square test and binary logistic regression. Out of the 230 participants, 60 were clinically diagnosed with periodontitis, while 170 were afflicted with gingivitis. Out of the 230 patients, 25 (10.9%) tested positive for E. gingivalis infections. An in-depth analysis unveiled that a significant majority of infections were recorded within subgroups characterized by a marital status (15.45%), manifestation of periodontitis (25.00%), and concomitant presence of underlying disease (20.83%). Furthermore, the high risk factor associated with E. gingivalis infection was the female (ORadj = 13.65, 95% CI = 1.08-173.21), followed by periodontitis (ORadj = 3.30, 95% CI = 1.21-9.00), respectively. The study employs a molecular diagnostic approach to screen for E. gingivalis enrichment within a subset of periodontal patients with advancing disease. The findings emphasize the necessity for further research to elucidate the pathogenesis of E. gingivalis and advocate for vigilant surveillance within a substantial population of periodontal patients.

In-hospital Mortality and Hospital Outcomes among Adults Hospitalized for Exacerbations of Asthma and COPD in Southern Thailand (2017-2021): A Population-Based Study / 中国医学科学杂志(英文版)

Background Hospitalizations for asthma and chronic obstructive pulmonary disease (COPD) exacerbations frequently occur in Thailand. National trends in hospital outcomes are essential for planning preventive strategies within the healthcare system. We examined temporal trends in in-hospital outcomes, including mortality rate, length of stay (LOS), and expenses for reimbursement in adults hospitalized for asthma and COPD exacerbations in southern Thailand.Methods A retrospective, population-based study on adults hospitalized for exacerbations of asthma and COPD was carried out using data from the National Health Security Office in southern Thailand. Baseline demographic and in-hospital outcome assessments were conducted on 19,459 and 66,457 hospitalizations for asthma and COPD, respectively, between 2017 and 2021.Results Significant reductions in hospital admissions for exacerbations of asthma and COPD were observed over time, particularly in 2020/2021. From 2017 to 2021, the in-hospital mortality rate for asthma rose from 3.2 to 3.7 deaths per 1,000 admissions (P<0.05). The rates for COPD admissions, on the other hand, reduced from 20.3 to 16.4 deaths per 1,000 admissions between 2017 and 2020, but subsequently increased to 21.8 in 2021 (P<0.05). The prominent contributor to the higher mortality rate was found to be increasing age. Nonetheless, the average LOS for both asthma and COPD decreased slightly over the study period. The total expenses for reimbursing exacerbations of asthma and COPD per hospitalisation have risen significantly each year, with a particularly notable increase in 2020/2021.Conclusion During 2017-2021, exacerbations of asthma and COPD in Thailand continued to account for significant in-hospital mortality rates and reimbursement expenses, despite the overall decrease in hospitalizations and slight fluctuations in the LOS.

Prevalence of Depression Among Community Dwelling Older Persons in Thailand and the Associated Factors: A Systematic Review

@#Aim: Depression symptoms in older persons are overlooked and untreated because they coincide with other conditions that older persons face. This review aimed to determine the prevalence and factors associated with depression among community dwelling older persons in Thailand according to the Social Cognitive Theory constructs. Design: Systematic review. Data sources: Four electronic databases: PubMed, PsychINFO, ScienceDirect and Scopus, with only articles published between January 2000 and December 2021 were included. Methods: The Preferred Reporting Systems for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct this systematic review. All included articles were appraised using the Crowe Critical Appraisal Tool (CCAT), with all 13 studies were assessed to be of high quality, with score of more than 75. Results: A total of 13 full-texts articles were included in this review, of which 12 were cross-sectional study design, and only one was a cohort study. The prevalence of depression among older persons in Thailand were between 5.7% to 68%, with the most commonly reported factors that significantly associated with depression were gender, social support, marital status, employment status or income, and education level. Conclusion: Depression among older persons is a mental Health challenging issue in Thailand. Studying the factors that contribute to depression in older persons is more important in order to have a better understanding of the underlying causes as well as for early detection and effective management of depression among older persons in Thailand.

QuantiFERON-TB Gold Plus and QuantiFERON-TB Gold In-tube assays for detecting latent tuberculosis infection in Thai healthcare workers

ABSTRACT Detecting latent tuberculosis infection (LTBI) is important, especially in high-risk populations including healthcare workers (HCWs). QuantiFERON-TB Gold Plus (QFT-Plus) is a new version of the interferon-gamma release assays (IGRAs) to replace the QuantiFERON-TB Gold In-tube (QFT-GIT). However, data on the use of QFT-Plus for LTBI detection in high TB-burden countries are limited. This study was conducted in a TB-endemic setting in Thailand. HCWs were enrolled in the study and underwent both tests during the annual health screening. The testing results were compared and the concordance was determined. Of 102 HCWs, 11 (10.78%) were positive according to both tests, and 15 (14.71%) were positive according to QFT-Plus. The overall agreement between assays was 96.08%, with Cohen's kappa coefficient (k) at 0.82. All four discordant results occurred with QFT-GIT negative and QFT-Plus positive. The comparison between QFT-GIT and QFT-Plus based on each antigen tube (TB1 or TB2) exhibited similar concordance with 99.02% and 95.10% agreement, respectively. The intra-comparison between TB1 and TB2 of QFT-Plus also showed good concordance at 96.08%. Among this group of HCWs, the LTBI prevalence of any positive results in both tests was low. Overall, the study showed good agreement between QFT-Plus and QFT-GIT (k = 0.82) with a minimal difference, suggesting similar assay performance to that mainly carried out in TB-low incidence countries. The results support the use of QFT-Plus for detecting LTBI in a format similar to QFT-GIT.

A study of malaria in bordering countries of India: Nepal, Pakistan, and Thailand

Background: Malaria still occurs in Nepal, Pakistan and Thailand which are countries of the South-east Asia region. Material and Methods: For the present study, three countries’ (Nepal, Thailand, and Pakistan) Malaria Prevalence and their strategic elimination programs of were taken into consideration based on all the available online data. These countries were compared by their preventive strategies and stipulated eradication time according to their geographical areas. They were further classified as endemic, non-endemic areas of their country maps and tabulated respectively. Results: During 2021, there were 623 reported confirmed cases of Malaria in Nepal. Of these, 94% were caused by Plasmodium vivax while 5% were due to P. falciparum. During 2021, there were 350,467 reported confirmed cases of Malaria in Pakistan. Of these, 78% were caused by Plasmodium vivax while 21% were due to P. falciparum. During 2021, there were 7420 cases of Malaria in Thailand of which 61% were due to Plasmodium vivax and 23% were due to P. falciparum. Conclusion: The number of imported cases of Malaria from India to Nepal and vice versa would decrease if anti-Malaria measures are stepped up in the respective countries’ border districts. The main species causing Malaria in Pakistan is Plasmodium vivax. This will prove a challenge to eliminate because of the hypnozoites that are difficult to treat which remain latent in the liver and cause recurrent attacks of the disease even if the initial phase is apparently cured. Thailand aims to eliminate Malaria by 2024 using the methods of timely surveillance and quick response.

Regional Disparity of Physical Function Limitation Among Older Adults in Thailand.

Thailand was among the first to introduce a universal healthcare coverage among low- and middle-income countries but, regional disparities remain in the health status of people. Using the 2016 Population Change and Well-being in the Context of Ageing Societies, a nationally-representative survey, the prevalence of having limitations in physical function activities, instrumental activities of daily living, or activities of daily living were identified to estimate how each was associated with region of residence, sociodemographic and health behaviour and conditions. It was observed that living in Bangkok was associated with having limitations in any form than the other four regions of the country where generally the socioeconomic status of its older population is lower. Although higher prevalence of functional status was consistently observed in Bangkok, older people in the rural areas have a disadvantage in healthcare because of lower socioeconomic capacity and less access to healthcare facilities.

Can Family Carer Groups Help People with Intellectual Disabilities? Applying Focused Ethnography Methods in Community Contexts of Northeastern Thailand

@#Introduction: This study aimed to explore the experience of family carer groups caring for individuals with intellectual disabilities (IDs) in the community contexts of Northeastern Thailand. Materials and Methods: We applied a focused ethnography method with a purposive sampling technique to conduct 35 in-depth interviews (of 14 individuals with IDs, 12 caregiving parents and nine disability group leaders, respectively), which were audio-recorded and transcribed verbatim, then translated from Thai to English. We used content analysis to code the interviews and develop themes. To evaluate the reliability of the coding attempt, we employed data triangulation techniques. Results: Family carer groups seemed to provide benefit to people with IDs and their families by offering support related to information records, the recovery of health and occupational skills development. Conclusion: Family carer groups are an integral part of efforts to support people with IDs. Notably, these groups may facilitate the early formation of long-term parent carer plans, which can better optimise the care and health outcomes of people with IDs in Thailand.

Needs assessment of caregivers of children with disabilities in resource-limited settings / Journal of Rural Medicine

Objective: This study aimed to identify and classify the needs of caregivers of children with disabilities living in resource-limited settings and develop a framework for need assessment.Participants and Methods: This study was conducted in the Maha Sarakham Province, Thailand, with 15 caregivers caring for children with disabilities recruited from hospitals, the Association for the Disabled, and primary health centers. Semi-structured interviews were conducted in local dialects, recorded, transcribed, converted into standard Thai, and then into English for thematic analysis. Meaning units corresponding to caregivers’ needs were extracted, interpreted, coded, and hierarchically organized into subcategories by comparing similarities and differences among the extracted codes. The subcategories were further grouped and abstracted into categories, and then domains of caregivers’ needs were formed.Results: Nineteen categories were identified across five domains of caregivers’ needs: health and medical, welfare, educational, social, and informational. Although basic medical treatment was covered, specific support, such as referral to a specialist, rehabilitation, or psychological support, was limited. Financial support and relief from the care burden are the main welfare needs. Educational needs were identified to provide knowledge to children and to offer respite to their caregivers. Social needs revealed ethical problems that arose because of strong rural community ties, making it difficult to maintain privacy. Informational needs were intertwined with the other four domains. In rural areas, where parents of children with disabilities migrate to cities to find work, the special needs of grandparents who were primary caregivers of the children needed to be addressed.Conclusion: This study provides a conceptual framework for comprehensive needs assessment and policy development for caregivers of children with disabilities living in resource-limited settings.

Detection and factors associated with tuberculosis and rifampicin resistance among presumptive patients at the Thailand-Myanmar border

@#Tuberculosis (TB) continues to be a major public health problem in Thailand and many countries. Endemic TB and outbreaks of TB drug resistance in the borderlands are particularly important. The Thailand-Myanmar border has extensive cross-border travel that may accelerate TB’s spread. This cross-sectional study aimed to determine the frequency and factors associated with TB, and rifampicinresistant TB (RR-TB) among presumptive tuberculosis patients in Mae Sot Hospital. Sputum was processed by microscopic examination and Xpert MTB/RIF assay. Laboratory results and socio-demographic characteristics were collected and analyzed. Univariate and multivariate analyses were performed to assess the association of the risk factors with TB and RR-TB. The significant variables at p-values < 0.05 in univariate analysis were selected for multivariate analysis. Of 365 presumptive patients enrolled, 244 (66.85%) were males and 199 (54.52%) were Burmese. Of these, 314 (86.03%) were registered as new cases and 183 (50.14%) worked as laborers. Sputum microscopy was positive in 132 (36.16%) cases. Based on Xpert MTB/RIF, the frequency of TB was 136 (37.26%) and RR-TB was 15 (11.03%). TB was more common in males than females. The majority of the cases belonged to the 26-50-year-old age group and migrant workers. In RR-TB detection, the rpoB mutations covered by probe E were the most frequently observed. Sequencing showed that the most highly mutated codon was codon 531 and Ser531Thr was the most common mutation. For risk factor analysis, working as laborers was significantly (p-value < 0.05) associated with TB (aOR 2.83; 95% CI 1.43-5.63) and previously treated cases were significantly associated with RR-TB (aOR 12.33; 95% CI 2.29-66.49). The high frequency of TB and RR-TB in migrants highlights the problem and factors associated with TB at the border and the need for efforts in TB control programs in this setting.

A new record of Rickettsia japonica in ticks infesting a Burmese ferret-badger in Thailand

@#Ticks are important vectors of arthropod-borne diseases and they can transmit a wide variety of zoonotic pathogens to humans, domestic and wild animals. Rickettsia japonica is a member of SFG rickettsiae causing Japanese spotted fever (JSF) and can transmit to humans via infected ticks. In this study, we report the first case of Rickettsia japonica in Haemaphysalis hystricis tick collected from a roadkill Burmese ferret-badger (Melogale personata) in Loei province, northeastern Thailand. According to the DNA sequences and phylogenetic analyses of the outer membrane protein A and B genes (ompA and ompB), the detected R. japonica was identical to those found in JSF patients in Korea, Japan, and China, and closely related to Rickettsia detected by ompA in a tick from Thailand. Further study on the prevalence of R. japonica and diversity of mammalian reservoir hosts will be useful to gain a better understanding of JSF epidemiology.

Sex estimation using ulna in a Thai population / Estimación del sexo utilizando la ulna en una población tailandesa

SUMMARY: Sex estimation from fragmentary bone remain is still challenge for forensic pathologist. Ulna has been reported useful for sex estimation by metric analysis. This study generated sex estimation function for fragment and complete of ulnar bone in a Thai population. The function was generated from 200 pairs of ulnar bone, and others 20 pair of ulnar bone were used for test the accuracy of the functions. Olecranon width was the best single variable for sex predicting of proximal part of ulna, which right olecranon width could be classified the sex 90.5 %. While distal end width of ulna was the variable for predicting the sex of distal part, which left distal end width could be classified the sex with 83.0 %. Stepwise discriminant function analysis was applied to proximal part. For proximal part of right ulna 4 measurements were selected (inferior-medial trochlear notch length, olecranon width, olecranon-coronoid process length, and maximum proximal ulnar width), while the left side, superior trochlear notch width, olecranon width, and maximum proximal ulnar width were chosen, and their functions could be predicted the sex with 91.0 % and 90.0 %, respectively. Our results indicated the ulnar bone had high ability for estimating the sex in a Thai population.

RESUMEN: La estimación del sexo a partir de restos óseos fragmentarios sigue siendo un desafío para el patólogo forense. Se ha informado de la utilidad de la ulna para la estimación del sexo mediante análisis métrico. En este estudio se analizó la estimación del sexo para un fragmento y de la ulna completa en una población tailandesa. La función se generó a partir de 200 pares de ulnas y se utilizaron otras 20 pares de ulnas estimando la precisión de las funciones. El ancho del olécranon fue la mejor variable individual para predecir el sexo en la parte proximal de la ulna (90, 5 %). Si bien el ancho del extremo distal de la ulna fue la variable para predecir el sexo, el ancho del extremo distal izquierdo podría clasificarse por sexo con un 83,0 % de certeza. Se aplicó un análisis de función discriminante escalonada a la parte proximal. Para la parte proximal de la ulna derecha se seleccionaron 4 medidas (longitud de la incisura troclear inferior-medial, ancho del olécranon, longitud del proceso olecraneano-proceso coronoides y ancho ulnar proximal máximo), mientras que en el lado izquierdo, fue determinado el ancho de la incisura superior troclear, ancho del olécranon y ancho ulnar proximal máximo. Se eligió el ancho, y se pudo predecir el sexo en el 91,0 % y 90,0 % de los casos, respectivamente. Nuestros resultados indicaron que la ulna tenía una alta capacidad para estimar el sexo en una población tailandesa.

Impact of duration of untreated psychosis on remission in first-episode schizophrenia in Thailand: a cohort study

ABSTRACT Background: To scale up the services for first-episode schizophrenia in Thailand, it is essential to understand to what extent health care-seeking is delayed, and how much the delay affects the treatment outcome. Objectives: To investigate the duration of untreated psychosis (DUP) and its impact on remission in first-episode schizophrenia across the country. Methods: 276 outpatients with a first-episode schizophrenia were followed for 6 months and assessed whether they fulfilled the criteria for remission at the follow-up. The proportion of those achieving remission was compared by the DUP. The impact of DUP on remission was estimated in multivariate analyses. Results: At the follow-up, 83% (71/86) of patients who had met the criteria for symptomatic remission at the baseline achieved enduring remission, whereas 63% (119/190) of patients who had not met the criteria for symptomatic remission at baseline met it at the follow-up. The shorter the DUP, the higher the proportion of those who achieved symptomatic or enduring remission at the follow-up. The impact of DUP on symptomatic remission appeared to be significant after controlling for other factors influencing remission. Conclusion: Since the DUP would influence remission of patients with schizophrenia, early detection and intervention services should be provided in Thailand.

Prevalence and Associated Factors of Depression Among Karen Hilltribe Elderly Population in Thailand

@#Introduction: Depression among older population in community has been identified as a significant problem to improve care and quality of life. Although prevalence rates for Thai older population have been established in many parts of Thailand, there are still an under-recognition of depression among ethnic minority older people in Thailand. Hence, this study aimed to investigate depression in Karen older population, one of hilltribe groups in the northern part of Thailand. The objective of the study was to find prevalence rate and associated factors related to depression in Karen hilltribe elderly in Doi-Luang district, Chiang Rai, Thailand. Methods: Cross sectional study was carried out in the outpatient primary care clinic of Doi-Luang hospital, a community hospital. Total 174 Karen elders aged ≥ 60 years were randomly selected and PHQ-9 was applied to assess depression by clinician researchers in the Karen version. Demographic characteristics and factors associated with depression were collected by structural questionnaire. Results: The average age of participants were 69 ± 8 years. The prevalence of depressive mood was 11.49% (95% CI 7.50 - 17.21). Binary logistic regression revealed that associated factor of depression among Karen older people was marital status (OR = 6.66, 95% CI 2.31-19.23, P<0.001). Conclusion: Depression was found to be one of mental health problems in Karen older people. A validated screening tool which considers the Karen culture and language is a useful tool for the detection of depression in the ethnic group elderly leading to its prevention and provision of care.

Experiences of Living with HIV: Social Stigma and Discrimination among HIV-Positive Mothers in Southern Thailand

@#Introduction: This paper discusses the lived experience of mothers living with HIV/AIDS in the southern region of Thailand. Methods: We employed semi-structured interviewing and drawing method with 30 HIV-positive mothers. Thematic analysis method was used to analyse the data. Results: Most mothers living with HIV found their HIV status through a blood test service at the Antenatal Care Clinic of local hospitals while some visited the doctors because their partner showed severe symptoms of illness. When they learnt about the infection, they experienced a great shock and feared that illness would be disclosed to others in the community. The women were concerned about keeping HIV secret because they would be blamed by people in locality, labeled as “disgusting” people, and excluded from social networks. Nevertheless, we found that social support played a crucial role in assisting these mothers to cope with their HIV status. Religious beliefs and living positively also helped them to deal with their health conditions. Conclusion: Health care providers should design sensitive programs to promote self-confidence for HIV-positive mothers as this could increase their quality of life. The findings revealed that tangible and emotional support from family members and religious sources, as well as positive thinking, played a significant role in supporting these women to deal with their health and well-being, and negative effect associated with their HIV condition. These can be incorporated into the provision of health care, which would enhance their well-being and reduce the feeling of isolation and discrimination among these vulnerable women.

Opisthorchis viverrini metacercarial infection in cyprinid fish in Nakhon Phanom Province, Northeastern Thailand

@#Opisthorchiasis is endemic in parts of Southeast Asia, including the northern and northeastern regions of Thailand. In these regions, the transmission by fish intermediate hosts has received little attention. We investigated the intensity of Opisthorchis viverrini metacercariae (OV MC) in wild cyprinid fishes from five districts within the Nakhon Phanom Province, Northeast Thailand. Fishes were procured from local markets in five districts throughout three different seasons (hot, rainy and cold) between February 2018 and January 2019. The samples were identified, counted and weighed before metacercariae detection was performed via the artificial digestion method. A total of 2,149 freshwater fishes, representing 20 species were collected. The fish most commonly contaminated with OV MC were Anematichthys repasson and Hampala dispar. The intensity of OV MC in Nakhon Phanom was 0.23 OV MC/fish and varied among districts, ranging from 0.07 to 0.52. A low intensity of OV MC/fish (defined as <1 cyst) was found in all three different seasons in the Nakhon Phanom Province; hot season (0.55), cold season (0.22) and the rainy season (0.13). The intensity of OV MC/fish was moderate (defined as >1 cyst) in the Renu Nakhon district (2.5) in the hot season. By fish species, H. dispar yielded the highest, with a moderate intensity of 2.1. In natural freshwater cyprinid fish in Nakhon Phanom, OV MC infection is endemic with intensity rates varying according to district, season and fish species.

Migrations and HIV transmission as experienced by people living with HIV in Lao PDR / Lao Medical Journal

Objective@#The aim of this paper is to assess the interactions between migration paths and HIV infection risks among and from the views of people living with HIV in Lao PDR.@*Methods@#Twenty-four in-depth interviews with eight interviewees were carried out by four trained members of the Association of People Living with HIV (APL+), in 2017. The qualitative analysis was done manually to explore the influence of social determinants through migratory paths on the evolution of individual lifestyles, working and living environments, access to information, prevention and healthcare that contribute to HIV infection risks.@*Results@#Low levels of economic and education lead to migration and also increase risky practices and vulnerability to HIV infection of migrant workers. Insufficient awareness and access to prevention against HIV/STIs in their home country increase risky behaviours during migration. Moreover, inadequate referral system for HIV treatment, stigma, and family relationships contribute to influence the life courses of migrants' post-HIV infection.@*Conclusions@#Raising awareness and providing access to information on HIV/STIs, both for internal and external migrant workers are crucial in order to diminish the prevalence of HIV infection among the target audience. A reinforcement of the existing collaborative health measures between Lao PDR and Thailand is needed to enhance migrants’ access to healthcare services.

Morphological study and molecular epidemiology of Anisakis larvae in mackerel fish

Objective: To examine and study the morphology, epidemiology, and molecular phylogeny of Anisakis larvae in blue mackerel [Scomber australasicus (Cuvier, 1832)] and Indian mackerel [Rastrelliger kanagurta (Cuvier, 1816)] using light microscope, scanning electron microscope, molecular phylogeny, and species delimitation methods for confirmation and investigation of Anisakis species and their evolutionary relationship. Methods: A total of 90 fish (45 per species) were purchased from a department store in Chiang Mai, Thailand. Anisakis samples were investigated for morphological characteristics using light and scanning electron microscopes. Molecular phylogeny and species delimitation methods based on the cox2 gene were performed. Results: The prevalence, mean intensity (Mean±SEM), and mean abundance of Anisakis larvae (Mean±SEM) in blue mackerel were 77.78%, 6.74±1.320, and 5.24±1.107, respectively, and in Indian mackerel, these values were 13.33%, 2.50±0.764, and 0.33±0.159, respectively. Scanning electron microscopy showed the detail of morphological characteristics and provided the different shapes of mucron and excretory pores in Anisakis larvae congruent with the phylogenetic tree. The species tree was congruent with the phylogenetic tree. Conclusions: The prevalence, mean intensity, and mean abundance of Anisakis larvae were higher in blue mackerel. To the best of our knowledge, this is the first time that Anisakis pegreffii was found in blue mackerel in Thailand. The phylogenetic tree also supported the morphological data of Anisakis larvae. However, species delimitation based on cox2 revealed 1-3 possible cryptic species in this genus. Anisakis spp. contamination of fish products is unpleasant and a health concern considering human infection with larvae (anisakiasis) arises.