A randomized controlled trial to improve the quality of life of type 2 diabetic patients using a self-help group program.

The purpose of study was to determine the effect of a self-help group program on the quality of life among type 2 diabetic patients. The study subjects were type 2 diabetic patients attending one of six studied health centers or a community hospital in Saraburi Province, Thailand. At each health center/hospital, the patients were randomly allocated into the intervention group attending the self-help group program or the control group receiving diabetic services. Information was collected from September 2007 to April 2008 using a structured questionnaire with interview technique at baseline, 12 and 24 weeks. One hundred forty-six patients completed the program. Five self-help group programs carried out for 16 weeks gave instruction regarding building-up good relationships, improvement of knowledge about diabetes and skills for dietary control, skills in physical exercise, improvement of group structure, improvement of training skills for group leaders, self-monitoring, motivation in self-care activities and sharing experiences among group members. Descriptive statistics were used to provide basic information regarding the two groups. For analytical purposes the chi-square test and t-test were applied. The majority (77.4 %) of study participants were females. Most patients were either > or = 50 years old (52%) or 40-49 years old (37%). The intervention resulted in significantly higher scores in quality of life compared to controls at 12 and 24 weeks (p < 0.05). The findings indicate the program is effective for improving perceived quality of life. The program focused on enhancement of experience sharing among group members and participation in problem-solving. We recommend implementing this program for diabetic patients and patients with other chronic diseases at primary health care level.

Quality of life and compliance among type 2 diabetic patients.

A cross-sectional study was conducted to explore the quality of life (QOL) and compliance among type 2 diabetic patients in Saraburi Province, Thailand. Compliance was assessed by evaluating dietary intake and life style patterns useful for diabetes patients to maintain health and prevent complications of the disease. A multistage sampling technique was used for selecting patients from 2 districts (Wihan Daeng and Nong Don) and subjects were classified into 2 groups according to a quality of life (QOL) score (good = 70, poor to moderate = 94) using WHOQOL-BREF-THAI criteria. Data were collected from September to December 2007 using a self-administered questionnaire. Simple descriptive statistics were used to provide basic information about the two groups and for analytical purposes the chi-square test and multiple logistic regression were applied. The majority (78.7%) of study participants were females. Most patients belonged to the age groups of either > 50 years (50%) or 40-49 years (36.6%). Bivariate analysis revealed socio-demographic factors were not significantly associated with QOL (p > 0.05). As far as compliance was concerned dietary control and drug intake were significantly associated with QOL (p < 0.05). Multivariate analysis indicated that overall compliance was associated with QOL (OR = 1.91, 95% CI = 1.02-3.57). We conclude that good QOL is significantly related to good compliance. Therefore, diabetic patients should be made aware that following the suggestions to prevent side effects of the disease and trying to stay healthy despite suffering from the disease will significantly improve their QOL.

Factors associated with alcohol consumption among upper secondary school students.

A cross-sectional study was conducted to explore factors associated with alcohol consumption among upper secondary school students in Nakhon Ratchasima Province. A multistage sampling technique was used for selecting 850 students from 6 schools and subjects were classified into 2 groups according to hazardous alcohol drinking (yes=107, no=743) by the Alcohol Use Disorders Identification Test (AUDIT). Data were collected by questionnaire from August to September 2005. Descriptive statistics, the chi-square test and multiple logistic regression were used to analyze data. The results showed the percent of hazardous drinking was 12.59. Most of the students were 5 < or =6 years old (51.41) and in the science program (52.68%). Univariate analysis revealed the socio-demographic factors of gender, grade point average (GPA), monthly expenditure, age, and educational level were significantly associated with alcohol drinking (p < 0.05). Sibling and peer alcohol intake were associated with hazardous alcohol consumption (p < 0 .05). Multivariate analysis, after adjusting for age, educational level and gender, revealed only 3 factors associated with male alcohol consumption: peer usual alcohol intake (OR = 23.46, 95% CI= 7.29-75.43) and peer occasional alcohol intake (OR = 5.57, 95% CI = 2.02-15.31), GPA > 3.0 (OR = 0.29, 95% CI= 0.11-0.73). Only 2 factors were associated with female alcohol drinking: peer usual alcohol intake (OR = 63.41, 95 CI= 9.24-435.31) and peer occasional alcohol intake (OR = 7.94, 95 CI= 1.89-33.43). As a result, peer groups and close friends should be considered carefully when attempting to reduce the risk of alcohol consumption.

Relationship between body size and severity of dengue hemorrhagic fever among children aged 0-14 years.

A hospital based case-control study was conducted from October 2002 to November 2003 among children aged 0-14 years at Queen Sirikit National Institute of Child Health (Children's Hospital), Bangkok, Thailand. This study focused on body size and severity of dengue hemorrhagic fever (DHF) in children. One hundred five patients diagnosed as having DHF grade III or IV were the cases and 105 diagnosed as having DHF grade I or II were controls. They were matched at a ratio of 1:1 by their gender and age (within 5 years). Normal growth charts were used to differentiate child body size into normal, thin and obese. Data were collected using face to face interviews with caregivers, questionnaires, laboratory and physical examination reports as research tools. Multiple logistic regression analysis revealed that only two variables were related to severity of DHF: obesity (OR = 3.00, 95 % CI = 1.20-7.48) and dengue virus type II (OR = 4.94, 95 % CI = 2.57-9.47), respectively. Other variables were childhood factors: duration of breast-feeding, education, and parity; caregivers factors: age, gender, marital status, education, occupation, family income, knowledge of DHF, antipyretic type, treatment before hospitalization, and duration of fever; environmental factors: history of DHF patients in house, house pattern, time from house to hospital, and residence; and etiological factors: type of infection and history of DHF among children. These factors showed no significant association (p > 0.05). This result can be utilized in a preventive and control program, particularly in more aggressive management of overweight children. Health personnel should continue to provide health education, particularly, signs and symptoms of shock, to the community and private sectors. Government and Non-Government Protective Projects in primary schools (5-9 years children) should be continued in the high risk groups.

Behavioral factors and malaria infection among the migrant population, Chiang Rai province.

A cross-sectional study was conducted from January, 2001 to June, 2002 among some migrant populations, living in malaria endemic areas along the Thai-Myanmar border, in the Mae Fah Luang and Mae Sai districts, Chiang Rai Province, Northern Thailand using blood exams and face-to-face interviews as the research methods. This study focused on the knowledge and practice of primary malaria prevention, aimed at identifying the association between behavioral factors in migrant populations and malaria infection. P. vivax (51.8%) was detected more often than P. falciparum (47.7%). The proportion of malaria infections was 45.4% of the total of 421 blood examinations. The working age group (15-44 yr) and males were the majority of the study subjects. Two age groups (0-14 and 15-34 yr) and visiting or staying in the forest 14 days prior to the blood exam were significant risk factors. The ethnic group of Thai-Yai and hilltribe was a significant protective factor (p < 0. 05) compared to the Myanmar people. A poor knowledge of primary malaria prevention (63-68%), the presence of international migration, poverty, lack of malaria prevention resources, namely bednets (not using or taking them) and not using a smoky fire were factors which led to failure in primary prevention and control of malaria infections. Residence-workplace-living style in the forest need more consideration to serve the common failure of effective primary prevention.

Cigarette smoking among Thai Buddhist monks, central and eastern Thailand.

A cross-sectional study was conducted from June to December, 2003 among Thai Buddhist monks in 4 provinces of the central region (Nonthaburi, Pathum Thani, Saraburi and Chai Nat) and in 4 provinces of the eastern region (Chachoengsao, Rayong, Trat, and Sa Kaeo) of Thailand. Data were collected using face to face interviews, questionnaires, and physical examination reports (weight, height, heart rate, blood pressure, etc) as the research tools. This study focused on sociodemographics, history of illness, and smoking behavior. The proportion of the cigarette smoking was 47.6% of the total of 920 Buddhist monks. The age group 20-34 years, Maha Nikaya section and Public temple were the majority of the study subjects. Multivariate analysis revealed that only four factors were related to smoking consumption: dharma education, Naktharm To (grade 2) (OR = 0.6, 95% Cl: 0.4-0.9), Naktharm Aek (grade 3) or above (OR = 0.4, 95% Cl: 0.2-0.6); Lay education, secondary school (OR = 0.7, 95% Cl: 0.5-0.9), bachelor degree or above (OR = 0.4, 95% Cl: 0.2-0.8); systolic blood pressure > or = 140 mmHg (OR = 1.8, 95% Cl: 1.1-2.8) and history of respiratory illness (OR = 3.2, 95% Cl: 1.5-6.9). As a result, dharma education and well educated persons were the crucial factors which led to success in decreasing cigarette smoking. Smoking cessation campaigns and education of the consequences of smoking are strongly recommended among risk groups.

Energy drinks consumption in male construction workers, Chonburi province.

This unmatched case-control study aimed to determine the relationship among caffeine drinks consumption known as "energy drinks consumption", drug dependence and related factors in male construction workers in Chonburi Province. It was conducted during December 15, 2001 and February 15, 2002. Data were collected using interview questionnaires. The logistic regression was used to control possible confounding factors. The subjects consisted of 186 cases who had consumed energy drinks for more than 3 months and 186 controls who had given up for more than 3 months. They were frequency/group matched by age group. There was statistically significant association among energy drinks consumption and overtime work, motivation from advertisements, positive attitude of energy drinks consumption, alcohol drinks, smoking and ex-taking Kratom behavior. Multivariate analyses revealed that only 5 factors were related to energy drinks consumption: marital status (OR = 1.88, 95%CI: 1.14, 3.11), overtime work (OR = 2.84, 95%CI: 1.73, 4.64), motivation from advertisements (OR = 2.72, 95%CI: 1.67, 4.42), positive attitude of energy drinks consumption (OR = 4.06, 95%CI: 1.65, 10.01) and ex-taking Kratom behavior (OR = 2.77, 95%CI: 1.19, 6.44). As a result, construction workers should be provided with the knowledge of energy drinks consumption, the effect of drug dependence behavior, and the advantages of safe and healthy food that is cheap, readily available, and rich in nutrients.

Malaria infection and life-style factors among hilltribes along the Thai-Myanmar border area, northern Thailand.

A cross sectional study was conducted between January, 2001 and June, 2002 to determine the life-style factors associated with malaria infection among hilltribes in the Chiang Rai Province, Mae Fah Luang district located along the Thai-Myanmar border, northern Thailand. The data collected were a thick blood film examination and a face-to-face interview using a local language interviewer at a mobile clinic or a home visit. The chi-square test, odds ratio, 95% confidence interval and multiple logistic regression were used as data analysis. P. vivax (61.3%) was detected more than P falciparum (38.2%). Parasitic infection was seen in 45.8% of a total of 417 blood examinations. The study area was in a valley covered with forests and small streams, which was ideal for a malaria epidemic. The communities were distributed along different ethnic groups. There were 12 ethnic groups, dominated by the Muser, Eko, and Akha tribes (60-70%). The risk factors included living or working in the forest, accompanying their family during movement through the forest, age < or =14 years (40.9%), poor knowledge of how to protect against malaria (75-80%), and unavailability of protection against malaria via long sleeved clothes, topical repellents, and insecticide treated nets (use and carry), which resulted in an increased exposure to malaria and risk for malaria infection.

Malaria infection among the migrant population along the Thai-Myanmar border area.

A population based case-control study was performed to determine factors associated with malaria infection among the migrant population, foreign nationals aged 15 years or over. Data were obtained from 217 malaria and 217 non-malaria patients attending the Vector-Borne Disease Control Units 6-9 (Thong Pha Phum and Sangkhla Buri districts) in Kanchanaburi Province and at the Vector-Borne Disease Control Units 1,9 (Mae Fa Luang and Mae Sai districts) in Chiang Rai Province, between June and December 2002. All study subjects were interviewed by trained interviewers using a structured interview form. The statistical analysis was carried out by the chi-square test and multivariate logistic regression: a p-value of less than 0.05 was considered to be statistically significant. The results showed that the study subjects were predominantly Thai-Yai and Myanmar. Plasmodium falciparum was the major type of the malaria (60.8%). Logistic regression analysis, controlling for possible confounding factors, revealed that residence located in the forest increased the risk of malaria infection by a factor of 6.29 (OR = 6.29, 95% CI = 1.56-25.42); outdoor stay < 7 and > 7 days prior to the blood examination also increased the risk by a factor of 4.34 and 4.13 respectively (OR = 4.34, 95% CI = 1.05-17.99; OR = 4.13, 95% CI = 1.29-13.13).

Hepatitis B carrier among married hilltribe women in northern Thailand.

A cross-sectional study of 540 married Akha and Lisaw women of reproductive age was conducted in Chiang Rai Province, Thailand, between June 1st and August 31st, 1999, in order to determine the seroprevalence of HBsAg and identify the risk factors for chronic HBsAg carriage. HBsAg was detected by the reverse passive hemagglutination technique (RPHA). Data were obtained by questionnaires and serological testing. There were 164 Lisaws and 376 Akhas: most were illiterate (88.71%) and the annual family income was < or = 9,999 baht (50.93%). The seroprevalence of HBsAg was 8.15%. Logistic regression analysis, controlling for possible confounding factors, revealed that one to five injections in the year prior to the study increased the risk of HBsAg carriage by a factor of 4.84 (95% CI = 1.42-16.49); more than six injections increased the risk by a factor of 5.84 (95% CI = 1.47-23.18).

Unintentional injuries among children aged 1-4 years at home.

A hospital based case-control study was performed to determine causes of unintentional injuries among children aged 1-4 years at home. Data were obtained by interviewing parents and guardians of 242 children at Lerdsin Hospital in Bangkok, from August to October 1999. The results showed that falls were the most common type of injuries (54.6%). The age of 2 years comprised the major group (28.9%). The study subjects were injured within the home (60.7%). Sunday and Saturday were the most frequent days of injuries (18.2% and 16.5% respectively). The proportion of cases involving playing with others was 71.1%. Most of the injuries occurred in the period 16.00-19.00 hours (32.2%). Head and neck were the main injured area (45.5%). The multivariate model showed that children who had previous injuries were 19.22 times more likely to be injured again than those who had not previously been injured. Children with vigorous physical activities also had a higher risk (OR = 19.73, 95% CI 6.11-63.74). Outdoor working mothers were at higher risk than houseworking mothers (OR = 4.14, 95% CI 1.57-10.93) of having children affects. Children who spent most of the daytime at their relatives' houses had a higher risk than those who stayed at their home (OR = 3.48, 95% CI 1.02-11.81), while, 37.9% of children injured at their relatives' houses and 50.8% of all injured children were without supervision.