Potential effectiveness of health warning labels among employees in Thailand.

OBJECTIVE: Explore and investigate the perceptions and responses of employees regarding the effects of a Health Warning Label (HWL) on their decision to encourage quitting and stages of change in smoking behavior. MATERIAL AND METHOD: One thousand six hundred thirty seven employees in workplaces from four regions, including Bangkok city, were studied during the year 2005-2006. Six hundred nine employees (both non- or cigarette smokers) were part of a cohort study using qualitative and quantitative approaches. Questionnaires were used to sample the cohort twice and two individuals per factory were interviewed in-depth. RESULTS: The New-HWL that made the best impression was the "cancer caused by cigarette smoking" and 3.8% stopped smoking after seeing the New-HWL. Moreover, New-HWL increased employees "pro" attitudes about smoking cessation. Decisional balance that reflected different "con" to quit, among non-quitting and quitting smokers. CONCLUSION: New-HWL significantly increased attitudes about smoking cessation.

Clinical features and differences between child and adult dengue infections in Rayong Province, southeast Thailand.

A retrospective study was conducted among patients with dengue infection admitted to Rayong Hospital during September 2004-September 2005. Data were collected from medical charts and outpatient records created when the patients came to the hospital. Of the patients diagnosed with dengue, only 301 who met the WHO criteria for dengue fever and DHF/DSS were selected. The study cohort was comprised of 147 children (76 males, 71 females) and 154 adults (71 males, 83 females), with an overall mean age of 17.6 years. Some adult clinical symptoms were different from the children. Headache and myalgia were more common among adults (p < 0.05), but cough, vomiting, abdominal pain, and rash were more common among children (p < 0.05). Among the major bleeding symptoms, epistaxis (nasal bleeding) was more common in children (p = 0.012) and gum bleeding was more common in adults (p < 0.001). Myalgia was more likely in less severe grades of infection. Adults showed some different clinical manifestations of dengue infection from children. It is necessary for health personnel to take these differences into consideration when seeing probable cases of dengue infection.

Risk factors for multi-drug resistant Acinetobacter baumannii nosocomial infection.

OBJECTIVE: To assess factors associated with multi-drug resistant Acinetobacter baumannii (MDR-AB) nosocomial infection. MATERIAL AND METHOD: This hospital-based case-control study was conducted in patients admitted to Siriraj Hospital, Bangkok, Thailand between January 1, 2005 and December 31, 2005. The study population consisted of 155 cases with MDR-AB nosocomial infection and 310 controls without nosocomial infection. The cases were matched with controls by age and ward of admission with a ratio of 1:2. RESULTS: The average age of the present study population was 63.5 +/- 18.7 years among cases and 62.9 +/- 18.2 years among controls. The mean of length of stay in hospital among cases was 4.9 +/- 1.4 weeks and controls 1.8 +/- 1.0 weeks. The most common site of MDR-AB nosocomial infection was lower respiratory tract (74.8%). The antimicrobial susceptibility of MDR-AB was 3.9% to cetriaxone and 42.1% to cefoperazone/sulbactam. Multiple logistic regression analysis showed the following associated factors with MDR-AB nosocomial infection: duration of admission prior to MDR-AB nosocomial infection > 1 week (OR = 2.06; 95% CI 1.09-3.89), indwelling urinary catheter > 1 week (OR = 8.24; 95% CI 3.81-17.82), mechanical ventilation > 1 week (OR = 5.73; 95% CI 2.96-11.10), central venous line > 1 week (OR = 3.29; 95% CI 1.48-7.31), nasogastric intubation > 1 week (OR = 6.22; 95% CI 3.24-11.93), prior administration of 3rd-4th generation cephalosporins (OR = 1.80; 95% CI 1.04-3.13), metrodazole (OR = 2.59; 95% CI 1.21-5.56), and piperacillin-tazobactam (OR = 4.68; 95% CI 1.93-11.32). CONCLUSION: A case-control study in medical and surgical patients in Siriraj Hospital in 2005 revealed risk factors for AB nosocomial infection. Prolonged admission of more than 2 weeks, use of devices, and prior treatment with certain antimicrobials were found to be significant risk factors for the infection. To reduce the infection, strict infection control measures must be applied to the patients with these risk factors. Education to medical personnel and enforcement of infection control practices are all needed to reduce antimicrobial resistant bacterial nosocomial infection.

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.

Hepatitis C virus infection among Thai blood donors: antibody prevalence, risk factors and development of risk screening form.

Hepatitis C virus (HCV) infection is an important blood-borne infection in many countries, including Thailand. For epidemiological surveillance and controlling the infection, 2167 blood donors were screened for antibody to HCV by an enzyme immunoassay method and interviewed by using a structured questionnaire which consisted of personal health history and some risk behaviors. The prevalence and risk factors were assessed and the risk screening form was developed. The results revealed that the prevalence of anti-HCV was 2.90%. Male blood donors had relatively higher anti-HCV positive rate than females (3.21% vs 1.77%). The significant risk factors from univariate analysis were: (a) gender as male, OR = 1.94 (p = 0.042), (b) education to the primary level, OR = 4.15 (p < 0.001), (c) occupation as laborer or agriculture workers, OR = 2.87 (p < 0.001), police and military, OR = 1.82 (p = 0.046), (d) residence in a rural area, OR = 3.09 (p < 0.001), (e) a history of receiving blood or blood products, OR = 5.21 (p < 0.001), (f) a history of tattooing, OR = 1.70 (p = 0.043), (g) a history of IDU (Infecting Drug Use), OR = 41.43 (p < 0.001), (h) a history of STDs (sexually transmitted diseases) in the last year, OR = 3.87 (p = 0.021), and (i) a history of sexual service, OR = 4.24 (p = 0.017). After multivariate analysis, four variables related to HCV infection among the studied samples included education to the primary level, OR = 3.34 (p = 0.0036), occupation as a laborer or agriculture worker, OR = 2.14 (p = 0.0092), a history of receiving blood or blood products, OR = 4.13 (p = 0.0029), and a history of IDU, OR = 3.82 (p < 0.0001).The risk screening form was developed using risk scores. The validity was calculated by the Receiving Operating Curve. The sensitivity of this form was approximately 55.3% and the specificity was 85.7% when a cut-off score at risk > or =7 was used. If the cut-off score was > or =6, the screening form showed 77.1% of specificity and 61.3% sensitivity. This risk screening form should be applied not only for blood donation but also for pre-marital health screening.

Typing of dengue viruses in clinical specimens from central Thailand.

Typing of dengue viruses was done for clinical specimens from a total of 136 patients (children under 15-years-old) suspected of having dengue virus infections and who had been admitted to Pathum Thani Provincial Hospital during the period May 1999 to April 2000. Altogether, 44 strains were isolated (isolation rate: 32.4%), consisting of 18 DEN-1, 18 DEN-2, 7 DEN-3 and 1 DEN-4. The isolation rate decreased according to the number of days after the onset of disease, from day 4 to day 8.

Dengue hemorrhagic fever: knowledge, attitude and practice in Ang Thong Province, Thailand.

A cross-sectional study was carried out between July 1998 and June 1999 to identify dengue virus-infected patients under age 15 admitted to seven government hospitals in Ang Thong Province, a central region of Thailand, and to assess the knowledge, attitude, and practice (KAP) of their care takers. To differentiate dengue cases, clinical evaluation and laboratory diagnosis were used. Serum samples were collected from 90 admitted children and also from 80 healthy students. The dengue cases were classified as dengue fever (9 cases, 12.2%) and dengue hemorrhagic fever (DHF: 65 cases, 87.8%). Nine patients had dengue shock syndrome, but no death occurred. With serological confirmation, primary antibody response was observed in 8 (11.3%) and definite secondary infection in 49 (69%). Out of 41 serum samples, 14 (34.1%) were positive for dengue virus isolation: dengue serotypes 1, 2 or 3. A total of 131 care takers of enrolled children were interviewed in the context of KAP in DHF. The majority of them were mothers with primary school education level. Half of the care takers were workers. DHF knowledge of the care takers of the dengue cases, non-cases, and healthy students was almost the same. However, the care takers of dengue cases recognized petechiae as a danger sign, p-value of 0.006. They had a higher response in prevention, control and treatment of DHF than the other two groups after their children were admitted to hospital, p-value of 0.000. The results indicated that DHF remains a public health problem in this area and the people need more understanding of the disease. Continuous campaigns are required for community participation so as to prevent and control DHF successfully.

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).

An improved method for concentrating rotavirus from water samples

A modified adsorption-elution method for the concentration of seeded rotavirus from water samples was used to determine various factors which affected the virus recovery. An enzyme-linked immunosorbent assay was used to detect the rotavirus antigen after concentration. Of the various eluents compared, 0.05M glycine, pH 11.5 gave the highest rotavirus antigen recovery using negatively charged membrane filtration whereas 2.9 percent tryptose phosphate broth containing 6 percent glycine; pH 9.0 was found to give the greatest elution efficiency when a positively charged membrane was used. Reconcentration of water samples by a speedVac concentrator showed significantly higher rotavirus recovery than polyethylene glycol precipitation through both negatively and positively charged filters (p-value <0.001). In addition, speedVac concentration using negatively charged filtration resulted in greater rotavirus recovery than that using positively charged filtration (p-value = 0.004). Thirty eight environmental water samples were collected from river, domestic sewage, canals receiving raw sewage drains, and tap water collected in containers for domestic use, all from congested areas of Bangkok. In addition, several samples of commercial drinking water were analyzed. All samples were concentrated and examined for rotavirus antigen. Coliforms and fecal coliforms (0->1,800 MPN/100 ml) were observed but rotavirus was not detected in any sample. This study suggests that the speedVac reconcentration method gives the most efficient rotavirus recovery from water samples

A comparison of sputum examination for acid fast bacilli By modified cold stain and ziehl-neelsen stain for screening of pulmonary tuberculosis.

A comparative study of the conventional Ziehl-Neelsen (ZN) stain and a new modified cold (MC) stain was carried out to evaluate the efficiency of this staining method in sputum examination for acid fast bacilli (AFB). The MC technique was simplified by avoiding the need for heat and combining the stage of counterstaining to overcome the problem aerosolized phenol and the more laborious heating method. Of the 392 sputum samples examined, 84 were positive and 297 were negative on both staining techniques, with an agreement of 97.2%. In comparison with culture as the gold standard for the diagnosis of tuberculosis, the ZN stain exhibited a sensitivity, specificity, positive and negative predictive values and efficiency of 68.9, 97.4, 92.1, 87.8 and 88.8%, respectively. The same values for the MC stain were 70.6, 97.8, 93.3, 88.4 and 89.5%, respectively with no statistically significant differences (P > 0.05) between the 2 methods. The MC stain was also as reliable as the ZN stain in retaining the color of the stained slide after prolonged storage; an agreement with the first reading was 90% after 4 weeks storage and 80% after 16 weeks storage. The staining reagents had a long shelf life; with agreement between both staining methods of 100% at every time of re-stocking aliquots. To apply this new MC stain for future use at the peripheral level of the health care system, we made a survey by using questionnaires sent to 200 hospitals. Most of the respondants also accepted that the MC stain was easier to perform, more comfortable and much less expensive than the ZN stain. Together, these factors make the MC stain suitable for use as a practical and rapid sputum staining test for screening for patients with pulmonary tuberculosis and for assessment of their treatment.