Ecologic and sociodemographic risk determinants for dengue transmission in urban areas in Thailand.

This study analyzed the association between household-level ecologic and individual-level sociodemographic determinants and dengue transmission in urban areas of Chachoengsao province, Thailand. The ecologic and sociodemographic variables were examined by univariate analysis and multivariate logistic regression. In the ecologic model, dengue risk was related to households situated in the ecotope of residential mixed with commercial and densely populated urban residential areas (RCDENPURA) (aOR = 2.23, P = 0.009), high historical dengue risk area (aOR = 2.06, P < 0.001), and presence of household window screens (aOR = 1.62, P = 0.023). In the sociodemographic model, the dengue risk was related to householders aged >45 years (aOR = 3.24, P = 0.003), secondary and higher educational degrees (aOR = 2.33, P = 0.013), household members >4 persons (aOR = 2.01, P = 0.02), and community effort in environmental management by clean-up campaign (aOR = 1.91, P = 0.035). It is possible that the preventive measures were positively correlated with dengue risk because these activities were generally carried out in particular households or communities following dengue experiences or dengue outbreaks. Interestingly, the ecotope of RCDENPURA and high historical dengue risk area appeared to be very good predictors of dengue incidences.

Application of eco-friendly tools and eco-bio-social strategies to control dengue vectors in urban and peri-urban settings in Thailand.

BACKGROUND: Dengue is considered one of the most important vector-borne diseases in Thailand. Its incidence is increasing despite routine implementation of national dengue control programmes. This study, conducted during 2010, aimed to demonstrate an application of integrated, community-based, eco-bio-social strategies in combination with locally-produced eco-friendly vector control tools in the dengue control programme, emphasizing urban and peri-urban settings in eastern Thailand. METHODOLOGY: Three different community settings were selected and were randomly assigned to intervention and control clusters. Key community leaders and relevant governmental authorities were approached to participate in this intervention programme. Ecohealth volunteers were identified and trained in each study community. They were selected among active community health volunteers and were trained by public health experts to conduct vector control activities in their own communities using environmental management in combination with eco-friendly vector control tools. These trained ecohealth volunteers carried out outreach health education and vector control during household visits. Management of public spaces and public properties, especially solid waste management, was efficiently carried out by local municipalities. Significant reduction in the pupae per person index in the intervention clusters when compared to the control ones was used as a proxy to determine the impact of this programme. RESULTS: Our community-based dengue vector control programme demonstrated a significant reduction in the pupae per person index during entomological surveys which were conducted at two-month intervals from May 2010 for the total of six months in the intervention and control clusters. The programme also raised awareness in applying eco-friendly vector control approaches and increased intersectoral and household participation in dengue control activities. CONCLUSION: An eco-friendly dengue vector control programme was successfully implemented in urban and peri-urban settings in Thailand, through intersectoral collaboration and practical action at household level, with a significant reduction in vector densities.

Snails and trematode infection after Indian Ocean tsunami in Phang-Nga Province, southern Thailand.

The tsunami and non-tsunami affected areas of Takua Pa District, Phang-Nga Province were investigated for fresh- and brackish-water snails that transmit human parasitic diseases during 2006 and 2007. Among 46 snail species found, 17 species of 8 families were freshwater snails, 28 species of another 7 families were brackish-water snails, and 1 species was a land snail. Of these species, 11 freshwater snails, 4 brackish-water snails and 1 land snail were of medical importance. The fresh-water snails were Pomacea canaliculata, Pila angelica, P. gracilis, P. polita, Filopaludina (S.) martensi, F. (F.) s. polygramma, Melanoides tuberculata, Indoplanorbis exuxtus, Radix rubiginosa, Helicorbis umbilicalis, Gyraulus convexiusculus. Four brackish-water snails were Cerithidea cingulata, C. djadjarensis, C. alata, Sermyla riqueti and Achatina fulica was the land snail. I. exutus, M. tuberculata and F. (F.) s. polygramma harbored Xiphidio, Microcercus, Furocercus, Echinostome cercariae, and cercaria without eyespots or tail with hair. Three species of brackish-water snails, Cerithidia cingulata, C. djadjariensis, and C. alata presented with 6 types of trematode cercariae and rediae. Knowledge of medically important snails and their parasitic diseases, and prevention were given to Takua Pa people by poster, pamphlets and broadcasting through community radio.

Adherence to antimalarial drug therapy among vivax malaria patients in northern Thailand.

Vivax malaria is a significant cause of morbidity due to malaria in northern Thailand, accounting for approximately 50% of all malaria cases. The objective of this study was to determine the behavioural factors associated with adherence to the standard 14-day course of chloroquine and primaquine, prescribed from malaria clinics, among patients with vivax malaria. A retrospective study was conducted among 206 patients living in Muang and Mae Sa Riang districts of Mae Hon Son province in northern Thailand. Data on adherence and potential behavioural factors relating to adherence were collected using a structured interviewer-administered questionnaire and supplemented with qualitative data from focus-group interviews. The results indicated that 76.21% of the 206 patients with vivax malaria did not complete the medication course. The adherence of the patients was associated with knowledge scores of malaria (adjusted odds ratio [AOR]=2.2, 95% confidence interval [CI] 1.1-4.5) and accessing drug prescription scores (AOR=5.6, 95% CI 2.13-15.3). Therefore, further effort is needed to educate patients with vivax malaria on knowledge of malaria and its treatment with simple health messages and encourage them to adhere to their treatment.

An empowerment program to enhance women's ability to prevent and control malaria in the community, Chiang Mai Province, Thailand.

Paulo Freire's theory was modified to empower a women's group in Chiang Mai Province, Thailand, to prevent and control malaria. This study conducted an intervention in Mueang Na Wan Village, Mueang Na Sub-district, Chiang Dao District, Chiang Mai Province, where 45 women were systematically recruited into the study cohort. Navail Village was selected as a control village because it resembled the intervention village. The empowerment program emphasized enhancement of malaria preventive levels, using insecticide-treated bed nets, self-esteem, and self confidence expectation to prevent and control malaria. Intensive training was conducted and activities performed among the women's group, with 10 participatory meetings in all. Data collection was conducted for the pre-test in month 1, and post-intervention in months 3, 6, 9, and 12. The qualitative methods used were focus-group discussions, non-participant observations, and in-depth interviews with housewives, their husbands, and youths at risk for malaria. The results showed that, post-intervention, there were significantly increased levels for malaria preventive behaviors, behaviors of using insecticide-treated nets, self-esteem, and self confidence expectations, in the intervention village compared with the control village. Insecticide-treated net usage and insecticide-treated net usage behaviors increased in the intervention village more than before and more than that in the control village. The women's group in the intervention village created the following plans, which were crucial to malaria prevention: (1) a family protection plan, (2) providing malaria education to community members, (3) a mosquito-control campaign, (4) scaling-up insecticide-impregnated bed nets, and (5) malaria control among foreign laborers. Finally, the empowered women's group performed sustainable activities. Between malaria-prevention activities, they conducted a joint program to raise income for their families.

Avian influenza protection knowledge, awareness, and behaviors in a high-risk population in Suphan Buri Province, Thailand.

Avian influenza (Al) had outbreaks in Thailand from January 2004 to December 2005, which resulted in 22 human cases, and 14 deaths. Three confirmed cases were reported in Suphan Buri Province in 2004, one of whom died. A cross-sectional study aimed to investigate knowledge, attitudes, and practices about AI in Song Phi Nong District of Suphan Buri Province. Most of the respondents had moderate levels of knowledge. Most of their attitudes towards and practices of the prevention and control of AI were also appropriate. However, the peoples' knowledge about major signs and symptoms of AI was limited. The study suggested that those who had received information from media had better attitudes towards and practices of AI prevention and control, compared with those who had not received information from media. Therefore, the media played an important role in improving knowledge, attitudes, and behaviors; but for the better protection from AI, continuing health education will be necessary in Thailand.

Freshwater mollusks at designated areas in eleven provinces of Thailand according to the water resource development projects.

The study was conducted at 75 collecting loci in 15 districts of 11 provinces in Thailand during 1999-2004. A total of 12,079 live mollusks were collected, 11,874 were snails and 205 were clams. The snails were comprised of 39 species and classified into 9 families: Ampullariidae, Bithyniidae, Buccinidae, Potamiopsidae, Stenothyridae, Thiaridae, Viviparidae, Planorbidae and Lymnaeidae. The clams were comprised of 14 species classified into 2 families: Amblemidae and Corbiculidae. Fifteen species were medically important snails: Pomacea canaliculata, Pila ampullacea, P. pesmei, P. polita, Bithynia (Digoniostoma) funiculata, B. (D.) siamensis goniomphalos, B. (D.) s. siamensis, Filopaludina (Siamopaludina) martensi martensi, F. (Filopaludina) sumatrensis polygramma, Melanoides tuberculata, Tarebia granifera, Helicorbis umbilicalis, Gyraulus convexiusculus, Indoplanorbis exustus and Radix rubiginosa. Of these 3 snail species harbored trematode cercariae. I. exustus harbored Echinostoma malayanum, Xiphidio and Schistosoma spindale, and R. rubiginosa and B. (D.) siamensis goniomphalos harbored Xiphidio and intestinal flukes, respectively.

Health and nutrition survey of tsunami victims in Phang-Nga Province, Thailand.

The post-tsunami health and nutritional statuses of survivors were surveyed three months after the disaster struck. Non-participant observations and questionnaires were used to study the effects of the disaster on their lifestyles and health while residing in temporary shelters provided by the government and private donors. Anthropometrics were measured and dietary surveys conducted to elicit nutritional status. Our findings indicated good management of drinking water in the temporary shelters. Toilet construction and water supply were adequate, but wastewater and sewage systems were poorly managed. The study group still suffered from injuries after the disaster, and complained of back pain, stress, and sleep disorders. Most in the study group had unsatisfactory health behaviors, and obesity was an increasing problem among female participants.

Willingness to be vaccinated against shigella and other forms of dysentery: a comparison of three regions in Asia.

We conducted a cross sectional survey of 3163 women and men in six Asian countries to examine willingness for children and adults to be vaccinated against shigellosis and other forms of dysentery. The six sites were clustered into three regions for ease of comparison. The regions are: Northeast Asia (China), Southeast Asia (Thailand, Vietnam, and Indonesia) and South Asia (Bangladesh and Pakistan). We used multiple logistic regression to identify region-specific models for vaccination willingness for both adults and children. A vaccine to protect against dysentery, if available would be very much in demand throughout the three Asian regions for children. For adults, the responses indicate that vaccine uptake by adults will vary. A large proportion of respondents in all regions, specifically in China, do not perceive themselves at risk yet still consider a shigellosis vaccine desirable.

Freshwater mollusks of medical importance in Kalasin Province, northeast Thailand.

A snail survey was performed in six districts around irrigation areas of Lampao Dam, in Kalasin Province. The survey caught a total of 5,479 live snails and classed them into five families, 12 genera and 15 species, of which 7 species are suspected of transmitting human parasitic diseases. The seven species were Pila polita, Pomacea canaliculata, Filopaludina (S.) m. martensi, Bithynia (Digoniostoma) siamensis goniomphalos, Melanoides tuberculata, Radix rubiginosa, and Indoplanorbis exustus. Of these, B. (D.) s. goniomphalos and I. exustus were found to harbor emergent cercariae. Only B. (D.) s. goniomphalos hosted several types of cercariae--Opisthorchis viverrini, unidentified species of intestinal flukes, echinostomes, xyphidio and furcocercous cercariae. Indoplanorbis exustus shed only echinostome cercariae. B. (D.) s. goniomphalos showed a rather high natural infection rate with O. viverrini, 1.3% in Yang Talat district, and 0.61% in Kamalasai district, in Kalasin Province.

Health promotion program for the safe use of pesticides in Thai farmers.

The purpose of this study was to determine the knowledge, attitudes and practices (KAP) concerning the safe use of pesticides of Thai farmers in Don Kha subdistrict, Bang Phae district, Ratchaburi Province. Thirty-three voluntary Thai farmers of thirty-three farming families, recruited by convenience sampling, participated in a training program for six months. Data were collected by questionnaire interviews, and KAP on the safe use of pesticides were compared by paired t-test. Research findings showed that the mean scores of KAP in the posttest were significantly higher than the pretest. The results of this study provided health professionals with information to develop more effective prevention and intervention programs. To prevent illness, the most important role of health officers should to be focus on education and information for individuals, families, and communities.

The health belief model and factors relating to potential use of a vaccine for shigellosis in Kaeng Koi district, Saraburi province, Thailand.

Shigellosis is an important cause of morbidity and mortality throughout the world. Approximately, 1.1 million deaths occur a year due to this disease, making it the fourth leading cause of mortality worldwide. This paper explores local interest in and potential use of a vaccine for shigellosis in Thailand where Shigella poses an important public-health concern. Data for this study were collected during June-November 2002 from 522 subjects surveyed using a sociobehavioural questionnaire in Kaeng Koi district in central Thailand. The community demand and likely use of a vaccine were examined in relation to the Health Belief Model, which provides analytical constructs for investigating the multiple issues of local readiness to accept and access a new vaccine. As the key outcome variable, most respondents showed interest in receiving a vaccine against dysentery which they thought would provide useful protection against the disease. However, there was only a moderate number who perceived dysentery as serious and themselves as susceptible to it, although it was perceived to cause some burden to and additional expense for families. Most people identified a number of groups who were thought to be especially vulnerable to dysentery, such as the elderly, pre-school, and school-age children, and poor labourers. Other outcomes of the study included the identification of acceptable and convenient sites for its delivery, such as government health clinics and private clinics, and respected sources for information about the vaccine, such as health clinic personnel and community health volunteers. This information suggests that components of the Health Belief Model may be useful in identifying community acceptance of a vaccine and the means of introducing it. This health information is important for planning and implementing vaccine programmes.

Gnathostoma infection in fish caught for local consumption in Nakhon Nayok Province, Thailand. II. Deasonal variation in swamp eels.

From August 2000 to August 2001, 1844 swamp eels (Monopterus albus) were purchased from several local markets in Nakhon Nayok Province, Thailand, and examined for the presence of Gnathostoma advanced third-stage larvae. The overall prevalence was 30.1% and the mean number of larvae/eel (infection intensity) was 10.0. The highest infection rate (44.1%) was found in August 2000 and the lowest (10.7%) in March 2001. The greatest mean number of larvae/eel (75.1) was found in August 2000, whereas the fewest (2.3) was in July 2001. It is suggested that the prevalence and intensity of infection decreased within two months after the end of the rainy season and started to rise again about two months after the next rainy season began. A total of 5,532 Gnathostoma larvae were recovered from 555 infected eels, with a maximum number of 698 larvae/eel. The highest rates of Gnathostoma infection according to eel body length and weight were 87.5% in the group 91-100 cm, and 100% in groups of 901-1100 g, respectively. There were significant correlations between eel body lengths and infection rates, body lengths and infection intensities; eel body weights were also significantly correlated with infection rates and infection intensities. It was noted that the longer/ heavier the eels were, the higher would be the infection rates and the greater the infection intensities. Tissue distributions of Gnathostoma larvae in the livers and muscles of swamp eels were as follows: 43.0% of the total number of larvae were found in the muscles and 57.0% were in the liver; 29.7, 51.7, and 18.6% were in the anterior, middle, and posterior parts, respectively; 35.1% were in the dorsal part, while 64.9% were in the ventral part; 9.0, 18.7, 7.4, 20.6, 33.1, and 11.2% were in the anterodorsal, mediodorsal, posterodorsal, anteroventral, medioventral and posteroventral parts, respectively. Of the 5,532 Gnathostoma larvae examined, 1101 (19.9%) were found to possess morphological variants or abnormal cephalic hooklets. The most common unusual feature was that there were few to numerous extra rudimentary hooklets below row 4 and between the 4 rows of hooklets (7.6%), the presence of a fifth row of hooklets (3.5%), abnormal hooklets in any of the 4 rows of hooklets (5.2%), spiral arrangement of the 4 rows of hooklets (1.8%), and larvae having only 3 rows of hooklets (0.3%).