Knowledge, attitudes, and practices about tuberculosis and choice of communication channels in Thailand.

INTRODUCTION: The aim of this study was to assess tuberculosis (TB) knowledge, attitudes, and practices in both the general population and risk groups in Thailand. METHODOLOGY: In a cross-sectional survey, a general population (n = 3,074) and family members of a TB patient (n = 559) were randomly selected, using stratified multistage sampling, and interviewed. RESULTS: The average TB knowledge score was 5.7 (maximum = 10) in the Thai and 5.1 in the migrant and ethnic minorities general populations, 6.3 in Thais with a family member with TB, and 5.4 in migrants and ethnic minorities with a family member with TB. In multivariate linear regression among the Thai general population, higher education, higher income, and knowing a person from the community with TB were all significantly associated with level of TB knowledge. Across the different study populations, 18.6% indicated that they had undergone a TB screening test. Multivariate logistic regression found that older age, lower education, being a migrant or belonging to an ethnic minority group, residing in an area supported by the Global Fund, better TB knowledge, having a family member with TB, and knowing other people in the community with TB was associated having been screened for TB. CONCLUSION: This study revealed deficiencies in the public health knowledge about TB, particularly among migrants and ethnic minorities in Thailand. Sociodemographic factors should be considered when designing communication strategies and TB prevention and control interventions.

Determinants of cervical cancer screening adherence in urban areas of Nakhon Ratchasima Province, Thailand.

Cervical cancer is the most common disease among Thai women. The cervical cancer mortality rate has increased in the previous decade. Therefore, this cross-sectional study was conducted to examine the factors associated with cervical cancer screening adherence. Stratified sampling with the proportional to size method was used to select registered women aged 30-60 years. Of the 700 self-administered questionnaires distributed during July and September of 2012, 675 were returned, resulting in a response rate of 96.2%. Approximately 65.4% of the women were considered to be adherent to cervical cancer screening (i.e., maintainers) as defined by at least one screening within the recommended 5-year screening interval and the expectation of attending a screening in the future. Chi-square tests revealed that occupation, marital status, number of children, sexual activity, health insurance scheme, history of oral contraceptive pill use, perceived barriers, perceived benefits, and knowledge about cervical cancer prevention were significantly associated with cervical cancer screening adherence. After adjusting for occupation, marital status, number of children, and health insurance in the model, perceived barriers (Adj OR=1.97, 95% CI=1.24-3.10) and knowledge (Adj OR=1.65, 95% CI=1.13-2.41) remained significant predictors of cervical cancer screening adherence. These findings suggest that the non-housewives, women of single/separated/divorced/widowed status, and women with no children should be the first priorities for getting Pap tests. Strategies for overcoming the barriers of these women, such as using mobile units for cervical cancer screening, should be promoted. Education programs should be strengthened and promoted to overcome negative perceptions and knowledge deficiencies.

Knowledge, attitudes and preventive behaviors related to dengue vector breeding control measures among adults in communities of Vientiane, capital of the Lao PDR.

This research aimed to determine the knowledge, attitudes and preventive behaviors (KAP) of adults in relation to dengue vector control measures in the communities of Vientiane, the capital of the Lao PDR. A total of 207 respondents were actively participating in this cross-sectional descriptive study in 2011. Representatives of households were interviewed face-to-face by six trained interviewers using a structured questionnaire. KAP reliabilities of 0.89, 0.91 and 0.95 were reported in the pilot sample of 30 cases. The associations between each independent variable and prevention behavior were tested with chi-square tests. Multiple logistic regression was used to determine the factors that were significantly associated with preventive behavior while controlling for the other variables. The results revealed that 51.69% of the respondents had a high level of knowledge. More than 94% of the respondents knew that dengue fever is a dangerous communicable disease and that dengue fever is transmitted from person to person via mosquitoes. More than half (56.52%) of the participants had positive attitudes toward vector control measures, and 52.17% exhibited a high level of preventive behavior in terms of dengue vector control measures. Preventive behaviors were significantly associated with information provided from sources that included health personnel (p = 0.038) and heads of villages (p=0.031) and with knowledge levels (p < 0.001). This study suggests that proactive health education through appropriated mass media and community clean-up campaigns should strengthen and encourage community participation, particularly in terms of addressing mosquito larvae in overlooked places, such as the participants' own homes, for example, in flower vases and ant traps.

Emotional development and nutritional status of HIV/AIDS orphaned children aged 6-12 years old in Thailand.

OBJECTIVE: To explore the emotional development and nutritional status of HIV/AIDS orphans by their infection status. METHODS: A community-based cross-sectional survey was conducted during January and December 2005 in four provinces and Bangkok Metropolis where the prevalence of HIV/AIDS among pregnant women was high. The study population consisted of 388 HIV/AIDS orphans who were maternal or paternal or double orphans aged 6-12 years old. The orphans' main caregivers gave informed consent to the project and assessed the emotional development of their orphaned children. The children were measured for weight, height, and emotional development by standard instruments. They were divided into three groups regarding their HIV/AIDS infection status reported by their caregivers: infected, non-infected, and unknown. The chi(2) test was used to determine the association between nutritional status and infection status. RESULTS: Regarding HIV/AIDS infected children, 19.1% were infected, 57.5% were not infected, and 23.4% were unknown. The main caregivers of all types of orphans were grandparents. Only 13.7% of infected orphans lived with their mothers. Most caregivers were females and more than 40 years old. Infected orphans had mean scores of overall emotional development and for each domain less than other groups. The mean scores of self-control and quick recovery were significantly different between infected and non-infected groups (P-value < 0.05). Nearly 50% of infected orphans were rather short and approximately 42% were under weight and light. The findings revealed a significant association between height for age, weight for age and infection status of orphans at a P-value of <0.001. CONCLUSIONS: Orphanhood itself is a vulnerable status and HIV/AIDS infected orphans are most vulnerable. Acceptable and friendly services for orphans and their families are crucial. The services should continue and protect stigmatization.

Implications of family protective-risk index for screening cognitive development of children aged 13-15 years.

BACKGROUND: A simple screening tool is essential for priority setting and operating activities in communities. OBJECTIVE: The present study aimed to identify the implications of a family protective-risk index (FPRI) for screening cognitive development of children aged 13-15 years. MATERIAL AND METHOD: The cross-sectional survey among 319 children aged 13-15 years old was conducted in one district. The cognitive development was measured by TONI version 3. Studied family factors consisted of parents' education, parents' occupation, sufficiency of family income, family relationships, stressful life events in the family, family type, and quality of child care. The protective characteristic of each factor was given one point and the risk was given zero point. FPRI was constructed in three models. The FPRI 1 was the cumulative effects of nine family factors mentioned above. The FPRI 2 was the cumulative effects of seven family factors that were significantly associated with cognitive development in the present study by Chi-square test: parents' education, parents' occupation, family relationship, stressful life events and family type. The FPRI 3 was constructed from 4 family factors that were significantly associated with cognitive development by logistic regression analysis: mother's education, mother's occupation, family relationship and stressful life events. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were applied to identify the optimal cut off point of prediction. RESULTS: The present results showed that 52% of the sample had an intellectual level lower than 90. The FPRI 1 at 6 or 7 scores and the FPRI 2 at 4 or 5 scores yielded the same phenomena, high sensitivity but moderate specificity, PPV and NPV The FPRI 3 at 2 scores gave high PPV and moderate for the rest. The FPRI 3 at 3 scores gave high sensitivity and NPV moderate PPV and low specificity. Among three indices, the FPRI 3 was found to be the best index as its Receiver Operating Characteristic (ROC) curve was furthest into the top left corner. CONCLUSION: The FPRI 3 at 3 scores can be used as a preliminary screening tool for health personnel to identity families at risk of having children with slow cognitive development and then, provide urgent support and help.

Talked and deteriorated head injury patients: how many poor outcomes can be avoided?

The objective of this study was to assess the effectiveness of head injury management on the incidence and outcome of talked and deteriorated patients. Of 337 severe head injury patients admitted to Songklanagarind Hospital during 1994 to 1997, 30 were identified as 'talked and deteriorated'. Most deterioration was due to intracranial haematomas. The incidence (8.9%) and poor outcome (40%) were lower than those from a previous study in 1990 (incidence 15.8% and poor outcome 50%). The poor outcome in this group should not be more than 10%, which may be achieved by appropriate practice guidelines combined with a multidisciplinary team approach in caring for head injury patients, and the collaboration of hospitals within a regional trauma system.