Lack of significant effects of Chlamydia trachomatis infection on cervical cancer risk in a nested case-control study in North-East Thailand.

Cervical cancer continues to be an important public health problem in Thailand. While the high risk human papillomavirus (HPV) types have been established as the principle causative agent of both malignancies and the precursor lesions, cervical intraepithelial neoplasia (CIN), other factors may also be involved like other sexually transmitted diseases, as well as smoking. Chlamydia trachomatis is an obligate intracellular Gram-negative bacterium which has a tendency to cause chronic infection featuring inflammation and therefore might be expected to increase the risk of cervical cancer. In the present nested case-control study, 61 cases of cervical cancer and 288 matched controls with original serum samples were identified from the Khon Kaen Cohort, established in the North-East of Thailand, by linkage to the Khon Kaen population based cancer registry. C. trachomatis specific IgG antibodies at recruitment were measured by microimmunofluorescence and assessed for association with cervical cancer using STATA release10. No significant link was noted either with all cancers or after removal of adenocarcinomas. The results suggest no association between Chlamydia infection and cervical cancer development in North-East Thailand, but possible influencing factors must be considered in any future research on this topic.

Evaluation of health education in the Multi-professional Intervention and Training for Ongoing Volunteer-based Community Health Programme in the north-east of Thailand.

This was a survey research conducted in Northestern Thailand during 2009-2010 and designed to evaluate the success of a health education program by comparing levels of health knowledge in the community before and after the launching of a Multi-professional Intervention and Training for Ongoing Volunteer-based Community Health Programme. The survey questionnaire included items about demographic characteristics and health knowledge. The participants were 1,015 members of various communities, who were randomly selected to be included in the survey before launching the intervention, and 1,030 members of the same communities randomly selected to be included in the survey after the intervention was completed. The demographic characteristics of both groups were similar. Overall knowledge and knowledge of all the diseases, except lung and cervical cancer, were significantly higher after the intervention. In conclusion, a Volunteer-based Community Health Programme has advantages for areas where the numbers of health personnel are limited. The use of trained community health volunteers may be one of the best sustainable alternative means for the transfer of health knowledge.

Evaluation of the nationwide cervical screening programme in Thailand: a case-control study.

OBJECTIVES: To evaluate the effectiveness of the Pap smear screening programme in Thailand in the prevention of invasive cervical cancer. SETTING: Four tertiary hospitals, in two provinces of north-east Thailand. METHODS: A hospital-based case-control study of women aged 30-64, who were resident in north-east Thailand. A total of 130 women with a diagnosis of invasive cervical cancer were compared with two groups of controls: a) hospital controls, b) hospital patient companions. Information on risk factors for cervical cancer and history of screening by cytology (Pap smear) were collected using a structured interview. RESULTS: Eighty percent of control subjects reported having had a Pap test in the past, and some two-thirds within the three years before interview. There was a significant protective effect for multiple (6+) previous screening tests as reported by 20% of controls. When women who had tests less than six months prior to the study were excluded, there was a strong, significant protective effect of the number of tests (for 1-5 tests: OR = 0.45 95% CI = 0.25 to 0.84, and for 6+ tests: OR = 0.29 95% CI = 0.11 to 0.82). Tests carried out 1-2 years and 3+ years before diagnosis were associated with an OR of 0.27 (95% CI = 0.13-0.56) and 0.42 (95% CI = 0.20-0.88), respectively. CONCLUSIONS: The cervical screening programme in north-east Thailand has achieved excellent coverage and is preventing cervical cancer. Women who have been screened multiple times are at substantially lower risk than those only screened a few times suggesting that the quality of the screening could be improved.