Cost-Effectiveness Analysis of Xpert MTB/RIF for Multi-Outcomes of Patients With Presumptive Pulmonary Tuberculosis in Thailand.

OBJECTIVES: The cost-effectiveness of screening adult patients for pulmonary tuberculosis is not clear. As such, this study aims to identify the cost-effectiveness between the Xpert MTB/RIF assay and the sputum acid-fast bacilli (AFB) smear. Multi-outcomes were correct diagnosis, time to achieve correct diagnosis, and gain in quality-adjusted life-years (QALYs). METHODS: A decision tree model was constructed to reveal a possible clinical pathway of tuberculosis diagnosis. The researchers used a clinical study to establish the probability of all clinical pathways for input into this model. The sample size was calculated following the correct diagnosis. Participants were randomly divided into 2 groups. A structural questionnaire and the Thai version of quality of life (EQ-5D-5L) were used for interviewing. RESULTS: The results showed that the time to achieve the correct diagnosis for the group using Xpert MTB/RIF was shorter than that for the group using the sputum AFB smear. Both the correct diagnosis and QALYs of the base case analysis presented the Xpert MTB/RIF method as dominant. A Monte Carlo model, which analyzed the Xpert MTB/RIF method, revealed that the average number of patients who were correctly diagnosed was 673, the QALYs were 945.85 years, and the total cost was $143 110.64. For the sputum AFB smear method, the average number who received a correct diagnosis was 592, the QALYs were 940.40 years, and the total cost was $196 666.84. Probabilistic and one-way sensitivity analysis confirmed that the Xpert MTB/RIF remained dominant. CONCLUSIONS: These results provide useful information for the National Strategic Plan to screen all adult patients for pulmonary tuberculosis.

Effectiveness of Tuberculosis Screening Technology in the Initiation of Correct Diagnosis of Pulmonary Tuberculosis at a Tertiary Care Hospital in Thailand: Comparative Analysis of Xpert MTB/RIF Versus Sputum AFB Smear.

Pulmonary tuberculosis (PTB) is one of the top 10 causes of mortality worldwide in 2016. Early detection is very important, as it can help early treatment. This study compared 2 separate methods of diagnosing PTB among suspected patients, specifically examining correct diagnosis and the duration of receiving a correct diagnosis. It was carried out in a tertiary care public hospital in Bangkok, Thailand. Ninety patients were randomly assigned to 2 groups, one with the Xpert MTB/RIF ( Mycobacterium tuberculosis/rifampicin) and the other with sputum AFB (acid-fast bacilli) smear. The proportion of correct diagnosis was 90.9% and 83.7% for the Xpert MTB/RIF and the comparison group, respectively. The difference was not statistically significant ( P > .05). However, the time to correct diagnosis in the Xpert MTB/RIF group was significantly shorter than the comparison group (2.23 days). This could lead to early diagnosis and lower transmission rate of PTB cases. Results support the provision of Xpert MTB/RIF as the initial diagnostic test for PTB in Thailand.

Prevalence of Facebook Addiction and Related Factors Among Thai High School Students.

OBJECTIVE: To determine the prevalence ofFacebook (FB) addiction and its related factors among Thai high school students. MATERIAL AND METHOD: This cross-sectional study was performed among 972 high school students in four provinces associated with high economic prosperity in Thailand: Bangkok, Ubon Ratchathani, Chiang Mai and Songkhla, utilizing a multistage cluster sampling technique. A self-administrative questionnaire was produced composing of three parts; demographic data, a Thai version of the Bergen Facebook Addiction Scale (Thai-BFAS) and the Thai version of the General Health Questionnaire-28 items. Multivariate analysis was employed to analyze thefactors associated with FB addiction. RESULTS: The prevalence ofFB addiction amongst Thai adolescents was 41.8% (95% CI; 38.6, 45.2). Related factors included gender school location, sufficiency ofpersonalfinance, devices ofFB access, duration ofstaying online via FB, andFB usage during holidays. In addition, every 1-hour increase in usage enhanced the risk for FB addiction (OR = 1.12, 95% CI; 1.05, 1.19). CONCLUSION: The prevalence of FB addiction in Thai high school students was found to be higher than in many other countries. Relatedfactors should be controlled in order to reduce FB addiction and its detrimental impacts, such as behavior modification and the promotion of healthier free-time activities. Further studies are recommended to understand why FB addiction is so high in Thailand.

Facebook Addiction and Its Relationship with Mental Health among Thai High School Students.

OBJECTIVE: To investigate the relationship between Facebook addiction and mental health among high school students. MATERIAL AND METHOD: This cross-sectional analytic study was performed among 972 high school students from four provinces associated with high economic prosperity in Thailand: Bangkok, ChiangMai, Ubon Ratchathani and Songkhla, utilizing a multistage cluster sampling technique. Facebook addiction was assessed using the Thai version of the Bergen-Facebook Addiction Scale (Thai-BFAS), while a Thai version ofthe General Health Questionnaire (Thai GHQ-28) was used for mental health evaluation. The relationship between Facebook addiction and mental health was analyzed through multiple logistic regressions. RESULTS: The prevalence of Facebook addiction and abnormal mental health were 41.9% (95% CI; 38.6, 45.2), and 21.9% (95% CI; 19.2, 24.8), respectively. After adjustment for confounding factors (sufficiency of household income, school location, level of education, GPAX learning deficits and attention deficit hyperactivity disorder), the individuals identified as having Facebook addiction were discovered to be at a high risk of developing abnormal general mental health (ORadj = 1.7, 95% CI: 1.1, 2.4), somatic symptoms (OR = 1.2, 95% CI: 0.9, 1.7), anxiety and insomnia (ORadj = 1.3, 95% CI: 0.9, 1.8), social dysfunction (OR = 1.5, 95% CI: 1.1, 2.1) and severe depression (ORadj = 1.5, 95% CI: 1.0, 2.2). Moreover; there were pronounced trends of increasing risk according to the level of Facebook addiction (Ptrend < 0.05). CONCLUSION: It was found that Facebook addiction among high school students could be associated with abnormal, general mental health status, somatic symptoms, anxiety & insomnia, social dysfunction, and severe depression. Therefore, it is essential that the relevant authorities educate young people about the mental health impacts linked with Facebook addictive usage and impose appropriate public health policies by screening Facebook addiction and mental health issues in risk groups.

Validation of the Thai version of Bergen Facebook addiction scale (Thai-BFAS). .

OBJECTIVE: To determine the validity ofthe Thai version ofthe Bergen FacebookAddiction Scale (Thai-BFAS) using Facebook addiction screening in Thai high school students. MATERIAL AND METHOD: The original BFAS was authorized for translation and validation in Thai. After content validity and usability were approved by three Thai psychiatrists, the Thai-BFAS was adjusted again by the authors and back translated by an English expert. Thisfinal version was investigated using the internal consistency method among 874 high schools students in Bangkok, Chiang Mai, Ubon Ratchathani and Songkhla, and confirmatoy factor analysis (CFA) was employed to prove that the six-component model could be representative of addiction behaviors. In addition, test-retest reliability was performed separately among 30 pilot high school students in Bangkok. RESULTS: The Thai-BFAS has six items, which are each scored on a 5-point scale with total score ranges from 0 to 24; the cutoff score for Facebook addition stands at least 12 points. The Cronbach s alpha coefficient was 0.91 (95% CI; 0.90, 0.92) and the inter-class correlation coefficient was 0.80 (95% CI; 0.49, 0.92). The CFA showed that the six items accurately represent the six-component model of addiction such as salience, mood modification, tolerance, withdrawal, relapse and conflict. CONCLUSION: The Thai-BFAS is consistent as a screening testfor Facebook addiction among high school students due to good reliability and validity. It also conforms well to the original version. The six items in the Thai-BFAS are a good representation of the addiction behaviors. Further studies should be undertaken in cases of sensitivity and specificity when compared with other similar tests of addiction as well as in various additional populations and circumstances.