Obesity among school children in a province of southern Thailand and its association with socioeconomic status.

The association of nutrition status of children aged 7-12 years (n=663) with socioeconomic factors in a province of southern Thailand in 1995 was investigated. Three type of schools were surveyed: a school with a higher educational standard (elite school) in the municipality of the province, a school with many children from low-income families (low-income school) in the same municipality, and five ordinary schools in rural areas of the province (district schools). The proportions of obese children were 22.1%, 5.8% and 2.7%, respectively for the three type of schools, when obesity was defined as weight to height of over 120% of the median of children in Bangkok. The risk ratios and 95% confidence intervals for obesity in the elite and the low-income schools were 5.0 (3.5-7.2) and 1.9 (0.8-4.8), respectively, taking the district schools as a reference. Our research suggested that the high prevalence of obesity among elite-school children could be related to the comparatively high socioeconomic status of the children's families. It also shows that the children in the province studied were as a whole considerably leaner than children in the big cities of Thailand. These results imply a need for appropriate interventions which cannot only prevent obesity, but also improve the malnutrition of school children in the rural provinces of southern Thailand.

Development of cancer registry in Phatthalung Hospital.

Evaluation of feasibility is required for development of a hospital-based cancer registry of Phatthalung Hospital. The completeness of case finding from in-hospital sources was evaluated for cancer cases diagnosed from January 1, 1994 to December 31, 1994. Cancer patients were collected from a file of pathological reports and medical records in Phatthalung Hospital. Items in the registration form included identification, demographic data and the data specific to cancer. During the same period of time, all biopsy cases sent from Phatthalung Hospital were selected from the pathological record of the Department of Pathology, Songklanagarind Hospital and from the database of the cancer registry of Songklanagarind Hospital. Ninety cases with histological verification were identified either from Phatthalung or Songklanagarind sources. Twenty seven cases were male and 63 were female. Fifty records were identified from Phatthalung sources and 40 additional records from Songklanagarind sources. Identification of cancer cases only from Phatthalung sources represented only 56% of all histologically verified cases. The two most common primary sites in males were colon and prostate. The percentages were 18.5 and 11.1 respectively. Lung cancer accounted only for 7.4% of all histologically verified cases. The two most common primary sites in females were cervix uteri and breast which accounted for 31.7% and 23.8% respectively. There was too much failure of case identification by in-hospital sources only. Songklanagarind sources were important for case findings. However, it is important that the medical records and filing system in Phatthalung Hospital should be improved.

A case-control study of acute diarrheal disease among school-age children in southern Thailand.

We conducted a case-control study of school-age children in Phatthalung, a province in southern Thailand using a questionnaire to investigate associations of children's hygiene-related behavior and hygienic conditions in their homes with acute diarrheal disease. We compared 69 acute diarrhea (less than 7 days duration) cases that attended two hospitals in Phatthalung during August 1995 to June 1996 with 69 age-, sex- and address-matched controls in primary schools who had not suffered from diarrheal disease for the past one year before August 1995. Three factors were found to be significantly associated with acute diarrheal disease: farmer or gum planter as the occupation of father [Odds ratio (OR) 6.6; 95% confidence interval (CI) 1.7-26.1, p < 0.01], installation of a refrigerator in children's homes (OR 0.2; CI 0.1-0.8, p < 0.05), and drinking untreated water (OR 2.3; CI 0.9-6.1, p < 0.1). There was no significant difference for sources of drinking water between cases and controls. Considering the data on drinking water, the results indicated that there are some problems with quality of sources of drinking water. The results also suggested that having a refrigerator could have preventive effects on acute diarrheal disease, while inadequate behavior and unhygienic environment in the homes of farmers and gum planters might be related to acute diarrheal among school-age children.