Prevalence of Suspected Cholangiocarcinoma Based on Ultrasonography Screening and its Associated Factors in Northeastern Thailand.

Background Ultrasonography of the liver allows detection of liver mass and bile duct dilatation which are findings of suspected Cholangiocarcinoma so that early stage Cholangiocarcinoma can be detected. Objective To estimate the prevalence of suspected Cholangiocarcinoma as well as its associated factors. Method These reported results were obtained from the baseline screening for Cholangiocarcinoma as of July 2013 of an ongoing project the Cholangiocarcinoma Screening and Care Program conducted in Northeastern Thailand. Participants were northeasterners who were at least one of the followings: 40 years or older, ever been infected with liver fluke, ever been treated with praziquantel, or ever been consumed raw fresh water fish. Ultrasonography was done by well-trained medical radiologists. Result Of the total 1,196,685 participants, 58.9% were females with a mean age of 58.2 (standard deviation ± 9.9) years. Suspected Cholangiocarcinoma was found in 15,186 (2.6%; 95% CI: 2.56 to 2.65) individuals. The results observed that the participants with higher age group had high association as compared to younger age group (AOR=1.98; 95% CI: 1.77 to 2.21; p-value < 0.001), hepatitis B infected participants were highly significant as compared to the non- hepatitis B infected (AOR=1.22; 95% CI: 1.07 to 1.39; p-value = 0.002) and participants having Hepatitis C were also significantly associated with Cholangiocarcinoma infection (AOR=1.46; 95% CI: 1.04 to 2.05; p-value = 0.029) based on ultra-sonographic screening respectively. However, patients having diabetes were less likely to be associated with Cholangiocarcinoma (AOR=0.87; 95% CI: 0.81 to 0.93; p-value < 0.001). Conclusion About one out of a hundred cases required further investigations such as Magnetic resonance imaging or Computed Tomography. Early age of ultrasonography screening for Cholangiocarcinoma enhanced the opportunities for early detection of Cholangiocarcinoma and might reduce irrational requests for expensive or invasive methods of diagnosis.

Offspring Education, Mental Health Status and Quality of Life among Parents of High School Students in the Northeast of Thailand.

Background Providing children best education could be burden on parents which might impaired their mental health and quality of life (QOL). Objective To assess children education, mental health status and their influence on QOL of parents of high school students in the Northeast of Thailand. Method This cross-sectional study was conducted among 1,098 parents of high school students. The study population were selected by using multistage random sampling from 20 high schools in 10 provinces of the Northeast of Thailand to response to a structured questionnaire interview. Multilevel logistic regression was performed to identify the influence of mental health status and offspring education on QOL of parents of high school students. Result Among the total of 1,098 respondents, 28.78% had poor quality of life. Factors that were associated with poor QOL of the parents were had moderate to severe depressive symptoms (adj.OR=5.72; 95% CI:4.01-8.16), had moderate to high levels of stress (adj.OR=2.32; 95% CI:1.64 - 3.29), not expected the child to study bachelor degree (adj.OR=2.59; 95% CI:1.74 -3.84), perceived children's academic performance as not to minimal importance (adj.OR=2.20; 95% CI: 1.54 - 3.14), had 2 or more children currently studying (adj.OR= 1.62; 95% CI:1.00 - 2.64), and had low to high concerns on their children low examination scores (adj.OR=1.51; 95% CI: 1.06 - 2.15). Conclusion Depression, stress, children education as well as physical health and work-related problems had influence on QOL.

Prevalence and Determinants of Type 2 Diabetes among the Pulmonary Tuberculosis Cases in Nepal: A Cross Sectional Study.

Background Since prehistoric time to the earlier 20th century, diabetes was accounted as comorbidity among tuberculosis patients, which is reducing the treatment efficiency. Objective To investigate the prevalence and determinants of type 2 diabetes mellitus among tuberculosis patients in central development region of Nepal. Method An analytical cross-sectional study was conducted by using structured questionnaire. Face to face interview as well as reviewing of the medical records of the tuberculosis cases has been performed during September 2018 - February 2019. The systematic random sampling was applied to select 306 tuberculosis cases. Then the respondents were examined for blood glucose level as well as Glycated haemoglobin (HbA1c) level to identify TB with Diabetes Mellitus. The proportion of respondents with fasting blood glucose level ≥ 126 mg/dl or a random blood glucose ≥ 200 mg/dl was considered as Tuberculosis with Diabetes Mellitus cases. Similarly, haemoglobin A1C ≥ 7% was accessed as amplified risk for tuberculosis. Multiple logistic regression was performed to analyse the factors associated with Tuberculosis with Diabetes Mellitus by using STATA. P value < 0.05 was taken as statistically significant. Result A total of 306 tuberculosis patients were included in the study. The mean ± standard deviation of age of participants was 36.82±15.94 years. The proportion of male slightly exceeded than that of female with a ratio of 1.73:1. The prevalence of TBDM was 17.32% (95% CI: 13.05-21.58) of all diagnosed tuberculosis cases. Our multivariable analysis identified the factors those were associated with TBDM were age ≥ 45 years (adj.OR=3.97, 95% CI 1.81-8.71, p value 0.001), patients residing in the urban areas (adj.OR=9.75, 95% CI 1.99-47.6, p value 0.005), had Body Mass Index (BMI) < 18.5 Kg/m2 (adj.OR=3.20, 95% CI 1.58-6.51, p value 0.001), had diastolic blood pressure ≥ 80 mmHg (adj.OR=2.34, 95% CI 1.17-4.66, p value 0.015) and patients who were treated with Cat II and Cat III tuberculosis treatment regimens (adj.OR=2.65, 95% CI 1.22-5.73, p value 0.013). Conclusion The prevalence of type 2 diabetes mellitus among tuberculosis patients was higher than prevalence of diabetes in general population of Nepal and it was higher among male, urban residents, patients with low BMI and the older aged tuberculosis patients.

Chemical Pesticide Use and Quality of Life of Rubber Farmers in the Northeast of Thailand.

Background Chemical pesticide has known to have impacts on human health and environment. However, there are limited studies on chemical pesticide use has influence on quality of life (QOL) of rubber farmers in Thailand. Objective To determine the pesticide use and its association with quality of life of rubber farmers in the northest region of Thailand. Method This cross sectional study recruited the total of 362 samples by using a multistage random sampling from eight provinces in the Northeast of Thailand. A selfadministered questionnaire was developed and used to collect the data. The multiple logistic regressions were used to determine the association between chemical pesticide use and quality of life when controlling other covariates, presenting adjusted odd ratio, 95% CI and p-value. Result Of the total 362 respondets, 66.57% of rubber farmers used chemical pesticides, only 32.60% had good quality of life (95% CI:27.75 - 37.45%). The multivariable analysis indicated that those who did not use chemical was associated with having good quality of life (adj. OR = 2.19; 95% CI = 1.34 to 3.58, p-value =0.002). Similarly, other factors associated with good quality of life were; working 6-7days/week (adj. OR = 1.75; 95% CI = 1.05 to 2.91, p-value = 0.031), had good attitude on rubber farming (adj. OR= 1.83; 95% CI: 1.071 to 3.14, p-value = 0.027, had low to moderate levels of stress (adj. OR=1.73; 95% CI: 1.017 to 2.67, p-value= 0.042) and had low level of knowledge on occupational health in rubber farming (adj. OR=1.66; 95% CI: 1.01 to 2.72, p-value = 0.044). Conclusion Most of the farmers used chemical pesticides, only one-third had good quality of life. Chemical pesticide use as well as work load, psychological factors and awareness on occupational health problems had influence on quality of life.

Clustering of Road Traffic Injuries During the 7-day Songkran Holiday, Thailand: A Spatial Analysis.

Background Road traffic injury (RTI) is a major cause of fatalities around the world and Thailand is the second leading country. Objective To determine the spatial pattern of road traffic injury during the 7-day Songkran holiday in Thailand. Method This study utilized the data obtained from the Information Technology for Emergency Medical System (ITEMS) covering the nationwide road traffic injury during the Songkran festival, Thai New Year holiday (April 9-15, 2015). The Moran's I was used to identify global autocorrelation within the country whereas the Local Indicators of Spatial Association (LISA) analysis was administered for analyzing the spatial distribution of RTIs and determining the spatial autocorrelation and correlation of numbers motor vehicles and length of road networks and road traffic injury. Result During Songkran holiday 2015, the univariate Moran's I of RTIs distribution among provinces in Thailand showed a slightly positive spatial autocorrelation, as the Moran's I was 0.1701, with statistical significance at 0.05. Local indicators of spatial association indicated seven hotspots and five cold spots. In addition, the number of motor vehicles, and length of trunk road (super highway), tertiary roads, secondary roads, and primary roads had positive spatial autocorrelation with road traffic injury, with Moran's I values of 0.173, 0.117, 0.219, 0.162, and 0.279, respectively. Conclusion This study demonstrates that local indicators of spatial association could detect the spatial pattern of road traffic injury. The number of motor vehicles, length of all roads served as new parameters for determining road traffic injury hotspots.

Health Literacy and Complementary and Alternative Medicine Use among Type 2 Diabetes Mellitus Patients in the Northeast of Thailand.

Background Globally, type 2 Diabetes Mellitus is in increasing trend. With its chronic and incurable natures, type 2 diabetes patients have been increasingly seeking various regiments to relive their sufferings. However, magnitude and influencing factors are still unclear. Objective To identify prevalence of complementary and alternative medicine among type 2 diabetes patients and the association between health literacy and its use in the Northeast region of Thailand. Method This cross-sectional study aimed to determine the prevalence of Complementary and Alternative Medicine use and the roles of health literacy on its use among type 2 diabetes patients in the Northeast Region of Thailand. A total of 1,012 type 2 diabetes mellitus patients were systematic randomly selected to response to a structured questionnaire interview. The generalized linear mixed model was applied to identify factors associated with it. Result There were 30.89% (95% CI: 28.25 to 33.67) of type 2 diabetes patients used complementary and alternative medicine. Majority of these patients (52.23%, 95% CI: 49.30 to 55.15) had sufficient level of health literacy related to complementary and alternative medicine. Type 2 diabetes patients who had sufficient to excellent levels of health literacy had 2.64 times higher Odds of complementary and alternative medicine use (95% CI: 1.91 to 3.65) when compared with those who had inadequate to problematic levels of health literacy. Others covariates that were also associated with complementary and alternative medicine use were had adequate income (ORadj. = 2.52; 95% CI: 1.81 to 3.52), had HbA1C < 7 (OR Adj. = 2.50; 95%CI: 1.86 to 3.37) and had comorbidity (OR Adj. = 2.07; 95%CI: 1.57 to 2.73). Conclusion About thirty percent of type 2 diabetes patients used complementary and alternative medicine. Health literacy, economic status, comorbidity and diabetic control had strong influence on complementary and alternative medicine use.

Child-Rearing Practices and its Effect on Cognitive Development of Children at the First Year of Age: The Prospective Cohort Study of Thai Children.

Background Child-rearing during the first year of age has long been known as a strong predictor of child cognitive development, particularly cognitive development. Most studies investigated styles and factors related to child-rearing, but the study of impact of child-rearing practices on child development is limited and unclear. Objective To investigate the child-rearing practices and its effect on cognitive development of children at the age of 12 months, in Thailand. Method This study is part of the prospective cohort study of Thailand. The data were collected via face-to-face interviews and child cognitive development assessment using Capute scale. The multivariable linear regression was used to determine the effect of child rearing practices on child cognitive development. Result Among the total of 4,116 infants. The most common child rearing practices mostly performed by care givers for the responsiveness domains were warmth (96.60%). Concerning demandingness, only proper confrontation was perform by (39.94%). Factor influencing the cognitive development were: Total score; the children who were not reared warmly, had lower Capute score with the mean difference of -7.69, 95% CI: -12.25 to-3.14. For Cognitive Adaptive Test score; the children who were not reared with warmly, had a lower Capute score with the mean difference of -8.11, 95% CI: -14.37 to -1.85. For Clinical Linguistic and Auditory Milestone Scales score; the children who were not reared warmly, had a lower cognitive score with the mean difference of -8.72, 95% CI: -14.74 to -2.69. Do not giving children in proper confrontation had a lower cognitive score than those who were, with the mean difference of -3.06, 95% CI: -5.26 to -0.86. Conclusion When controlled the influence of other variables, raring with warmth was the strongest predictor of child cognitive development.

Self-Efficacy in Child Rearing and Quality of Life among Adolescent Mothers in the Northeast of Thailand.

Background Incidence of adolescent pregnancy has been increasing continuously in Thailand. These adolescent mothers might face various problems such as social acceptance, poor knowledge of child rearing with affect their quality of life. However, there are insufficient studies quality of life and the associated factors of the adolescent mothers in the biggest region, the Northeast of Thailand. Objective To identify the level of quality of life and the association between self-efficacy, ability in child rearing and quality of life of adolescent mothers in the Northeast of Thailand. Method Cross-sectional study with systematic randomization 232 adolescents who gave a first singleton live birth in a hospital, with data collection done through a structured questionnaire administration. The multiple logistic regressions were used to determine the association. Result The majority of postpartum adolescent mothers were age 18 years old (52.59%). All participants were primiparous mothers. Almost all of adolescent mothers had senior relative within family assisting in child rearing (90.95%). Nearly half of them (46.98%) had high scores of quality of life on living and child rearing. Most of the mothers perceived self-efficacy during pregnancy or pre-childbearing in moderate level (87.93%). However, only 36.64% had high level of self-efficacy on living and child rearing. Majority had moderate to high scoring of stress on living and child rearing (65.52%). Only 32.06% received high scoring of social support on living and child rearing. The multiple logistic regressions were used to measure association of significant factors by backward elimination. Factors associated with quality of life in postpartum adolescent mothers were no stress (adjusted odds ratio: AOR = 4.37, 95% CI; 2.29 to 8.30, p-value < 0.001), high level of self-efficacy (AOR = 4.01, 95% CI; 2.04 to 7.88, p-value < 0.001), and high level of social support (AOR = 3.31, 95% CI; 1.74 to 6.31, p-value < 0.001). Conclusion Social support, self-efficacy and stress have strong influences on quality of life of the postpartum adolescent mothers. Therefore relevant sectors should develop system to improve social support and child rearing competency of adolescent since pregnancy and postpartum.

Respiratory Tract Problems among Wood Furniture Manufacturing Factory Workers in the Northeast of Thailand.

BACKGROUND: Wood furniture manufacturing factory workers are at high risk of exposure to wood dust in wood working processes. Wood dust exposure could cause respiratory symptoms, such as reduce lung function, chronic bronchitis, and asthma. The Northeast region of Thailand has many wood furniture manufacturing factories. However, limited studies were carried out to explore the effect of wood dust exposure on workers. OBJECTIVE: This study aimed to assess the respiratory symptoms and determine factors associated with these symptoms among wood furniture manufacturing factory workers. METHOD: This cross-sectional analytical research used a multistage random sampling to select 511 workers from three provinces in the Northeast of Thailand. The data was collected using a structured questionnaire interview. The content validity of questionnaire was tested by 3 experts and had a Cronbach's alpha coefficient of 0.82. Data were analyzed using descriptive statistics and multiple logistic regressions. RESULT: The result indicated that 29.94% of these workers had respiratory symptoms, including coughing(18.79%), nasal secretion (15.66%), and stuffy nose (15.07%). Factors that were significantly associated with respiratory symptoms (p-value < 0.05) were (a) not always wearing mask (adjusted OR=2.26;95% CI=1.37-3.72), (b) low to medium level of knowledge on dust prevention (adjusted OR=1.83;95% CI=1.23- 2.73) and (c) contacted softwood dust (adjusted OR=1.97;95% CI= 1.06-3.64). CONCLUSION: About 30% of wood furniture manufacturing factory workers had respiratory symptoms with related to both personal preventive behaviors and their working environments. Therefore, the raising awareness for using personal protective equipment during work will help them to prevent from various respiratory track problems.

Factors Associated with Musculoskeletal Disorders among Registered Nurses: Evidence from the Thai Nurse Cohort Study.

Background Health, safety, and well being have been known to be influenced by occupational characteristics. Nurses constantly encounter musculoskeletal disorders (MSDs) from work demands worldwide. Nevertheless, there is insufficient of knowledge regarding causes of musculoskeletal disorders among nurses in Thailand. Objective To investigate factors associated with musculoskeletal disorder among registered nurses in Thailand. Method This study is part of the 2009 Thai Nurse Cohort Study which consisted of 18,756 nationally representative sample of registered nurses. Data collection was performed via postal self-administered questionnaires. Manifesting musculoskeletal disorders was self-reported by registered nurses, 1,070 nurses were excluded since they were unemployed during previous 12 months. Multiple logistic regression was used for data analysis. Result Of 17,686 registered nurses, the overall 12 months prevalence of musculoskeletal disorders was 47.8%. It was found that workplace violence was the strongest factor which statistically significant associated with musculoskeletal disorders (adjusted odds ratio, OR, 2.01; 95% confidence interval, 95% CI, 1.42 to 2.83; P < 0.001), anxiety/depression (OR = 1.96: 95% CI: 1.78 to 2.15; P < 0.001), perceiving job required a lot of physical effort (OR = 1.69; 95% CI: 1.52 to 1.87; P < 0.001), every 10 years increased of age (OR = 1.40; 95% CI: 1.22 to 1.62; P < 0.001), overweight (OR = 1.39; 95% CI: 1.01 to 1.52; P = 0.015). Conclusion Registered nurses were most vulnerable of musculoskeletal disorders especially those who experienced workplace violence, anxiety/depression, strenuous work, older age, and overweight. Consequently, recommending safety practices to nurses should be considered for musculoskeletal disorders (MSDs) prevention by ergonomics and workplace design.

Movement disability: situations and factors influencing access to health services in the northeast of Thailand.

BACKGROUND: Persons with movement disability (PWMDs) are the biggest group of persons with disabilities (PWDs) with needs helps especially on health. There has been no evident to show health services accessibility situation of PWMDs in the Northeast of Thailand, the biggest region. OBJECTIVE: This study aimed to explore the current situation of accessibility to health services among PWMDs, and factors influencing such access. METHOD: This cross-sectional study used a multistage stratified random sampling to select 462 subjects from the national registered PWMDs poll to response to a structured questionnaire. This study complies with the principles of the Declaration of Helsinki and was approved by the Khon Kaen University Ethics Committee for Human Research prior to the data collection. RESULT: We found that most of PWMDs (66%) had overall health service accessibility at medium level. Factors influencing the access to health services were living in rural area (adj. mean diff.= -24.01; 95 % CI: -45.88 to-2.31; p-value=0.032), high income (adj. mean diff.=0.002; 95 % CI: 0.001 to 0.005; p-value = 0.044), and having offspring or spouse as care givers (adj. mean diff.=40.44; 95% CI: 7.69 to 73.19; p-value=0.044; and adj. mean diff.=48.99; 95%CI: 15.01-82.98; p-value=0.016, respectively). PWMDs who lived in rural areas had better access to health services especially to the subdistrict health promoting hospital than those in the urban area. CONCLUSION: Accessibly to health services of PWMDs still limited. Income, care givers and residential areas had influences on their access.

A community participation intervention to reduce HIV/AIDS stigma, Nakhon Ratchasima province, northeast Thailand.

This paper explores HIV/AIDS stigma in the socio-cultural context of Nakhon Ratchasima Province in the northeastern region of Thailand. Action research was used to develop a community participation intervention. The intervention was implemented in one village over a period of eight months. We describe the intervention and then test its effect on HIV/AIDS knowledge and HIV/AIDS stigma using a non-equivalent pre-test-post-test control group design. Analysis of co-variance confirms that, controlling for initial levels of HIV/AIDS knowledge and stigma, the intervention had a significant effect on HIV/AIDS knowledge score (p<0.01) and HIV/AIDS stigma score (p<0.01). Participatory observations by the researchers on villagers' perceptions and behaviour were consistent with the quantitative results. These results suggest that community interventions which empower the community, combined with a financial contribution to reduce resource constraints, are a useful and effective means of increasing interaction between people living with HIV/AIDS (PLWHA) and other community members, increasing tolerance and reducing HIV/AIDS stigma.

Promotion of the health of rural women towards safe motherhood--an intervention project in northeast Thailand.

An intervention project focusing on the health of women in the reproductive age was conducted in three districts of Khon Kaen Province, northeast Thailand between 1991 and 1996. Main emphasis was placed on improving reproductive health, the nutritional status including the iron deficiency anemia (IDA) as well as iodine deficiency disorders (IDD), and the parasitic diseases liver fluke (Opisthorchis viverrini) and hookworm. For implementation a community based Primary Health Care approach was used including the training of health officials in health matters, primary health care workers and villagers as well as enhancing health education and the dissemination of health information. The health delivery system was encouraged to take appropriate actions such as in the treatment of parasitic diseases and the control of IDA and IDD. Monitoring was done on a regular basis. The outcome of the project was assessed by comparing baseline data compiled from a random sample of the target population with the results of the final evaluation. An attempt to compare results obtained from villages within and outside of the project area failed most probably because of spill over effects. A number of important indicators on family planning and mother and child health care improved during the time the project was implemented; this included practising family planning, and participation in antenatal care. Also the proportion of females becoming pregnant for the first time when 20 years or older increased. Child-raising also improved in that almost all females gave colostrum to their babies by this time. Almost 75% of the women breast-fed their children. Improvements occurred in the nutritional status as far as the micronutrients iron and iodine were concerned, however the overall nutritional status of females did not change, but a rather high proportion of females were found to be overnourished. The project failed in reducing abortion and the proportion of females becoming pregnant when they are 18 years old or younger. It was also not possible to improve the usage of postnatal care. As anticipated, the results achieved so far are most suitable in serving as a training ground and providing a favorable example to improve family planning, mother- and child health care, and also the general health of females in the region, particularly in neighboring countries such as Lao PDR, Cambodia and Vietnam.

Reproductive health in selected villages in Lao PDR.

The aim of the project was to improve the knowledge and attitude towards birth spacing by training the villagers in the selected villages of Vientiane Province in Lao PDR in family planning, providing them with the various family planning methods, and improving antenatal (ANC) and postnatal (PNC) care in the villages. Throughout the province, traditional birth attendants (TBA) were trained on several occasions during the project period. There were clear indications that reproductive health improved between 1995 and 1997. Considerable improvements were observed in the percentage of women making use of ANC and practising birth spacing by using some form of contraception or other. The most common methods used were contraceptive pills and injectables. In the case of child mortality a slight decrease was found in the percentage of women having their first pregnancy below the age of 18 years. A still unsolved problem is the high number of abortions.