Estimation of the onset time of diabetic complications in type 2 diabetes patients in Thailand: a survival analysis.

BACKGROUND: This study aimed to identify factors associated with the onset time of diabetic complications in patients with type 2 diabetes mellitus (T2DM) and determine the best-fitted survival model. METHODS: A retrospective cohort study was conducted among T2DM patients enrolled from October 1, 2016 to July 15, 2020 at the National Health Security Office (NHSO). In total, 388 T2DM patients were included. Cox proportional-hazard and parametric models were used to identify factors related to the onset time of diabetic complications. The Akaike information criterion, Bayesian information criterion, and Cox-Snell residual were compared to determine the best-fitted survival model. RESULTS: Thirty diabetic complication events were detected among the 388 patients (7.7%). A 90% survival rate for the onset time of diabetic complications was found at 33 months after the first T2DM diagnosis. According to multivariate analysis, a duration of T2DM ≥42 months (time ratio [TR], 0.56; 95% confidence interval [CI], 0.33-0.96; p=0.034), comorbid hypertension (TR, 0.30; 95% CI, 0.15-0.60; p=0.001), mildly to moderately reduced levels of the estimated glomerular filtration rate (eGFR) (TR, 0.43; 95% CI, 0.24-0.75; p=0.003) and an eGFR that was severely reduced or indicative of kidney failure (TR, 0.38; 95% CI, 0.16-0.88; p=0.025) were significantly associated with the onset time of diabetic complications (p<0.05). CONCLUSION: Patients with T2DM durations of more than 42 months, comorbid hypertension, and decreased eGFR were at risk of developing diabetic complications. The NHSO should be aware of these factors to establish a policy to prevent diabetic complications after the diagnosis of T2DM.

Association between media use and poor sleep quality among senior high school students: a cross-sectional study.

Background : Poor sleep quality (PSQ) is an increasing health problem among adolescents. Mobile phones and portable media devices have become a part of children's lives and may affect their sleep duration and quality. This study aimed to explore the prevalence of PSQ and identify the association between media use and PSQ among adolescents studying in high school grades 10-12. Methods: This cross-sectional study was conducted in central Thailand. A multi-stage sampling technique was used to enroll 777 adolescents from eight schools from August to October 2016. The research instruments comprised factors of demographics and consumption behaviors and the Pittsburgh Sleep Quality Index questionnaire. Multivariable logistic regression was used to calculate adjusted odds ratios (OR adj) and 95% confidence intervals (CI). Results: Prevalence of PSQ was 56.24%. The study subjects were mostly 16-17 years old (67.82%) and female (70.39%). Multivariable logistic regression, after controlling for possible confounders, revealed an increased odds of PSQ among those who used a social media device (OR=1.34, 95%CI=0.97-1.87), and showed a higher proportion of social media use in the PSQ group. Conclusion: A surveillance system to detect media use and PSQ should be conducted accompanied by knowledge sharing on media use among parents, teachers and adolescents. To determine causal relationships, further longitudinal studies will be required to test the association between media users and PSQ. This study may also provide some implications for health promotion on sleep quality of senior high school students.

Caries with Dental Fluorosis and Oral Health Behaviour Among 12-Year School Children in Moderate-Fluoride Drinking Water Community in Quetta, Pakistan.

OBJECTIVE: To determine the prevalence of dental caries and its relationship with dental fluorosis, oral health behaviour and dietary behaviour among 12-year school children in moderate-fluoride drinking water community in Quetta, Pakistan. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Government and private schools of Quetta, from November 2012 to February 2013. METHODOLOGY: Atotal of 349 children aged 12-year from 14 randomly selected schools were included. The data collection was done on questionnaire designed for children. Dental caries status was examined by using WHO criteria. RESULTS: Dental caries was found in 81 children (23.2%) with mean DMFT0.61. Boys had 1.6 times more chance to have dental caries than girls. Dental fluorosis was found in 63.6% of children with majority of moderate degree (50.5%). Dental fluorosis status was found significantly associated with dental caries status in children. The children who had mild, moderate and severe fluorosis, had 4 times more chances to develop caries than those who did not have fluorosis. There was no significant association between children's caries status and use of paste, brushing habit, miswak, and visit to the dentist. The use of pastries and juices had a direct relation with the children's dental caries status. CONCLUSION: Dental caries in children of Quetta is not so much frequent as compared to the fluoride deficient countries. However, the high prevalence of moderate dental fluorosis and consumption of pastries and juices resulted in dental caries.

DENTAL FLUOROSIS AND ITS RELATION TO SOCIOECONOMIC STATUS, PARENTS' KNOWLEDGE AND AWARENESS AMONG 12-YEAR-OLD SCHOOL CHILDREN IN QUETTA, PAKISTAN.

This study aimed to determine the prevalence of dental fluorosis and its relationship to socioeconomic status, knowledge, and awareness among 12-year-old school children in Quetta, Pakistan. A cross sectional study was conducted among 349 school children aged 12 years in Quetta, Pakistan. By interviewing children and questionnaire for parents, socioeconomic status, knowledge, and awareness of fluorosis were collected. Dental fluorosis was examined using Dean's Index and Community Fluorosis Index. Prevalence of dental fluorosis was high (63.6%) among children with a majority of moderate and mild degree at 32.1% and 27.5%, respectively. The community fluorosis index was 1.6. While most children and parents had low-to-moderate levels of fluorosis knowledge, the majority of them worried about dental fluorosis. Most parents (84.8%) were uncertain about the condition of fluorosis in their children, and 87.4% did not know about fluorosis before. Dental fluorosis was found significantly associated with gender, family income, and parents' awareness (p ≤ 0.05). Multivariate analysis indicated that gender, and parent's awareness significantly predicted children's dental fluorosis. Knowledge and basic information regarding dental fluorosis is lacking in the community. Efforts in dissemination and communication about dental fluorosis should be increased in order to raise awareness and prevent the dental fluorosis in Pakistan.

The Impact of Cigarette Plain Packaging on Health Warning Salience and Perceptions: Implications for Public Health Policy.

The study employed a mixed methods design using focus group interviews with 6 student groups and self-administered questionnaires with 1239 students. The participants were nonsmoking, current smokers, and quit-smoking teenagers from secondary schools and colleges. Focus group revealed that although nonsmoking teenagers perceived fear appeals to warning messages, current smokers did not perceive fear appeals to health. Black and white backgrounds of the cigarette package were chosen as the best color for plain packaging. However, most participants suggested various pictorials and a bigger size of pictorial warnings for greater and more effective fear appeal. Odds ratio showed that males had 2.43 times the odds to perceive intention not to smoke. Teenagers who had never smoked and those who had quit smoking had 13.27 and 3.61 times the odds, respectively, to perceive intention not to smoke.

Homocysteine but not serum amyloid A, vitamin A and E related to increased risk of metabolic syndrome in post-menopausal Thai women.

This study aims to investigate serum amyloid A, homocysteine, and biochemical-anthropometric measurements in post-menopausal women with and without metabolic syndrome (MS), and determine whether serum amyloid A and homocysteine are linked to MS among this group. This study was performed with 405 post-menopausal Thai volunteers with a mean age of 57.95±5.90 years (135 subjects with MS and 270 subjects without MS). The levels of serum amyloid A, homocysteine, vitamins, glucose, and lipids were measured. Homocysteine levels were significantly higher in the group with MS than in that without MS (p<0.001), whereas for serum amyloid A, vitamin A, vitamin E and vitamin B12, there were no significant differences. There were significant differences between the groups in folate, HDL-C, and anthropometric measurements (p<0.001). Thirty seven percent of the group with MS and 14.1% of the group without MS were classified as having hyperhomocysteinemia (p<0.001). Furthermore, logistic regression analysis revealed that hyperhomocysteinemia (odds ratio (OR): 2.67, 95% confidence interval (95%CI): 1.57-4.58), low folate (OR: 1.79, 95%CI: 1.11-2.89), and BMI (OR: 1.25, 95%CI: 1.16-1.33) were significantly related to MS. These findings suggest that increased homocysteine levels and decreased folate concentrations may influence susceptibility to MS and this effect may be an early event in the development of cardiovascular diseases among post-menopausal women. Therefore, there is a need to evaluate homocysteine levels, especially among post-menopausal Thai women.

Effect of oat consumption on lipid profiles in hypercholesterolemic adults.

BACKGROUND: Hypercholesterolemia is a strong risk factor in cardiovascular disease. Oat (Avena sativa L.) beta-glucan, the soluble fiber in oat, has been known to reduce blood cholesterol levels considerably. However, the effect of oat soluble fiber in the Thai population is unknown. OBJECTIVE: To determine the effect of oat consumption on serum lipid profiles in Thai hypercholesterolemic adults. MATERIAL AND METHOD: The present study was a randomized, crossover design. Twenty-four hypercholesterolemic adults, male and female aged 30-60 years, were randomly assigned into two groups of twelve each. Group 1 consumed 70 g (3 g beta-glucan) of oatmeal daily through the first 4-week intervention, and then switched to 70 g rice porridge (control product) daily for the next 4-week intervention. Group 2 consumed rice porridge first and then oatmeal. Before and after each intervention period, lipid profiles including total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) of all subjects were measured. RESULTS: Following daily oat consumption, total cholesterol and LDL-cholesterol levels were significantly lower than baseline levels and lower than the levels observed with rice consumption. Oat consumption reduced total cholesterol by 5% and LDL-cholesterol by 10% from baseline levels. In addition, mean and percent changes were significantly different from the levels after consuming rice porridge (p < 0.05). CONCLUSION: Oatmeal reduced serum total cholesterol and LDL-cholesterol levels in hypercholesterolemic Thai adults. Hence, oat consumption is a reasonable recommendation for Thai individuals with hyperlipidemia.

Not chewing food among the Thai elderly with complete denture.

OBJECTIVE: The study aims to investigate the use of a complete denture in terms of not chewing food and determining the strength of association between not chewing food and several potential risk factors among the Thai elderly. MATERIAL AND METHOD: Under the support of the "Khao Aroi" or "Delicious Rice" or "Dental Implant" Project of Institute of Dentistry, Department of Medical Services, Ministry of Public Health, and in co-operation with the Ministry of Science and Technology during 2007-2011, a cross-sectional survey by multi-stage cluster sampling was conducted in 2008, in 21 provinces, 87 hospitals, with 2,676 Thai elderly. The sample was drawn from a sampling frame of 58,043 target Thai people aged 60 years and over under the Dental Prosthesis Service Campaign (DPSC) project during 2005 and 2007. All Thai elderly, who received a complete denture from the DPSC project at least three months prior were surveyed from May to October 2008 through questionnaires. Data were analyzed by a set of descriptive analyses and binary logistic regression models. RESULTS: Not chewing food among the Thai elderly, after receiving a complete denture, was 12.5%, quite a bit more effective than ordinary work. Nontaluck found 38% for the proportion not wearing dentures in the 30-baht health care program. This finding is confirmed by the work of Dalodom et al that the use of dentures by Thai elderly was 93% in the DPSC project. The important risk factors that influenced not to chew food were satisfaction with dentures, patients satisfaction with the denture fitting and care, while controlling the amount of dentures, respectively. CONCLUSION: Satisfaction of patients with their dentures, good oral health care in fitting denture work, and good communication between dentists and patients are important keys affecting the use of dentures.

Predictors of malaria-association with rubber plantations in Thailand.

BACKGROUND: The national Global Fund-supported malaria (GFM) program in Thailand, which focuses on the household-level implementation of vector control via insecticide-treated nets (ITNs)/long-lasting insecticidal nets (LLINs) combined with indoor residual spraying (IRS), has been combating malaria risk situations in different provinces with complex epidemiological settings. By using the perception of malaria villagers (MVs), defined as villagers who recognized malaria burden and had local understanding of mosquitoes, malaria, and ITNs/LLINs and practiced preventive measures, this study investigated the predictors for malaria that are associated with rubber plantations in an area of high household-level implementation coverage of IRS (2007-2010) and ITNs/LLINs (2008-2010) in Prachuap Khiri Khan Province. METHODS: A structured questionnaire addressing socio-demographics, household characteristics and health behavioral factors (knowledge, perceptions and practices) regarding the performed interventions was administered to the 313 households (70 malaria-affected and 243 malaria-unaffected) that had respondents aged ≥18 years of both genders. In the univariate and multivariate analyses, only 246 (78.6%) MV respondents (62 malaria-affected and 184 malaria-unaffected) were analyzed to determine the predictors for risk (morbidity). RESULTS: The majority (70%) of households were covered by IRS. For a combination of ITNs/LLINs, there were 74% of malaria-affected households covered and 46% of malaria-unaffected households. In a logistic regression analysis using odds ratios (aORs) adjusted on the variables and a 95% confidence interval (CI), malaria affecting MVs was associated with daily worker (i.e., earning daily income by normally practicing laborious activities mostly in agriculture such as rubber tapping and rubber sheet processing at the smallholdings of rubber plantations) (aOR = 2.9, 95% CI: 1.1-7.4), low-moderate level of malaria knowledge (aOR = 2.4, 95% CI: 1.1-5.0) and sleeping under mosquito-nets (nets/ITNs/LLINs intermittently and ITNs/LLINs only) (aOR = 2.0, 95% CI: 1.0-3.7). CONCLUSIONS: The MV predictors for malaria-association with rubber plantations included occupation (daily worker), misconceptions about malaria (mosquito and prevention) and the use of mosquito-nets. Human practices such as revisiting rubber plantations while exposed to multiple bites at multiple locations are more likely to apply to daily workers than to rubber farmers/tappers and others. The promotion and use of ITNs/LLINs depends substantially on cultural factors and defensive behaviors relevant to their occupational risk despite the perceived threats of malaria and the perceived benefits of ITNs/LLINs. This information supports the conclusion that GFM program implementation in Thailand or elsewhere for malaria-associated with rubber plantations would benefit from the potential use of ITNs/LLINs and changes in personal protection behaviors.

Risk factors for malaria infection among rubber tappers living in a malaria control program area in southern Thailand.

Rubber tappers work begins at midnight during the feeding time of Anopheles maculatus and An. minimus, two common malaria vectors in southern Thailand. We studied the association between rubber tapper behavior and malaria infections as reported to the Notified Disease Surveillance System during 2010 in Prachuab Khiri Khan Province, Thailand. In that province insecticide treated bednets are distributed free to the population and insecticide residual spraying is performed annually. A random sample of 394 rubber tapper households was interviewed from October 2010 to May 2011. Twenty-six households (6.6%) had at least one family member who contracted malaria during 2010. Poisson regression was used to identify potential characteristics associated with malaria. Multilevel Poisson regression was used to test for simultaneous effects of tapper behavior and household risk for malaria infection. The estimated incidence rate ratio (IRR) for contracting malaria among those owning a farming hut was 2.9 (95% CI 1.1-7.3, p < 0.05) after controlling for other variables. Even in areas where control programs are in place, malaria infection among rubber tappers is common. Given the Thai Government's plan to expand the rubber plantation areas to other regions of the country without specific prevention for this at-risk population, the malaria burden in Thailand may increase.

Factors associated with breast self-examination among Thai women living in rural areas in Northeastern Thailand.

OBJECTIVE: To identify factors associated with monthly breast self-examination (BSE) performance among Thai women living in rural areas, Northeastern Thailand. MATERIAL AND METHOD: This present cross-sectional study was conducted during April to July 2008. A random sample of 705 women aged 20 to 64 years living in the rural areas of Northeastern region was interviewed using a structured questionnaire seeking information on demography, prior experience of BSE, knowledge (of breast cancer and breast examination techniques) and health belief Logistic regression was performed to identify the potential predictors of monthly BSE performance. RESULTS: Seventy-five percent of women had performed BSE in the last year, and only 49% had performed BSE monthly. Monthly BSE performance was associated with having heard of BSE (OR = 2.8; 95% CI: 1.1-6.9), been taught to perform BSE (OR = 2.4; 95% CI: 1.5-3.7), higher knowledge about breast cancer and BSE procedures (OR = 2.4; 95% CI: 1.7-3.5), and higher confidence in one's ability to perform BSE (OR = 4.4; 95% CI: 3.0-6.4). CONCLUSION: To increase monthly BSE performance among Thai women living in the Northeastern rural areas, health officers should address women levels of accurate knowledge of breast cancer, provide training in BSE procedures, and advocate women' confidence in performing BSE.

A comparison of population size estimators under the truncated count model with and without allowance for contaminations.

The purpose of the study is to estimate the population size under a homogeneous truncated count model and under model contaminations via the Horvitz-Thompson approach on the basis of a count capture-recapture experiment. The proposed estimator is based on a mixture of zero-truncated Poisson distributions. The benefit of using the proposed model is statistical inference of the long-tailed or skewed distributions and the concavity of the likelihood function with strong results available on the nonparametric maximum likelihood estimator (NPMLE). The results of comparisons, for finding the appropriate estimator among McKendrick's, Mantel-Haenszel's, Zelterman's, Chao's, the maximum likelihood, and the proposed methods in a simulation study, reveal that under model contaminations the proposed estimator provides the best choice according to its smallest bias and smallest mean square error for a situation of sufficiently large population sizes and the further results show that the proposed estimator performs well even for a homogeneous situation. The empirical examples, containing the cholera epidemic in India based on homogeneity and the heroin user data in Bangkok 2002 based on heterogeneity, are fitted with an excellent goodness-of-fit of the models and the confidence interval estimations may also be of considerable interest.

Potential effectiveness of health warning labels among employees in Thailand.

OBJECTIVE: Explore and investigate the perceptions and responses of employees regarding the effects of a Health Warning Label (HWL) on their decision to encourage quitting and stages of change in smoking behavior. MATERIAL AND METHOD: One thousand six hundred thirty seven employees in workplaces from four regions, including Bangkok city, were studied during the year 2005-2006. Six hundred nine employees (both non- or cigarette smokers) were part of a cohort study using qualitative and quantitative approaches. Questionnaires were used to sample the cohort twice and two individuals per factory were interviewed in-depth. RESULTS: The New-HWL that made the best impression was the "cancer caused by cigarette smoking" and 3.8% stopped smoking after seeing the New-HWL. Moreover, New-HWL increased employees "pro" attitudes about smoking cessation. Decisional balance that reflected different "con" to quit, among non-quitting and quitting smokers. CONCLUSION: New-HWL significantly increased attitudes about smoking cessation.

Lifestyle-related risk factors for stomach cancer in northeast Thailand.

BACKGROUND: Stomach cancer is not common in Thailand but the life styles of the Thai population are changing to become more Western so that information for planning control programme of stomach cancer is necessary. The highest incidence rates of this neoplasm are found in Eastern Asia, ranging from age-standardized rates of 95.5/105 (men) and 40.1/105 (women) in Yamagata, Japan to 4.1/105 (men) and 2.1/105 (women) in Khon Kaen, Northeast of Thailand. In Thailand, the estimated age-standardized incidence rates in 1993, 1996 were 4.9/105, 4.1/105 in men and 3.0/105 , 2.6/105 in women. Risk factors for stomach cancer in Thai population are unclear, but possibly include low intake of vegetables and fruits, alcohol drinking, tobacco smoking and high intake of salt. OBJECTIVE: To investigate various aspects of dietary factors, smoking, and alcohol drinking in determining risk of stomach cancer in Thai population. METHODS: A case-control study was conducted in Khon Kaen, Thailand during 2002-2006, to study the role of these factors in stomach cancer. 101 stomach cancer cases and 202 matched controls (case : control = 1:2) by sex, age (? 3 years) and region were recruited from Srinagarind Hospital and Khon Kaen Regional Hospital, in Khon Kaen Province. All of cases were histologically confirmed. Controls had a variety of diseases, the main ones being disease of the eye. Information on dietary habits, alcohol drinking and smoking were collected by a structured questionnaire, blood samples were collected for further study. RESULTS: The distribution of the general characteristics by case-control status, the distribution of age and sex were similar in cases and controls. In the final analysis, the factors that found to be higher risk but not statistically significant were long-term filter cigarette smoking (OR=1.9, 95%CI: 0.85-4.50), long-term alcohol consumption (OR=1.2, 95%CI: 0.51-2.60) and low intake of vegetables and fruits (OR=1.2, 95%CI: 0.74-1.96). A high intake of vegetable oil (OR=4.5, 95%CI: 1.00.-20.17) was found to be associated with increased risk, and similar tendencies were noted for pork oil (OR=1.4, 95%CI: 0.63-3.01) and jeaw prik (mainly chilly with plara broth) (OR=1.2, 95%CI: 0 .76- 2.01). CONCLUSION: Our study confirmed protective effects of a high intake of fruits and vegetables against stomach cancer development and showed a high intake of sauces to increase risk of stomach cancer as in other countries in Asia.

Risk factors for colorectal cancer in northeast Thailand: lifestyle related.

BACKGROUND: The incidence of colorectal cancer is variable around the world. Hiroshima, Japan had the highest incidence in men in 1997 with an age-standardized rate of 86.7 per 100,000 and New Zealand had the highest, at 40.6 per 100,000, in women. The incidence of colorectal cancer in Thailand is rather low and the latest figures for Northeast of Thailand are 7.1 per 100,000 for men and 4.7 for women. The reasons for these differences between countries are possibly due to variation in dietary habits, alcohol drinking or other cofactors. METHODS: A case-control study was conducted in Khon Kaen, Northeast Thailand during 2002-2006 to study risk factors for colorectal cancer in a low risk area. Totals of 253 colorectal cancer cases (males 135, females 118) and 253 age- and sex-matched controls were recruited. Information on dietary habits, alcohol drinking, smoking and other information were collected by a structured questionnaire. Blood samples were collected for further study. Both univariate and multivariate analyses were carried out. RESULTS: In the final model of multivariate analysis, the significant risk factors for colorectal cancer were a family history of cancer (OR=1.9 95%CI=1.2-2.9) and meat consumption (OR=1.0 95%CI=1.0007-1.0026). For BMI, subjects with higher BMI unexpectedly had a lower risk of colorectal cancer (OR=0.5 95%CI=0.3-0.8). CONCLUSION: Our study confirmed risk factors for colorectal cancer i.e. meat consumption and cancer in the family (genetic problem). However, the results for BMI are the reverse of expected, underlining one limitation of hospital-based case-control studies, in which cases are ill and admitted to the hospital at late stage.

Short-term effects of treatment with 300 mg oral-dose diethylcarbamazine on nocturnally periodic Wuchereria bancrofti microfilaremia and antigenemia.

Seven microfilaremic Myanmar patients were treated with a single 300 mg dose of diethylcarbamazine (DEC) orally, as part of a case-finding survey in Ranong Province, Southern Thailand. This was conducted in order to evaluate the short-term effects of single-dose DEC on Wuchereria bancrofti microfilaremia and antigenemia during a 12-week course of treatment. Analysis of microfilarial periodicity on initial treatment revealed the microfilarial peak density (k) was at 52 minutes after midnight (0052). The periodicity index was then 103.26%. Single-dose DEC treatment did not affect the k values. A linear model of W. bancrofti microfilarial density reduction predicts a sharp decrease in the mean microfilarial density 2 weeks after DEC intake (Z = -2.197, p = 0.028). Over a longer period, a non-linear model predicts an increase in the mean microfilarial density to pre-treatment levels, having little or no macrofilaricidal effects. We reconfirmed the existence of nocturnally periodic W. bancrofti infection in Myanmar migrants in Ranong Province, and the short-term microfilaricidal activity of 300 mg single-dose DEC treatment used for biannual mass treatment and the DEC provocative test. Without an adequate DEC treatment dose, recrudescence can occur. A rational approach to the management of introduced nocturnally periodic W. bancrofti in Myanmar migrants, who came for short periods of stay in transmission-prone areas, is needed.

Border and imported bancroftian filariases: baseline seroprevalence in sentinel populations exposed to infections with Wuchereria bancrofti and concomitant HIV at the start of diethylcarbamazine mass treatment in Thailand.

Border bancroftian filariasis caused by Wuchereria bancrofti nocturnally subperiodic mainly exists in Karens residing alongside the Thailand-Myanmar border. Imported bancroftian filariasis caused by W. bancrofti nocturnally periodic mainly exists in cross-border Myanmar migrants. We analyzed seroprevalence data based on W. bancrofti adult worm antigen (Ag) loads and human immunodeficiency virus (HIV) immunoglobulins in the sentinel population samples which were studied prior to the start of the diethylcarbamazine (DEC) mass treatment phase in the PELF during fiscal years 2002-2006. In the Karens, the cumulative infection prevalence (36.8% serological antigen positivity or SAP) was specific for age (p < 0.001) but universal for gender (p = 0.77). The infection intensity (median Ag load = 60,827 antigen units or AU/ml) was specific for age (p = 0.031) and for males (p = 0.016). In the Myanmars, infection prevalence (24.0% SAP) was universal for age (p = 0.961) and for gender (p = 0.676). The infection intensity (median Ag load = 19,068 AU/ml) was universal for age (p = 0.433) but specific for females (p = 0.027). Overall, the Ag loads between the groups were significantly different (p = 0.014). In analysis of concomitant HIV and W. bancrofti infections, 7 (3.2%) Myanmars infected with HIV 1 and 3 (5.7%) with concomitant infections, subjected to biannual DEC treatment with 300 mg oral-dose FILADEC, were prevalent. The antigenemia clearance in the concomitant infections (r = -0.732, p = 0.039) as well as in the single W. bancrofti infection (r = -0.781, p = 0.022) was correlated with time required to clear antigenemias. We reemphasize that W. bancrofti adult worm Ag loads in the sentinel population samples would be beneficial for the PELF's implementers at the provincial level to probe the disease burdens in target areas and to evaluate and monitor the DEC treatment efficacy and effectiveness in those sentinel populations, including those with concomitant HIV eligible for the DEC mass treatment phase in the PELF.

Evaluation of a single oral dose of diethylcarbamazine 300 mg as provocative test and simultaneous treatment in Myanmar migrant workers with Wuchereria bancrofti infection in Thailand.

We assessed the efficiency of oral diethylcarbamazine (DEC) 300 mg as a provocative test on blood examination 30 minutes after administration, while gauging the overall infection rate in Myanmar migrant workers with Wuchereria bancrofti infection who enrolled for work permits in Thailand in 2002, using circulating filarial antigens (CFA) assays, the NOW ICT Filariasis card test and the Og4C3 ELISA as reference. Overall infection rates of 0.3% (95% CI=0-0.7%), 4.2% (95% CI=1.8-6.5%) and 5.9% (95% CI=3.2-8.7%) by three diagnostic tests, respectively, were observed. Among three different location groups of Myanmar population sample tested, there were no statistically significant differences in the overall infection detection rates. When either the ICT card test or the Og4C3 ELISA was used as a reference, the specificity and positive predictive value of the DEC-provocative day test was the same, 100%. The sensitivities were 25.0% (95% CI = 0.5-49.5%) and 17.6% (95% CI = 0-35.8%) on the ICT and ELISA tests, respectively. The negative predictive values were 96.8% (95% CI = 94.8-98.9%) and 95.1% (95% CI = 92.6-97.6%), respectively. In three microfilaremic persons followed-up monitored at 8-weeks DEC post-provocation, there were 6 x 10(-1) and 7 x 10(-1) decreases in microfilaremia and antigenemia. These findings suggested that, unlike the CFA assays, the DEC-provocative day test is unsuitable for the diagnosis of active W. bancrofti infection in the population tested, and for gauging current infection prevalence. The treatment would likely be beneficial to reduce microfilaremia and antigenemia.

No effect of garlic extract supplement on serum lipid levels in hypercholesterolemic subjects.

OBJECTIVE: The authors assessed the effects of an enteric-coated Thai garlic extract tablet standardized for allicin-releasing potential on serum lipid levels in hypercholesterolemic subjects. SUBJECTS AND METHOD: The authors performed a randomized, double-blind, placebo-controlled trial in 136 hypercholesterolemic subjects (cholesterol concentrations > or = 5.2 mmol/L; mean age +/- SD: 47.0 +/- 6.6 yr). All subjects were given dietary advice to lower fat intake within 4 weeks and were advised to eat normally during the study period. The subjects were randomly assigned to receive an enteric-coated Thai garlic extract tablet once daily (standardized to 1.12% allicin or 5.6 mg/tablet), or placebo after the evening meal for 12 weeks. Seventy subjects (32.9% male; mean age +/- SD and BMI of 47.0 +/- 6.6 yr and 24.6 +/- 3.3 kg/m2) received the garlic extract treatment while 66 subjects (37.9% male, mean age +/- SD and BMI of 47.0 +/- 6.0 yr and 24.3 +/- 3.4 kg/m2) received placebo. RESULTS: There were no statistically significant changes in serum total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol after the 12-week treatment as analyzed on repeated measures by analysis of variance. In addition, no changes in plasma glucose, liver and renal functions were found. CONCLUSIONS: Treatment with an enteric garlic-coated Thai garlic extract and dietary advice did not produce any significant changes in lipid levels in subjects with hypercholesterolemia.