Associations between sexual violence, domestic violence, neglect, and alcohol consumption among Lahu hill tribe families in northern Thailand.

BACKGROUND: Domestic violence is one of the largest silent problems in the world. Women, children, and elderly individuals often fall victims to family members who use alcohol. However, there is lack of scientific evidence on alcohol consumption and domestic violence among Lahu hill tribe families. OBJECTIVES: The objective of this study was to investigate the prevalence of family violence, violence against women, and alcohol-related harm to children and elderly individuals and to determine the correlations between alcohol consumption and family violence among Lahu tribe families in northern Thailand. METHOD: A cross-sectional study was applied to collect data from participants living in 10 randomly selected villages from the list of Lahu villages in Chiang Rai Province, Thailand. A validated questionnaire and the Alcohol Use Disorders Identification Test were used to collect information from the participants in private and confidential rooms at a community hall between March and August 2019. Data were described and tested for correlation at the significance levels of α = 0.05 and 0.01. FINDINGS: A total of 350 of 719 recruited Lahu families participated in the study (response rate = 48.7%). Among female participants, 22.3% reported history of sexual harassment and 4.1% had been forced to have sex. Children and elderly individuals reported several experiences with people who had used alcohol in the past year; 6.4% had been left to live alone, 5.0% experienced financial neglect, and 1.8% had been neglected while sick. In a correlation analysis, it was found that age (r = -0.02, p value < 0.009), education (r = 0.15, p value < 0.047), marital status (r = 0.25, p value < 0.001), and religion (r = 0.20, p value < 0.008) were significantly correlated with verbal arguments among family members. Experience of sexual harassment was correlated with the presence of a drinker in the family (r = 0.22, p value < 0.001). CONCLUSION: Government and relevant agencies should cooperate to reduce the consumption of alcohol among Lahu men. Moreover, a specific training program to personally improve one's skill in responding to domestic violence among children, women, and elderly individuals should also be developed and implemented in Lahu communities.

Pesticide Spraying and Reduced Cholinesterase Activity among Hill Tribe Farmers in Thailand.

BACKGROUND: Farming is an important occupation in Thai hill tribe communities, which are often remote, and lack other economic opportunities along with basic educational, health care, and occupational health and safety services. Additionally, these communities have a unique culture and language. OBJECTIVES: The present study was conducted in northern Thailand to evaluate pesticide exposures and associated health impacts among hill tribe farmers, and to compare them to Thai farmers. METHODS: Lahu hill tribe farmers in a mountain community were recruited by public health hospital staff, along with a reference group of lowland Thai farmers. Participants completed a survey on demographic factors and work practices, and blood and urine samples were collected by a trained nurse. Acetylcholinesterase activity (AChE) was quantified to assess pesticide exposure, whereas liver and kidney functions were evaluated using clinical biomarkers. RESULTS: A large fraction (nearly 50%) of Lahu farmers were illiterate and could not speak Thai. Thai farmers worked fewer hours per week (39.4) than did Lahu farmers. Among Lahu farmers, AChE levels were significantly lower (worse) than those of Thai farmers. However, other health outcomes in these populations were similar. Formal education and language skills were not associated with pesticide exposures or health outcomes. Pesticide spraying was found to be a significant predictor of reduced AChE (OR=8.5, 95% CI 1.1-69.6). CONCLUSIONS: Pesticide exposures are a significant occupational health hazard among Thai hill tribe farmers. Training, potentially delivered by community health volunteers, is needed to communicate safe pesticide work practices to these farmers. PARTICIPANT CONSENT: Obtained. ETHICS APPROVAL: The study protocol was approved by the Institutional Review Board of Mae Fah Luang University (REH-61080). COMPETING INTERESTS: The authors declare no competing financial interests.

Factors associated with domestic violence in the Lahu hill tribe of northern Thailand: A cross-sectional study.

BACKGROUND: Domestic violence significantly affects physical and mental health, particularly among children, women, and the elderly. Living in certain family environments could lead to victimization by domestic violence, especially among families with a poor socioeconomic status, such as the Lahu hill tribe people in Thailand. This study aimed to estimate the prevalence of and determine the factors associated with domestic violence among Lahu children, women, and the elderly. METHODS: A cross-sectional study was conducted of participants who belonged to the Lahu hill tribe and lived in 20 selected villages in Chiang Rai Province, Thailand. A validated questionnaire was used to collect personal information and information regarding experiences related to domestic violence in the past year from children (aged 5-15 years), women (aged 16-59 years), and the elderly (aged 60 years and over). A binary logistic regression was used to detect associations between the variables. RESULTS: A total of 646 participants were recruited into the study, specifically, 98 children aged 5-15 years, 430 women aged 16-59 years, and 118 elderly people. Children who smoked (AOR = 8.70; 95%CI = 1.27-59.45) had greater odds of experiencing domestic violence than children who did not smoke. Women who had a role as a family member (AOR = 1.59; 95%CI = 1.02-2.50), used alcohol (AOR = 3.36; 95%CI = 2.27-4.99), lived in a family with financial problems (AOR = 4.01; 95%CI = 2.52-7.66), and lived with a family member who uses alcohol (AOR = 2.87; 95%CI = 2.20-5.63) had greater odds of suffering domestic violence than women who did not share these characteristics. The elderly who used alcohol (AOR = 3.25, 95%CI = 1.08-9.81), lived with a family member who uses alcohol (AOR = 3.31; 95%CI = 1.26-7.34), or lived in a family with financial problems in the past year (AOR = 2.16; 95%CI = 1.16-8.77) had greater odds of facing domestic violence than the elderly who did not have these characteristics. CONCLUSION: Family financial problems and substance use are associated with domestic violence in Lahu families in Thailand. Health interventions to reduce the use of substances, including training programs to respond to domestic violence, should be promoted for Lahu children, women, and the elderly.