What causes H5N1 avian influenza? Lay perceptions of H5N1 aetiology in South East and East Asia.

BACKGROUND: Health education to reduce population poultry exposures has limited effect. Lay beliefs about H5N1 highly pathogenic avian influenza (HPAI) causes could provide insights helpful for improving public health interventions. METHODS: Qualitative interviews of poultry farmers, retailers, market stall holders and consumers in Hong Kong (n = 20), Guangzhou (n = 25), Vietnam (n = 38) and Thailand (n = 40) were conducted using purposive sampling and analysed using ethnographic principles. RESULTS: Each location produced three comparable themes: 'viruses': HPAI exemplified a periodic, natural, disease process therefore, deserving little concern. For some, science had 'discovered' something long known to farmers and lived with for generations. Others believe the virus to be new. Viral ecology was reasonably well understood among farmers, but less so by retailers and consumers; 'husbandry practices' included poor hygiene, overcrowding and industrial farming, modern commercial feed and veterinary drugs; 'vulnerability factors' included uncontrollable 'external' explanations involving the weather, seasonal changes, bird migrations and pollution. CONCLUSIONS: Lay explanations were generally ecologically consistent. Nonetheless, beliefs that HPAI is a normal, recurrent process, external factors and roles of industrialized poultry rearing countered health worker claims of H5N1 seriousness for smallholders. These causal beliefs incorporate contemporary models of H5N1 ecology, but in a manner that contradicts public health efforts at control.

Quality of life in Thai patients after bone marrow and peripheral blood stem cell transplantation: a comparison study with patients treated with conventional chemotherapy.

This study of adult patients of Thai cultural background compared the quality of life (QOL) of patients undergoing bone marrow and peripheral blood stem cell transplantation (BMT/PBSCT) with that of patients treated with conventional chemotherapy (CT). The study population comprised 59 patients who were transplant recipients (29 allogeneic, 29 autograft, and one syngeneic BMT/PBSCT) and 24 patients treated with CT for various hematologic malignancies. The participants completed a 50-item structured QOL questionnaire sent by mail. No significant differences were found between the two patient groups regarding their psychological, social, and treatment-related well-being or their overall QOL; all scores were above 75% of the total. The mean score regarding the physical domain, however, was significantly lower in BMT/PBSCT patients. Areas of highest concern in both groups were sexuality and financial burden. Happiness, functional ability, financial burden, and the degree of familial acceptance were the most important predictors of the self-rated QOL in BMT/PBSCT patients. Seventy-five percent of BMT/PBSCT patients would be willing to undergo the procedure again under the same circumstances. These results indicated that the QOL of Thai patients undergoing BMT/PBSCT was in general satisfactory and comparable to patients treated with conventional CT.

Study on the factors associated with contraceptive discontinuations in Bangkok.

Detailed information was collected from 666 cohorts of pill, injectable-DMPA and IUD acceptors at 14 Bangkok Metropolis Health Clinics (MHCs). The contraceptive status at 12-month follow-up home interview shows that 47% of pill acceptors, 39% of DMPA acceptors and 55% of IUD acceptors were still using the same contraceptive method and receiving them from the original source. The women who initially adopted the pill could seek the oral contraceptive from other sources with a higher significant percentage (14%) than was found in the DMPA and IUD group. The DMPA group revealed the lowest percent of using same method and same source but higher rate of clinic switch (15%), including method and clinic switch (18%), than the pill and IUD acceptors. The women who adopted the pill had stopped using any contraceptive method with the highest percentage (31%). The main reason for method switch among the three contraceptive acceptors was disagreeable health effects; 50% of pill acceptors, 75% for DMPA acceptors and 49% for IUD acceptors. Another important reason for IUD switch was a 32% expulsion of IUD. Those who switched clinic gave the three important reasons of distance inconvenience, opening hour inconvenience and disagreeable health effects. Service-related factors are likely to play a less important role in determining discontinuation of the pill and DMPA, while the reasons on doctors objecting to removing the IUD appear to be the major service-related factor in discontinuation of IUD (19%). The decision to stop using any contraceptive appeared to be related to dissatisfaction with the method and side effects was the primary reason and the secondary reason was that they wanted another child.(ABSTRACT TRUNCATED AT 250 WORDS)