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1.
Telemed J E Health ; 2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39229683

RESUMO

Objective: The National Health Security Office in Thailand introduced a telemedicine program called "Telehealth/Telemedicine" in December 2020, which aimed to reimburse telemedicine services for patients with stable chronic diseases under the Universal Coverage Scheme (UCS). The current study investigated patient characteristics and trends in telemedicine service utilization under the UCS in Thailand and examined the impact of COVID-19 outbreaks on telemedicine services. Methods: A retrospective secondary data analysis using e-claim data from December 1, 2020, to April 18, 2023, was conducted. The analytical methods included descriptive analysis and an interrupted time series analysis. Results: During ∼29 months, 110,153 unique patients used telemedicine services, leading to a total of 259,047 visits. The average age was 54 years, and most of patients were female (57%). Hypertension was the most common diagnosis for patients receiving telemedicine services. Patients with mental health conditions often engaged in telemedicine consultation with drug delivery. During the Delta and Omicron outbreaks, telemedicine service utilization significantly increased compared with that in any nonpandemic periods within the 29-month timeframe (odds ratio [OR]: 3.85, p-value <0.01; OR: 2.55, p-value <0.01). Conclusions: The study findings highlight the initial trend of telemedicine services in Thailand from the start of the COVID-19 pandemic to the beginning of the post-COVID-19 period. As telemedicine will play a critical role in the future of health care, this information can support the scale-up of telemedicine, including monitoring and evaluation plans, to help improve the efficiency of the system.

2.
Patient Prefer Adherence ; 18: 1815-1828, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39253588

RESUMO

Introduction: Vaccination is an important strategy to prevent or reduce hospitalizations and mortality caused by COVID-19 infection. However, some people with chronic diseases are hesitant to get the COVID-19 vaccination. Objective: This study aimed to assess the acceptance of COVID-19 vaccination and associated factors among people with chronic diseases. Methods: A cross-sectional online survey was conducted between May and August 2021. A sample of 457 Thai adults living with one or more chronic diseases was drawn from a larger online survey. Results: Participants were 19 to 89 years old. The three most commonly reported chronic diseases were hypertension, diabetes, and obesity. The acceptance rate of COVID-19 vaccination was 89.1%. Forty-six percent of respondents had received the COVID-19 vaccination, and 43.1% intended to get the vaccine. Reasons for vaccine hesitancy/refusal included concerns about adverse side effects from the vaccines including long-term effects that might complicate their disease condition. Multiple logistic regression analyses revealed that having a bachelor's degree or higher [aOR 4.40; 95% CI: 2.12-9.14], being employed [aOR 2.11; 95% CI: 1.03-4.39], and having positive attitudes [aOR 2.36; 95% CI: 1.69-3.29] and negative attitudes [aOR 0.38; 95% CI: 0.27-0.55] predicted acceptance of the COVID-19 vaccination. Vaccine literacy was significantly associated with acceptance of COVID-19 vaccination in binary logistic regression analyses, but it was not retained in the multiple logistic regression model. Conclusion: Vaccine literacy and attitudes influence acceptance of COVID-19 vaccination in people with chronic diseases.

3.
PhytoKeys ; 246: 189-195, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39263253

RESUMO

Typhoniumvinicolor from Khon Kaen Province (Northeastern Thailand), is described and illustrated as a species new to science. Color plates, phenology, distribution, discussion of similar taxa, and conservation status assessment are provided.

4.
J Vet Sci ; 2024 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-39231787

RESUMO

IMPORTANCE: Antimicrobial resistance (AMR) is a serious public health threat. AMR bacteria and their resistance determinants in food can be transmitted to humans through the food chain and by direct contact and disseminate directly to the environment. OBJECTIVE: This study examined the AMR characteristics and transferable R plasmids in Escherichia coli isolated from meat ducks raised in an open-house system. METHODS: One hundred seventy-seven (n = 177) commensal E. coli were examined for their antimicrobial susceptibilities and horizontal resistance transfer. The plasmids were examined by PCR-based plasmid replicon typing (PBRT) and plasmid multi-locus sequence typing (pMLST). RESULTS: The highest resistance rate was found against ampicillin (AMP, 83.0%) and tetracycline (TET, 81.9%), and most isolates exhibited multidrug resistance (MDR) (86.4%). The R plasmids were conjugally transferred when TET (n = 4), AMP (n = 3), and chloramphenicol (n = 3) were used as a selective pressure. The three isolates transferred resistance genes either in AMP or TET. The blaCTX-M1 gene resided on conjugative plasmids. Five replicon types were identified, of which Inc FrepB was most common in the donors (n = 13, 38.4%) and transconjugants (n = 16, 31.2%). Subtyping F plasmids revealed five distinct replicons combinations, including F47:A-:B- (n = 2), F29:A-:B23 (n = 1), F29:A-:B- (n = 1), F18:A-B:- (n = 1), and F4:A-:B- (n = 1). The chloramphenicol resistance was significantly correlated with the other AMR phenotypes (p < 0.05). CONCLUSIONS AND RELEVANCE: The meat ducks harbored MDR E. coli and played an important role in the environmental dissemination of AMR bacteria and its determinants. This confirms AMR as a health issue, highlighting the need for routine AMR monitoring and surveillance of meat ducks.

5.
Transpl Infect Dis ; : e14370, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39226139

RESUMO

BACKGROUND: Solid organ transplantation (SOT) has expanded significantly in Asia over past few decades. Donor-derived infections (DDIs) remain a significant concern as they may adversely impact transplant outcomes. We aim to review the existing regulatory frameworks, screening protocols, and management practices for DDIs in Asia. METHODS: We reached out to transplant infectious diseases experts in Asia to provide standardized data on annual SOT numbers, incidence of DDIs, regulatory frameworks, donor and recipient screening protocols, and DDI surveillance measures. We present the data from Singapore, Japan, and Thailand. RESULTS: Donor screening for HIV, hepatitis B, hepatitis C, and syphilis is mandatory in all countries. Additionally, Japan screens for HTLV-1 antibody due to its endemicity. We also reviewed the protocols for screening and prevention of endemic infections in Asia. Singapore is the only country implementing universal screening for all donors for dengue, Zika, and chikungunya via blood and urine RT-PCR. Strongyloidiasis screening is not routinely done, although some transplant centers empirically give ivermectin prophylaxis to organ recipients. Tuberculosis screening with a donor questionnaire and chest radiograph is common for deceased donors, and some centers do Interferon Gamma Release Assay test for living donors. We also found a significant gap in the surveillance and reporting of potential DDIs in Asia and the overall incidence of DDIs in Asia is unknown and likely underreported. CONCLUSION: The experiences of Singapore, Japan, and Thailand offer valuable insights into current practices and the unmet needs regarding a DDI registry and call for coordinated efforts to address this critical issue in the region.

6.
Sci Rep ; 14(1): 20639, 2024 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-39232021

RESUMO

Rasch analysis was employed to investigate the psychometric properties of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and its shorter versions (EUROHIS-QOL-8 and WHOQOL-5) within the context of patients undergoing warfarin in Thailand. A group of 260 patients were recruited from three public hospitals and tasked with completing the WHOQOL-BREF questionnaire. Rasch analysis showed that the WHOQOL-BREF, structured into four-domain subtests, achieved a commendable fit to the Rasch model (χ2[16] = 12.26, p = 0.73), met the criterion of unidimensionality (7.31% significant t-tests; lower bound confidence interval, 4.66), and demonstrated satisfactory reliability (PSI = 0.87). The adoption of a subtest approach facilitated an acceptable fit to the Rasch model for each domain of the WHOQOL-BREF, except for the social domain. However, the presence of local dependency of the three-item social domain was detected, so the reliability was not reported. The WHOQOL-5 proved to be unidimensional, fitting the Rasch model acceptably, and had satisfactory reliability. Conversely, the EUROHIS-QOL-8 presented local dependency; thus, reliability was not reported. Consequently, the WHOQOL-BREF in its four-domain subtests is recommended for pre- and post-HRQoL measurements, whereas the WHOQOL-5 can effectively measure HRQoL levels in between-group analyses.


Assuntos
Psicometria , Qualidade de Vida , Varfarina , Humanos , Varfarina/uso terapêutico , Tailândia , Psicometria/métodos , Feminino , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Idoso , Reprodutibilidade dos Testes , Anticoagulantes/uso terapêutico , Organização Mundial da Saúde , Adulto , População do Sudeste Asiático
7.
PeerJ ; 12: e17884, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39247554

RESUMO

Introduction: Homelessness is a significant global challenge affecting people worldwide. In Thailand, the health-related issues of people experiencing homelessness have not been a major research focus. This scoping review aims to explore the scope of research on health-related issues among people experiencing homelessness in Thailand. Methods: Eight databases (ACI, AMED, Embase, PsycINFO, PubMed, Scopus, TCI, and Web of Science) were searched from inception of each database to August 2022. The search terms consisted of terms related to people experiencing homelessness in Thailand. Research articles published in Thai or English were included. Results: Of 186 articles, 167 were excluded during duplicate removal (n = 45), title and abstract screening (n = 106), seeking for full-text articles (n = 2), and full-text screening (n = 14). Nineteen articles were included for extraction and synthesis. Three topics (health status, causes of homelessness and effects of homelessness on health, healthcare and social services) were summarised. The included studies described mental health (e.g., depression, suicide, alcohol and drug dependence), physical health (e.g., poor self-hygiene, injuries, accidents), and health behaviours (e.g., alcohol drinking, substance use, unsafe sex). Social behaviours and health problems linked to homelessness, and several factors related to health and living conditions (e.g., stigma, discrimination) were reported. People experiencing homelessness had some barriers to access to healthcare and social services (e.g., health insurance, social welfare, financial difficulties). Conclusions: The majority of studies on health-related issues in people experiencing homelessness in Thailand are descriptive studies. Future studies should focus on the interactions and mechanisms between homelessness and health.


Assuntos
Nível de Saúde , Pessoas Mal Alojadas , Humanos , Pessoas Mal Alojadas/psicologia , Pessoas Mal Alojadas/estatística & dados numéricos , Tailândia/epidemiologia , Comportamentos Relacionados com a Saúde , Saúde Mental/estatística & dados numéricos
8.
BMC Public Health ; 24(1): 2432, 2024 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-39242509

RESUMO

This concurrent qualitative study was carried out with the main objective to determine wildlife beliefs, taboos, usages, health perceptions, and practices among ten ethnic groups in four communities in Tak and Mae Hong Son provinces of Thailand from November 2020 to January 2021. We also gathered comprehensive information on study respondents' knowledge related to potential risk behaviors that could lead to zoonotic disease transmission and infection. Furthermore, we intended to use the study's findings to develop communication strategies and health literacy improvement interventions for mitigating risky behaviors, with a focus on ethnic groups and particular individuals who live in close proximity to forests and wildlife, to prevent future pandemics. Sixty-five respondents were purposively selected based on their extensive knowledge, active participation in local cultural contexts, beliefs, and exposure to wildlife contact or consuming game animals. Twenty (30.8%) participated in in-depth interviews (IDIs), while 45 (69.2%) participated in eight focused group discussions (FGDs). The results revealed that the characteristics of wildlife contact are similar and distinct based on their beliefs and taboos among various ethnic groups and study locations, which are influenced by cultural backgrounds and traditions. Although some ethnic groups do not have explicit restrictions on the consumption of wildlife, others adhere to specific beliefs and taboos that forbid the consumption or killing of specific wild animals. These beliefs frequently correspond with conservation initiatives, thereby facilitating the preservation of threatened species. The study also revealed a lack of appropriate health knowledge, perceptions, and practices regarding wildlife contact and consumption. As a result, it is recommended that public health officials and local governments develop and execute communication and education initiatives. These campaigns should aim to increase health literacy and promote safe handling, preparation, and cooking practices to reduce the risk of zoonotic disease transmission and infection effectively. Moreover, it is necessary to design and implement wildlife conservation education and outreach activities. The programs should promote environmental stewardship while considering the cultural contexts, beliefs, and practices of various ethnic groups. The activities should involve diverse stakeholders, including local leaders, religious influencers, community members, schoolteachers, students, health professionals, village health volunteers, and civil society organizations.


Assuntos
Animais Selvagens , Etnicidade , Conhecimentos, Atitudes e Prática em Saúde , Pesquisa Qualitativa , Tabu , Humanos , Tailândia/etnologia , Animais , Masculino , Etnicidade/estatística & dados numéricos , Etnicidade/psicologia , Feminino , Adulto , Pessoa de Meia-Idade , Zoonoses/prevenção & controle , Grupos Focais , Adulto Jovem
9.
Int J Vet Sci Med ; 12(1): 125-133, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39262677

RESUMO

This study investigates the distribution of the Lymnaea (Radix) spp. in Pak Chong district, Nakhon Ratchasima province, northeast Thailand, where a vast cattle farming area is located and has a high prevalence of Fasciola spp. in the cattle. By random selection, 1,414 snails were collected from the natural and man-made ponds. The snails were recorded for morphology and processed for DNA isolation. The snail species were investigated by conventional PCR using a 16S rDNA-specific primer. The result demonstrated that all collected snails were R. (L.) rubiginosa. Moreover, the infection of Fasciola gigantica in the snails was investigated by PCR using a cytochrome c oxidase I (COX1)-specific primer. The results illustrated that the overall prevalence was 22.5% (318/1414), with the highest prevalence in the Nong Sa Rai subdistrict at 73.6% (81/110), which is the highest prevalence of Fasciola gigantica in the snail host that has ever been reported. The lowest prevalence existed in the Pong Ta Long subdistrict at 3.7% (4/109). Our results corresponded to the previous report on the Fasciola spp. infection in the cattle from this area, and the geographical analysis revealed that the most suspected factor would be the earth dam located in these subdistricts, where many animals live freely during the day. Our findings could be helpful for further parasite control and could trigger the study of the biology and associated factors in the future.

10.
Heliyon ; 10(17): e36807, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39263051

RESUMO

Objectives: To investigate the seroprevalence of SARS-CoV-2 nucleocapsid antibodies (NC-Ab) in sex workers. Methods: A cross-sectional/observational study was conducted between March and December 2022 among sex workers living in Chiangmai, Thailand, aged over 18 years and who had engaged in sex work in the previous 12 months. Consenting individuals completed a questionnaire and had blood drawn. IgG-specific for SARS-CoV-2 nucleocapsid was assessed using Euroimmun anti-SARS-CoV-2 NCP ELISA (IgG). Results: 264 sex workers (52.3 % male) with a median age 31 years were included. The overall seroprevalence of SARS-CoV-2 NC-Ab was 42.4 % (44.2 % in males, 40.5 % in females). It was significantly higher among non-Thai than Thai sex workers (57.1 % vs. 37.1 %, p = 0.004) and among individuals who reported a history of COVID-19 as compared those who did not (54.9 % vs. 34.3 %, p = 0.036). NC-Ab seroprevalence did not differ by sex, age, receipt of COVID-19 vaccines, or the number of vaccine doses. SARS-CoV-2 NC-Ab seropositivity was significantly associated with being non-Thai, having monthly income >15,000 Baht, having received inactivated COVID-19 vaccines, and having been diagnosed with COVID-19. Conclusions: This study shows a high seroprevalence of NC-Ab among sex workers in Chiangmai, Thailand during the fifth epidemic wave with Omicron variant. This may be due to combined effects of high transmissibility of the Omicron variant and high-risk behavior of those individuals. Specific health education interventions are needed for this specific population.

11.
BMC Infect Dis ; 24(1): 897, 2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-39223501

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) causes more deaths in older adults than in younger adults. Older adults are a vulnerable group with a high need for coronavirus vaccines to decrease the severity of the disease. The aim of this analytical cross-sectional study was to determine the factors influencing third COVID-19 vaccine booster dose acceptance among older adults in northern Thailand. METHODS: The study samples were composed of 2,155 older adults living in Kamphaeng Phet Province, northern Thailand. They were randomly selected by multistage random sampling. Data were collected in a self-administered questionnaire consisting of 7 parts: (1) personal factors, (2) knowledge about COVID-19, (3) perceived susceptibility to COVID-19 infection, (4) perceived severity of COVID-19, (5) perceived benefits of the third COVID-19 vaccine booster dose, (6) perceived barriers to the third COVID-19 vaccine booster dose vaccination, and (7) the third COVID-19 vaccine booster dose acceptance. Data were analyzed via frequency, percentage, mean, standard deviation, and binary logistic regression. All the significance levels were set to 0.05. RESULTS: The results indicated that only 28.5% of older adults accepted the third COVID-19 vaccine booster dose. The factors influencing third COVID-19 vaccine booster dose acceptance among older adults included 5 variables. The participants aged ≥ 70 years was 1.37 times (95%CI = 1.12-1.69) greater than those aged < 70 years who accepted the vaccine. Participants who were married were more likely to accept the vaccine by 1.39 times (95%CI = 1.09-1.79) compared with single individuals. Those with underlying diseases tended to accept the vaccine by 1.56 times (95%CI = 1.26-1.92) more than those without underlying diseases. Those who had high perceived benefit from the COVID-19 vaccine possibly accepted the vaccine by 1.50 times (95%CI = 1.10-2.04) more than those with low perceived benefit, and those who had a low perceived barrier to the third COVID-19 booster dose vaccination seemed to accept the vaccine by 1.29 times (95%CI = 1.01-1.52) more than those with a high perceived benefit. CONCLUSION: Older adults should receive health education regarding the perceived benefit of the COVID-19 vaccine and the perceived barrier to COVID-19 vaccination, especially older adults aged < 70 years, those who are single, and those who are free of underlying diseases.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Imunização Secundária , SARS-CoV-2 , Humanos , Tailândia , Masculino , Idoso , Feminino , COVID-19/prevenção & controle , COVID-19/imunologia , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/imunologia , Estudos Transversais , SARS-CoV-2/imunologia , Inquéritos e Questionários , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Conhecimentos, Atitudes e Prática em Saúde , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
12.
Terror Political Violence ; 36(7): 903-918, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39257629

RESUMO

This paper analyzes Malay-Muslim insurgents' attacks in the three southern provinces of Thailand between the years of 2010-2021 and identifies the role of public holidays on the level of violence. The existing literature suggests terrorists consider holidays during attack planning. However, there is a lack of agreement on the effect direction. Some studies have found that holidays are a force for peace while others have found they can act as trigger for more violence. Applying environmental criminology to the timing of terrorist attacks, we argue that the type of the holiday matters. Therefore, we analyze public (secular), Islamic, and Buddhist holidays separately. We show that Islamic holidays witness increased violence while Buddhist and public holidays see reductions. We discuss that Islamic holidays increase the Malay-Muslim insurgents' motivation to attack by assigning to those dates a higher symbolic value. On the other hand, on Buddhist and public holidays, insurgents may hesitate to attack to avoid the adverse effects of losing public support and triggering a backlash. The results demonstrate the necessity to analyze the temporal dynamics of terrorist attacks.

13.
Malar J ; 23(1): 239, 2024 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-39128989

RESUMO

BACKGROUND: Typically mobile and vulnerable, migrants face significant barriers to access to routine malaria prevention, diagnostics and treatment, which leads to unchecked malaria transmission, particularly in border regions with a high population displacement. This study aimed to investigate the demographic and socioeconomic obstacles to access to malaria services among Myanmar migrants residing in the Thailand-Myanmar border areas. METHODS: A cross-sectional study was conducted in early 2024 across three districts near the Thailand-Myanmar border. Quantitative data were collected from Myanmar migrants using standardized questionnaires through structured surveys. Data analysis included descriptive statistics and simple and multiple logistic regression models. RESULTS: Out of 300 participants, approximately a quarter (27.3%) reported adequate access to comprehensive malaria services, including prevention, diagnostics, treatment and malaria-related health information. In multiple logistic regression models, factors associated with inadequate access included Myanmar migrants aged over 60 years (aOR: 7.63, 95% CI 1.74-20.58), accompanied by one to three family members (aOR: 3.33, 95% CI 1.06-8.45), earning monthly incomes below 3000 THB (aOR: 5.13, 95% CI 1.38-19.09) and 3000 to 6000 THB (aOR: 3.64, 95% CI 1.06-12.51), belonging to the Karen ethnicity (aOR: 2.13, 95% CI 1.02-3.84), with poor perception toward malaria (aOR: 2.03, 95% CI 1.03-4.01) and with poor preventive and health-seeking practices (aOR: 5.83, 95% CI 2.71-9.55). CONCLUSIONS: A significant proportion of Myanmar migrants encounter demographic and socioeconomic barriers to access to routine malaria services in Thailand. Tailored interventions are required to expand such access, including the recruitment of worksite health volunteers, strengthening the role of ethnic health organizations across the border and collaboration with private sector stakeholders (e.g. farm/company owners) to distribute preventive tools and ensure timely referral of suspected malaria cases to health facilities.


Assuntos
Acessibilidade aos Serviços de Saúde , Malária , Migrantes , Mianmar , Tailândia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Estudos Transversais , Malária/prevenção & controle , Migrantes/estatística & dados numéricos , Masculino , Feminino , Adulto , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Fatores Socioeconômicos , Adolescente , Idoso
14.
Chemosphere ; 364: 143041, 2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39117079

RESUMO

Thailand ranks as the sixth largest contributor to global microplastic pollution, which is exacerbated by extensive plastic use. Despite rising concerns, no comprehensive review is available on microplastic contamination and its potential risk in Thailand. This review synthesised data on microplastic abundance and characteristics within the country from 118 peer-reviewed publications (2017-2024). We found predominant microplastic presence in crustaceans (1.69-160.15 items/g), followed by Mollusca (0.03-9.5 items/g) and fishes (0.01-28.17 items/g), with higher abundances in wastewater (4 × 102 to 6.09 × 105 items/m3) compared to that in freshwater (1.44-2.92 × 106 items/m3) and seawater (2.70 × 10-1 to 6.25 × 104 items/m3). Marine sediments (48.3-2.13 × 104 items/kg) also showed significantly higher microplastic concentrations than terrestrial sediments (3-2.92 × 103 items/kg). Predominant microplastics were identified as fibers (59.36% and 35.05% for biological and environmental samples, respectively) and fragments (24.14%, 30.68%) in blue (25.95%, 18.64%), and colourless/transparent (20.01%, 14.47%), primarily composed of polyethylene terephthalate (19.46%, 9.19%), nylon (3.23%, 9.99%), polypropylene (19.78%, 24.23%), and polyethylene (14.81%, 11.66%). The potential ecological risk was low in all ecosystems except for wastewater. Shrimp and fish were more susceptible to microplastics compared to other studies in the region. Additionally, the sources, transport, and pathways of microplastic pollution in Thailand's aquatic territories and the current measures and policies implemented by the government to address plastic pollution are discussed. This review has compiled up-to-date insights into the prevalence, distribution, and risks associated with microplastics, which is instrumental in formulating effective strategies for contaminant control and ultimately reducing plastic pollution.

15.
Int J Health Policy Manag ; 13: 7930, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39099526

RESUMO

BACKGROUND: Various features in health insurance schemes may lead to variation in healthcare. Unwarranted variations raise concerns about suboptimal quality of care, differing treatments for similar needs, or unnecessary financial burdens on patients and health systems. This realist review aims to explore insurance features that may contribute to healthcare variation in Asian countries; and to understand influencing mechanisms and contexts. METHODS: We undertook a realist review. First, we developed an initial theory. Second, we conducted a systematic review of peer-reviewed literature in Scopus, MEDLINE, EMBASE, and Web of Science to produce a middle range theory for Asian countries. The Mixed Methods Appraisal Tool (MMAT) was used to appraise the methodological quality of included studies. Finally, we tested the theory in Thailand by interviewing nine experts, and further refined the theory. RESULTS: Our systematic search identified 14 empirical studies. We produced a middle range theory in a context-mechanism-outcome configuration (CMOc) which presented seven insurance features: benefit package, cost-sharing policies, beneficiaries, contracted providers, provider payment methods, budget size, and administration and management, that influenced variation through 20 interlinked demand- and supply-side mechanisms. The refined theory for Thailand added eight mechanisms and discarded six mechanisms irrelevant to the local context. CONCLUSION: Our middle range and refined theories provide information about health insurance features associated with healthcare variation. We encourage policy-makers and researchers to test the CMOc in their specific contexts. Appropriately validated, it can help design interventions in health insurance schemes to prevent or mitigate the detrimental effects of unwarranted healthcare variation.


Assuntos
Seguro Saúde , Tailândia , Humanos , Atenção à Saúde/organização & administração
16.
Malar J ; 23(1): 247, 2024 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-39154186

RESUMO

The Asia-Pacific region has had decades of progress in reducing malaria cases and deaths. The region is now accelerating its efforts towards malaria elimination by 2030 using a science-based approach by applying evidence-based best practices alongside existing tools. However, there are concerns of knowledge gaps and external factors challenging this goal. The COVID-19 pandemic served as reminder of the need for a holistic approach. This report summarizes the outcomes of the discussions from the "Asia Pacific Conference on Mosquito and Vector Control" held in Chiang Mai, Thailand from 27 to 30 November, 2023. The conference aims to provide insights into recent research, cutting-edge tools, and the strength of the Asia-Pacific regional mosquito and vector control capacity post-COVID-19 pandemic era. The conference featured discussions on mosquito surveillance, monitoring and control; enabling the resolution of local problems with local expertise and forging new partnerships; and exploring recent research advancements in vector control strategies. More than 500 experts from 55 countries attended.


Assuntos
Controle de Mosquitos , Mosquitos Vetores , Controle de Mosquitos/métodos , Animais , Humanos , Ásia , Malária/prevenção & controle , COVID-19/prevenção & controle , COVID-19/epidemiologia , Congressos como Assunto
17.
BMC Pediatr ; 24(1): 531, 2024 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-39164706

RESUMO

BACKGROUND: Health-related quality of life (HRQOL) is a vital assessment to demonstrate the achievement in pediatric cancer care parallels that of medical treatment. The Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module in the Thai Version has become a standard tool to access the HRQOL among Thai children with cancer and their families. This study aimed to explore the HRQOL and factors related to HRQOL among pediatric oncology patients using the PedsQL 3.0 Cancer Module. METHODS: In 2018-2019, a single-institution, cross-sectional study was conducted among children with cancer and their families in Bangkok, Thailand. A paired-sample t-test was performed to evaluate the differences between the HRQOL scores of the child and parents' reports. Linear regression was used to evaluate factors associated with HRQOL and which particular domains of the PedsQL 3.0 Cancer Module were influenced. RESULTS: Eighty-five children with cancer and their families were enrolled. The patients' mean age was 10.82 ± 5.48 years. The most common cancer types included acute lymphoblastic leukemia (n = 32, 67%), central nervous system tumors (n = 13, 15%), osteosarcoma (n = 10, 27%) and neuroblastoma (n = 9, 24%), in rank. The mean HRQOL scores in child and parent reports were 74.37 ± 15.7 and 70.42 ± 17.15, respectively (p = 0.034). Factors negatively correlated to HRQOL in parent reports were the number of outpatient visits (p = 0.019) and hospital admissions (p = 0.002). The number of hospitalizations was the only independent factor that affected HRQOL (p = 0.044). The number of outpatient visits and/or hospital admissions was influenced by pain and hurt, nausea, procedural anxiety and communication domains (p < 0.05). Only the number of hospitalizations was an independent factor influencing the procedural anxiety domain in HRQOL (p = 0.005). CONCLUSION: HRQOL among Thai children with cancer was desirable from both children's and parent's perspectives. Differences between child and parent HRQOL scores were observed. The number of outpatient visits and hospital admissions affected HRQOL, particularly in the procedural anxiety aspect. TRIAL REGISTRATION: Thai Clinical Trials Registry (TCTR) Number: TCTR20200904001 (04/09/2020),  https://www.thaiclinicaltrials.org/ .


Assuntos
Neoplasias , Pais , Qualidade de Vida , Humanos , Tailândia , Masculino , Feminino , Estudos Transversais , Neoplasias/psicologia , Neoplasias/terapia , Criança , Pais/psicologia , Adolescente , Pré-Escolar , Inquéritos e Questionários , População do Sudeste Asiático
18.
Mol Genet Genomics ; 299(1): 80, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39172145

RESUMO

Austroasiatic (AA) speakers constitute around 4% of the population of Thailand, while the majority (89.4%) speak Kra-Dai (KD) languages. Previous forensic and population genetic studies in various Thai populations have employed a limited number of short tandem repeats (STRs). This study aims to expand the investigation of the genetic makeup of AA populations in Thailand and their relationship to KD populations using a larger number of autosomal STRs with the VeriFiler™ Plus PCR Amplification Kit. We generated 593 new genotypes from AA-speaking groups and combined them with previously reported data from AA and KD groups. A total of 1,129 genotypes across 23 STR loci were used to construct the largest allelic frequency profile for Thai and Lao populations. However, several loci deviated from Hardy-Weinberg equilibrium, likely due to the reduced genetic diversity in some highland populations, which should be considered in forensic investigations. Beyond forensic applications, our findings reveal genetic differences between AA-speaking groups in Northern and Northeastern Thailand. The AA groups from Northeastern Thailand exhibit greater genetic homogeneity and diversity, likely due to population interactions. In contrast, reduced diversity and increased heterogeneity in AA groups from Northern Thailand are possibly driven by genetic drift and cultural and geographic isolation. In conclusion, we emphasize the usefulness of increasing the number of autosomal STRs in forensic and anthropological genetic studies. Additional Y-STR and X-STR data from various AA-speaking groups in Thailand would further enhance and strengthen forensic STR databases in the region.


Assuntos
Frequência do Gene , Variação Genética , Genética Populacional , Repetições de Microssatélites , Tailândia , Humanos , Repetições de Microssatélites/genética , Variação Genética/genética , Etnicidade/genética , Povo Asiático/genética , Genótipo , Idioma
19.
Biomed Rep ; 21(4): 144, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39170756

RESUMO

Breast cancer is the most prevalent cancer and also the leading cause of cancer death in women worldwide. A comprehensive understanding of breast cancer risk factors and their incidences is useful information for breast cancer prevention and control planning. The present study aimed to provide information on single nucleotide polymorphisms (SNPs) and copy number variations (CNVs) in breast cancer, the allele frequency of two SNPs in breast cancer-related genes BRCA1 DNA repair associated (BRCA1; rs799917) and ATP binding cassette subfamily G member 2 (ABCG2; rs2231142), and the prevalence of human papillomavirus (HPV) infections in a normal population living in Phayao Province, Northern Thailand. One breast cancer and 10 healthy samples were investigated by whole exome sequencing (WES) and compared for genetic variation. The WES data contained SNPs in genes previously implicated in breast cancer and provided data on CNVs. The allele frequencies for SNPs rs799917 and rs2231142 were also examined. The SNP genotype frequencies were 35.88% CC, 46.54% CT, and 17.58% TT for rs799917 and 33.20% CC, 46.88% CA, and 19.92% AA for rs2231142. A total of 825 human whole blood samples were examined for HPV infection by PCR, and the pooled DNA was tested for HPV infection using metagenomic sequencing. No HPV infections were detected among all 825 samples or the pooled blood samples. The incidence of breast cancer among the tested samples was estimated based on acceptable breast cancer risk factors and demographic data and was 1.47%. The present study provided data on SNPs and CNVs in breast cancer-related genes. The associations between SNPs rs2231142 and rs799917 and breast cancer should be further investigated in a case-control study since heterozygous and homozygous variants are more common. Based on the detection of HPV infection in the blood samples, HPV may not be associated with breast cancer, at least in the Northern Thai population.

20.
Vet World ; 17(7): 1555-1561, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39185059

RESUMO

Background and Aim: Some Culex mosquitoes are competent vectors for Japanese encephalitis virus (JEV) and Zika virus (ZIKV), which cause public health problems worldwide, especially in South-east Asia. Xenosurveillance of Culex mosquitoes remains limited compared with other common mosquito-borne diseases. This study aimed to identify JEV and ZIKV in field-caught Culex mosquitoes collected from Ubon Ratchathani province. Materials and Methods: We investigated the presence of JEV and ZIKV in Culex mosquitoes from two districts in Ubon Ratchathani province, Thailand, and examined their role in viral interepidemic circulation. Female Culex mosquitoes (5,587) were collected using a mechanical aspirator from indoors and outdoors. The consensus sequences of the E and NS1 genes of JEV and the E gene of ZIKV were identified using real-time reverse transcription-polymerase chain reaction. Results: From 335 sample pools that contain a total of 5587 adult female Culex mosquitoes collected from Don Yung, Mueang district (4,406) and Phon Duan, Det Udom district (1,181), none of the collected mosquitoes tested positive for either JEV or ZIKV. Conclusion: This study did not find JEV and ZIKV in Culex mosquitoes collected from the area of collection, which may be due to the low circulating amount of the virus in the vectors in the area, making it undetectable, or it may be because Culex mosquitoes are not suitable vector for the virus being tested. However, further xenosurveillance study of JEV and ZIKV in mosquito is suggested to prepare for the next outbreak.

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