Disease Control Journal

Factors Associated with Health Behaviors of Type 2 Diabetes Patients in Chumphon Khet Udomsakdi Hospital, Chumphon Province

2026-05-01T14:02:39+07:00

This cross-sectional survey research aimed to examine the factors associated with health behaviors among patients with type 2 diabetes mellitus at Chumphon Khet Udomsakdi Hospital, Chumphon Province, Thailand. The study included 249 patients diagnosed with type 2 diabetes mellitus who attended the outpatient clinic at Chumphon Khet Udomsakdi Hospital between October 1 and December 31, 2024. Data were collected using a structured questionnaire consisting of personal characteristics, predisposing factors, enabling factors, reinforcing factors, and health behaviors related to diabetes management. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to summarize the data. The associations between categorical demographic variables and health behavior levels (low, moderate, and high) were analyzed using the Chi-squared test. The relationships between scores for predisposing, enabling, and reinforcing factors and health behavior scores were examined using Pearson’s Product-Moment Correlation Coefficient. The results showed that most participants had low levels of health behaviors for diabetes management. In addition, the scores for predisposing, enabling, and reinforcing factors were significantly associated with health behavior scores. Perceived diabetes knowledge demonstrated a moderate positive correlation with health behavior scores (r=0.42, 95% CI=0.25-0.55). Perceived self-efficacy in diabetes management showed a relatively high positive correlation (r=0.54, 95% CI=0.32-0.62). Access to diabetes-related health information was moderately positively correlated with health behavior scores (r=0.50, 95% CI=0.35-0.65), whereas social support demonstrated a relatively high positive correlation (r=0.57, 95% CI=0.30-0.65). The findings provide baseline information for planning interventions to promote health behaviors among patients with type 2 diabetes mellitus. Interventions should emphasize improving diabetes-related knowledge, enhancing self-efficacy, increasing access to diabetes-related health information, and strengthening social support to develop appropriate health promotion strategies for patients and the general population.

Retrospective Study of Adenovirus Infections at Ramathibodi Hospital (2012-2022): Investigating Risk Factors through Nucleic Acid Amplification Testing (NAAT) in Virology Laboratory Diagnostics

2026-05-20T09:55:56+07:00

Human adenovirus (HAdV) has been identified as a significant causative agent of infection, affecting patients of all age demographics. The present retrospective study was conducted with the objective of investigating the association of risk factors with adenovirus infection. An analysis was conducted on data from the Virology Laboratory, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, from 2012 to 2022. The study included a total of 46,128 individuals. The study identified 2,348 infections (5.09%), with the highest number of infections (436, 9.86%) recorded in 2013. In particular, the infection rate was found to be higher in children under 12 years. The former group included toddlers (8.46%), preschoolers (9.17%), and school-aged children (6.11%), with the infection rate greather than for the newborn and infant being 3.92%. Correlation analysis was performed Multivariable logistic regression analysis revealed that toddlers (Adjusted OR=2.12, 95% CI=1.74-2.57), preschoolers (Adjusted OR=2.41, 95% CI=1.95-2.97), and school-aged children (Adjusted OR=1.63, 95% CI=1.26-2.12) had a significantly higher risk of adenovirus infection than newborns and young children, respectively. There was no significant difference in infection risk between males and females. The sample with the highest incidence of adenovirus infection was nasal rinse fluid (Adjusted OR=1.82, 95% CI=1.28-2.59), followed by throat swabs (Adjusted OR=1.70, 95% CI=1.25-2.32). The findings reported herein pertain to adenovirus infection in the period preceding the advent of the pandemic caused by the severe acute respiratory syndrome (SARS)-coronavirus (CoV-2). The levels were found to be significantly higher than during the post-pandemic period, with an observed increase of 1.93 times (Adjusted OR=1.93, 95% CI=1.52-2.44). These findings have the potential to inform the enhancement of medical and public health preparedness in anticipation of future adenovirus outbreaks, thereby facilitating more effective responses.

A Retrospective Study of Human Bocavirus Infection in Patients at Ramathibodi Hospital between 2012 to 2022

2026-05-01T14:04:46+07:00

Bocavirus (BoV) has been identified as a significant causative agent of respiratory infections, particularly in young children. The objective of this study was to ascertain the prevalence of BoV infection and to investigate the factors associated with it, including gender, age group, type of sample, and the period of the COVD-19 outbreak. The study focused on patients whose samples were analysed at the Virology Laboratory, Faculty of Medicine, Ramathibodi Hospital, between 2012 and 2022. The present study demonstrates that 1,774 individuals were infected with the BoV, representing 4.24% of all cases. The period of greatest incidence of outbreaks occurs from June to August, with the highest number of cases of BoV infections occurring in July of each year. Multivariable logistic regression analysis revealed a statistically significant association between children under 12 years of age and BoV infection compared to the elderly group. The group with the highest risk was toddlers (Adjusted OR=21.28, 95% CI=14.12-32.07), followed by newborns and infants (Adjusted OR=16.01, 95% CI=10.53-24.32), preschoolers (Adjusted OR=7.23, 95% CI=4.60-11.37), and school-aged children (Adjusted OR=2.51, 95% CI=1.37-4.62), in that order. Moreover, the period following the emergence of the novel strain of the virus was found to be significantly associated with a 1.61-fold increase in detected cases (Adjusted OR=1.61, 95% CI=1.25-2.08). The present study found no statistically significant association between gender and the type of respiratory sample, and the presence of the BoV. This retrospective study, encompassing a 10-year period, is poised to furnish pivotal baseline data, facilitating the identification of high-risk groups, the prediction of seasonal disease patterns, and the enhancement of comprehension regarding the BoV. This facilitates the utilisation of the aforementioned information for the purpose of preparing for and implementing preventive measures, in addition to the promotion of knowledge in surveillance for the more effective control of BoV infection.

Falls among Older Adults in Private Nursing Homes in Northeastern Thailand

2026-04-17T00:03:16+07:00

Falls are the second leading cause of death from unintentional injury worldwide, and older adults have the highest mortality rates. However, there have been no published studies on falls among older adults in private nursing homes, particularly in northeastern Thailand, which has the highest proportion of older adults in the country. This mixed-method study aimed to determine the prevalence and characteristics of falls, and examine factors associated with falls among older adults in private nursing homes. Fifty-six eligible older adults from 20 nursing homes were recruited to collect quantitative fall data over the previous six months. Qualitative data were collected via in-depth interviews with one key informant (a representative or caregiver) from all 20 facilities. Quantitative data were analyzed using descriptive statistics, and Firth's penalized logistic regression was used to analyze factors associated with falls among older adults. Qualitative data were analyzed using thematic analysis. The quantitative results showed that 5 of 56 older adults (8.9%, 95% CI: 3.7-20.2) experienced falls within the previous six months, with most events occurring in the bedroom while walking or changing positions. The only factor significantly associated with falls was the sedatives use. The most common environmental fall-risk factors were the absence of bathroom partitions and inadequate lighting. The qualitative findings revealed that older adults received close constant 24-hour supervision, and that factors associated with falls included caregiver-related, environmental, and individual (older adult-related) factors. In conclusion, the prevalence of falls among older adults residing in private nursing homes in northeastern Thailand was low. However, some facilities had environmental conditions that led to falls among older adults.

Effect of an Activity-Based Learning Program on Pulmonary Tuberculosis Screening Practices Among Prison Health Volunteers

2026-05-08T15:16:51+07:00

This quasi-experimental study employed a two-group pretest-posttest design to examine the effects of an activity-based learning program on pulmonary tuberculosis (TB) screening practices among Prison Health Volunteers (PHVs). The sample consisted of 64 PHVs selected through purposive sampling, with 32 participants in the experimental group and 32 in the control group. The intervention was an activity-based learning program developed based on the framework of the National Center for the Study of Adult Learning and Literacy (NCSALL) and implemented over a four-week period. Data collection instruments included a general information questionnaire and an observational checklist for pulmonary TB screening practices. Data were analyzed using descriptive statistics, including frequencies, percentages, means, and standard deviations. Screening practice outcomes were presented as frequencies and percentages. The findings revealed that, before the intervention, no participants in either group correctly performed pulmonary TB screening. After the intervention, all participants in the experimental group (100%) correctly performed the screening, whereas no participants in the control group did so. Therefore, the activity-based learning program can be applied to promote learning and improve pulmonary TB screening practices among Prison Health Volunteers.

Outcomes of Antimicrobial Resistance Surveillance System Development, Warinchamrab District, Ubonratchathani Province

2026-05-19T15:34:26+07:00

This mixed-methods action research aimed to develop and evaluate the effectiveness of a digital antimicrobial resistance (AMR) surveillance system at Warinchamrab Hospital, Ubon Ratchathani. The study was conducted from July 2024 to September 2025, and utilized low-code platforms including Google Forms, Google Sheets, Looker Studio, and Line Notify API, to overcome the limitations of the previous manual, paper-based reporting process, which had an average notification time of 6 hours. Data were collected from 50 primary healthcare users and analyzed using descriptive statistics and in-depth interviews. The results demonstrated a significant enhancement in operational efficiency, achieving a notification time for AMR detection cut to 5 minutes and 100% real-time data availability. The system captured 915 reports from 566 patients, identifying Acinetobacter baumannii (CRAB) and Klebsiella pneumoniae (CRKP) as the most prevalent pathogens, particularly within the medical intensive care unit. User satisfaction was high (mean=4.28 SD=0.79) and 84% of participants reported utilizing the system’s data for immediate clinical treatment planning and outbreak management. In conclusion, this study demonstrates that the development of an AMR surveillance system using accessible and low-cost technologies can significantly improve the efficiency of surveillance processes and information communication within hospitals. This approach supports timely clinical decision-making and effective infection control.

Development of a mosquito repellent spray for insecticide-resistant Ae. aegypti mosquitoes under laboratory conditions

2026-05-18T12:16:49+07:00

Insecticide-resistant Aedes aegypti mosquitoes have been documented in all provinces of Thailand, reducing the effectiveness of insecticidal products against these vectors. This study aimed to develop and evaluate a mosquito repellent spray against insecticide-resistant mosquitoes under laboratory conditions. The project involved formulating a mosquito-repellent spray with Icaridin as the active ingredient. The formulation was quantified for Icaridin using gas chromatography-flame ionization detection (GC-FID). An acute dermal irritation study was conducted on rabbits in accordance with OECD Guidelines 404 “Acute dermal irritation/corrosion” and OECD GLP standards. The efficacy of the spray against insecticide-resistant Ae. aegypti mosquitoes was assessed using modified repellency testing procedures. Polymerase chain reaction (PCR) and DNA sequencing were performed to identify mutations in the para gene (V1016G) in the mosquitoes used in the study. The results demonstrated that the mosquito repellent spray contained 9.78% w/w Icaridin and met the criteria for the skin irritation test in rabbits. Furthermore, the spray provided repellency time against insecticide-resistant Ae. aegypti mosquitoes from six provinces, ranging from 9.9 (SD 1.3) to 12.0 (SD 0) hours, with a median repellency time between 9.50 (IQR 3) and 12.0 (IQR 0) hours. The median repellency time of the spray differed significantly across mosquitoes from six provinces (Kruskal-Wallis test, p<0.05). A point mutation at amino acid position 1016 (V1016G) in the para gene was identified in mosquitoes from all six provinces, with mutation frequencies ranging from 0.20 to 0.33. The developed repellent spray targeting insecticide-resistant Ae. aegypti mosquitoes will be valuable for tasks related to vector control and the supportive functions of the Department of Medical Sciences.

Factors influencing hepatitis B virus infection among people, Sa Kaeo province

2026-05-15T15:00:52+07:00

This case-control analytical study aimed to investigate factors influencing hepatitis B virus (HBV) infection among people in Sa Kaeo Province. A total of 165 participants were recruited in the study, divided into the case group (55 individuals) and the control group (110 participants). The case group involved individuals with positive hepatitis B surface antigen (HBsAg) screening results, confirmed physician diagnosis of HBV infection, and positive HBV DNA results. The control group comprising individuals with negative HBsAg screening results, no previous history of hepatitis B diagnosis and no history of completing hepatitis B vaccination regimen. Data were collected using a questionnaire and analyzed using multiple logistic regression at a significance level of 0.05. The results revealed that the most significant personal risk factor was receiving blood or undergoing surgery or receiving injections from a non-healthcare professional (adjusted odds ratio: AOR=10.98, 95% CI=2.70-44.60). Other important personal risk factors included having a chronic disease (AOR=4.30, 95% CI=1.74-10.63), using shared personal items (AOR=3.28, 95% CI=1.16-9.24), and getting tattoos or piercings (AOR=2.82, 95% CI=1.06-7.55). Protective factors were aged 35-44 years (AOR=0.23, 95% CI=0.06-0.83), which was also a pathogenic factor. Environmental factors did not have an influence on hepatitis B infection. Therefore, public health agencies should urgently develop mechanisms for strictly monitoring and controlling medical procedures or injections conducted by non-medical personnel. Furthermore, proactive HBV screening policies should be implemented for individuals with chronic diseases and high-risk behaviors. Raising public awareness and promoting behavioral change regarding the sharing of personal items, is essential to reduce the HBV transmission in the community.

The Effectiveness of Rapid Antiretroviral Therapy Initiation for People Diagnosed with HIV in an ART Clinic

2026-05-20T10:02:34+07:00

The objective of this study was to compare the clinical outcomes of rapid antiretroviral therapy (ART) initiation (within 1-7 days of HIV diagnosis) with non-rapid ART initiation, The samples were 178 newly diagnosed people living with HIV comprising of non-rapid ART 88 participants and rapid ART 90 participants. The participants were recruited from 27 ART clinics at government hospitals in Nakhon Si Thammarat Province, Thailand, between October 2022 and September 2024, with a minimum follow-up of three months. Data were extracted from medical records and analyzed using descriptive statistics, Chi-square tests, and multiple logistic regression. The Rapid ART group started treatment significantly earlier after diagnosis than the non-rapid group (mean 3.46 vs. 31.31 days). After multivariable adjustment, The rapid ART showed a non-significant trend toward fewer opportunistic infections (ORadj=0.13; 95% CI=0.02-1.16) and lower mortality (ORadj=0.42; 95% CI=0.13-1.42). No significant difference was observed in viral suppression between the two groups (ORadj=1.67; 95% CI=0.87-3.20). However, missed appointments were significantly associated with failure to achieve viral suppression (ORadj = 0.28; 95% CI=0.13-0.62). Underlying comorbidities (ORadj=4.56; 95% CI=1.31-15.89) and tuberculosis co-infection (ORadj=5.28; 95% CI=1.36-20.53) were independently associated with mortality. Receiving care at general or regional hospitals (ORadj=2.98; 95% CI=1.26-7.05) and alcohol use (ORadj=3.78; 95% CI=1.29-11.11) were associated with missed appointments. These findings suggest that timely Rapid ART may help reduce the period of immunocompromised vulnerability. However, clinical outcomes were also influenced by comorbidities, facility-level factors, and patient adherence. Strengthening continuity-of-care interventions, particularly patient tracking systems at hospitals and targeted support for patients with alcohol use, alongside prompt ART initiation is therefore recommended.

Factors Associated with the Intention to Quit Smoking among Clients Attending Smoking Cessation Clinics in Nakhon Ratchasima Province

2026-04-23T09:41:41+07:00

This study aimed to assess the level of intention to quit smoking and analyze associated factors among clients attending smoking cessation clinics in Nakhon Ratchasima Province. A multi-stage sampling approach was employed. In the first stage, seven hospitals with smoking cessation clinics were selected. In the second stage, 272 participants who met the inclusion criteria were recruited through consecutive sampling. Data was collected between November 2024 and February 2025 using a researcher-developed questionnaire The results showed that majority of sample were male (94.85%), with a mean age of 37.88 years (SD=15.63). Most participants had a history of smoking conventional cigarettes (97.78%), and 25.19% had a history of e-cigarette use. The participants demonstrated a good-to-moderate level of intention to quit smoking (93.41%), and 57.58% reported a high level of perceived self-efficacy in controlling their smoking cessation behavior. Stepwise multiple linear regression analysis revealed five factors significantly associated with the intention to quit smoking: perceived self-efficacy (β=0.52, p-value<0.001), age (β=0.25, p-value=0.001), motivation to quit smoking (β=0.21, p-value=0.013), adherence to advice from healthcare providers (β=0.14, p-value=0.038), and having no history of e-cigarette use (β=0.13, p-value=0.047). The model accounted for 65.2% of the variance in intention to quit smoking (Adjusted R²=0.652). These findings indicate that perceived self-efficacy, motivation, and support from healthcare providers play a crucial role associated with the intention to quit smoking. Therefore, the development of integrated counseling programs aimed at enhancing perceived self-efficacy and clearly communicating smoking-related risks would improve readiness and intention to quit, particularly among adolescents and young adults.

Effectiveness of a Health Belief Model-Based Program on the Consumption of Sweetened Beverages among Health Science Students

2026-05-25T17:56:15+07:00

This quasi-experimental study with a two-group pretest-posttest design aimed to examine the effectiveness of a Health Belief Model-based program on the consumption of sweetened beverages among health science students. The sample consisted of 66 students from Sirindhorn College of Public Health Phitsanulok. The two curricula were randomly designated as the experimental and control groups by drawing lots. Subsequently, 33 students from each curriculum were selected by simple random sampling without replacement. The experimental group participated in a four-week Health Belief Model-based program designed to improve sweetened beverage consumption behaviors, whereas the control group continued their usual routines by attending regular classes or engaging in self-directed learning activities. Data were collected between December 2024 and February 2025 using self-administered questionnaires. Descriptive statistics, independent samples t-test, and paired samples t-test were employed for data analysis. The results showed that, before the intervention, the mean scores of health beliefs and sweetened beverage consumption behaviors did not differ between the experimental and control groups (MD=0.06, 95% CI=-0.01-0.12 and MD=0.06, 95% CI=−0.09-0.21, respectively). After the intervention, the mean scores of health beliefs and sweetened beverage consumption behaviors differed significantly between the experimental and control groups at the 0.05 level (MD=2.11, 95% CI=2.01-2.23 and MD=2.15, 95% CI=1.95-2.36, respectively), with the experimental group having higher mean scores than the control group. In addition, within the experimental group, the post-intervention mean scores of health beliefs and sweetened beverage consumption behaviors differed significantly from the pre-intervention scores at the 0.05 level (MD=−2.08, 95% CI=−2.20-−1.97 and MD=−2.12, 95% CI=−2.35-−1.89, respectively), with the post-intervention mean scores being higher than the pre-intervention scores. In contrast, within the control group, the mean scores of health beliefs and sweetened beverage consumption behaviors did not differ from the pre-intervention scores (MD=−0.03, 95% CI=−0.07-0.03 and MD=−0.03, 95% CI=−0.15-0.10, respectively). These findings indicate that effective modification of sweetened beverage consumption behaviors requires the development of accurate health beliefs.

Factors Associated with Blood Cholinesterase Levels among Crop Rotation Farmers Exposed to Pesticides in Ban Sa Subdistrict, Chae Hom District, Lampang Province, Thailand

2026-05-12T09:41:10+07:00

Crop rotation farming requires the use of insecticides at multiple stages of the production process, resulting in continuous occupational exposure among farmers. In particular, insecticides that inhibit cholinesterase activity are of significant concern, as decreased blood cholinesterase levels serve as an important biomarker of pesticide exposure and associated health risks. This study aimed to identify factors associated with blood cholinesterase levels related to insecticide exposure among rotational crop farmers in Ban Sa Subdistrict, Chae Hom District, Lampang Province, Thailand. This study included 281 participants, and data were collected between July and September 2025. The research instruments consisted of structured questionnaires assessing knowledge, attitudes, and practices regarding the surveillance, prevention, and control of pesticide-related illnesses, as well as a cholinesterase reactive test paper for measuring blood cholinesterase levels. Relationships between variables and blood cholinesterase levels were analyzed using Spearman’s rank correlation coefficient and the Chi-squared test. Predictive factors were subsequently identified using ordinal logistic regression analysis. The results revealed that nine factors were significantly associated with blood cholinesterase levels, including sex, age, educational level, body mass index (BMI), personal hygiene after work, pesticide use per application, average working duration per week, agricultural experience, and the level of surveillance, prevention, and control practices for pesticide-related illnesses. In the multivariable ordinal logistic regression model, four factors significantly associated with blood cholinesterase levels: sex (Adjusted OR=0.52, 95% CI=0.28-0.95), body mass index (Adjusted OR=0.88, 95% CI=0.81-0.96), personal hygiene after work (Adjusted OR=0.31, 95% CI=0.14-0.71), and pesticide use (Adjusted OR=1.28, 95% CI=1.02-1.60). The findings provide empirical evidence to support the planning and implementation of occupational health and safety measures aimed at reducing health risks associated with insecticide exposure among crop rotation farmers.

Evaluation of Treatment Outcomes for Patients with Multidrug-Resistant Tuberculosis Registered in Thailand’s National Tuberculosis Information Program, Fiscal Year 2022 to 2024

2026-04-22T17:51:27+07:00

Patients with drug-resistant tuberculosis (DR-TB) who are treated with various DR-TB regimens are registered in the National Tuberculosis Information Program (NTIP) of Thailand by the hospitals providing care. This study aimed to evaluate the treatment outcomes of DR-TB patients registered in the national reporting system during fiscal years 2022-2024 (B.E. 2565-2567). The study was conducted as a cross-sectional research on the time to sputum culture conversion from positive to negative using survival analysis. Factors associated with treatment success were examined using the Chi-square test at a statistical significance level of 0.05. Statistically significant variables identified from the univariate analysis were further analyzed using multiple logistic regression. A total of 3,145 DR-TB patients were included. The majority were male (male-to-female ratio: 2.4:1.0). The largest number of patients were aged 41-50 years (21.84%), followed by 51-60 years (20.13%). Comorbidities included diabetes mellitus (10.46%) and HIV infection (12.66%). Treatment outcomes showed a success rate of 62.07%, with failure (1.81%), death (15.83%), loss to follow-up (8.81%), transfer-out (2.07%), and unevaluated outcomes (9.41%). Monitoring sputum culture conversion monthly for nine months revealed that the highest rate of conversion from positive to negative at month two was observed in patients receiving BPaLM regimen, followed by BPaL. These regimens were also associated with lower mortality and loss to follow-up compared to other regimens. Patients aged <60 years had 1.5 times higher odds of treatment success rate compared with those aged >60 years (AOR=1.50; 95% CI: 1.30-1.82). HIV-negative patients had 1.9 times higher odds of treatment success rate compared with HIV-postive patients (AOR=1.90; 95% CI: 1.57-2.42). In fiscal year 2024, 248 patients were still undergoing treatment and therefore could not be evaluated. Future research should aim to monitor and evaluate treatment outcomes among this ongoing patient cohort. Furthermore, cured DR-TB patients should undergo follow-up clinical assessments at 6 and 12 months post-treatment completion.

Factors Associated with Dietary Consumption Behaviors among Older Adults with Hypertension without Complications in Pa O Don Chai Subdistrict, Mueang District, Chiang Rai Province

2026-05-18T12:11:09+07:00

This cross-sectional descriptive study aimed to examine the factors associated with dietary behaviors among older adults with uncomplicated hypertension in Pa O Don Chai Subdistrict, Mueang District, Chiang Rai Province. The study was conducted between July and September 2024. A sample of 115 participants was recruited through simple random sampling. The research instrument consisted of a questionnaire assessing demographic data, predisposing factors (knowledge and attitudes), enabling factors regarding food consumption, reinforcing factors regarding food consumption, and dietary behaviors. Data were analyzed using percentage, mean, standard deviation, and Spearman's rank correlation coefficient. The findings revealed that participants had an overall high level of predisposing knowledge regarding hypertension (X=4.14, SD=0.78), whereas predisposing attitudes toward hypertension prevention and management were at a moderate (X=2.78, SD=0.72). Enabling factors (X=3.44, SD=0.33) and reinforcing factors (X=3.98, SD=0.96) were both at a high level, while overall dietary behaviors were at a moderate level (X=3.16, SD=1.13). Furthermore, predisposing knowledge (r_s=0.73, 95% CI: 0.62 to 0.80) and enabling factors (r_s=0.71, 95% CI: 0.60 to 0.79) showed statistically significant strong positive correlations with dietary behaviors (p<0.05). Reinforcing factors showed a statistically significant weak positive correlation with dietary behaviors (r_s=0.38, 95% CI: 0.21 to 0.54, p<0.05), whereas predisposing attitudes showed no statistically significant association with dietary behaviors. The results of this study provided baseline evidence for the development of health promotion strategies targeting older adults with uncomplicated hypertension. These findings provide essential baseline evidence for designing health promotion programs to improve dietary practices among older adults with uncomplicated hypertension. Interventions should prioritize actionable health education, enhance access to clear health information, and cultivate supportive environments that facilitate healthy eating habits.

Outbreak Investigation of Legionnaires in European Travelers, at Hotel, Talat Yai Subdistrict, Muang District, Phuket Province, 3-4 March 2025

2026-04-07T09:49:29+07:00

On February 28, 2025, the Office of Disease Prevention and Control No. 11 (ODPC 11) investigated a Legionnaires' Disease outbreak involving three tourists linked to a Phuket hotel. The investigation, conducted on March 3-4, 2025, confirmed a high probability of hotel-acquired infection as symptoms aligned with the 2-14 days incubation period and laboratory tests found Legionella spp. in 22% of samples, including cooling towers and poolside showers. Key systemic failures included a 40% failure rate in residual chlorine levels due to sunlight-induced degradation at rooftop dosing points and hot water temperatures dropping to growth-favorable levels during peak usage. Consequently, the team recommended that the hotel improve chlorine shielding, stabilize water temperatures, utilize standardized measuring tools, and maintain rigorous maintenance logs to prevent future occurrences.