Disease Control Journal

Determination of Risk Factors or Health Issues Utilizing Multiple Binary Logistic Regression Analysis

2025-09-30T15:59:28+07:00

The occurrence of diseases or health problems is influenced by multiple factors. Analyzing data without considering all relevant variables may lead to inaccurate conclusions, which can negatively affect the planning of effective interventions. Binary logistic regression is a widely used statistical method for analyzing data when the dependent variable is dichotomous, while independent variables may be categorical (with more than two levels) or continuous. When the dependent variable still has two categories, but the model includes two or more independent variables, it is referred to as multiple binary logistic regression analysis. The method aims to describe the relationship between independent and dependent variables, indicating the magnitude of risk or association, while controlling confounding factors. Accurate and reliable results from such analyses can provide valuable evidence to support the planning, promotion, prevention, and control of diseases.

Survival Analysis and Risk Prediction Model for Tuberculosis Development in HIV-Infected Patients

2025-11-19T14:25:47+07:00

HIV/TB coinfection is a significant public health problem in Thailand. Understanding risk factors and predicting tuberculosis (TB) development is therefore essential for developing effective strategies. The objective of this study was to analyze TB - free survival time and to develop a risk prediction model for TB in HIV-infected patients in Thailand. This retrospective cohort study utilized data from the National AIDS Program (NAP) database from 2009 to 2023 (B.E. 2552 to 2566), analyzing data from 289,847 HIV-
infected patients. Kaplan-Meier survival analysis revealed that the TB-free Restricted Mean Survival Time (RMST) was approximately 9 years. The developed Cox proportional hazards model effectively predicted the risk of TB development in HIV-infected patients in Thailand. Significant risk factors for TB development identified by the Cox proportional hazards analysis included older age, male sex, symptomatic HIV infection and AIDS stage (compared to asymptomatic stage), presence of other opportunistic infections, and use of alternative drug regimens. Conversely, higher CD4 count, receiving ART, and ART initiation within 1 week of diagnosis were significant protective factors. These findings can help identify high-risk individuals for targeted surveillance, potentially leading to a reduction in TB incidence and further improving clinical outcomes in this patient population.

The Relationship between Health Literacy and Healthy Food Consumption Behaviors for Obesity Prevention among Female High School Students in Thung Song District, Nakhon Si Thammarat Province

2025-10-14T17:29:41+07:00

Health literacy in selecting healthy foods is a critical factor in preventing obesity among adolescent girls, aligning with the Ministry of Public Health’s strategic plan to promote adolescent health. This cross-sectional survey aimed to assess the level of health literacy and its association with healthy food selection behaviors for obesity prevention among female high school students in Thung Song District, Nakhon Si Thammarat Province. A total of 350 students participated in this survey, and data were collected using a structured questionnaire with item-content validity indices ranging from 0.66 to 1.00 and Cronbach’s alpha coefficients of 0.88 and 0.79. Data were analyzed using descriptive statistics and inferential statistics, including Spearman’s rank correlation coefficient. The overall health literacy level was found to be adequate (mean=84.75±10.33). When examined by component, access to health information and services for obesity prevention (mean=25.90±3.81), communication for enhancing obesity prevention skills (mean=19.37±2.86), media and information literacy (mean=14.81±2.97), management of personal health conditions (mean=11.05±2.40), and health knowledge and understanding (mean=3.14±0.85) were all at an adequate level. However, decision-making for proper obesity prevention behaviors was insufficient (mean=10.47±2.24). In addition, access to health information and services was positively associated with healthy food selection behaviors (r=0.17, p=0.00). Although most students exhibited adequate health literacy, decision-making skills remained insufficient. Therefore, promoting and developing analytical and decision-making skills through practical activities and appropriate media is recommended to enable students to translate knowledge into correct and sustainable obesity-prevention practices.

Effects of a behavioral promotion program on hand-foot-mouth disease prevention by applying the protection motivation theory among parents in early childhood development centers in Saraburi Province

2025-07-09T15:28:36+07:00

This quasi-experimental study with a two-group pretest-posttest design aimed to examine the effects of a behavioral promotion program on hand-foot-mouth disease prevention. The Protection Motivation Theory was applied to conduct a study among parents in early childhood development centers in Saraburi Province from February 3 to March 28, 2025. A total of 100 parents were purposively selected from 2 childhood development centers and randomly assigned into experimental and comparison groups, with 50 participants in each group. The experimental group received an 8-week intervention consisting of classroom activities, online learning, and reminder messages via the LINE application. Data were collected using a self-administered questionnaire and analyzed using descriptive statistics and inferential statistics, including Paired t-test, Wilcoxon signed ranks test, and Mann-Whitney U test. The results showed that after the intervention, the experimental group had a significant difference (p<0.05) in knowledge, perceived severity, perceived susceptibility, perceived self-efficacy, response efficacy, and prevention behavior compared to the comparison group with p=0.001, p<0.001, p=0.002, p<0.001, p<0.001 and p=0.005, respectively. These findings suggest that the behavioral promotion program was effective and could be integrated into hand-foot-mouth disease prevention and control strategies in early childhood development centers.

Ergonomic Risk Assessment and Associated Factors among Academic Support Staff Working with Computers

2025-10-28T16:36:19+07:00

This cross-sectional descriptive study aimed to assess ergonomic risks and examine associated factors among 73 computer user support staff working in the Office of the President Building, Suratthani Rajabhat University. Data were collected using a general information questionnaire and the Rapid Office Strain Assessment (ROSA) tool. Descriptive and inferential statistics were applied, including Pearson’s Chi-square test and logistic regression. The results showed that most respondents were female (83.6%), aged 40-49 years (45.2%), obese based on body mass index (49.3%), and physically inactive (61.6%). A vast majority (95.9%) of respondents worked more than eight hours per day, while 43.8% reported working overtime. Additionally, 78.1% used computers, a mouse, and a keyboard for more than six hours daily. According to ROSA scores, 89% were classified as having high to very high ergonomic risk, 11% had moderate risk, and none were in the low-risk category. Common ergonomic risk factors included inappropriate seat cushions (32.9%), absence of lumbar support (31.5%), and lack of hands-free equipment (32.9%). Work experience had statistically significant association with ergonomic risks, those with 4–6 years and 7–10 years of experience had 5.6 and 7.3 times higher risk, respectively, than those with 1–3 years of experience (p < 0.05). These findings highlight a high prevalence of work-related musculoskeletal disorder (WMSD) risks among academic support staff. Workplace ergonomic improvements, promotion of correct work behaviors, and the implementation of occupational health policies are recommended for sustainable risk prevention.

Development of health promotion model for the elderly through community participation in Khok Sung Subdistrict, Mueang District, Nakhon Ratchasima Province

2025-11-12T11:36:23+07:00

This study aimed to analyze the health status and quality of life of older adults in Khok Sung Subdistrict, Mueang District, Nakhon Ratchasima Province; to develop a community participatory health promotion model; and to evaluate the key success factors of the implementation. The research employed a Participatory Action Research (PAR) design based on the conceptual framework of Cohen and Uphoff. The sample consisted of 150 participants, including 60 older adults, 45 caregivers, and 45 community stakeholders. Quantitative data were collected using questionnaires, while qualitative data were obtained through focus group discussions and in-depth interviews. Quantitative data were analyzed using descriptive statistics and paired t-tests, and qualitative data were analyzed using content analysis. The findings revealed that the quality of life and overall health of older adults significantly improved after the implementation (p<0.05). The developed health promotion model comprised four stages: 1) situation and needs assessment, 2) participatory planning with the community and network partners, 3) capacity-building activities and local health innovation development, and 4) monitoring and evaluation. The network partners reported a high level of satisfaction with the program (mean=4.27, SD=0.60). Key success factors included proactive leadership within the community, continuous support from local administrative organizations, and collaboration among all relevant sectors.

COVID-19 preventive behaviors based on the health belief model among people in Khueang Nai District, Ubon Ratchathani Province

2025-09-14T14:32:01+07:00

This survey research was conducted to examine covid-19 preventive behaviors and community management approaches in caring for COVID-19 patients. The sample was residents from Ko Ae Subdistrict, Khueang Nai District, Ubon Ratchathani Province. Data were collected from January 1 to September 30, 2022. Quantitative data were collected from 456 participants using a questionnaire measuring 25 items on COVID-19 perception and 12 items on preventive behaviors related to COVID-19. The reliability of the questionnaire was validated with 30 similar participants, yielding Cronbach’s alpha coefficients of 0.83 and 0.90, respectively. Data were analyzed using descriptive statistics and multiple regression analysis. For the qualitative study, purposive sampling was used to recruit 30 key informants, including public health personnel, community leaders, and community representatives. The focus group discussions were conducted using semi-structured interviews. Qualitative data were analyzed using content analysis. The result showed that the majority of the sample had good COVID-19 preventive behaviors (71.93%). History of COVID-19 infection and perceived benefits of preventive practices could predict preventive behaviors for COVID-19 by 14.84%, with a statistical significance level of 0.05. Regarding community management of COVID-19 patients, it was found that participatory processes were implemented in collaboration with related organizations. Disease prevention and control measures should emphasize the benefits of preventive behaviors and promote community participation, which would enhance the sustainability and efficiency of implementation.

Surveillance of heat related deaths in Thailand during 2018-2023

2025-09-30T16:05:32+07:00

The increasing global warming has led to severe consequences in terms of heat-related deaths. More recently, Thailand has also experienced similar impacts from global warming. The objective of this research is to report the mortality rates of individuals related to hot weather conditions in Thailand during the period of 2018-2023. The data were collected from the surveillance database of heat-related deaths at the Epidemiology Division, Department of Disease Control from 2018 to 2023. The data were analyzed annually using descriptive statistics. Differences of mortality rates in each year were analyzed by the Chi-square test, and the distribution of deaths was observed using QGIS. There were 139 heat-related deaths, with a male-to-female ratio of 7.2:1. The median age was 53 years, with the age group of 51-60 years and 60 years and older having the highest mortality rates. Occupations involving outdoor work were reported as the location of death. Underlying diseases such as diabetes and cardiovascular diseases were also reported in this group. Deaths related to heat in each year showed a statistically significant difference (p<0.001, α=0.05). In conclusion, the trend of deaths from heat-related conditions in Thailand increased each year with rising temperatures. Males, outdoor workers, the elderly, and those with underlying health conditions were predominantly reported in the heat-related death cases.

Readiness and competency of village health volunteers in triage and care for patients with respiratory infection in the post-COVID-19 era, Thailand

2025-09-17T14:39:29+07:00

This descriptive study aimed to assess the readiness of village health volunteers (VHVs) to triage, manage, and care for patients with respiratory infection, an important disease burden after the COVID-19 pandemic in Thailand. Healthcare providers’ perspectives were also examined in the study to determine the gap between actual and expected VHVs’ practice This study was conducted in Khon Kaen Province, by using multistage random sampling, and included 215 VHVs and 111 healthcare providers. Data were collected from June to December 2023 using questionnaire and a knowledge tests, validated by three experts with reliability coefficients of 0.82-0.90 and KR-21 of 0.77 The results revealed that most VHVs were aged over 45 years, had completed primary school education, and had low to moderate levels of knowledge (89.30%) and practices (70.23%) in triaging, managing, and caring for patients with respiratory infections. The barrier was insufficient equipment for patient assessment. Only education level significantly associated with knowledge and practices (p<0.05). Particularly, VHVs showed low to moderate practices in triaging by severity and providing self-care advice. Most health care providers had more than 10 years of work experience. There was a statistically significant difference between their expectations and their perceptions of actual VHV practices (p=0.026). The priority need index for improving basic clinical skills for VHVs was demonstrated, such as physical examinations, disease control and prevention, and patient triage by severity and screening of high-risk patients for infection. The study suggested the need to enhance VHVs competencies to strengthen respiratory infections effectively. It recommended focusing on basic clinical skills training and providing additional resources to improve community healthcare, reduce disease burden, and support global health security, aligning with goals for developing a sustainable health system.

Prevalence of Tuberculosis Infection in People Living with HIV who Received Antiretroviral Therapy More Than 12 Months

2025-11-12T12:02:40+07:00

A retrospective study in people living with HIV (PLHIV) who had been on antiretroviral therapy (ART) for more than one year and had a CD4 count greater than or equal to 200 cells/mm3 was conducted to determine the prevalence of tuberculosis (TB) infection and the treatment outcomes among PLHIV with TB co-infection. A total of 321 PLHIV from three hospitals, between September 1, 2023, and February 29, 2024, were screened for TB infection using two types of Interferon-Gamma Release Assays (IGRAs): ELISA or ELISPOT. Of these, 51.4% were male with a median age of 48 years (19-74). Most had co-infection with hepatitis C virus and underlying dyslipidemia. The average duration since HIV diagnosis and treatment was 15 and 12 years, respectively. The prevalence of TB infection was found to be 6.9% (22 cases), with detection rates of 7.0% by ELISA and 6.7% by ELISPOT. Most HIV patients co-infected with TB had CD4 counts greater than 500 cells/mm3 and a viral load of less than or equal to 50 copies/mL. Those HIV patients diagnosed with TB co-infection were treated with either the 1HP regimen (2 patients) or the 3HP regimen (20 patients), and all were able to complete the full course of treatment. The most reported adverse event was dizziness, occurring in 3 patients (13.6%).

Knowledge and social support related to the accident prevention behavior of the elderly living in the Kuchinarai Municipality, Kalasin Province

2025-11-07T21:30:59+07:00

This research was a descriptive cross-sectional design. The objectives were to study the level of accident prevention behavior among the elderly and to investigate how knowledge and social support related to accident prevention behavior among elderly living in the Kuchinarai Municipality, Kalasin Province. The study sample consisted of 327 participants who were 60 years or older. A validated questionnaire was employed to collect data between June and August 2024. The knowledge questionnaire’s reliability was verified by a KR-20 coefficient of 0.73, while the social support and accident prevention behavior questionnaires were found to have Cronbach’s alpha coefficient of 0.72 and 0.71, respectively. The sample was characterized using descriptive statistics, and the relationships between variables were analyzed using Pearson's correlation coefficient, with a significance level of 0.05. The findings revealed that the majority of elderly had a high level of knowledge (56.58%) and a high level of social support (72.17%), whereas accident prevention behavior was predominantly at a moderate level (57.80%). Knowledge was found to have a statistically significant negative correlation with accident prevention behavior (r=-0.53, p<0.05), while social support demonstrated a statistically significant positive correlation (r=0.15, p<0.05). In conclusion, although the elderly possessed a high level of knowledge, it did not translate into optimal accident prevention behavior. In contrast, better accident prevention behavior can be achieved through increased social support levels. Therefore, relevant agencies should implement programs that enhance awareness and encourage support from families and communities to promote sustainable accident prevention among the elderly.

Development of the Thai Version of the iWorkHealth Assessment Tool for Work-Related Mental Health

2025-09-14T14:16:12+07:00

Mental health problems and work are related. Mental health problems can negatively impact work performance, and the work itself can impact a worker's mental health. This study aimed to develop a Thai version of iWorkHealth to be a screening tool for mental health problem in the workplace. The study procedures included requesting permission, translating questions, assessing the validity, trying out, and finalizing the complete instrument. The overall Cronbach Alpha coefficient was 0.65. The results of the separate assessments found that the Cronbach Alpha coefficient of general mental health, psychosocial conditions related to work, work stress and burnout, management of the organization related to mental safety and health of workers were 0.95, 0.97, 0.96 and 0.97 respectively. Although the overall Cronbach Alpha coefficient was lower than 0.70, but the Cronbach alpha coefficients of each dimension were higher than 0.90. However, the corrected item-total correlations varied from 0.21 to 1.00. Therefore, it can be used as a screening tool for mental health conditions in workplaces before referred to experts.

Development of Health Indicator Setting Process for Subdistrict Health Promoting Hospital in Pathum Thani Province

2025-10-11T09:26:44+07:00

This study aimed to develop a process for defining successful indicators for health-related operations at Sub-district Health Promotion Hospitals (SHPHs) in Pathum Thani Province, A participatory approach was employed with involvement from various local sectors to ensure that the indicators reflect community problems and needs. The data collection tools included summary reports of indicator definition, observation of brainstorming sessions, and in-depth interviews. The sample group consisted of 15 individuals from government/political networks, academic/professional sectors, and civil society. Data analysis involved calculating frequencies and percentages for quantitative data and content analysis for qualitative data. The results reveal that the participatory approach, which involved the Health Assembly process to gather community input on determining indicators, helped align the indicators with the community’s needs and problems. Health officials in the area also accepted and were willing to cooperate in reporting results for 20 indicators. Of these, 10 indicators were mandatory across all areas, while the remaining 10 indicators depended on the priority issues identified by the relevant networks within the community. The indicators covered health promotion, communicable disease control, non-communicable disease control, environmental and occupational health, dental public health, and primary healthcare, with the highest importance placed on the latter. Recommendations suggest that the development of indicators should respond to the needs of the community, emphasizing participation from all sectors. Indicators can be categorized as follows: 1) those necessary for the national context, 2) those developed by local public health experts to improve quality of life based on local contexts and 3) community-driven indicators that are create and owned by the community. Continuous monitoring and evaluation should also be conducted.

Factors Related to Preventive Behaviors against Tuberculosis Infection among Household Contacts of Pulmonary Tuberculosis Patients, Udon Thani Province

2025-10-14T17:27:28+07:00

This analytical cross-sectional study aimed to investigate factors associated with tuberculosis (TB) prevention behaviors among household contacts of TB patients in Udon Thani Province. The study was conducted between July 2022 and June 2023, involving a population of 6,544 individuals. A sample size of 320 participants was determined using a multiple logistic regression and selected through multi-stage sampling. The research framework was based on the PRECEDE Model and the Health Belief Model. Data were collected using a validated questionnaire and analyzed using descriptive statistics and multiple logistic regression. The results revealed that age was a significant factor: household contacts aged 41 years or older were 2.34 times more likely to exhibit TB prevention behaviors compared with those younger than 41 years (AOR=2.34, 95% CI: 1.19-4.56, p=0.01). Regarding relationship to the patient, those who were parents or relatives demonstrated better preventive behaviors compared with those who were spouses or children (AOR=2.45, 95% CI: 1.22-4.89, p=0.01). In addition, knowledge about TB was strongly associated with prevention behaviors; individuals with high levels of knowledge were 4.82 times more likely to engage in preventive behaviors than those with moderate or low knowledge (AOR=4.82, 95% CI: 2.15-10.81, p<0.00). These findings highlight the importance of planning for TB prevention among household contacts of TB patients. The study emphasizes promoting appropriate preventive behaviors to reduce the risk of infection, improving household environments and protective measures to limit transmission from TB patients, and enhancing knowledge and awareness among household contacts. This information is crucial to support self-protection behaviors and strengthen TB control efforts within households.

Development Risk Assessment Tool for Hepatitis B and C Virus Infections for People in Health Region 7

2025-10-17T16:39:31+07:00

This research aimed to develop a risk assessment tool for hepatitis B and C infections to support disease prevention and control efforts. The research involved three stages: firstly, developing instrument; secondly, testing; and finally, usability assessment. The study samples included individuals aged 30 years and older who lived in the areas of local administrative organizations within Health Region 7. Qualitative data were analyzed using content analysis and quantitative data using descriptive and inferential statistics. The developed assessment tool contained 12 questions related to risks for hepatitis B and C infections, and 12 questions designed to assess the participants’ knowledge and understanding of the diseases. The Item-Objective Congruence (IOC) values ranged from 0.67 to 1.00, and the KR-20 reliability coefficient of an assessment tool was 0.84. For hepatitis B infection prediction, the area under the ROC curve was 69.33% (95% CI: 0.60-0.80), with a sensitivity of 68.00% (95% CI: 65.42-70.61), specificity of 66.30% (95% CI: 63.63-68.92), and accuracy of 66.30%. For hepatitis C prediction, the ROC curve was 60.20% (95% CI: 0.80-1.00), with a sensitivity of 75.40% (95% CI: 74.33-6.64), specificity of 41.50% (95% CI: 40.11-42.82), and accuracy of 41.80%. In addition, the developed risk assessment tool demonstrated acceptable validity and reliability and was rated highly satisfactory by users, with an average satisfaction score of 4.34 (SD=0.76).