Disease Control Journal

Food Poisoning Outbreak Investigation Report at a Wedding Ceremony, Khuan Don District, Satun Province, January 2025

Rutkalya Khawcho — 2026-03-28

On January 18, 2025, the Epidemiology Department of Khuan Don Hospital was notified by the emergency room that several patients were admitted with symptoms of abdominal pain and diarrhea. They provided information that they had eaten food from a wedding ceremony on January 18, 2025 at approximately 11:00 a.m., in Khuan Don District, Satun Province. Therefore, disease investigation and control measures were being carried out to confirm the outbreak, study the distribution patterns and factors that cause of the disease, and find measures to prevent the disease. This study was a descriptive epidemiological study collecting data from medical records, interviews of patients and additional patient searches, as defined as follows: Those who ate food from the wedding ceremony, and had any of the following symptoms: loose stools, watery stools, bloody stools, abdominal cramps, nausea, vomiting, fatigue, fever between January 18 and 24, 2025. An Analytical epidemiological study using case-control study, collecting samples for laboratory examination and studying the environment were carried out. There were 245 cases of food poisoning with no deaths. approximately 1,000 people attended the ceremony. The most
common symptom was diarrhea (90.20%). The median incubation period was 7 hours. The food at risk was spicy clams salad with coconut milk. An epidemiological analysis study found that those who ate them had a 576-fold higher risk of food poisoning than those who did not. (Odds ratio=576, 95% CI: 77.93-4,257, p<0.05. Laboratory test results found vibrio parahaemolyticus in 11 rectal swab samples and 2 fresh stool samples. This food poisoning outbreak was characterized by a common source of disease. Disease prevention measures include providing food hygiene advice to food handlers and related personnel, informing people in the area about the outbreaks, and establishing ongoing guidelines for behaviors that reduce the risk of disease.

An Outbreak Investigation of Influenza A (H1N1 and H3N2) in an Elementary School, Chachoengsao Province, Thailand, June-July 2024

Kridsada Chareonrungrueangchai — 2026-03-28

On June 20, 2024, the Chachoengsao Provincial Public Health Office (CPPHO) was notified of a cluster of influenza-like illness cases among students at a local elementary school. The CPPHO initiated an investigation to confirm the diagnosis and outbreak, determine the distribution of the disease, identify risk factors and recommend control measures. The study employed a descriptive epidemiological study, including reviewing medical records for the influenza situation in Mueang District and Chachoengsao Province. Further case findings were conducted by interviewing school nurses, teachers and students. Additionally, samples were collected for viral genetic testing. Environmental surveys were also conducted at the school. A case-control study was performed to identify risk factors for the outbreak. The school had 2,373 students and 170 teachers and staff. A total of 131 cases were identified, resulting in an attack rate of 5.15%. A total of 14.50% of patients required inpatient care, and the case fatality rate was zero. The three most common symptoms were fever (100%), cough (92.62%), and rhinorrhea (72.95%). Laboratory tests confirmed one case of Influenza A H1N1 and three cases of Influenza A H3N2 out of four specimens tested. The key risk factors identified were close household contact, participation in the teacher appreciation ceremony, the lack of hand hygiene prior to eating (Adjusted Odds Ratio [AOR] 5.25, p=0.011), sitting near students with influenza-like symptoms (AOR 3.52, p=0.002), and using air-conditioned classrooms (AOR 3.77, p=0.001). The outbreak of Influenza A H1N1 and A H3N2 at the school was confirmed. Key risk factors included close contact with sick family members, the teacher appreciation ceremony, poor hand hygiene, proximity to symptomatic individuals, and the use of air conditioning in classrooms. The CPPHO intervened by performing a disease investigation, educating on sanitary and safe food handling practices, and providing medical supplies for control. Consequently, the outbreak's severity was reduced, and it was ultimately terminated.

Intention to use HIV Self-Testing and Its associated factors among young men who have sex with men in Bangkok Metropolitan Region

Kullawadee Jantarasorn — 2026-03-28

HIV self-testing is a safe, accurate, private, and convenient approach for HIV detection that enhances accessibility and frequency of HIV testing. This cross-sectional analytical study aimed to examine the intention to use HIV self-testing and associated factors among young men who have sex with men (YMSM) aged 18-25 years in the Bangkok Metropolitan Region. A total of 586 participants were recruited using Respondent Driven Sampling (RDS). Data was collected through an online questionnaire (Google forms). Among 586 young MSM participants with a mean age of 20.25 years (SD=2.25), 82.0% expressed intention to use HIV self-testing. Factors significantly associated with intention to use HIV self-testing (p<0.05) included perceived risk of HIV/AIDS infection and perceived self-efficacy for HIV self-testing. The Ministry of Public Health and related agencies should develop programs to promote knowledge and skills regarding HIV self-testing, including sexual risk behavior assessment through various communication channels such as social media, health websites, and applications. They should also develop age-appropriate promotional materials for youth and implement programs to enhance perceived self-efficacy in HIV self-testing among young men who have sex with men. This includes developing clear instructional learning materials that demonstrate usage procedures to increase confidence in using HIV self-test kits, thereby strengthening perceived self-efficacy and promoting intention to conduct HIV self-testing.

Translation and quality assessment of a questionnaire for practice toward Helicobacter pylori

Sasitorn Tandorn — 2026-03-28

Helicobacter pylori infection is a preventable disease with correct practice. This study aimed to translate a questionnaire on practice toward Helicobacter pylori infection and to examine its content validity and reliability in the Thai version. The research design was a descriptive study, and it was conducted in two phases. Phase 1 involved the translation of the questionnaire using a forward-backward technique by professional translators from two independent university language institutes, followed by content validity assessment by five experts. Phase 2 focused on testing the reliability of the questionnaire in a sample of 30 individuals with dyspeptic symptoms who were at risk of the infection. Inclusion criteria were adults aged 20-59 years with a history of Helicobacter pylori testing. Participants were recruited from a tertiary hospital between July and August 2025. Data was analyzed using Cronbach’s alpha. The findings revealed that the Thai version of the questionnaire was conceptually equivalent to the original English version. Content validity was acceptable (Content Validity Index=0.91), and reliability was satisfactory, with a Cronbach’s alpha coefficient of 0.73. In conclusion, the translated questionnaire demonstrated good quality and can be applied to assess practice toward Helicobacter pylori infection in the Thai context.

Application of coaching model to promote the adult vaccine clinics

Kaitsuda Saiprom — 2026-03-28

The Department of Disease Control, Ministry of Public Health, developed an adult immunization program in 2016. This includes establishing guidelines and service models for adult vaccination clinics, which serve as service points with vaccines under the National Immunization Program. The goals of adult vaccine clinics are to provide comfortable and sustainable access to vaccination for target populations, under national standard, enhance immunity across all age groups. This study aimed to examine the support model for promoting adult vaccination clinics within Health Region 9 during the 2024 fiscal year. From December 7, 2023, to July 9, 2024. Office of Disease Prevention and Control, Region 9 Nakorn Ratchasima (ODPC 9) promoted and supported adult vaccination clinics in a total of 28 healthcare service units. This study used the GROW model (coaching approach) to enhance the implementation of adult vaccination clinics. There are 22 healthcare service units (78.57%; p<0.05) that has improved their operations according to the criteria of the Ministry of Public Health, with an average score at 13.29 from totally 16 points. The increasing of coverage vaccine in healthcare service units such as diphtheria-tetanus vaccine were 10 healthcare service units (35.71%; p=0.06) and influenza vaccine in pregnant group were 15 healthcare service units (53.57%; p=0.02). The results showed that the GROW model can be applied to enhance the implementation of adult vaccine clinic. To improve vaccine coverage and immunity in adults, the problems of immunization services in term of access to vaccine services and tracking of target population is recommended to be strengthened.

A Comparison of Hearing Assessment Between Automated and Manual Audiometry of Person Who Receive Health Check-ups at a Hospital, Thailand

Possavee Winuntamalakul — 2026-03-28

This cross-sectional analytical study aimed to compare automated and manual audiometry across three important dimensions: hearing test outcomes, testing duration, and user satisfaction. Twenty-four participants (forty-eight ears) underwent hearing threshold testing at frequencies ranging from 500 to 8000 Hz by both automated and manual audiometry. The data were analyzed using descriptive statistics and analytic statistics. The results showed that the hearing threshold differences between the two methods did not exceed 10 decibels at any frequency. Furthermore, a statistically significant high correlation was found between automated and manual audiometry (p<0.05), confirming the reliability of the automated method. Also, automated audiometry was significantly faster than the manual approach (p<0.05). Regarding user satisfaction, overall levels were similar, although participants expressed lower satisfaction with the duration of the automated test (p<0.05). These findings suggest that automated audiometry provides results comparable to manual testing while saving time. The method therefore shows promise for integration into medical surveillance programs. Moreover, its use in hearing conservation program could further enhance accessibility to timely screenings. However, improvements in the testing procedure or user instructions are recommended to address participant concerns about test duration.

Hand-arm vibration exposure assessment among farmers using agricultural tools in Pathum Thani Province

Chaiwat Sritanarach — 2026-03-28

Prolonged exposure to high levels of vibration on agricultural tools can affect hand-arm vibration syndrome (HAVS). This cross-sectional study aimed to evaluate hand-arm vibration (HAV) exposure among farmers using agricultural tools. A convenience sampling method was used to select 76 farmers from Nong Suea district in Pathum Thani province. A three-part questionnaire generated data that included demographics, work conditions, and vibration measurement with VM31. Data analysis was performed using frequency, percentage, mean, and standard deviation. The results revealed that most farmers were men (73.7%), with average age of 48.6 years (SD=10.0). The farmers had experience for working involved using vibrating agricultural tools with average of 18.4 years (SD=11.4). The results of HAV exposure indicated that 60.5% of farmers were at the low risk level (dose-response <5.0 m/s2 (A8)), followed by the high risk with 39.5 % (dose-response ≥5.0 m/s2 (A8)). The mean of HAV exposure categorized by agricultural tools were walking tractor of 11.2 m/s2 (SD=0.3), brush cutter of 4.7 m/s2 (SD=1.0), and backpack sprayer of 2.4 m/s2 (SD=0.6). The results of the study revealed that the farmers had a high dose-response of HAVS. This information can be utilized for the occupational health and safety management of farmers' exposure to vibration from the use of walking tractors, backpack brush cutters, and backpack sprayers. This study suggests that exposure duration should also be considered.

Factors associated with Undiagnosed Hypertension in Thailand, Fiscal Year 2022 : A Cross-Sectional Study from Health Data Center (HDC) database

Choosakun Piriya — 2026-03-28

Hypertension (HT) is a major cause of cardiovascular diseases in Thailand, where approximately 13.2 million adults have HT, and half of them are unaware of their condition. This study aimed to describe the characteristics of patients with elevated BP and undiagnosed HT and to identify factors associated with undiagnosed HT in Thailand. A cross-sectional study was conducted using data from the Health Data Center (HDC) database of the 2022 fiscal year. HT was defined as having two consecutive elevated BP visits (BP 140/90-179/109 mmHg) or a single BP reading of ≥180/110 mmHg. Data analysis was conducted using multiple Poisson regression. Results show out of 31 million valid last visits, 5.1 million (16%) had a BP of ≥140/90 mmHg. Among this group, one million (20%) were undiagnosed HT patients. The highest proportion of undiagnosed cases was among males, those aged 45-54, and patients accessing health services outside their registered area (type area 4). Factors strongly associated with undiagnosed HT included lower BP levels (140/90-159/99 mmHg), younger age (18-44 years), enrollment in "other" health insurance schemes, and having the last visit at a primary care hospital. The study concluded that undiagnosed HT remains a significant challenge in Thailand. To narrow the diagnostic gap, it is crucial to prioritize adherence to healthcare guidelines and establish a sustainable system to support physicians in diagnosing HT at primary care units. Further qualitative study is strongly suggested.

Evaluation of the Effects of Sand Sachet Materials on Efficacy of Temephos Sand Granules against Aedes aegypti L. Larvae

Wisachon Sripho — 2026-03-28

The use of temephos sand granules for the control of Aedes aegypti larvae is a widely accepted and effective method. One application form of this larvicide is the ready-to-use sand sachet. However, based on bioefficacy data from 2016 to 2022, none of the sachet-based products fulfilled the standard criteria set by the Department of Medical Sciences. Therefore, this study aimed to evaluate the structure and properties of various materials, to select the optimum material for the sand sachets, and to compare two testing equipment for ensuring adequate larval bioefficacy. Sand sachet packaging made from various materials were selected and filled with 1% w/w temephos sand granules at a concentration of 1 ppm for testing. Two types of observation equipment were used: floating larval cages and free-living larval cages. Based on initial material evaluations, one commercially available sachet and one alternative sachet made of nylon were selected for comparative testing under simulated natural conditions. Larvicidal efficacy was assessed 24 hours post-exposure, following periods of 24 hours, 7 days, and every 30 days up to 180 days after temephos application. The results showed that the 24-hour larval mortality rate from sachets made with commercial materials after 24 hours and 7 days of applying was the lowest among all test treatments. From 24 hours to 120 days after application, the 5 g nylon sachets (4 sachets) demonstrated larvicidal efficacy comparable to that of 20 g of unpackaged temephos-treated sand (positive control), followed by the 20 g nylon sachets. Furthermore, from 90 days onward following the application of all forms of temephos-treated sand, a statistically significant difference (p<0.05) in larval mortality was observed between the two types of test equipment, with free-living larval cages showing higher mortality rates than floating larval cages. These findings suggest that nylon is the most suitable material for use as packaging for temephos sand granules. Additionally, the use of free-living larval cages enhances the effectiveness of bioassay evaluations under simulated natural conditions.

Community Participation in Risk Factor Analysis and the Strategic Development to Reduce Road Traffic Accidents in Khao Thong Subdistrict, Phayuha Khiri District, Nakhon Sawan Province

Chalita Chimpuk — 2026-03-28

Road traffic accidents remain a major public health concern in Thailand, contributing to high rates of injury and mortality. This study aimed to enhance community participation in identifying risk factors and develop appropriate strategies to reduce road accidents in Khao Thong Subdistrict, Phayuha Khiri District, Nakhon Sawan Province. A participatory action research (PAR) approach was employed with engagement from local authority organizations, government organizations, educational institutions, and people resided in the community in Moo 5, Khao Thong Subdistrict. Data was collected using structured questionnaires and five community health network tools. Risk analysis based on “the Health Determinant Triangle” indicated significant associations and relative statistical significance between road accidents and personal factors such as age and education level, as well as vehicle inspection behavior and behavioral factors related to vehicle maintenance (p<0.05). Key interventions included the formation of local working groups, collaborative partnerships, safety campaigns, (e.g., public education, platform campaigns, and infrastructure improvements, e.g., traffic sign repairs). vehicle inspection, and traffic sign improvement. Following the intervention, over 60% of participants demonstrated significant improvements in safety knowledge and safety behavior. Additionally, community-led policy proposals emerged, fostering sustainable accident prevention efforts.

Factors Associated with Good Quality of Life Among Tuberculosis Patients in Chiang Rai Thailand

Suphatthanapong Chummuangyen — 2026-03-28

Tuberculosis (TB) is a major public health affecting many countries worldwide. In Thailand, the notification rate of newly diagnosed and relapsed TB cases was 86.4 per 100,000 population in 2023. In Chiang Rai, the notification of tuberculosis was 111 per 100,000 population in 2024. The treatment success rate was 82.4%, while the mortality rate was 12.1%. Chiang Rai province ranked seventh nationally for TB in terms of disease burden. Currently, TB prevention and control efforts focus on active case finding, improving treatment success rates, treating latent TB infection, and managing multidrug-resistant TB. However, these efforts have not fully addressed quality of life and associated factors among TB patients. Therefore, this study aimed to measure quality of life and its associated factors among TB patients. A cross-sectional design assessed quality of life and analyzed factors associated with good quality of life among 317 tuberculosis patients in Chiang Rai Province using the SF-36 for health-related quality of life. The findings revealed that 82.4% of TB patients had a good to very good quality of life. Several factors were significantly associated with better quality of life. These included: being aged 18–45 years, having high school education or above, being employed, and having a monthly income greater than 5,000 baht. In addition, participants with no debt, those who were single, and those living in households with fewer than three members, no comorbidities, a treatment duration of six months, and those following the usual prescribed drug regimen were more likely to have a better quality of life. Therefore, quality of life should be assessed in tuberculosis patients from the start of treatment, and the information should be used to monitor their well-being alongside treatment outcomes. This approach will help improve the effectiveness of tuberculosis patient care in Chiang Rai Province.

Evaluation of the implementation of the communicable disease act B.E. 2558 (2015): key lessons and directions for the development of Thailand’s disease control system

Supinda Teerarat — 2026-03-28

This mixed-methods study aimed to evaluate the implementation of the Communicable Disease Act B.E. 2558 (2015) and the National Action Plan for Communicable Disease Surveillance, Prevention, and Control B.E. 2566-2570 (2023-2027) at the mid-term stage, in order to derive lessons learned and
develop policy recommendations for strengthening Thailand’s disease control system. Quantitative data were collected from key performance indicators, while qualitative data were obtained through document review and in-depth interviews with 66 stakeholders across six provinces: Chiang Rai, Kanchanaburi, Chonburi, Bangkok, Songkhla, and Ubon Ratchathani. Quantitative findings demonstrated progress in several indicators, including the development of subordinate legislation, strengthening of surveillance systems, and enhanced performance of Emergency Operations Centers (EOCs). Qualitative findings revealed that Thailand has established strong disease control mechanisms—such as Provincial Communicable Disease Committees, Communicable Disease Control Units, and Surveillance and Rapid Response Teams (SRRTs)—as well as active community networks that contributed to timely epidemic response. However, key challenges remain, including structural complexity, limited confidence among Communicable Disease Control Officers in exercising legal authority, and constraints related to human resources, budgets, and information systems. Based on the findings, three strategic directions are proposed to strengthen Thailand’s disease control system: (1) Decentralize, by empowering local authorities and modernizing legal mechanisms; (2) Digitalize, by advancing integrated information systems and digital technologies to enhance surveillance and emergency response; and (3) Collaborate, by fostering multisectoral partnerships and promoting multilingual public communication. These strategies are expected to enhance the flexibility, efficiency, and long-term sustainability of Thailand’s disease control system.

Road Traffic Injuries among Children and Juveniles: Trends, Epidemiological Characteristics, and Factors Associated with Severe Injuries in Mueang Kanchanaburi District, Kanchanaburi Province

Chanatip Chailek — 2026-03-28

This research aimed to describe the situation of road traffic injuries among children and juveniles in Mueang Kanchanaburi District, Kanchanaburi Province, during the years 2022-2024. A retrospective study was conducted, including all 2,066 eligible patients under 18 years of age. Secondary data were retrieved from the Injury Surveillance system of Phahol-polpayuhasena Hospital. Data were analyzed using descriptive statistics, time series analysis, and multiple logistic regression analysis. Key findings showed that the number of injured and deceased patients increased from 579 cases in 2022 to 761 cases in 2024, representing an increase of 31.4% (p=0.003). Most cases were male (58.5%), aged 15-17 years (52.7%), were the driver (56.4%), used a motorcycle (90.1%), and did not wear a helmet (91.1%). Motorcycles were the most common counterparty (33.2%). Accidents primarily occurred on highways (89.8%) and during the daytime (61.7%). Factors associated with severe injury included the counterparty being a pickup truck (aOR=2.91, 95% CI: 1.89-4.50), truck/trailer (aOR=7.39, 95%CI: 2.63-20.76), occurring in other sub-districts (aOR=2.54, 95% CI: 1.85-3.50), on weekends (aOR=1.35, 95% CI: 1.06-1.74), festival holidays (aOR=2.29, 95% CI: 1.20-4.36), and nighttime (aOR=1.55, 95% CI: 1.23-1.97). In conclusion, the trend of road traffic injuries among children and juveniles has continuously increased. The high-risk group consisted of male juveniles driving motorcycles without wearing a helmet. Counterparty vehicle type, occurring incident sub-district, type of day, and time of day are statistically significant factors associated with severe injury. Therefore, relevant agencies must design measures specific to the age group, vehicle type, sub-districts distant from the hospital, and high-risk time periods to reduce losses.

Results of Tuberculosis Symptom Screening and Factors Associated with Tuberculosis Infection Prevention Behavior among Myanmar Migrant Workers in Samut Sakhon Province, Thailand

Pituck Armud — 2026-03-28

Pulmonary tuberculosis (TB) is caused by Mycobacterium tuberculosis and can be transmitted from person to another through inhalation of the pathogen into the body. TB remains a significant problem health in Thailand and other countries in the world. This cross-sectional analytical study aimed to (1) screen people with suspected pulmonary tuberculosis symptoms and (2) determine factors associated with preventive behavior of pulmonary tuberculosis among migrant workers in Samut Sakhon Province. The sample consisted of 246 Myanmar migrant workers selected by simple random sampling. Research instruments included a self-developed questionnaire and a pulmonary TB symptom screening form of the Department of Disease Control, Ministry of Public Health. Data were collected between May and June 2025. Percentages were used to analyze the prevalence of risk for pulmonary tuberculosis. Pearson’s correlation coefficient was conducted to identify factors associated with preventive behavior of pulmonary tuberculosis. The results showed that 12.20 percent was at risk of pulmonary tuberculosis and factors associated with preventive behavior at the 0.05 level of significant included body mass index (r=0.13, p=0.03), knowledge of pulmonary TB (r=0.28, p<0.01) and attitudes toward TB prevention (r=0.15, p=0.01) with all correlations at a low level. The study recommended that public health authorities should implement regular surveillance and screening programs for TB risk among migrant workers, along with continuous diagnostic referral systems. Furthermore, educational interventions to enhance knowledge and promote positive attitudes are encouraged, due to their correlations with disease prevention behaviors.

Prevalence and Factors Influencing Substance Use among Ethnically Diverse Adolescents in the Upper Northern of Thailand

Thirawat Chaichana — 2026-03-28

In contemporary society, characterized by cultural diversity and varying living environments, adolescents face heightened risks of substance use. This cross-sectional analytical study aimed to investigate the prevalence and factors influencing substance use. Participants included 238 adolescents (aged 15-17 years) recruited via simple random sampling. Research data were gathered through questionnaires between December 2024 and February 2025. Data was analyzed using descriptive statistics and logistic regression analysis. The findings revealed that alcohol consumption was the most prevalent form of substance use among adolescents (56.3%), followed by kratom use (18.5%), tobacco product use (13.9%), and cannabis use (7.1%). Tobacco use was significantly associated with being male (AOR=5.8; 95% CI: 2.39-14.39), alcohol consumption (AOR=33.1; 95% CI: 3.06-192.84), and kratom use (AOR=3.1; 95% CI: 1.40-8.58). Alcohol consumption was associated with depression (AOR=2.3; 95% CI: 1.25-4.34) family and peer factors (AOR=0.4; 95% CI: 0.23-0.89) tobacco use (AOR=22.2; 95% CI: 2.80-176.16) and kratom use (AOR=17.2; 95% CI: 3.83-77.31). Cannabis use was associated with being male (AOR=46.6; 95% CI: 6.14-403.02) and kratom use (AOR=65.6; 95% CI: 9.54-452.43). Kratom use was associated with tobacco use (AOR=2.8; 95% CI: 1.09-7.50), alcohol consumption (AOR=14.4; 95% CI: 3.19-65.80), and cannabis use (AOR=25.5; 95% CI: 4.49-145.01). The findings reveal a rising trend in substance use prevalence, particularly polydrug use. It recommended that rigorous and sustained policies be established to control and prevent access to alcohol and kratom among the adolescent population.