Disease Control Journal

Factors Related to Fall Prevention Behaviors Among The Elderly in Waeng Noi Sub-district, Waeng Noi District, Khon Kaen Province

Thu, 25 Jun 2026 00:00:00 +0700

This cross-sectional analytical study aimed to assess factors related to fall prevention behavior among the elderly in Waeng Noi Sub-district, Waeng Noi District, Khon Kaen Province. A proportional stratified sampling method was used to randomly recruit 322 elderly from the registered list, based on inclusion criteria of 13 villages. Data collection was conducted between February and March 2024 using a questionnaire. The results showed that 78.9% of the participants were female, with an average age of 68.73 years (SD=6.95). In the past year, 28.3% of the participants had fallen. Additionally, 18.3% reported using cane, crutches, or other mobility aids. Regarding knowledge about fall prevention, 53.1% demonstrated a prominent level of understanding, while 97.2% exhibited a good perception regarding fall prevention. Moreover, 54.7% received a satisfactory level of encouragement and reminders from people around them, 57.4% expressed a high fear of falling, and 91.3% engaged in good fall prevention behaviors. Binary logistic regression indicated that elderly individuals who did not use canes, crutches, or other mobility aids were 3.85 times more likely to have good fall prevention behaviors compared to those who did (95% CI AOR=1.59 to 9.09). In addition, those who received good levels of encouragement and reminders from people around them were 4.54 times more likely to have good fall prevention behavior than those who received poor levels of such support (95% CI AOR=1.50 to 13.75). Therefore, dual support integrating instrumental assistance with emotional and social support should be promoted through community networks, with particular emphasis on providing encouragement and reminders to elderly individuals who use mobility aids to strengthen fall prevention behaviors among the elderly.

Effect of Smoking Prevention Program among Students who Attended a Secondary School in Mueang district, Buri Ram Province

Teerawart Pongpanupart; Nittaya Teeraviroj (Author) — Thu, 25 Jun 2026 00:00:00 +0700

This two groups, pre- and post-test quasi-experimental design aimed to evaluate the effectiveness of a smoking prevention program developed based on Bloom’s learning theory on knowledge, attitudes, outcome expectancies, self-efficacy, and intention not to smoke among lower secondary school students aged 13–15 years. The experimental group participated in a six-session program, conducted once a week for one hour per session, while the control group received usual school-based care. Each group was comprised of thirty students. Data was collected using questionnaires with IOC 0.67-1.00. The Cronbach’s alpha coefficients reliability of the scales measuring attitudes toward smoking, outcome expectancies of not smoking, self-efficacy in smoking prevention, and intention not to smoke were 0.88, 0.86, 0.89, and 0.87, respectively. Descriptive statistics, paired t-test, and independent two-sample t-test were performed for the analysis. The results indicated that, after the intervention, the experimental group showed significantly more improvements from baseline in attitudes toward smoking and intention not to smoke as compared to the control group (p = 0.041 and 0.048, respectively). However, no statistically significant differences were found between the groups in knowledge, outcome expectancies, and self-efficacy (p = 0.318, 0.310, and 0.748, respectively). In conclusion, the program was effective in improving attitudes and intention not to smoke among the target students. Further program development is recommended to enhance self-efficacy and outcome expectancies to achieve more sustainable behavioral outcomes.

Utilizing Biometric Technologies to Identify Non-Thai Migrant Workers: The Integration of Iris and Facial Recognition for Disease Surveillance and Control

Thu, 25 Jun 2026 00:00:00 +0700

Inaccurate identification of migrant workers represents a structural barrier to Thailand’s disease surveillance and control systems. The COVID-19 pandemic significantly exposed these limitations in contact tracing and patient follow-up. This study aimed to analyze the evolution and lessons learned from implementing the Thai Red Cross Biometric Authentication System (TRCBAS), which utilizes iris and facial recognition technology for undocumented migrants. A qualitative study was conducted across five pilot provinces. Data was gathered from 49 key informants, including executives, data users, and operators, through focus group discussions and participant observation from February 2023 to May 2024. Thematic analysis was employed to synthesize findings. Results: The system’s development progressed through three distinct phases, successfully registering 139,184 individuals across 100 health facilities by early 2025. Key success factors included high technical precision in iris recognition (>99%), strong policy-level commitment, and system user-friendliness. Nevertheless, critical challenges persist, such as the lack of integration with Hospital Information Systems (HIS), fragmented identification numbers, and unstable internet connectivity in remote border regions. Biometric technology effectively bridges gaps in health security for mobile populations. Crucial policy recommendations include: (1) establishing a centralized "Health ID" to unify health data across sectors; (2) investing in digital infrastructure within border areas; and (3) implementing robust data governance and ethical framework aligned with international human rights standards to ensure long-term national sustainability.

Hearing Protection Device Use Behaviors and Personal Attenuation Rating (PAR) among Production Workers in an Electrical Appliance Component Factory in Chonburi Province

Arutchaporn Chiamchunya, Saksith Kulwong, Anamai Thetkathuek (Author) — Thu, 25 Jun 2026 00:00:00 +0700

This cross-sectional analytical research aimed to study: 1) hearing protection device (HPD) uses behaviors, 2) Personal Attenuation Ratings (PAR), and 3) the association between HPD use behaviors and PAR. The study participants were 120 production workers at an electrical appliance manufacturing company in Chonburi province. Data was collected from July to August 2025 using a self-administered questionnaire, an HPD use behavior observation form, and the hearing protection fit-testing system. Data was analyzed using descriptive statistics and binary logistic regression analysis. The results showed that the majority of workers were male (87.5%) and aged 30-39 years (43.3%). While 81.7% of workers regularly wore HPDs when exposed to loud noise, only 22.5% performed HPD maintenance correctly. The median PAR was 17 dB (IQR(Q1-Q3):9(11-20)). A total of 81.7% of workers achieved a PAR greater than or equal to the Target PAR. Workers who did not regularly wear HPDs with a proper tight fit had 4.28 times higher odds of having an inadequate PAR compared to those who did (AOR=4.28, 95% CI: 1.53-11.95). However, 18.3% of workers had a PAR below the target, which could lead to hazardous noise exposure and long-term noise-induced hearing loss. Therefore, workplaces should emphasize correct HPD wearing and provide training on both usage and maintenance. Additionally, relevant agencies should establish a policy for hearing protection fit testing to effectively reduce the risk of occupational noise exposure.

The Relationship Between Knowledge, Attitude, and Health Care Behaviors of Older Adults with Hypertension Living in Rural Areas of Ubon Ratchathani Province

Natjira Khotwongsa, Kunlanat Kaewwong, Kaewjai Maleelai (Author) — Thu, 25 Jun 2026 00:00:00 +0700

This cross-sectional study aimed to investigate the relationships between knowledge, attitudes, and healthcare behaviors among older adults with hypertension. The participants were 160 older adults with hypertension residing in a rural area of Ubon Ratchathani Province, Thailand. Proportional sampling by village followed by simple random sampling was employed. The instruments included a knowledge assessment and a structured questionnaire, both of which were validated for content by experts. Data were analyzed using descriptive statistics and Spearman’s rank correlation coefficient with a statistical significance level set at 0.05. About half of participants were women (53.1%), with an average age of 69.4 years (SD=6.2), and the majority worked as farmers (91.2%). Only 12,5% were at good level of knowledge, however 39.4 % were at the level of need improvement. 67.5% were at good level of attitude and only 21.9% were at good level of healthcare behaviors regarding hypertension. A significant relationship was found between attitudes toward hypertension and healthcare behaviors (p<0.001), which suggests that fostering positive attitudes in community-based hypertension control programs could lead to improved healthcare behaviors.

Prevalence of Drug-Resistant Extrapulmonary Tuberculosis in Thailand from 2023 to 2024

Thipparat Nasrisuk (Author) — Thu, 25 Jun 2026 00:00:00 +0700

Drug-resistant tuberculosis (DR-TB) is a major global public health concern. Physicians are usually aware of the occurrence of drug-resistant pulmonary tuberculosis (DR-PTB) but lack concern about Drug-resistant extrapulmonary TB (DR-EPTB). DR-EPTB poses a formidable diagnostic, therapeutic challenge. There is limited information available about the drug resistance patterns in extrapulmonary tuberculosis (EPTB) and prevalence of DR-EPTB remain limited. This retrospective study aimed to determine the prevalence of DR-EPTB among 373 EPTB patients who underwent drug susceptibility testing (DST) for first (FLDs) and second-line drugs (SLDs) at the National Tuberculosis Reference Laboratory (NTRL) between 2023 and 2024. The results showed that among the 373 EPTB cases, 14.21% (n=53; 95% CI: 11.01-18.14) were drug-resistant EPTB, with a mean (±SD) age of the patients was 43.88±18.23 years, and a male predominance of 54.29% (95% CI: 42.70-65.43). Most drug-resistant cases occurred among previously treated patients 86.67% (95% CI: 73.45–94.12). The prevalences of drug resistant EPTB were isoniazid 10.46% (95% CI: 7.72-14.00), rifampin 6.17% (95% CI: 4.10-9.12), ethambutol 0.27% (95% CI: 0.01-1.66), levofloxacin 0.94% (95% CI: 0.19-2.85) and multidrug-resistant EPTB was 3.22% (n=12; 95% CI: 1.79-5.60). Specimen with MDR prevalence was found to be: pus 75%, blood 17% and pleural fluid 8%. Drug resistance, including isoniazid-resistant, rifampin-resistant was observed in a significant proportion of extrapulmonary specimens referred for DST. Access to culture and DST for extrapulmonary specimens should be expanded. Guidelines for drug-resistant management should have explicit sections on extra-pulmonary tuberculosis.

Clinical Outcomes and Quality of Life of Patients with End-Stage Chronic Kidney Disease following Advance Care Planning in the Community

Thu, 25 Jun 2026 00:00:00 +0700

This participatory action research aimed to: 1) examine the situation and problems in caring for patients with end-stage chronic kidney disease in the community; 2) develop an advance care planning (ACP) process appropriate to the local context; and 3) evaluate the effects of the model on clinical outcomes, quality of life, and treatment decision-making. The sample consisted of 20 patients. Data were collected between January and April 2025. Research instruments included a demographic questionnaire, a quality-of-life assessment, and a clinical outcomes record form. Quantitative data were analyzed using descriptive statistics and compared before and after the intervention using paired t-test, while qualitative data were analyzed using content analysis. The results revealed that the existing care system had limitations in service structure, resource allocation, and multidisciplinary communication. After implementing the ACP process, patients demonstrated clearer treatment decision-making. The proportion of patients choosing palliative care increased from 30.0% to 56.7%, while those choosing renal replacement therapy decreased from 70.0% to 43.3%. Clinical outcomes showed significant reductions in systolic and diastolic blood pressure (p=0.010 and 0.019 respectively) and serum potassium levels, along with a significant increase in hematocrit levels (p=0.005 and 0.001respectively). Additionally, the proportion of patients receiving erythropoietin increased from 2.9% to 38.2%. Quality of life significantly improved, with overall scores increasing (p=0.003). Scores related to disease burden, symptoms, and the impact on daily life significantly decreased (p<0.001, 0.028 and <0.001 respectively). In conclusion, the participatory ACP process effectively enhanced informed treatment decision-making and led to significant improvements in clinical outcomes and quality of life among patients with end-stage chronic kidney disease in the community.

Factors Influencing Tuberculosis Prevention Behaviors Among Household Contacts of New Pulmonary Tuberculosis Patients at Nakhon Sawan Province

Suphasajee Sawaengjaroen, Sanae Saengngern (Author) — Thu, 25 Jun 2026 00:00:00 +0700

This cross-sectional research aimed to analyze factors influencing tuberculosis (TB) prevention behaviors among household contacts of new pulmonary TB patients in Nakhon Sawan Province. Data was collected from 184 participants using a validated and reliable questionnaire. Data analysis involved descriptive and inferential statistics, including correlation analysis and stepwise multiple regression analysis. The results showed that 70.1% were female, with an average age of 50 years (SD=14.1). Most participants (77.7%) demonstrated high levels of TB prevention behavior. The predictive model revealed six significant factors: cues to action for TB prevention (beta=0.489, p<0.001), knowledge of tuberculosis (beta=0.147, p=0.026), room-sharing with the index case prior to treatment (beta=-0.127, p=0.018), marital status (widowed/ divorced/separated) (beta=-0.139, p=0.013), no history of chest X-ray screening within the past 6 months (beta=-0.144, p=0.007), and alcohol consumption (beta=-0.167, p=0.002). These factors collectively accounted for 52.5% of the variance in TB prevention behaviors (Adjusted R²=0.509, p<0.001). In conclusion, health interventions should focus on enhancing TB knowledge and creating effective cues to action. Promoting regular Chest X-ray screening, encouraging separate sleeping quarters, and reducing risk behaviors such as alcohol consumption are essential to fostering appropriate TB prevention behaviors among household contacts.

Evaluation of Tuberculosis Registration by National Tuberculosis Information Program (NTIP), Nong Ruea Hospital, Nong Ruea district, Khon Kaen province, budget year 2022-2024

Riamjai Polwiang (Author); Kannika Jaitong — Thu, 25 Jun 2026 00:00:00 +0700

This study aimed to evaluate the quantitative and qualitative NTIP registration process and provide recommendations. Data was collected from tuberculosis and comorbidity patients treated at Nong Ruea Hospital during fiscal years 2022-2024. Patients were randomly selected from medical records based on ICD-10 classification using different sampling weights. A proportional sample of patients was then randomly selected for each fiscal year, and individual patients were systematically selected from HOSxP lists of patients, both outpatients and inpatients, in chronological order of hospital visits, according to ICD-10 records. The disease registration process was studied, and personnel were interviewed. The results showed that the hospital had a tuberculosis surveillance guideline and multi-sectoral collaboration involving physicians, nurses, medical statisticians, and patients referred from NTIP datasets. The sensitivity of registration based on the definition and diagnosis were 90.7% and 74.9%, respectively. The predictive values based on the definition compared to diagnosis were 99.6% and 98.6%, respectively. All variables were 100% complete except for the date of illness onset, which was 98.3%. Data was recorded correctly at 86.0–99.3%. Timeliness of registration in NTIP was 90.5%, and timeliness of screening was 84.9%. Gender, age, and age group were found to be representative of the system. Interviews with relevant personnel revealed awareness of the benefits, acceptance of the simple and flexible disease reporting procedures and system, ability to adapt workflows, personnel can in place of each other, and the utilization of surveillance data. The Khon Kaen Provincial Public Health Office is recommended to collaborate with hospitals in the province to develop an inter-healthcare referral system, and that the PCT team at Nong Ruea Hospital and the Tuberculosis Division develop a Lab Alert Pop-up system.

Health Impact Assessment of Heat Exposure among Agricultural Workers in Mueang District, Nakhon Ratchasima Province

Thu, 25 Jun 2026 00:00:00 +0700

This cross-sectional descriptive study aimed to: (1) assess heat index and workload among outdoor farmers; (2) evaluate chronic kidney disease (CKD) risk; (3) compare physiological parameter differences; and (4) identify physiological factors associated with dehydration among farmers in Mueang District, Nakhon Ratchasima Province. Field data were collected from May to June (08:30–17:30) using a Wet Bulb Globe Temperature (WBGT) heat stress monitor per ISO 7243, alongside physiological assessments including body temperature, blood pressure, digital body weight scales, urine dipstick tests, and microalbumin cassette kits. A structured interview covering personal information, occupational factors, and physiological changes was also administered. The sample comprised 130 outdoor agricultural workers (57 males, 73 females; mean age 47.84±12.8 years). Friedman test, Wilcoxon signed-rank test, Cochran Q Test. McNemar Test and multiple binary logistic regression were adopted for data analysis. Results revealed a maximum outdoor WBGT (WBGT_out) of 33.2°C, with 100% of outdoor agricultural workers exceeding ACGIH threshold limit values. Applying the clothing adjustment factor, the maximum effective WBGT reached 37.1°C. Dehydration prevalence was 73.8%, with abnormal urinary protein and leukocytes found in 12.3% and 16.2%, respectively. Approximately 16.3% showed risk for CKD of unknown etiology. Significant differences in body weight, core body temperature, and heart rate were observed before, during, and after work (p-value<0.05). Male outdoor agricultural workers had 2.86 times greater dehydration risk than females (95% CI=1.036–7.874; p-value=0.043), while BMI and age showed no significant association. These findings highlight the urgent need for heat management interventions and adequate hydration promotion among outdoor agricultural workers in tropical regions.

Prevalence of Laboratory Test Results Among Food Handlers and Association with Personal and Environmental Factors at King Chulalongkorn Memorial Hospital, Thai Red Cross Society

Nutcha Rojdamrongrattana, Surin Assawawitoontip (Author) — Thu, 25 Jun 2026 00:00:00 +0700

Foodborne diseases are a major global public health concern. The World Health Organization estimates approximately 600 million cases and 420,000 deaths occur annually. Food handlers play a critical role in preventing such diseases. This study aimed to determine the prevalence of abnormal laboratory findings among food handlers and to examine the associations between personal and environmental factors and those findings at King Chulalongkorn Memorial Hospital, Thai Red Cross Society. A retrospective cross-sectional descriptive study was conducted using retrospectively collected data from 247 food handlers between 2020 and 2024 at King Chulalongkorn Memorial Hospital, Thai Red Cross Society. Variables included sex, age, nationality, duration of employment, type of food establishment, stool culture results, chest X-ray findings, and hepatitis A virus immunity status. Data were analyzed using descriptive statistics and logistic regression analysis, with a statistical significance level set at 0.05. The majority of food handlers were female (75.7%), aged 25–34 years (33.2%), Thai nationals (77.3%), and had been employed for less than 3 years (76.5%). The most common types of establishments were dry food/packaged food shops (41.3%) and retail stores/convenience stores (51.0%). The prevalence of positive stool findings (including both bacterial and parasitic pathogens) was 30.3%. Logistic regression analysis revealed no statistically significant associations between the personal or environmental factors studied and abnormal laboratory findings under this retrospective cross-sectional study design. To identify true risk factors, a more comprehensive risk assessment is warranted. Abnormal laboratory findings should not be used as grounds for permanent exclusion of food handlers; rather, they should serve as information to guide appropriate medical management and follow-up.

A Road Traffic Accident and Death Investigation: Pickup Truck Collision at a Roundabout near Kanchanaburi Provincial Hall

Chanatip Chailek, Natthaphon Phongoenngam, Thanapong Jinvong (Author) — Thu, 25 Jun 2026 00:00:00 +0700

On September 1, 2025, the Surveillance and Rapid Response Team of Phaholpolpayuhasena Hospital was notified of a road traffic accident involving a pickup truck colliding with a roundabout and subsequently crashing into the Kanchanaburi Provincial Hall wall in Pak Phraek Subdistrict, Mueang Kanchanaburi District, Kanchanaburi Province, on August 31, 2025. The accident resulted in one fatality. A road traffic accident death investigation was initiated on September 8, 2025. A descriptive epidemiological study was conducted to identify the characteristics and contributing factors of the crash and the subsequent fatality. It included reviewing injury surveillance data, analyzing the decedent's medical records, interviewing officials, and conducting a detailed survey of the vehicle, road, and surrounding environment. Risk factors were analyzed using the Haddon Matrix and the Swiss Cheese Model. The findings revealed that the Provincial Hall roundabout has experienced 60 road traffic accidents and 2 fatalities between 2022 and 2025. This event occurred on August 31, 2025, at approximately 02:55 AM. The deceased was a 29-year-old male pickup truck driver employed as a security guard at an entertainment venue; the incident occurred shortly after his shift ended. Post-mortem analysis revealed a blood alcohol concentration (BAC) of 249.89 mg/dL. The primary cause of the accident was driving under the influence (DUI). Significant environmental risk factors included faded rumble strips and lane markings, an undersized splitter island at the roundabout approach, and poor nighttime visibility of the central island. Factors contributing to the fatality included the failure to use a seatbelt, the proximity of the concrete wall to the roundabout, and a damaged guardrail. Although roundabouts are a safe traffic management system at intersections, the lack of maintained road markings, insufficient traffic calming measures, and poor nighttime visibility can lead an intoxicated driver to collide with the central island. Relevant agencies should urgently improve roads and roundabouts, strictly enforce traffic regulations, and establish organizational measures in entertainment venues to prevent future DUI incidents.

Health Surveillance Guidelines for Ionizing Radiation Emergencies

Tapakorn Wattanakanoktham, Wisuthipong Sawetprasart (Author) — Thu, 25 Jun 2026 00:00:00 +0700

Ionizing radiation emergencies cause both deterministic and stochastic health effects. This review article synthesizes health surveillance guidelines for emergency responders and the public by comparing International Atomic Energy Agency (IAEA) standards, Chinese occupational health standards (GBZ), and Thailand's current guidelines. Finding that Thailand's existing general health examinations lack specificity for radiation exposure, this article proposes an integrated framework. It recommends lowering the long-term surveillance threshold to >100 mSv and emphasizes organ-specific monitoring for radiosensitive targets (eye lens, thyroid, reproductive, and hematopoietic systems) alongside cancer and mental health screening. A “Tiered approach” is also proposed to optimize limited medical resources. Ultimately, this article serves as a practical guideline for occupational medicine physicians to systematically manage radiation health risks.

Seizure Assessment for Driving License Medical Certification in Thailand

Sutpattida Pattaramongkolchai, Nattanand Chamroonsawasdi (Author) — Thu, 25 Jun 2026 00:00:00 +0700

Epilepsy is a significant health condition that increases the risk of traffic accidents by approximately 1.13 to 2.13 times compared with the general population and accounts for about 0.2 percent of traffic-related fatalities. Consequently, seizure disorders are recognized as a condition requiring thorough health evaluation prior to the issuance of a driving license. This narrative review aimed to examine information on seizure characteristics, health assessment procedures, and appropriate seizure-free intervals for granting driving privileges across different types of seizures and vehicle categories, with a comparative analysis between Thai regulations and international practice guidelines. Findings from the review indicated that Thailand currently mandates a seizure-free period of more than one year before individuals with epilepsy are permitted to drive. This requirement corresponds to an acceptable annual risk of sudden incapacity of approximately 20 percent. In contrast, international authorities delineate seizure-free intervals based on both seizure type and driving category to minimize the risk of sudden incapacitation among private and commercial drivers. The authors propose that seizure assessment should include a comprehensive medical history, physical examination, and evaluation of sensory, motor, and cognitive functions to establish a probable diagnosis. Furthermore, it is recommended that a 10-year seizure-free period be required for individuals with epilepsy seeking to drive commercial vehicles. The specific seizure-free duration applicable to each vehicle category should also be clearly stated in the medical certificate for driving authorization. These measures aim to help reduce accidents, minimize losses, lower medical expenses, and enhance safety standards through stricter health-related regulations.

Essential Preparation Issues for Conducting Epidemiological Research of the unknown Pathogen Outbreak in Thailand

Thu, 25 Jun 2026 00:00:00 +0700

Emerging infectious diseases have occurred more frequent since 1997. The World Health Organization has emphasized the need for preparedness against unknown infectious pathogen or “disease X”. One lesson learned by Thailand in responding to emerging infectious diseases is that the essential knowledges for decision-making were not available in a timely manner. The epidemiological knowledge gained from outbreak investigations often had limitation. Utilizing a well-structured research framework could enhance the knowledge generation. This report aimed to describe learning points and recommendations after conducted a project to develop a generic protocol and researchers’ network for disease X in Thailand. The activities of this project included literature reviews, workshops with expert and stakeholders to determine key issues and develop the research protocol. The findings revealed four groups of symptoms that should be prioritized: food and waterborne diseases, respiratory infectious diseases, central nervous system infections, and infections causing abnormal bleeding. The options for operational models were improving the epidemiological investigation or employ research methods. However, both approaches require additional preparations and support especially the ethical review process. The most challenging issue found was knowledge transferring. Emerging infectious diseases that cause widespread outbreaks, such as influenza, occur approximately once every 35-40 years. After an outbreak, the importance of the issue and the approaches taken often fade or change. To prepare for responses to unknown infectious diseases, Thailand should support robust and continuous collaboration among researcher networks, reviewing and designing a new ethical research review system, and enhancing the outbreak investigation to overcome limitations which will result to generate a timely valid knowledge.