Disease Control Journal

Development of training courses for capacity development for Occupational and Environmental Disease Control Units in Thailand

Jatuporn Bunnag, Satit Namwicha (Author) — Sun, 31 Mar 2024 00:00:00 +0700

The training course for capacity development for occupational and environmental disease control units was developed and offered by the Department of Disease Control under the Occupational and Environmental Diseases Control Act B.E. 2562 (2019). The objectives of this descriptive cross-sectional study included comparing the participants knowledge before and after participated the training, as well as evaluating their satisfaction with the occupational and environmental disease control capacity development curriculum. In addition, the study also aimed to compare individuals who have completed the training concerning the establishment of units for occupational and environmental disease control. The study population comprised 2,852 individuals who have undergone training in both on-site and e-learning formats. A total of 2,094 participants who completed both theoretical and practical training during the fiscal year 2021-2022 were purposively included in the study. A self-administered questionnaire on knowledge and satisfaction were performed to obtain the data from each participant. The data was also collected from the registry of the orders of the Occupational and Environmental Diseases Control Unit. Descriptive statistics, including number, percentages, mean, standard deviation, and paired sample t-test for the comparison of mean score of knowledge before and after the participation to the training course were employed at 5% level of significance. The results revealed that the majority of participants were female (69.0%), who worked as public health technical officers (79.2%), whose position was at professional level (38.5%), and affiliated with sub-district health promotion hospitals (35.0%). The knowledge and understanding of before and after training was statistically difference (p-value<0.001). The average score before the training was 11.3, while after the training increased to 16.8. This has demonstrated that the training resulted in gaining more knowledge and understanding. Of all participants who have completed this training course, 1,209 (57.7%) from 120 units in 60 provinces nationwide have been appointed as officials in the Occupational and Environmental Diseases Control Unit in the provinces and Bangkok. Participants have rated their satisfaction with the training course at the highest level (=3.9). It is recommended that the curriculum quality be periodically evaluated to identify areas of improvement for effective implementation and to ensure it responds to changing circumstances. Furthermore, lessons should be learned from provinces that are successful in establishing their functional and effective Occupational and Environmental Diseases Control Units.

Prevalence, factors associated with, and consequences of long COVID symptoms in people diagnosed with Coronavirus disease 2019 (COVID-19) at Sida Hospital, Nakhon Ratchasima province, Thailand

Sun, 31 Mar 2024 00:00:00 +0700

This cross-sectional descriptive study investigated the prevalence, relevant factors, and consequences of long COVID symptoms through telephone follow-up with the patients at Sida Hospital, Nakhon Ratchasima province, who were diagnosed with COVID-19 and discharged between 9 and 12 months. The results showed that 186 of 220 patients (84.5%) reported experiencing at least one of long COVID symptoms. They experienced two or three long COVID symptoms among fourteen symptoms on average. Fatigue (82.3%), muscle pain (33.6%), memory issues (33.6%), and sleeping difficulties (10.5%) ranked as the most prevalent symptoms. Female (AOR=2.71; 95% CI: 1.25-5.87) and the level of symptoms of COVID-19 disease on admission (AOR=7.89; 95% CI: 2.34-26.63) were significantly related to long COVID symptoms (p<0.05). The effects of long COVID symptoms are not limited only to physical health, but they also affect emotional (COR=3.93; 95% CI; 1.33-11.66) and mental health (COR=3.84; 95% CI: 1.70-8.69). Therefore, dedicated policies and guidelines should be established and implemented to support patients suffering from long COVID symptoms, both in the hospital and in the community. The program should be developed for assessing the symptoms, risks, and consequences of long COVID, as well as enhancing people's ability to manage long-term symptoms and consequences of the disease.

Comparison of pregnancy outcomes in pregnant women using a cesarean section protocol for COVID-19 infection versus the standard cesarean section protocol

Sun, 31 Mar 2024 00:00:00 +0700

Pregnant women with COVID-19 are at a higher risk of death. This study aimed to compare the outcomes in pregnant women undergoing cesarean section using guidelines for people with COVID-19 versus standard practices. Pregnant women who underwent cesarean section at Ramathibodi Chakri Naruebodindra Hospital were recruited retrospectively: 100 cases of COVID-19 infection and 130 non-infectious cases. Findings reveal that pregnant women with COVID-19 had an average gestational age at cesarean section of 36.63±2.88 weeks, while non-infectious pregnant women had an average gestational age of 37.53±2.58 weeks. The differences were statistically insignificant (p>0.05). However, it was found that pregnant women with COVID-19 had a statistically significant longer length of hospital stay than the non-infectious group. The study also revealed that the neonatal outcomes for births to mothers with COVID-19 were at a higher risk of requiring continuing care at intensive care units (p<0.001). In summary, the study highlighted that COVID-19 infection in pregnant women affects gestational age, hospital stay, and newborn health. Therefore, priority should be given to infection control, care for babies born to mothers infected with COVID-19 and improving safety practices for patients and staff at Ramathibodi Chakri Naruebodindra Hospital. Careful consideration is necessary to avoid unwanted consequences. Proper preparation and practice are crucial for the healthcare team.

Assessment of smell dysfunction in mild symptomatic COVID-19 patients

Nannaphat Pradutdecha, Gun Bhakisongkhram, Jirayupa Paewponsong (Author) — Sun, 31 Mar 2024 00:00:00 +0700

This quasi-experimental study examined smell function and was conducted at Suranaree University of Technology Hospital from April to July 2021. The study included 30 healthy participants in the control group and 125 admitted COVID-19 patients who had tested positive for SARS-CoV-2 using PCR. Subjectively, 49.6% of the COVID-19 patients reported smell loss. Olfactory assessment using phenyl ethyl alcohol (PEA) indicated smell dysfunction in 60.8% of the patients. Patients with COVID-19 were 6.2 times more likely to have smell dysfunction (95% CI 2.4-16.3). The mean duration of smell loss was 6.1 days (median 5 days, 95% CI 5.1-7.1 days, min-max: 1-21 days), which mostly followed other symptoms by 2.9 days (median 2 days, 95% CI 1.9-3.7 days, min–max: -2–13 days). The risk of smell dysfunction in COVID-19 patients were male (p=0.004) and smoking (p=0.04). No significant risk of smell dysfunction by age older than 45 years (p=0.528), BMI 25 more than kg/m² (p=0.773) or severity of disease (pneumonia) (p=0.143) were observed.

Model development for providing emergency health services: The case of take Buriram people back home in the Coronavirus Disease 2019 epidemic, Buriram Province, Thailand

Sun, 31 Mar 2024 00:00:00 +0700

This action research aimed at developing a model for providing emergency health services in the Coronavirus Disease 2019 epidemic called “take Buriram people back home”, Buriram Province, Thailand. The project consisted of 4 phases. The first phase encompassed a situational review and analysis. The second phase involved model planning and development. The third phase applied the model to pilot and extended areas. The fourth phase, evaluation, concludes emergency health service prototypes in emergency situations. The population in the study consisted of 1) the working group committee for model development, 2) service recipients, and 3) the operation team. Purposive sampling enrolled a sample size of 40 members of the working group committee: 1,257 service recipients, relatives, and families, and 400 members of the operations team. The research was conducted between April 2020 and May 2023. The data was collected from data collection forms, focus group discussions, interviews, questionnaires, lessons learned, and performance reports. Data analysis was performed with the program Epi Info Ver. 7. Descriptive statistics included frequency, percentage, mean, and standard deviation, along with content analysis were adopted for data analysis. The results showed that 80.8 percent returned home for treatment, 9.3 percent were treated at nearby hospitals in their residence, and 7.1 percent were isolated and quarantined at home. Most people were sent back via the program’s car (68.5 percent), while most received treatment at field hospitals (55.2 percent). At the highest level of satisfaction, both the operation team and service recipients express equal levels regarding the structure (mean=4.57, SD=0.50) and facilities (mean=4.57, SD=0.05). The model has been effectively implemented through the seamless operation of the provincial communicable disease committee mechanism and network partners.

The relationship between knowledge, health literacy and preventive behaviors against COVID-19 among healthcare personnel in Chumphon Khet Udomsakdi Hospital

Kanit Chanchai (Author) — Sun, 31 Mar 2024 00:00:00 +0700

The objective of this survey research was to assess the relationship between knowledge, health literacy, and preventive behaviors against COVID-19 among healthcare personnel of Chumphon Khet Udomsakdi Hospital. The respondents were 320 personnel working in various departments of Chumphon Khet Udomsakdi Hospital. The research instrument used for data collection was questionnaires adapted from the theory of health literacy. This cross-sectional survey data was analyzed using descriptive statistics and Pearson's correlation coefficient. Regarding the knowledge, there was statistically significant low positive correlation with COVID-19 prevention behaviors (r=0.246, p-value<0.001). However, most respondents have a high level of knowledge. In addition, in terms of health literacy on COVID-19, there was a moderate positive correlation with COVID-19 prevention behaviors with statistical significance (r=0.397, p-value<0.001). Most of the samples had health literacy about COVID-19 at a high level. This research can be used as a guidance for health education for personnel of Chumphon Khet Udomsakdi Hospital and can be adapted for use among the general public to prevent risky behaviors for COVID-19.

Hepatitis B virus and pre-employment examination

Pattamaphon Chanklom (Author) — Sun, 31 Mar 2024 00:00:00 +0700

Hepatitis B virus (HBV) is transmitted through bloodborne contact and sexual intercourse. Occupations that involve the exposure to blood, such as healthcare workers and emergency responders, are at a higher risk of HBV infection. However, despite these transmission routes, many workplaces asked job applicants for their HBsAg test results. This is a cross-sectional analytic study aimed to 1) determine the prevalence of HBsAg testing for employment application, 2) assess the prevalence of HBV infection, and 3) identify factors associated with prevalence of HBV infection. This study enrolled job applicants who underwent pre-employment examinations in Chonburi hospital between May 2019 and December 2022, comprising 8,022 cases. Data were collected from electronic medical records included the date of visit, sex, age, marital status, job applied for, and result of HBsAg. Descriptive statistics were utilized. Evaluation of factors related to the prevalence of HBV infection was done by simple and multiple logistic regression. The findings revealed that total of 1,872 or 23,3% requested HBsAg testing for employment application. Regarding job categories, HBsAg testing in food handlers, healthcare workers, service workers, and manufacturing workers were 52.5%, 46.2%, 16.6%, and 9.4%, respectively. The prevalence of HBV infection among the applicants was 1.9%. Factors significantly associated with HBV infection (p<0.05) were age 41-50 years (AOR=12.6; 95% CI: 1.6-102.6), age 51-60 years (AOR=12.7; 95% CI: 1.3-123.9) and married (AOR=2.25; 95% CI: 1.1-4.8). In conclusion, applicants were facing unnecessary HBsAg testing. Additionally, the prevalence of HBV infection among applicants was found to be low and not significantly associated with job categories. Consequently, employers should consider discontinuing the requirement for HBsAg results from job applicants.

Evaluation of measles immunization measures to develop policy recommendation for global commitment of measles elimination

Chaninan Sonthichai (Author) — Sun, 31 Mar 2024 00:00:00 +0700

Thailand has initiated measles elimination project following a global commitment since 2010. In an early phase, routine immunization was implemented as a main measure which the decreasing trend of disease was reported. However, a large measles outbreak occurred during 2016-2019, with 12,667 confirmed cases, 48 deaths and 363 outbreaks. The advisory committee for polio eradication and measles elimination under the Ministry of Public Health recommended the immunization measures included raising and maintaining measles vaccine coverage and providing vaccination for high-risk population. Accordingly, the Department of Disease Control launched the assorted immunization measures to raise immunity level countrywide: conducting catch-up vaccination campaign for under-immunized children aged 1-12 years old in 2019, conducting vaccination campaign among high-risk adult population in 2020, and modifying national vaccination schedule to accelerate immunity in 2021. The objective of this study was to evaluate the immunization measures for measles in Thailand during 2019-2021, using documentary research method. Findings reflected the decreasing number of measles cases since 2020, no death has been reported, and reduced number of outbreaks until no outbreak in 2021-2022. Besides, reports showed number of measles cases and attack rate declined in all health regions. The study results lead to policy recommendations regarding future measles immunization programs which includes raising and maintaining vaccine coverage among children, reducing immunity gap among high-risk population, and preparing sufficient vaccine stockpile for outbreak response. These measures will lead the country to achieve its measles elimination target.

Lessons learned and collaborative models between public health agencies and local administrative organizations at subdistrict level for malaria elimination

Sun, 31 Mar 2024 00:00:00 +0700

Sustainable malaria elimination requires long-term political commitment and financial support. During 2018-2020, the Division of Vector-Borne Diseases under the Department of Disease Control (DDC)
intensely implemented capacity building and mobilized collaboration and support from local administrative organizations (LAOs) at subdistrict level for malaria elimination. The efforts resulted in a significant increase in funding support from 3,714,999 Baht in fiscal year 2017 to 7,530,513 Baht in fiscal year 2020. This qualitative study aimed to identify goals and processes employed by local public health agencies in working collaboratively with LAOs in five high performance provinces and to provide some lessons learned for other areas. Data were collected during January-April 2021 by interviewing 44 key informants, who were administrators and practitioners of public health organizations and LAOs in 11 subdistricts. Analysis was done through thematic analysis and subsequent comparison of commonalities and differences among provinces. The study found three models of engagements: 1) LAO supported budget for malaria related prevention and control activities; 2) Building knowledge and skills of malaria vector control for LAOs in cooperation with public health agencies; and 3) Building local ownership of malaria work through local collaboration with LAOs in subdistrict level, community leaders, village health volunteers, and other stakeholders. Key lessons learned were that setting specific goals for engagement with LAOs by Office of Disease Prevention and
Control and Provincial Health Office was a key factor leading to processes and outcomes. The results showed that building capacity and ownership for LAOs and communities in malaria work can result in sustaining malaria elimination and real public health decentralization.

Development of natural compound aerosol spray against genetic fipronil and pyrethroid-resistant Aedes aegypti mosquitoes in dengue risk areas in Thailand

Sun, 31 Mar 2024 00:00:00 +0700

This research aimed to study a natural compound aerosol spray against genetic fipronil and pyrethroid-resistant Ae. aegypti mosquitoes in dengue risk areas in Thailand. A natural compound aerosol spray was developed that contained 5 natural compounds of citral, citronellal, citronellol, geraniol, and linalool at concentrations of 8.00%, 0.41%, 0.52%, 0.61%, and 0.75%, respectively as active ingredients. The aerosol spray was evaluated against fipronil and pyrethroid-resistant Ae. aegypti mosquitoes in glass chambers and Ae. aegypti mosquitoes in the fields of 6 provinces: Kanchanaburi, Chanthaburi, Chumphon, Phitsanulok, Nakhon Pathom, and Nakhon Ratchasima. Polymerase chain reaction (PCR) and DNA
sequencing were conducted to detect mutations in the para gene and the Rdl gene in Ae. aegypti mosquitoes that died in the fields. The result showed that the natural compound aerosol spray provided a 100% mortality rate for Ae. aegypti mosquitoes in both the glass chambers and the fields. Mutations in the para gene at amino acid positions of 989 (S989P) and 1016 (V1016G) were detected in the dead mosquitoes in the fields of 6 study provinces with mutation frequencies of 0.23-0.40 and 0.30-0.47, respectively. In addition, a mutation in the Rdl gene at an amino acid position of 302 (A302S) was found in dead mosquitoes in Kanchanaburi and Nakhon Pathom provinces with mutation frequencies of 0.13 and 0.20, respectively. In conclusion, the natural compound aerosol spray developed and tested in this study was effective against genetic fipronil and pyrethroid-resistant Ae. aegypti mosquitoes in dengue risk areas in Thailand. It suggests that the natural compound aerosol spray could be developed further as an alternative anti-mosquito product to anti-mosquito chemical products to prevent mosquito-borne diseases.

Effects of the health literacy program of people at risk of diabetes and hypertension in Nakhon Sawan Province

Pimpitcha Kantee, Watchara Chankrachang (Author) — Sun, 31 Mar 2024 00:00:00 +0700

Diabetes and hypertension are non-communicable chronic diseases (NCDs) which are important health problems at both national and global levels. The main causes are improper dietary habits, sleeping late, not exercising, having high stress, drinking alcohol and smoking. These behaviors can be changed if people have health literacy. Health literacy is an important factor in taking care of individuals’ health which affects behavior and health outcomes. A one-group pretest-posttest quasi-experiment was conducted to examine the effects of the health literacy program for people at risk of diabetes and hypertension on their health literacy and behavioral changes in Nakhon Sawan province. Total of 30 participants, age 30-75 years, who were at risk of diabetes and hypertension at Koei Chai health promoting hospital, Chum Saeng district, Nakhon Sawan province in 2022 were recruited into the study. Findings revealed a significantly higher mean score of health literacy and preventive behaviors regarding diabetes and high blood pressure after participated to the program than that before (p-values<0.001). Therefore, public health agencies at all levels should support and promote health literacy programs regarding diabetes and hypertension in all components, for the risk groups. Good health literacy among risk groups will lead to the prevention of new cases of diabetes and hypertension.

Proper lifestyle habits leading to remission phase of diabetes and hypertension patients, Pak Thong Chai district, Nakhon Ratchasima province

Sun, 31 Mar 2024 00:00:00 +0700

Noncommunicable diseases (NCDs) are caused by improper and unhealthy lifestyle. This qualitative case-study focused on proper lifestyle habits which led to a remission phase of diabetes and hypertension patients. Data were collected by in-depth interview, focus group discussion and both direct and indirect observation of twenty-seven purposively selected cases, and analyzed using content analysis. The results revealed that proper lifestyle habits contributing to disease remission were achieved through: 1) The operational model has had five main features including 1.1) using of the Four-Es Principle (Emotion, Eating, Exercise, and Elimination) and epidemiological principle to manage NCDs, 1.2) actions based on community participation, 1.3) developing health training program aimed at skill development, 1.4) accessibility to health services, and 1.5) implementation of participatory approach; 2) The combination of two lifestyle patterns leading to disease remission including 2.1) “daily practices” on, relaxation, adequate dietary intake, whole-body movement exercise for at least 30 min or until sweating and detoxification with sufficient water intake; and 2.2) “weekly practices” on health checkups (blood sugar level and blood pressure measurements), traditional Chinese medicine hand massage, foot massage using coconut shell, breathing using SKT method, and detoxification using “Gua Sha” therapy. In summary, the operational model development to encourage proper lifestyle habits leading to disease remission among diabetes and hypertension patients required both art and science involving an integration of knowledge and skills, activities design, effective practice guidelines based on the community context and requires cooperation among multidisciplinary teams.

Smoking consumption and its associated factors among youths in a university

Natthawadee Arasa, Chaweewon Boonshuyar, Vasin Pipattanachat (Author) — Sun, 31 Mar 2024 00:00:00 +0700

The purpose of this cross-sectional descriptive study was to estimate the prevalence of current smoking among youths, and to identify the relationship between knowledge and accessibility to cigarettes with smoking status among youths studying in the 1st-4th year of a university. Data were collected through google online questionnaire from 672 youths and analyzed by descriptive statistics, simple and multiple nominal logistic regression at 5% significance level along with Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) and its 95% confidence interval. The results showed that 4.6% of participants smoked currently, 12.4% and 83.0% were ex-smokers and non-smokers respectively. Regarding knowledge on smoking, 59.5% reported having knowledge of health effects of smoking and 52.1% reported having knowledge of tobacco control law, at good levels. However, 71.0% was easily accessed to cigarettes. Males had ever smoked and currently smoked more than females (AOR=3.02 and 10.77, 95%CI AOR: 1.68-5.42 and 3.46-33.59 respectively). Youths living with non-smoking and non-drinking peers were less likely to be ex-smoker and current smoker than those living with smoking or drinking peers (AOR=0.44 and 0.01, 95%CI AOR: 0.24-0.79 and 0.00-0.12 respectively). Youths with difficulty accessing to cigarettes were less likely to be ex-
smoker than those easily accessed (AOR=3.20, 95%CI AOR: 1.51-6.76) and youths easily accessing to cigarettes were more likely to be current smokers than youths with difficultly accessing
to cigarettes (AOR=3.50, 95%CI AOR: 1.00-12.31). However, knowledge of smoking was not significantly related to current youth smoking.

The effectiveness of a capacity development for qualified members in Provincial Tobacco Products Control Committee to support the tobacco control operational driven at the area level

Sun, 31 Mar 2024 00:00:00 +0700

This research aimed to assess the effectiveness of capacity development for the qualified members of the provincial tobacco products control committee using Kirkpatrick’s Model. The research was divided into 2 phases. Phase 1 focused on the reaction and knowledge evaluation, using a satisfaction questionnaire and knowledge test. Phase 2 focused on evaluating the trainees’ behavioral changes and the organizational outcomes through a monitoring form. Data were collected from all participants in the first-batch workshop, specifically for the qualified members and the assistant secretaries of the provincial tobacco products control committee, to rehearse their understanding of the essence and the operations under the Tobacco Products Control Act B.E. 2560. The collected data were analyzed using descriptive and inferential statistics. The results revealed that the trainees’ satisfaction was at a high level with the mean score of 4.80 (SD=0.40). There was a significant increase in the trainees’ knowledge (p=0.035). The trainees’ behavior changed after the training, as they implemented the tobacco control plan in their respective area. The evaluation of the results indicated that children and youth in educational institutions had gained knowledges about the dangers and consequences of tobacco products consumption. The number of educational institutions participating in the implementation of the 7 measures for smoke-free educational institutions had increased. Consequently, the reports of exposure to secondhand smoke or having seen someone smoking in public places had decreased. The guidelines for developing the training courses in the next batch include expanding training contents and duration of lectures to make them more comprehensive. Furthermore, the adaptation of activities and continuous follow-up on training results are recommended.

Relationship between rainfall and prevalence of the surveillance diseases during flood, Maha Sarakham province

Nuchnapa Prathumchai, Chuleewan Thunyasirinon, Santisith Khiewkhern (Author) — Sun, 31 Mar 2024 00:00:00 +0700

Floods are the most frequent type of natural disasters, representing approximately 45% of the total number of reported disasters worldwide. This disaster, especially flooding, can cause damage to the economy, society, environment, and people. This study aimed to determine the relationship between rainfall and prevalence of the diseases under surveillance during floods. The rainfall data were obtained from Meteorological Department from 2009 to 2018 and number of patients were obtained from the hospitals in Maha Sarakham Province during the same period. Data were analyzed by descriptive statistics and One-Way ANOVA statistics at p-value<0.05. The results showed that hand, foot, and mouth disease, dengue hemorrhagic fever, diarrhea, and influenza are significantly associated with rainfall (p=0.000, 0.002, 0.031, and 0.028, respectively). These diseases are 4 of 7 listed notifiable diseases during floods by the Department of Disease Control. The findings can be used as information for prevention and preparedness of treatment and medical supplies of flood-related diseases. Additionally, meteorological data can also be employed to provide early warnings on potential incidents and to help ensure preparedness.