The Development of Melioidosis Surveillance, Control, and Health Literacy Promotion for Prevention Among At-Risk Groups in the Lower Southern Region

Abstract

This research and development aimed to study the situation, problems, and needs, develop a model, evaluate the effectiveness, and policy recommendations for melioidosis surveillance, control, and health literacy promotion for prevention among at-risk groups.         The study was carried out in four stages: 1. Situational analysis: Studied the context, problems, and needs of public health personnel. Data were collected from 581 at-risk individuals and 120 personnel. 2. Model development: the operational model was reviewed by 5 experts, and its suitability, feasibility, and utility for implementation were evaluated by 27 target users. 3. Model evaluation: Examined the effectiveness using a two-group quasi-experimental design with pre-test and post-tests among 267 at-risk individuals and 31 personnel. Descriptive statistics and Paired t-tests were used for analysis. 4. Policy recommendations: Gathering policy recommendations from 10 experts. The findings were as follows:

1. The incidence rate of melioidosis in the lower Southern region showed an increasing trend, with fatalities reported annually. Personnel were unaware of the operational upon patient detection. At-risk groups lacked knowledge and exhibited inappropriate behavior. Personnel also lacked knowledge and required a comprehensive operational model covering surveillance, control, and prevention promotion guidelines.
2. Model for melioidosis surveillance, control, and health literacy promotion in the lower southern region is the ODPC12 Melioidosis Model - Early Detection, Early Reporting, Well-Controlled, Enhancing Health Literacy.
3. After implementation of the model: Disease detection sensitivity was 50.00%. Positive predictive value was 85.71%. Completeness of disease reporting was 92.85%. Case investigation according to criteria was 100.00%. For health literacy promotion in the at-risk group, health literacy, knowledge, and behavior all significantly improved after the activities (P≤0.05).
4. Policy recommendations emphasize hospital-based disease surveillance, developing a coordinated reporting system, enhancing personnel capacity, integrating
   the One Health network, and promoting health literacy in high-risk groups, especially diabetic patients. It is recommended to expand the ODPC12 Melioidosis Model to all Regional/ General Hospitals and large Community Hospitals in the lower Southern region with high melioidosis incidence rates.