Journal of Disease and Health Risk DPC.3

Factors Associated with Head Injury from Road Traffic Accidents Among Motorcycle Travelers in State Hospitals, Amnatcharoen Province, 2022-2023

Chainan ฺฺBootkan — 2026-03-02

This study aimed to examine the factors associated with head injuries among victims of motorcycle-related road traffic accidents who received treatment at emergency room in public hospitals in Amnat Charoen Province during 2022–2023. A cross-sectional analytical study design was employed, using secondary data from the Injury Surveillance (IS) system. From a total of 8,597 reported road traffic injury cases, 4,236 cases were selected based on defined inclusion and exclusion criteria. The independent variables included age, type of travelers, alcohol consumption, helmet use, road type, injury mechanism, referral and death. The dependent variable was head injury. Descriptive statistics were used to summarize frequency, percentage, mean, and standard deviation. Inferential statistics included binary and multiple logistic regression. Odds Ratios (OR), Adjusted Odds Ratios (OR_Adj), and 95% confidence intervals (95% CI) were reported, with a significance level set at p = 0.05. The majority of injured individuals were male (59.11%) with an average age of 32 years (S.D. = 18.71), and most were motorcycle riders (84.32%). Alcohol consumption was reported in 17.36% of cases, while 90.44% were not wearing helmets. Most accidents occurred on main roads (76.77%), with the predominant mechanisms being falls, overturns, or submersion (56.02%). EMS referral was not used in 51.65% of cases, and 1.27% resulted in fatalities. Statistically significant factors associated with head injuries included alcohol consumption (OR_Adj = 1.79; 95% CI = 1.43–2.23), not wearing a helmet (OR_Adj = 1.72; 95% CI = 1.23–2.40), accidents on minor roads (OR_Adj = 1.91; 95% CI = 1.55–2.34), EMS referral (OR_Adj = 1.73; 95% CI = 1.44–2.07), and death (OR_Adj = 34.97; 95% CI = 4.55–268.73). Age, type of travelers, and injury mechanism were not significantly associated with head injuries. The findings provide evidence for developing targeted prevention strategies aligned with the local context. Recommendations include identifying and improving high-risk locations on minor roads, enhancing digital risk communication outreach, applying artificial intelligence (AI) technologies for rider screening, expanding referral coverage, and strengthening EMS staff capacity. Additionally, these results offer a foundation for future operational research aimed at designing and evaluating head injury prevention interventions at the community and policy levels.

Influenza Surveillance System Evaluation In Bangkhla Hospital, Chachoengsao Province, 2023

Waraphon Arthuaikaeo — 2026-03-02

In 2022, Bangkhla Hospital reported 56 cases of influenza, and in 2023, the number increased to 320 cases, showing a 5.71-fold rise. Initially, diagnoses were based on symptoms and exposure history. Since October 1, 2022, Rapid influenza diagnostic tests (RIDTs) have been available. Therefore, an evaluation of the influenza surveillance system was conducted to describe the system, its quantitative and qualitative attributes, and to provide recommendations for its development. This descriptive study reviewed 1,036 medical records of influenza patients and related diseases from January 1 to December 31, 2023. The disease reporting process was assessed through in-depth interviews. The study found that the sensitivity was 11.36% (95%CI = 10.20-12.60), indicating a need for improvement, and the predictive positive value was 97.50%. The variables including gender, age, ethnicity, patient type, onset date, and diagnosis date were recorded with 100% completeness. The address variable had 99.06% completeness. The accuracy was 100% for gender and age, and 99.05%, 97.12%, 96.79%, and 46.47% for address, ethnicity, patient type, and onset date, respectively. All disease reports were submitted within 3 days. The surveillance system was found to be representative for gender and age, but only moderately representative for residential address and onset. In terms of qualitative attributes, staff recognized the importance of the surveillance system but were unaware that influenza was a notifiable disease, considering it to be a mild illness. The system was deemed simple and flexible. The data were used for disease prevention and control and were presented at various meetings to inform the network. An epidemiological team conducted a meeting to explain the surveillance system to staff. Laboratory personnel were advised to report RIDT-positive patients directly to the epidemiological team. All variables should be checked for accuracy before reporting. A hotline alert system should be designed for rapid and complete reporting. The Provincial Public Health Office should conduct random sensitivity assessments of the influenza surveillance system in other hospitals in Chachoengsao Province.

Factors Affecting of Disease-Free Standards of Child Care Centers in Health Area 1

Roadjaree Jankeaw — 2026-03-02

This mixed-method research aimed to evaluate the Disease-Free Childcare Center standards and the factors related to the Disease-Free Childcare Center standards in Health Region 1. The quantitative component involved 347 childcare teachers responsible for disease-free childcare centers under local administrative organizations, selected through quota sampling. Data were collected using a questionnaire developed based on the literature and previous studies, and the 2013 standard evaluation form issued by the Department of Disease Control, Ministry of Public Health. Descriptive statistics and chi-square tests were used for data analysis. The qualitative component included purposively selected childcare teachers from centers that either met or failed to meet the evaluation criteria. Data were collected through structured in-depth interviews and analyzed using inductive thematic analysis. The results indicated that 298 centers (85.9%) met the Disease-Free Childcare Center standards. Factors significantly related to successful evaluation outcomes included prior training in communicable diseases, duration of center operation, and previous participation in standard evaluations (p < 0.001). Additional significant factors included the adequacy of disease prevention equipment, availability of health education materials, and consistent budgetary support (p < 0.05). The main motivations for operating disease-free childcare centers included preventing disease outbreaks, promoting child health, and fostering community and parental trust in the centers’ ability to care for their children. Communication challenges remained with some parents who were uncooperative regarding keeping children at home when necessary. Key success factors included proactive administrators, supportive policies, adequate resources, and active collaboration from education committees and parents. Based on the findings, the study recommends the implementation of ongoing annual training in communicable disease prevention for childcare personnel, along with the provision of sufficient preventive equipment, educational resources, and sustained financial support from relevant agencies to ensure the long-term enhancement of Disease-Free Childcare Center standards.

Factors Associated with Multiple Blood Draws among Cancer Patients in Outpatient Department at Maha Vajiralongkorn Thanyaburi Hospital

Suriya Khueachanta — 2026-03-02

Repeated venipuncture attempts are common in oncology settings and may compromise patient comfort and the efficiency of care. This cross-sectional analytical study aimed to determine the prevalence and associated factors of more than one venipuncture attempt per visit. Data were collected from 173 cancer outpatients who received blood sampling services at Maha Vajiralongkorn Thanyaburi Hospital from October 1, 2024, to January 31, 2025, using simple random sampling. A structured record form was used for data collection, and the data were analyzed using descriptive statistics and multiple logistic regression. The mean age of participants was 58.3 ± 13.0 years, with 65.9% being female. The most common cancer types were breast cancer (40.5%) and colorectal cancer (22.5%). The prevalence of multiple blood draw attempts was 9.8%. Significant factors associated with multiple blood draw attempts in multivariate analysis were history of previous multiple attempts (AOR = 22.4, 95%CI = 5.2-96.4, p < 0.001), history of breast, chest, or axillary lymph node surgery (AOR = 11.7, 95%CI = 3.0-45.4, p = 0.001), and healthcare provider experience of less than 6 years (AOR = 3.6, 95%CI = 1.1-11.6, p = 0.030). Patients with a history of breast, chest, or axillary surgery are at increased risk for multiple venipunctures. Tailored risk-based protocols and experienced phlebotomist allocation should be considered to improve care quality.

Results of the Cooperative learning Program and New Theories in Protection against Pesticides and Cholinesterase Enzyme Levels Lan Dok Mai Tok Subdistrict Kosamphi Nakhon District Kamphaeng Phet Province

Chaithat Pattum — 2026-03-02

This quasi-experimental study investigated the effectiveness of a participatory learning program based on the New Theory in promoting pesticide protection behaviors and improving cholinesterase enzyme levels among farmers. The objectives were to compare farmers’ knowledge, self-protective behaviors, and cholinesterase levels before and after participation in the program. The study sample consisted of 45 farmers from Lan Dokmai Tok Subdistrict, Kosamphi Nakhon District, Kamphaeng Phet Province, who had a history of pesticide use or exposure. Participants were selected through purposive sampling. Data were collected using a standardized questionnaire on knowledge and self-protective behaviors developed by the Department of Disease Control. Descriptive statistics, including mean, percentage, and standard deviation, were used for data analysis, while the paired t-test was applied to compare pre- and post-intervention outcomes. The results showed that participants demonstrated a significant improvement in self-protection knowledge after the intervention ( = 4.60, SD = 0.49) compared to before ( = 4.31, SD = 0.57; p < 0.001). Post-intervention, 97.8% of participants exhibited good levels of protective behavior, with mean behavior scores significantly higher than those before the program (p < 0.001). Additionally, the mean cholinesterase enzyme levels increased significantly after the intervention (p < 0.001).

Proportion of isoniazid resistance-associated genes of Mycobacterium tuberculosis complex detected by Xpert MTB/XDR assay in Regional Health 3

Supanat Promploy — 2026-03-02

The declining trend of Isoniazid (H)-sensitive Mycobacterium tuberculosis (MTB) complex in Regional Health 3 from the fiscal year 2015 to 2024, decreasing from 83% to 68%. This trend reflects a rising prevalence of drug-resistant MTB. Various genes are associated with H-resistant MTB. This study aimed to determine the proportion of genes associated with H-resistant MTB among MTB-positive samples in Regional Health 3, using Xpert MTB/XDR (N = 655). The results showed that the proportion of mutations in katG, inhA, fabG1, and oxyR-ahpC was 72%, 23%, 4%, and 1%, respectively. The proportion of H-resistant isolates was higher among males than females; however, no significant differences were observed across age groups. The katG and inhA mutations were found in every province (Kamphaeng Phet, Phichit, Nakhon Sawan, Uthai Thani, and Chainat), while the fabG1 mutation was detected in Kamphaeng Phet and Phichit, and the oxyR-ahpC mutation was found only in Chinat. Additionally, fabG1 and oxyR-ahpC mutations were more frequently observed among newly diagnosed patients. These results indicate that the distribution patterns of H-resistant MTB vary by region, especially for genes with lower mutation frequencies. These findings can help identify transmission linkages among patient groups, genders, age groups, and geographic areas. This information is valuable for MTB investigations, which remain highly challenging at present.

Factors influencing self-protective behavior against PM2.5 exposure among populations aged 15-59 years in Kamphaeng Phet Province.

Rittichai Thithaphan — 2026-03-02

This cross-sectional analytical study aimed to examine the factors that influence to self-care preventive behaviors regarding PM_2.5 among populations aged 15-59 years in Kamphaeng Phet Province. There were 479 participants who selected by using multistage random sampling technique. Data were collected through a self-administered questionnaires and analyzed by using descriptive statistics and multiple Linear regression analysis. The results revealed that the majority of participants exhibited a high level of self-care preventive behaviors regarding PM_2.5 (Mean = 31.49, S.D. = 6.32). Significant factors influencing self-care preventive behaviors regarding PM_2.5 included self-management of information regarding PM_2.5 (Beta = 0.239, p-value < 0.001), age (Beta = 0.224, p-value < 0.001), awareness and verification of information about PM_2.5 (Beta = 0.152, p-value = 0.015), access to information about PM_2.5 (Beta = 0.130, p-value = 0.026), and attitudes toward PM_2.5 prevention (Beta = 0.058, p-value = 0.008). These 5 factors could 26.2% collectively predict the self-care preventive behaviors regarding PM_2.5 with statistically significant at 0.05 level. Therefore, Provincial Public Health Office should promote the establishment of policies or plans regarding self-management, awareness of information, access to information, and fostering attitudes that help the people protect themselves from PM_2.₅

Factors related to quality of life among undergraduate students in Bangkapi District Bangkok, Thailand during pandemic of COVID-19

Supattra Assawamaitree — 2026-03-02

This study “Factors related to quality of life among undergraduate students in Bangkapi District Bangkok, Thailand during pandemic of COVID-19” was a cross-sectional descriptive study. The aim of this study was to learn about the association between personal factors, factors supporting online learning, communication, and interpersonal relations with quality of life among undergraduate students. The respondents were 424 undergraduate students in Bangkapi District Bangkok. Data collection tool was a questionnaire. For the data analysis, descriptive statistics, and inferential statistics; Pearson Product-moment Correlation Coefficient, Chi-square test and Fisher’s Exact Test were employed. As for the association, it was found that the personal factors; gender and age were associated with quality of life among undergraduate students with statistical significance at 0.05 (p-value = 0.004, p-value = 0.011 and r = 0.815). Factors supporting online learning; information technology and online learning environment had a low level that positively associated with quality of life among undergraduate student with statistical significance at 0.01 (r = 0.393, p-value < 0.001 and r = 0.405, p-value < 0.001). Similarly, communication and interpersonal relations had a low level that positively associated with quality of life among undergraduate student with statistical significance at 0.01 (r = 0.322, p-value < 0.001). This study result could help in planning for quality of life promoting among undergraduate students in Bangkapi District Bangkok.

Development of a Collaborative Operational Model Between District Public Health Offices and Sub-district Health Promotion Hospitals in Transferred Areas to Enhance Access to Healthcare Services in Kamphaeng Phet Province

Sonthaya Plonkhot — 2026-03-02

This study had three objectives: (1) to identify factors influencing access to health services among populations in sub-district health-promoting hospitals (HPHs) transferred under administrative decentralization; (2) to develop a collaborative operational model between district public health offices and HPHs in decentralized areas; and (3) to evaluate the effectiveness of the proposed model. A research and development (R&D) design with an explanatory mixed-methods approach was. The sample consisted of 252 local residents and 252 HPH personnel in areas transferred to the Kamphaeng Phet Provincial Administrative Organization (PAO). Data were analyzed using analysis of variance (ANOVA) and structural equation modeling (SEM). Findings revealed that most service recipients at decentralized HPHs were female (72.2%), with one-third aged 50 years and above (33.7%). The majority were married (57.9%), and 38.5% had completed secondary education. Over half were engaged in agriculture (52.4%), while a small proportion worked in private companies (4.4%). Factors significantly associated with satisfaction included gender, age, marital status, and education level. Regarding HPH personnel, most were female (76.2%), with the majority aged between 30 and 39 years (35.3%). More than half (64.3%) held public health officer positions, and 67.1% had over six years of experience. All participants worked at HPHs. SEM results indicated that demographic, socioeconomic, knowledge, attitude, and decentralization impact components jointly predicted 52% of the variance in perceived decentralization impacts. The causal model of health service access in decentralized areas demonstrated good model fit (χ² = 37.826, p = 0.169, CMIN/DF = 1.243, RMR = 0.081, GFI = 0.971, AGFI = 0.948, RMSEA = 0.031). The development of the collaborative operational model through expert seminars based on the Connoisseurship approach yielded six operational guidelines, four strategies, and four expected outcomes. The evaluation of the model’s effectiveness, also through expert seminars, affirmed its practical applicability. It is recommended that relevant agencies apply the developed model to enhance cooperation among district public health offices, decentralized HPHs, and the PAO.

Assessment of capability of public health Emergency Operations Center (EOC) in Regional Health 3, 2025

Uthaiporn Arkaranupappong — 2026-03-02

This Objective of this study was to assessment of capability of public health Emergency Operation Centers (EOC) in Region Health 3, 2025 and to provide recommendations for the development of the EOC capabilities. The study utilized the EOC assessment tool, which consists of 10 capability elements with 74 indicators; it was developed and improved by the Division of Disease Control in Emergency Situation, Department of Disease Control. The Likert scale comprised four levels: 1 = No capability, 2 = Limited capability, 3 = developed capability, and 4 = demonstrated capability. This study employed a descriptive research design. The data were collected through documentary reviews, observation, and interviews. The assessment results showed that all provinces passed the assessment criteria at level 4 (60%). With respect to Capability Element 7, Risk communication and warning, all provinces passed the assessment criteria at level 4. However, continuous development is needed in certain capability elements, including Capability Element 2, Emergency Operation Center; Capability Element 3, Organization Framework; Capability Element 6, Incident management and response; and Capability Element 10, Training, exercise, and evaluation. Therefore, it is a recommended that the development plan for public health Emergency Operation Centers (EOC) in Region Health 3, be expedited, focusing on three aspects: resource enhancement, personnel capacity, and system functionality. This should also include improving personnel capabilities, ensuring the availability of essential basic equipment and facilities, and updating standard operating procedure in order to enhance the performance and efficiency of EOC in Regional Health 3.