Journal of Disease and Health Risk DPC.3

Comparative study of medical information in adult patients with tuberculosis patients, Chiang Saen Hospital, Chiang Rai Province

Panutda Yananuan — 2025-10-28

The World Health Organization (WHO) has reported the elderly are at increased risk of tuberculosis infection due to several factors, such as underlying medical conditions, the use of immunosuppressive drugs, chronic alcohol consumption, smoking, and cancer. This study is a comparative study of medical data, clinical data and laboratory results from tuberculosis patients at Chiang Saen Hospital, Chiang Rai Province. A retrospective analytical study was conducted from October 2017 to September 2022 in the Medical Laboratory at Chiang Saen Hospital. The study included a group of 240 individuals with confirmed or probable tuberculosis, consisting of 126 cases under 60 years of age and 114 cases aged 60 years and older. Factor analysis of clinical health data was performed to compare the two sample groups using the Chi-square statistic (p-value < 0.05) and the relationship between various factors in the two samples was analyzed using the odds ratio (OR). In individuals younger than 60 years, risk factors included smoking (OR = 1.89, p = 0.018), alcohol use (OR = 3.36, p=<0.001) and HIV infection (OR = 10.57, p = 0.001). Therefore, it is necessary to implement the strategy of behavior modification in Chiang Saen district to reduce the likelihood of comorbidities and mitigate severe symptoms, particularly among tuberculosis patients under 60 years of age.

Using triglyceride-glucose index to predict diabetes in prediabetic individuals

Potsawat Chantaphan — 2025-10-28

Type 2 diabetes is on the rise today, with the main risk group for developing diabetes being people with prediabetes. According to studies on diabetes prediction, higher triglycerides-glucose index values were associated with higher incidence of diabetes. However, there are limited studies of diabetes prediction with triglycerides-glucose index in prediabetes individuals. This study aims to study the ability to predict the occurrence of diabetes in people with prediabetes using the triglycerides-glucose index. The historical cohort study was conducted in Bhumibol Adulyadej Hospital personnel from 1 January 2017 to 31 December 2022 and tracked the incidence of diabetes by dividing the initial triglycerides-glucose index into groups greater than or equal to 9.02 and lower than 9.02. The results showed that the group with a triglyceride-glucose index greater than or equal to 9.02 had a 2.5-fold risk (p = 0.028) compared to the group with a triglyceride-glucose index less than 9.02. The cut-off point is 8.64 (sensitivity 75% specificity 50%) When comparing the ability to predict diabetes with glucose with the ROC curve, the triglycerides-glucose index and glucose AUC were 0.69 and 0.79, respectively. In conclusion, triglyceride-glucose index can predict diabetes in prediabetes population but when compared to the glucose. Triglycerides-glucose index has an inferior ability to predict diabetes.

Factors associated with reperfusion failure of ST-elevation myocardial infarction following thrombolytic therapy in Somdejphrajaotaksin Maharaj hospital, Tak province

Nat Kurusathian — 2025-10-28

This study objectivity to study the factors associated with reperfusion failure in ST-elevation acute myocardial infarction (STEMI) patients received thrombolytic therapy at Somdetphrajaotaksin Maharaj Hospital. This is a cross-sectional analytical study collected data between July 2019 and June 2024, involving acute ST-segment elevation myocardial infarction (STEMI) patients who received thrombolytic therapy. Data were analyzed using descriptive statistics, tests of differences among variable factors, and binary logistic regression analysis to explore associations between variable factors and results were presented with adjusted odds ratios (adjusted OR) and 95% confidence intervals (95%CI). The level of statistical significance was set at 0.05. The 84 patients were included with a mean age of 66.3 ± 11.34 years. 95.2% of patients received Streptokinase, while 4.8% of patients received Tenecteplase. Reperfusion failure occurred in 48.8% of patients, with 75.6% being male and 24.4% female. Three factors contributing to reperfusion failure are age (adjusted OR 1.081, 95%CI 1.001-1.168; p = 0.047, mean age 69.5 ± 9.72 years), alcohol consumption (adjusted OR 8.893, 95%CI 1.653-47.837; p = 0.011), and HbA1C levels (adjusted OR 3.081, 95%CI 1.085-8.746; p = 0.035). Complications following thrombolytic therapy included hypotension in 16.7% of patients and bleeding in 9.5%, which is consistent with previous studies. This study found that age, alcohol consumption, and HbA1C were factors contributing to reperfusion failure in acute STEMI patients. Further studies should include network hospitals to increase the sample size, which may reveal associations with other variable factors.

Association between Lead Exposure risk and Health Symptoms among Children in the Child Development Centers in Pollution Control Area, Rayong Province

Wannapa Sangsrijan — 2025-10-28

The purpose of this study was to association between lead exposure risk, and health symptoms among children in the child development centers in pollution control area, Rayong province. The sample consisted of 130 children in 6 child development centers. The tools used were parent interviews and Wipe test sample collection. Data were analyzed using univariate logistic regression. The results found that children were at risk of lead exposure (18.5 percent). The results of the measurement of the amount of lead on the surface did not exceed the recommended values in all samples. For the relationship analysis, it was found that children at risk of lead exposure had total health symptoms 4.3 times more than children not at risk (OR = 4.3, 95%CI = 1.7-10.8). Also classify health symptoms, children at risk of lead exposure were found to have anorexia, irritability, and nausea/vomiting 3.9, 3.5, and 4.7 times those of children not at risk, respectively (OR = 3.9, 95%CI = 1.4-10.7; OR = 3.5, 95%CI = 1.2-10.0 and OR = 4.7, 95%CI = 1.4-15.6 respectively). Recommendations for parents should reduce children's risky behaviors for lead exposure, such as keeping cleaning supplies inside the house. Public health agencies should monitor children's symptoms, such as loss of appetite, irritability, and vomiting, and further consideration should be given to the possibility of lead exposure.

The characteristics and distribution of alcohol retail outlets and the alcohol consumption behavior among rural populations in Thailand's lower northern region

Phoomtan Swaddee — 2025-10-28

Alcohol availability through retail outlets may influence drinking behaviors in rural communities. However, the relationship between outlet characteristics and consumption patterns in rural Thailand remains understudied. This cross-sectional analytical study aimed to examine the relationship between characteristics and distribution of alcohol retail outlets and drinking behaviors. The sample consisted of 73 alcohol outlet operators and 396 residents aged 18 years and above in a rural sub-district of lower northern Thailand. Research instruments included a survey of alcohol outlet characteristics, locations and sales; an alcohol consumption behavior questionnaire; and an alcohol use disorder identification test. Data were analyzed using descriptive statistics and chi-square tests for inferential statistics. Results showed that there were 73 alcohol outlets in the study area, with 91.8% being community stores and 2.7% convenience stores. The outlets were distributed throughout the area, with varying numbers per village according to population density. 98.5% of outlets were located less than 1 kilometer from drinkers' residences. All stores sold white spirits, colored spirits, and beer. The ratio of outlets to adult population was 1:42. Regarding drinking behaviors, 65.3% were male and 34.7% female. The classified 48.7 % as low-risk drinker, 29.1% as hazardous drinker, 12.1% as harmful drinking, and 10.1% as dependent drinking. 97.7% of drinkers purchased alcohol from stores near their homes. The analysis results indicate a statistically significant relationship between the distance from drinkers' homes to alcohol retail outlets and drinking behaviors (p < 0.05). In conclusion, all community stores sold alcoholic beverages with types matching consumer preferences. The outlets were easily accessible, operated without time restrictions, and located near residential areas. This distribution pattern was significantly associated with high-risk and dangerous drinking behaviors among populations in a rural sub-district of lower northern Thailand.

The Development of a Community Cerebrovascular Disease Surveillance Model for Community Health Volunteers (CHVs), Songkhla Province

Yutamas Wandao — 2025-10-28

This research and development project aims to investigate the stroke incidence among patients in Sadao District, Songkhla; develop a community-based stroke surveillance model and curriculum for community health volunteers (CHVs); compare the mean scores of knowledges, decision-making, and competency in stroke surveillance; and evaluate the satisfaction regarding the developed model and curriculum. The study was conducted between April and October 2024 and employs both quantitative and qualitative research methodologies across four phases: Phase 1, Situations Analysis in stroke patients, caregivers, CHVs, and community leaders, using a purposive sampling method with 25 individuals recruited; Phase 2 focuses on designing and developing the model with input from experts in stroke care including physicians, professional nurses, public health personnel, and emergency medical staff, purposively selected, totaling 15 experts; Phase 3, Pilot Testing and Model Refinement, involves with 36 CHVs randomly selected purposively; and Phase 4, Implementation Evaluation, evaluates the effectiveness and satisfaction of the implemented model among the same 36 CHVs in phase 3. The research instruments employed include a semi-structured interview protocol and knowledge, decision-making, and competency questionnaires, as well as the stroke surveillance model and the curriculum. Data analysis for quantitative data comprises descriptive statistics, satisfaction comparisons using the Wilcoxon Signed Ranks Test, and Repeated measures ANOVA with Bonferroni to compare means in knowledge, decision-making, and competency. The qualitative data were analyzed using content analysis. The findings indicate that the developed stroke surveillance curriculum was derived from an in-depth study of the local context and incorporates lectures emphasizing stroke knowledge based on the BEFAST protocol, hands-on workshops integrating real patient experiences, and principles from Bloom’s Revised Taxonomy to foster competency development through simulated scenarios. Statistically significant increases in the mean scores for knowledge, decision-making, and competency were observed following the training and subsequent application of the model, and participants reflected positively on the curriculum, reporting enhanced confidence and competency. The research findings suggest that competency related to stroke should be developed continuously at least every 6 months, focusing on knowledge, decision-making, and communication for emergency assistance to maintain volunteers' competency.

Innovation in Breast Model and Promoting Nutritional Literacy to Prevent Breast Cancer Model among Village Health Volunteers

Wanpen Suttikomin — 2025-10-28

The purpose of this research and development was to examine the effectiveness of a model that promotes nutritional literacy and innovative breast models in preventing breast cancer among village health volunteers in Health Region 3. This model was developed through four steps: 1) Analyze and assess the need for nutrition literacy and factors to prevent breast cancer from a systematic literature review (Cochrane Review: R1); 2) Design and develop a model for promoting nutritional literacy to prevent breast cancer and using innovative breast models to practice breast lump palpation skills (D1); developed under the theory of health literacy, health innovation, and the use of mobile technology for health; 3) Test the model with a sample of 60 village health volunteers to compare their health literacy to prevent breast cancer and record their 24-hour food intake; analyze nutrients using the Thai Nutri Survey program, Department of Health (before and after) for 3 months (R2); 4) Evaluate and follow up on continuous behavior (6^thmonth)in nutrition and breast self-examination, and improve the model (D2); analyze using descriptive statistics, including frequency, percentage, mean, and standard deviation. Comparative analysis will be conducted using paired t-tests statistical methods. The results of the study showed that village health volunteers had significantly increased scores in breast cancer prevention health Literacy and correct breast screening skills. The analysis of the changes in nutrient consumption included total daily energy consumption, carbohydrates, sugar, and sodium intake, while protein consumption increased significantly (P ≤ 0.05). Therefore, the model of promoting nutritional knowledge and breast model innovation can be studied for expansion and appropriate adaptation to prevent new breast cancer cases in the future.

The testing of efficiency of chemical insecticide in single and multiple formulation to death of Andes mosquitoes which carrier to Dengue fever with fogging machine in healthy region 3

Kitiyaporn Thammathorn — 2025-10-28

The objective of study is the effectiveness of chemical in single and multiple formulation to fogging to killed insect which carrier to Dengue fever with fogging machine as guideline of department of disease control and studied the rapidly and trendly of resistant of Andes mosquitoes in healthy region#3 by Cage Bio-assay as the standard of world health organization. (WHO) For using of substance of insecticide from regional surveying: Single formulation has 2 types, it is consisting of Deltamethrin 1% W/V EC and Cypermethrin 10% W/V EC. Multiple formulation have 2 types, Deltamethrin 0.5% W/V plus S-Bioallethrin 0.75% W/V and Casper-Series (Zeta-cypermethrin 2.25% W/V. The ratio of substance of insecticide will refer as the guideline of maximum value of WHO by testing with Aedes Aegypti amount 6 types as following: Aedes mosquitoes in laboratory (F61) and Andes mosquitoes in region of Kosamphee Kamphaengphet, Sanburi Chainat, Chumtabong Nakhonsawan, Buenarang Pichit and Huaikhot Uthaitani. The result of study of effectiveness of single and multiple formulation can affect to death of Aedes mosquitoes in laboratory more than 90% which it is not different with multiple formulation to testing with region. It was found that the effect with region of Buenarang Pichit 75.2%, Kosamphee Kamphaengphet 80% which less than standard of WHO. So, all of single-1 single-2 and multiple-1 formulation are effect to kill Andes mosquitoes more than 90% in 6 types. Andes mosquitoes in region, Buenarang Pichit and Kosamphee Kampaengphet have decrease of sensitivity with multiple-2 formulation. The fogging of insecticide will have effectiveness as the guideline of department of disease control.

Development of a long-term care system for the elderly with dependency Under the mechanism of the District Quality of Life Development Committee, Kamphaeng Phet Province

Sonthaya Plonkhot — 2025-10-28

This action research aimed to develop a long-term public health care model for dependent elderly under the mechanism of the District Quality of Life Development Committee in Kamphaeng Phet Province. 1) Use the questionnaire with the District Quality of Life Development Committee of 11 districts and 110 dependent elderly people or their caregivers. 2) The model development process was carried out between December 2024–May 2025. The study results found that: the long-term public health care model for the dependent elderly under the mechanism of the District Quality of Life Development Committee in Kamphaeng Phet Province include: 1) Long-term care (LTC) policy determination as an ODOP issue 2) Creating awareness to create cooperation from families, communities and network partners 3) Developing the potential of CM CG, village health volunteers and community leaders 4) Continuing care at home by the family medicine team 5) Support from local government organizations and various sectors. After participating in the development, the District Quality of Life Development Committee had more knowledge and participation in the operation, and the difference was statistically significant (p<0.05) compared to before participating in the development. Dependent elderly people or their caregivers had increased satisfaction with the long-term care system and had a statistically significant difference from before participating in the development (p<0.05). The recommendations are to develop the capacity of family caregivers and create cooperation in caring for the elderly with dependency and to study and develop a model of District Quality of Life Development Committee in implementing long-term public health care for the elderly with dependency (LTC).

Coverage of Drug Susceptibility Testing among New and Previously Treated Tuberculosis Patients in Public Health Region 3, Fiscal Year 2020–2023

Tanawan iemrord — 2025-10-28

Background: Drug-resistant tuberculosis (DR-TB) remains a critical public health challenge in Thailand. This descriptive study aimed to evaluate the coverage of DR-TB screening among newly diagnosed tuberculosis (TB) patients and those with a history of previous TB treatment, registered during fiscal years 2020 to 2023. Methods: Data were collected from 53 public hospitals under the Ministry of Public Health across five provinces Nakhon Sawan, Kamphaeng Phet, Phichit, Chai Nat, and Uthai Thani in Health Region 3. Information on drug susceptibility testing (DST) was obtained from the national tuberculosis database. For fiscal year 2023, DST data were compared with findings from supervisory site visits to assess accuracy and completeness. Results: In fiscal year 2020, the proportion of patients who underwent DST compared to those registered for treatment was 49.7%. In fiscal year 2023, the proportion of patients who underwent DST compared to those registered for treatment was 84.5%. In fiscal year 2020, the corresponding proportions for patients with available DST results were 38.4%. In fiscal year 2023, the corresponding proportions for patients with available DST results were 81.1%. In fiscal year 2023, categorized by patient characteristics, it was found that the drug susceptibility testing of new pulmonary tuberculosis patients in each province was between 76.3–92.3%. The corresponding proportions for patients with available DST results were between 75.6–90.9%. Categorized by patient characteristics, it was found that the drug susceptibility testing of Previously Treated Tuberculosis Patients in each province was between 83.0–96.7%. The corresponding proportions for patients with available DST results were between 74.0–91.0%. Conclusion: Although DST coverage improved substantially between 2020 and 2023, key barriers remain. The most common reasons for missed testing included a lack of awareness regarding referral criteria. Delays or absences of test results were primarily due to sputum transport issues, weak coordination between TB clinics and laboratories, and incomplete or delayed data entry into the national TB database. Strengthening training on referral guidelines and ensuring timely, integrated data reporting are essential to further enhance DR-TB surveillance and care.