Journal of Medical and Public Health Region 4

The prevalence and factors associated with dementia among older adults in Mae Sai Subdistrict, Muang District, Phayao Province

2024-02-18T20:47:38+07:00

This research was a cross-sectional survey using descriptive research methods. The purpose of the study was to examine the prevalence of dementia and factors associated with dementia among older adults in Muang district, Phayao province. The sample consisted of 197 older adults, and data was collected from July to December 2022. Participants were selected through simple random sampling based on the inclusion criteria. The tools used for data collection included: the Patient Health Questionnaire-2 (2Q) was used to screen and exclude individuals at risk for depression, 14-item Memory Function Screening Questionnaire was used to preliminarily screen individuals at risk for dementia for inclusion in the study, and Mini-Mental State Examination-Thai 2002 (MMSE-Thai 2002) was used to screen individuals at risk for dementia. These tools underwent validity testing and achieved reliability coefficients of .81, .83, and .84, respectively. Data were analyzed using descriptive statistics and the Chi-square test. The study found that the prevalence of dementia among older adults was 7.61 percent. Factors significantly associated with dementia among older adults in Mae Sai Subdistrict, Muang District, Phayao Province, were age and the presence of underlying disease (p < .05). The results of this study can be used to improve care planning, health promotion, and dementia prevention among older adults, making these strategies more effective.

Predictive factors influencing health care behaviors of menopausal women in Mae Klong Subdistrict, Mueang Samut Songkhram District, Samut Songkhram Province

2024-08-26T08:36:38+07:00

Menopause is a stage of life marked by significant physical, psychological, and social changes that affect their health and quality of life. This study aims to investigate the predictive factors influencing the health behaviors of menopausal women in Mae Klong Sub-district, Mueang Samut Songkhram District, Samut Songkhram Province, through a cross-sectional research design. The sample consisted of 317 menopausal women aged 45 - 59 years, selected through stratified random sampling proportional to the population in each village. Data were collected using a validated questionnaire and analyzed using descriptive and multiple regression analysis. The study found that the predictive factors influencing health behaviors of menopausal women included perceived susceptibility to disease (β = 0.355), perceived benefits of preventive health behaviors (β = 0.206), and cues to action for disease prevention (β = 0.256). These variables collectively predicted 58.40% of the health behaviors of menopausal women with statistical significance (R = 0.764, R²= 0.584, p-value < 0.001). The study recommends that relevant agencies incorporate these factors into developing health promotion models tailored to the local context. Emphasis should be placed on organizing activities or programs that enhance awareness of these issues to achieve sustainable health behavior changes. Additionally, further qualitative research is needed to gain a deeper understanding of the perspectives and health needs of menopausal women, which will be beneficial in developing healthcare models that better meet their requirements.

Factors affecting the delay in the treatment process for stroke patients at Sikhiu Hospital, Nakhon Ratchasima Province, fiscal year 2020 - 2022

2024-03-31T23:29:54+07:00

This study aims to investigate the factors that contribute to delayed treatment processes for stroke patients in Sikhiu District, Nakhon Ratchasima Province. A retrospective study design was employed, with the sample consisting of patients aged over 15 years who were diagnosed with stroke (ICD-10 I60-I69) and received treatment at Sikhiu Hospital, Nakhon Ratchasima, between 2020 and 2022, totaling 300 cases. The statistical methods used for data analysis included percentages, means, standard deviations, and multivariable logistic regression analysis. The research findings revealed that: 1) Patient and environmental factors, such as residence (F = 4.358, p-value = 0.013), having DLP (F = 5.748, p-value = 0.017), patient symptoms (F = 55.382, p-value = 0.003), and having DM (F = 5.748, p-value = 0.017) affected the delayed treatment process for stroke patients in Sikhio District, Nakhon Ratchasima Province. 2) Factors related to the emergency medical service system, such as the method of transportation to the hospital (F = 37.563, p-value < 0.001) and time of admission (F = 8.903, p-value = 0.003) also affected delayed treatment. 3) Hospital service factors, such as Door to Triage Time (F = 34.969, p-value < 0.001), Triage to Physician contact time (F = 16.047, p-value < 0.001), and Stroke care activation (F = 9.845, p-value = 0.002) significantly contributed to delayed treatment for stroke patients in Sikhio District, Nakhon Ratchasima Province.

A causal relationship model of factors affecting preventive behaviors for electronic cigarette use among Youth in Bangkok metropolitan

2024-09-10T13:37:46+07:00

This study is causal relationship research with the objective of empirically validating the causal structure of relationships in promoting behavior and preventing electronic cigarette consumption among youth in the Bangkok metropolitan area with empirical data. The sample group consists of middle school students in Bangkok aged 13 - 15 years, A total of 720 students. The sampling was done using multi-stage sampling methods. Data was collected using a questionnaire, which was content-validated by five experts and had an overall reliability of 0.94. The data was analyzed using structural equation modeling techniques. The results showed that the structural model of causal relationships in promoting behavior in preventing electronic cigarette consumption among youth in Bangkok metropolitan area was consistent with the empirical data after model adjustment (chi-square = 43.759, df = 17, p<0.05, chi-square/df = 2.574, RMSEA = 0.047, CFI = 0.994, RFI = 0.960). Path analysis results indicated that the intention towards behavior in preventing electronic cigarette consumption was significantly influenced by attitudes towards non-consumption of electronic cigarettes, media literacy regarding electronic cigarette advertisements, and perceived behavioral control over behavior in preventing electronic cigarette consumption,
with standardized influence coefficients of 0.70, 0.60, and 0.40, respectively, at a significance level of 0.05.

Guidelines for management of water supply system for promoting community health in drought conditions: A case study of the Mae Loa Watershed community, Mae Rim District, Chiang Mai Province

2025-03-10T09:55:25+07:00

This mixed-methods research aims to 1) explore the physical infrastructure and management of village water supply systems, 2) analyze the biological quality of village tap water, and 3) synthesize guidelines for managing village water systems to promote community health during drought conditions. The sample includes 180 residents and 20 stakeholders from the
Mae Lae Watershed community, Mae Rim District, Chiang Mai Province, Data were collected through questionnaires, informal interview, focus group discussion, and laboratory water quality analysis. The data were analyzed using descriptive statistics and content analysis. The study found that all the village water systems in the area are sourced from mountain water. During drought conditions, the water supply is insufficient and of poor quality. Additionally, the physical infrastructure of the mountain water system lacks maintenance and repair. Coliform bacteria, fecal coliform bacteria, and E. coli were detected in some areas, failing to meet the Department of Health's standards. The proposed guidelines for managing village water systems to promote community health during drought include designing and developing environmental education activities for water system management through genuine community participation and developing learning activities for basic village tap water quality monitoring.

Clinical characteristics, treatment outcomes, and factors associated with gram-positive and gram-negative bacterial septic arthritis at NongKhai Hospital

2024-08-24T18:01:16+07:00

This retrospective descriptive study collects data from the medical records of patients with septic arthritis who have been eligible for Newman criteria level A or B from 2016-2023. The objective is to study the clinical characteristics, treatment outcomes, and factors associated with gram-positive and gram-negative bacterial septic arthritis at NongKhai Hospital. Categorical variables were compared using the Chi-square or Fisher’s exact test, and continuous variables with the Unpaired T-test or Mann–Whitney U-test, then only the factors with p < 0.10 were further analyzed using multiple logistic regression. 126 eligible patients were enrolled. Patients with bacterial septic arthritis were classified into gram-positive 90 cases (71.4%) and gram-negative 36 cases (28.6%). Most gram-negative patients were caused by Burkholderia pseudomallei (20 cases, 15.9%) and usually work as laborers, farmers, or agricultural workers (p=0.025, adjusted OR 3.140), have liver disease
(p = 0.090, adjusted OR 2.898), fever (p = 0.117, adjusted OR 2.633), septicemia (p = 0.199, adjusted OR 2.014), and intubation (p = 0.160, adjusted OR 2.365). Whereas gram-positive patients often have a joint disease (p = 0.025, adjusted OR 0.241). In conclusion, according to this study, it is recommended that patients with bacterial septic arthritis particularly those with concomitant liver disease and suspected septicemia who work as laborers, farmers, or agricultural workers, should consider empirical antibiotics for gram-negative bacteria, especially melioidosis. In a while, patients with bacterial septic arthritis who have a concomitant joint disease should consider empirical antibiotics for gram-positive bacteria.

Factors related to heat-stroke among farmers in Nakhon Ratchasima Province

2024-10-03T11:04:45+07:00

This cross-sectional analytical study aimed to examine the factors associated with heat stroke among farmers in Pak Thong Chai District, Nakhon Ratchasima Province. The study sample comprised 1,024 farmers engaged in year-round agricultural work with continuous exposure to sunlight. Data were collected between March and July 2023 using a structured questionnaire. Descriptive statistics, including frequency, percentage, and multiple logistic regression, were employed for data analysis. The findings indicated that the majority of participants were male (54.4%) and aged between 31 and 40 years (28.9%). Most had attained a high school education (32.3%) and were engaged in sugarcane, corn, and cassava farming (30.5%). Additionally, 88.1% of participants reported no underlying health conditions. In terms of protective behaviors, 80.0% of farmers wore appropriate clothing, such as long pants, long-sleeved shirts, gloves, and hats, to shield themselves from sunlight. Conversely, certain risk behaviors were identified, with 5.9% of participants consuming alcoholic beverages while working to stimulate the nervous system, thereby increasing their susceptibility to heat-related illnesses. Regarding health effects, the most commonly reported symptoms included dizziness, headache, and faintness (38.7%), followed by pale complexion, cold sensations, and near-fainting episodes (11.3%). Analysis of behavioral factors associated with heat stroke occurrence revealed that farmers who took breaks in shaded areas after prolonged sun exposure were 0.24 times less likely to experience heat stroke than those who did not take breaks (Adjusted Odds Ratio (AOR) = 0.24; 95% Confidence Interval (CI): 0.10 - 0.55), corresponding to a 24% reduction in risk. Conversely, farmers who consumed alcohol or drugs while working were 6.13 times more likely to experience heat stroke compared to those who abstained (AOR = 6.13; 95% CI: 4.03 - 12.61). These findings underscore the significance of promoting appropriate preventive behaviors among farmers to mitigate the risk of heat stroke, particularly by encouraging shaded rest breaks and reducing alcohol consumption during work.

Evaluation of melioidosis surveillance system in the hospitals of Public Health Region 4, 2018 - 2020

2024-12-11T10:30:11+07:00

This study is mixed method research that combines quantitative and qualitative studies to evaluate the melioidosis surveillance system in Health Region 4 by randomly selecting 6 health facilities from regional hospitals, general hospitals, and community hospitals. The study also reviewed the medical records of 388 patients in a 3-year period (2018 – 2020) and interviewed 29 relevant medical personnel, including administrators, medical units, epidemiologists, medical statisticians, and laboratory personnel. The results found that melioidosis was underreported with a sensitivity of 39.0% and a positive predictive value of 76.5%. The data can represent both personnel and locations. Only areas with few patients were not reported. The time of illness could not be represented. The median timeliness was 29 days (0 – 592 days). Some variables, such as age and onset of illness, were inaccurate. The in-depth interviews showed that the system was responsive. In addition, some staff were unacquainted with melioidosis and R506, even though the staff directly responsible were familiar with the surveillance system. However, problems with data incompleteness were found, such as duplication, incorrect data, and insufficient staff. Recommendations are to review the surveillance process in all health facilities, enhance knowledge of melioidosis and definition of disease reporting in the surveillance system for staff, provide rapid diagnostic kits to reduce delays in confirmation testing, use laboratory results in detection, display data (dashboard) for use in supporting disease surveillance and control, and develop a hospital information system (HIS) that can add the onset date and screen symptoms.

The impact on persons affected by leprosy after the integration of leprosy colony into general communities in Thailand

2024-06-15T23:12:53+07:00

This study aims to examine the situation regarding the quality of life and stigma, as well as the impacts on persons affected by leprosy, following the integration of leprosy colony into the general community in Thailand. The research employs both quantitative and qualitative methods. Quantitative research involved a sample of 283 persons affected by leprosy living in former leprosy colony and 270 people from surrounding communities. The study used a quality-of-life assessment and a stigma measurement tool. Data were analyzed using descriptive statistics, including percentages, means, and standard deviations. Findings revealed that persons affected by leprosy had a good quality of life in all dimensions. The highest average score was in the physical domain (2.83), followed by social relationships and environment (2.80), and the lowest was in the psychological domain (2.75), with an overall average quality of life score of 2.77. Regarding stigma, 60.4% of respondents said they would not feel inferior or ashamed if a family member had leprosy. However, 47.8% believed that people in the community might refuse to visit families of those affected, and 47.0% thought that community members might avoid interacting with leprosy-affected persons. Qualitative research was conducted through in-depth interviews and focus group discussions with 34 representatives from relevant local agencies and 54 persons affected by leprosy. Findings from the qualitative data revealed that those affected received housing rights from the Treasury Department, with improvements made to their residences to support living and livelihood. Access to healthcare services was consistent with their entitled benefits. In terms of social and economic aspects, urban expansion has created diverse job opportunities, and persons affected by leprosy have been able to integrate into surrounding communities. Importantly, government agencies play a key role in continuous integration and support by providing services and welfare equally and fairly, similar to the general population. This has fostered mutual understanding and reduced stigma between communities, persons affected by leprosy, and government agencies, contributing to the achievement of the World Health Organization’s Zero Leprosy strategy. However, subdistrict health promoting hospitals still require support in knowledge related to wound care and prevention of disabilities among those affected by leprosy. Therefore, it is recommended that the Department of Disease Control designate this as a focus area for responsible agencies to monitor and supervise systematically.

The effects of the cognitive behavioral therapy program on depression of senior high school students at Non Khun District, Si Sa Ket Province

2025-01-15T14:37:54+07:00

Depression is a major mental health issue among adolescents, which may lead to suicide. Finding approaches to treat thoughts and behaviors related to depression is a way to help reduce the problem and provide a pathway to return to normal life. This study is a quasi-experimental research aimed to comparing the average depression scores and self-esteem of high school students between an experimental group receiving a cognitive-behavioral therapy (CBT) program and a control group. The sample consisted of students with adolescent depression assessment scores ranging from 5 to 15 points, divided into 35 students in the experimental group and 35 in the control group. Data were collected using the Adolescent Depression Screening Tool (CES-D) and self-esteem was assessed with the Rosenberg Self-Esteem Scale (RSES). The CBT program consisted of 8 activities, each lasting 45 minutes, over 8 weeks, with a follow-up period of 4 weeks. The data were analyzed using inferential statistics, with Repeated Measures ANOVA at a significance level of 0.05. The research findings revealed that the average depression score in the experimental group differed significantly from the control group (p < 0.001).
The score in the experimental group was 6.51 points lower than the control group (95% CI: -7.86, -5.17), and at the follow-up stage, the experimental group's score was 9.06 points lower than the control group (95% CI: -10.42, -7.70). Additionally,
the average self-esteem score after participating in the program was significantly higher in the experimental group than in the control group (p = 0.030), with a 2.00 points difference (95% CI: 0.20, 3.80). Therefore, individuals interested in applying the CBT program should receive theoretical and practical training in cognitive-behavioral therapy techniques from specialists. Schools can adapt the CBT program to conduct activities for high school students with depression in other areas or incorporate CBT knowledge into their curriculum, tailored to the school’s context, to reduce depression problems among students.

Effects of the self-efficacy promotion program to reduce e-cigarette smoking behavior among students in a university of Pathum Thani Province

2024-11-01T13:56:54+07:00

This quasi-experimental study aims to examine the effect of a program designed to enhance self-efficacy in order to reduce electronic cigarette use behavior among students at a university in Pathum Thani Province. The sample group consisted of 41 individuals, who were selected through purposive sampling. The research instrument was a program designed to enhance self-efficacy for reducing electronic cigarette use among students. Data were collected using a questionnaire and analyzed using statistical software. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used for data analysis. Inferential statistics were analyzed using a Paired Sample t-test. The results indicated that, after participating in the program, the sample group showed higher mean scores in self-efficacy for reducing electronic cigarette use behavior and in their expectations of the outcomes of reducing electronic cigarette use, compared to before participation. The sample group exhibited a significant reduction in electronic cigarette use behavior compared to before participating in the program, with a statistically significant difference (p-value < 0.05). Health practitioners in educational institutions can use strategies to reduce electronic cigarette use by decreasing the amount smoked each day, self-regulation, as well as supporting the refusal of peer or close acquaintances' invitations to smoke electronic cigarettes. These approaches can help promote behavior change and ultimately lead to quitting electronic cigarette use in the future.

Factors affecting the behavior of Drinkers aged 20-29 years in Noen Maprang district, Phitsanulok Province

2024-10-11T11:14:47+07:00

This cross-sectional descriptive study aimed to investigate the factors influencing drinking behavior among individuals aged 20 - 59 years in Noen Maprang District, Phitsanulok Province. A sample of 390 individuals who had consumed alcohol within the past 12 months was recruited. Data were collected using questionnaires assessing personal characteristics, health literacy, and alcohol drinking behavior. Descriptive and inferential statistics were employed for data analysis, with stepwise multiple regression used to identify predictive factors. The majority of participants (64.90%) exhibited high-risk drinking behavior. The overall health literacy level was high (mean = 4.86, S.D. = 0.49). Gender, community role, Facebook information seeking, age (41 - 50 years), and health literacy (access to health information and services) emerged as significant predictors of drinking behavior, explaining 10% of the variance. Conclusion: The study highlights the need for targeted interventions to reduce high-risk drinking among individuals in this age group. Interventions should focus on addressing gender-specific factors, promoting community engagement, encouraging responsible information seeking, and enhancing health literacy, particularly in the area of accessing health information and services

Prediction of multidrug-resistant gram-negative bacterial infections in community hospitals using the eXtreme Gradient Boosting algorithm

2024-10-25T09:29:43+07:00

Multidrug-resistant Gram-negative bacteria (MDR-GNB) constitute a pressing global public health concern.
The primary objective of this study was to develop a predictive model for identifying multidrug-resistant Gram-negative bacterial (MDR-GNB) infections using blood samples at Thatphanom Crown Prince Hospital, Nakhon Phanom Province, between January 2016 and December 2020, using the eXtreme Gradient Boosting algorithm. This retrospective study included a total of 624 samples. The findings revealed that the majority of patients with MDR-GNB infections were over 70 years old, accounting for 38%, with an average age of 65 years (S.D. = 18.42). The most frequently identified bacteria were Escherichia coli (63.02%) and Klebsiella pneumoniae (11.46%). The machine learning model developed using the eXtreme Gradient Boosting method demonstrated an ability to accurately classify patients with MDR-GNB infections with 71% accuracy and 66% of AUC. Additionally, logistic regression analysis identified that patients infected with Escherichia coli had a higher risk of MDR-GNB infection (adjusted OR 3.44, 95% CI 2.41 - 4.91, p-value < 0.001), with a significantly higher risk observed in cases involving Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBL) (adjusted OR 19.88, 95% CI 5.70 - 69.27, p-value < 0.001). Based on the study results, the overall performance of the XGBoost model showed Sensitivity, Specificity, and AUC values higher than 60%, reflecting its superior discriminatory ability compared to the logistic regression model. The results suggest that the developed model can be effectively used for surveillance among patients in the hospital setting, thereby improving the control and prevention of the spread of MDR-GNB infections.

Development of the health literacy model for COVID-19 and emerging infectious disease prevention among older adults by network participation in Uttaradit province

2024-08-23T15:15:21+07:00

The purpose of this action research was to develop health literacy model for COVID-19 and emerging infectious disease prevention among older adults by network participation in Uttaradit province. The research process was divided into 4 phases, which were 1) planning, 2) action, 3) evaluation, and 4) reflection the model. The amount of sample investigated included the elderly, representatives of community leaders related government agencies and the sample for the experiment consisted of 100 elderly individuals by purposive sampling, divided into an experimental group and a comparison group, with 50 participants in each group. The data was collected by questionnaire. The data was analyzed using descriptive statistics, and Independent t-test statistics. The results of the Phase 1 research showed that the older adults has overall of health literacy about COVID-19 and emerging infectious diseases was at a fair level of 52.3%, and coronavirus 2019 and emerging infectious diseases preventive behaviors at a fair level ( = 48.37, S.D. = 13.83). In phase 2, the health literacy model for COVID-19 and emerging infectious disease prevention among older adults by network participation in Uttaradit Province consists of 9 activities as follows:1) Individual level has 3 activities including developing health literacy, giving the guide book, and providing disease prevention equipment, 2) Community level has 3 activities includes public announcement, supporting disease prevention equipment and behavioral surveillances, 3) Government supporting has 3 activities includes supporting prevention equipment, disease screening and training. In phase 3, The result revealed that the experimental group had mean scores for health literacy after receiving the health literacy promotion program were significantly higher than those of the control group. and In phase 4, This developed model can be helpful for designing strategies to promote elderly health literacy on coronavirus disease 2019 and emerging infectious disease. The experimental group had mean scores for practices on prevention of COVID-19 and emerging infectious disease were significantly higher than those of the control group. Therefore, this model could be applied by allied organizations to enhance health literacy for COVID-19 and emerging infectious disease prevention.

Development of knowledge sheet model 4.0 for mothers after caesarean section at Health Promotion Center Region 5 Ratchaburi

2022-12-03T13:44:10+07:00

Research and development of innovations in mothers during the postpartum period generally takes place 6 weeks after giving birth. As for mothers after a cesarean section, every mother wants her body to return to normal as before pregnancy as soon as possible This innovation research and development was aimed to create, develop and compare a satisfaction of the Innovation 4.0 pamphlet for postpartum mothers at the 5^th region Health Promotion Center Hospital, Ratchaburi. The sample group was matching the inclusion criteria and selected by purposive sampling between 1^st May 2021 and 31^st July 2021. Using simple random sampling from caesarean section. By using the lottery method, for example, Monday, Wednesday, and Friday each week the data was collected using the innovation satisfaction questionnaire with a confidence value of 0.89 and were analysed by finding the frequency, percentage, mean, standard deviation, statistic (One Sample t-Test). showed that most of the samples were between 20-30 years old (54%) , first pregnancy (50%), married and lived with husband (92%), Bachelor's degree or Equivalent (44%), government service and state enterprise career (32%), average family income per month 10,001 - 25,000 baht (40%), completed antenatal care 5 times (84%), and the service payment choice was self-paid (54%).The satisfaction of the Innovation 4.0 pamphlet for postpartum mothers was found as follows items: Visualization at a high level A comparison between the satisfaction of the Innovation 4.0 pamphlet for postpartum mothers with a mean (3.50) was found that postpartum mothers had a statistically significantly higher level of satisfaction with the Innovation 4.0 pamphlet for postpartum mothers at the .05 level, except for the size and clarity of text that was not statistically significant.

The future of leprosy surveillance and control : A scenario - based study for Thailand

2026-02-26T09:34:26+07:00

Thailand has achieved the World Health Organization (WHO) target for leprosy elimination as a public health concern. However, the post-elimination context presents systemic challenges, particularly declining policy prioritization and reduced resource allocation, which may affect the efficacy of surveillance and control systems. This study aimed to analyze key factors and emerging trends influencing Thailand’s leprosy surveillance and control system, develop future scenarios, and develop synthesize an appropriate system aligned with the national context. The study employed the Ethnographic Delphi Futures Research (EDFR) methodology, conducting three Delphi rounds with 21 experts. Consensus was analyzed using median and interquartile range statistics, followed by an expert validation meeting to refine and confirm the proposed system model. As a result, a total of 89 key factors and trends were identified. The legal, political, and policy dimensions demonstrated the highest level of consensus. “Strength of policy governance” and “level of information technology integration” emerged as the primary driving forces shaping four future scenarios. Based on these findings, an integrated leprosy surveillance and control model was developed, comprising four core components : Rapid detection & response, Policy-driven governance, Sustainable stigma reduction strategy and Integrated information system appropriate to the Thai context. The findings underscore the necessity of sustaining strategic policy commitment and strengthening digital data integration within primary healthcare networks.

Policy proposals for prevention and control of disease and health hazards after the transfer of the Subdistrict Health Promoting Hospital to the Provincial Administrative Organization in Health Zone 4

2026-03-16T09:38:55+07:00

This study aimed to assess the impacts, challenges, and barriers related to disease prevention and control following the transfer of Subdistrict Health Promoting Hospitals (SHPHs) to the Provincial Administrative Organizations (PAOs) and to develop policy recommendations within the context of Health Region 4, Thailand. A mixed-methods study was conducted. Data were collected from 170 stakeholders at the provincial, district, and subdistrict levels through in-depth interviews, focus group discussions, stakeholder meetings, and structured questionnaires. Qualitative data were analyzed using interpretative thematic analysis, while quantitative data were analyzed using descriptive statistics including frequency, percentage, mean, and standard deviation. The findings indicated that transferred SHPHs demonstrated increased administrative flexibility in the management of budgets, medical supplies, and human resources. However, several challenges were identified, including policy discontinuity between central and local authorities, limited technical capacity of PAO personnel in disease surveillance prevention and control, the absence of long-term strategic plans for disease prevention and surveillance, and the lack of a clear monitoring and evaluation framework for disease control programs. Based on these findings, five policy recommendations were proposed: strengthening integrated health surveillance information systems; enhancing workforce capacity in disease surveillance, prevention, control, and public health emergency management; promoting proactive disease and health hazard prevention strategies; developing PAO public health emergency response systems; and ensuring adequate and timely resource allocation for disease prevention and control. Pilot implementation demonstrated feasibility, with over 80% of community members reporting satisfaction with access to health services and disease prevention activities, and more than 80% of stakeholders agreeing that the proposed policies enhanced collaborative disease control efforts and improved responsiveness to local health needs.

Outbreak investigation of Zika virus infection in seven districts of Saraburi Province, October 2023

2024-10-22T13:19:39+07:00

On September 29, 2023, the Joint Investigation Team (JIT) from the Office of Disease Prevention and Control Region 4,
Saraburi Province, was notified by the Situational Awareness Team (SAT) of a case involving an infant with microcephaly infected with the Zika virus in Kaeng Khoi District, Saraburi Province. The JIT, in collaboration with the Saraburi Provincial Public Health Office, the District Public Health Office, and, and Sub-district Health Promotion Hospitals, conducted an outbreak investigation between October 2 and 30, 2023. The objectives of the investigation were to confirm the diagnosis and outbreak of the disease, describe its distribution characteristics, identify the source of the infection and contributing factors, and propose prevention and control measures. The investigation followed a descriptive epidemiological approach, involving a review of medical records for infected patients, active case-finding for additional cases, laboratory testing, and entomological studies. The investigation identified 14 confirmed cases in 7 districts of Saraburi Province. These included 9 cases of microcephaly in infants and 5 cases in general patients. The general patients exhibited symptoms including fever (reported in all cases), rash (4 cases), muscle pain (2 cases), cough (2 cases), joint pain (1 case), headache (1 case), runny nose (1 case), and sore throat (1 case). The results of genetic material testing for the Zika virus using reverse transcription polymerase chain reaction (RT-PCR) from blood and urine samples from all 14 patients, conducted at the Bamrasnaradura Institute and Ramathibodi Hospital, detected the presence of the Zika virus in all cases. Entomological studies revealed that in the outbreak areas of Kaeng Khoi, Wihan Daeng, Nong Don, and Mueang Saraburi districts of Saraburi Province, the House Index (HI) exceeded 10% in all sub-districts. Aedes sp. larvae were found in household water containers such as cupboard legs, vases, and trays under refrigerators. The Zika virus outbreak in these areas was associated with both the detection of the Zika virus and a high density of Aedes mosquitoes. Risk factors contributing to the transmission and spread of the Zika virus included the timing of the outbreak during the rainy season and environments conducive to Aedes mosquito breeding, particularly in water-holding containers.

Investigation of road traffic injury involving 4 vehicles on Phahon Yothin road, Highway no.1 Pathumthani province, October 2023

2024-11-07T10:32:34+07:00

According to road accident statistics in 2023 in Thailand and Pathum Thani Province, most accidents occurred on highways, involving motorcycles, male drivers, and individuals aged 20–29 years. On October 16, 2023, a joint investigation team, including local authorities, conducted an inquiry into a road traffic accident involving four vehicles on Phahonyothin Road, Highway No. 1, Pathum Thani Province. The investigation aimed to describe the incident, identify contributing factors, and propose preventive measures to mitigate future accidents and injuries. Data were collected from hospital records and interviews with individuals involved in the incident, and injury factors were analyzed using the Haddon matrix. The accident occurred involving 21 individuals: 1 severely injured, including a laceration on the lower lip, broken front teeth, and a brain hemorrhage. This individual, a passenger in a public van, was seated in the front left seat without wearing a seatbelt, which bore the brunt of the collision impact. 6 moderately injured, and 14 with minor injuries. The injured included 8 males 13 females, with an average age of 35.71 years, ranging from 14 to 59 years old. The vehicles involved were a private pickup truck, a modified gas-carrying pickup truck, a passenger van, and a motorcycle. The investigation identified several contributing factors: (1) The driver of the first vehicle was driving against traffic for approximately 1 kilometer, had a history of schizophrenia, and was unfamiliar with the route; (2) The modified gas-carrying truck was overloaded; (3) The passenger van was carrying more passengers than legally allowed, with two standing passengers and several without seat belts; and (4) The accident occurred near a road junction within 200 meters. Proposed preventive measures include stricter enforcement of traffic laws, more rigorous licensing processes, thorough vehicle inspections, and public education on road safety compliance.

Investigation of influenza outbreak in one urban medical center for rehabilitation and palliative care, Bangkok, 23 July – 5 August 2024

2025-01-15T15:25:50+07:00

On 23 July 2024, Ratchaphiphat hospital’s Surveillance and Rapid Response Team (SRRT) was notified of 13 influenza-like illness (ILI) outbreak in Intermediate care (IMC) ward and medicine ward of urban medical center for rehabilitation and palliative care, Bangkok. An investigation was conducted to confirm a diagnosis and outbreak, describe the epidemiological characteristics, identify precipitating factors of transmission and provide proper recommendations to control the outbreak. The investigation including active case finding and interviews were conducted among patients, healthcare workers and their relatives. The influenza cases were confirmed to be ILI ones by RT-PCR technique. An environmental study was also conducted. A retrospective cohort study was undertaken to identify risk factors of infection among patients. The result was shown in relative risk with 95% Confidence Intervals. Of 110 patients, 20 cases met the case definition (overall attack rate 18.18 %) including 2 confirmed influenza A H1N1 (2009) cases. The top 3 most signs and symptoms were fever, cough and sputum, respectively. The index case was admitted in ward and 2 days before she developed symptoms after having close contacts with a healthcare worker who was diagnosed with Influenza. The analytical study suggests that the history of going to physical therapy at rehabilitation building was a statistically significant risk factor (Adjusted odds ratio = 3.97, 95% CI = 1.26 - 12.56) due to increasing direct contact from physical therapy equipment in the rehabilitation building. Significant protective factor was wearing a mask all the time (Adjusted odds ratio = 0.19, 95% CI = 0.04 - 0.99). This study found that the outbreak or risk factor was caused by infection from healthcare worker to patients in the ward, direct contact from equipment in the rehabilitation building and delayed reporting to responsible persons. Therefore, immediate reporting to SRRT and cleaning shared equipment after every use are important measures for influenza prevention and control.