Journal of Preventive Medicine Association of Thailand

Lifestyle Medicine and Healthy Sleep: Evidence, Roles in Noncommunicable Disease Prevention, and Opportunities for the Thai Health System

Srisiri Siriwanarangsun, Phudit Tejativaddhana — Mon, 31 Aug 2026 00:00:00 +0700

Sleep is a fundamental component of health and is closely associated with noncommunicable diseases (NCDs). This review aimed to synthesize current evidence on the relationships between sleep, health, and NCDs; examine the role of Lifestyle Medicine in promoting healthy sleep; and explore opportunities for integrating sleep health into the Thai health system. A narrative review was conducted using PubMed, Scopus, and Google Scholar, together with relevant clinical practice guidelines, academic reports, and publications published between 2004 and 2024. Priority was given to high-quality systematic reviews, meta-analyses, randomized controlled trials, cohort studies, and clinical practice guidelines. Current evidence indicates that approximately 30–35% of adults sleep less than the recommended duration and that inadequate sleep—including insufficient duration, poor sleep quality, circadian misalignment, and sleep disorders—is associated with increased risks of obesity, type 2 diabetes mellitus, hypertension, cardiovascular disease, depression, cognitive decline, and premature mortality. Proposed biological mechanisms include circadian rhythm disruption, alterations in appetite-regulating hormones, insulin resistance, inflammatory and metabolic dysregulation, and excessive sympathetic activation. Lifestyle Medicine interventions, including healthy nutrition, regular physical activity, stress management, sleep hygiene, behavioral counseling, and digital health technologies with wearable devices, can improve sleep health. Integrating sleep assessment and promotion into primary care, NCD clinics, community health services, and appropriate digital health strategies may reduce the burden of chronic diseases, improve quality of life, and promote healthy ageing and healthy longevity among the Thai population.

Preventing and Managing Postoperative Delirium in older adults with Hip Fracture: A Review of Anesthetic Techniques and Multidisciplinary Strategies

Parinyaporn Wattananetikul, Rungrawan Charoentaisong — Mon, 31 Aug 2026 00:00:00 +0700

Postoperative delirium (POD) is one of the most common complications following hip fracture surgery in older adults, affecting approximately 35–65% of patients, and is associated with increased mortality, prolonged hospitalization, functional decline, cognitive impairment, and substantial healthcare costs. This review aimed to synthesize current evidence regarding perioperative strategies for the prevention and management of POD in older adults undergoing hip fracture surgery, with a focus on anesthetic techniques, pharmacological interventions, non-pharmacological measures, and multidisciplinary care. Evidence was retrieved from PubMed, Google Scholar, and SciSpace, covering publications from 2009 to 2025, and included randomized controlled trials, systematic reviews, narrative reviews, meta-analyses, observational studies, and relevant clinical practice guidelines. Current evidence indicates that multicomponent perioperative interventions represent the most effective strategy for preventing POD: proactive geriatric consultation reduces the incidence of POD from 50% to 32% (RR 0.64, 95% CI 0.37–0.98); individualized anesthetic management, including regional anesthesia combined with peripheral nerve blocks in appropriate patients and multimodal analgesia, may further reduce the risk; and perioperative melatonin administration has demonstrated promising results, reducing POD incidence from 32.7% to 9.4% in selected studies, while non-pharmacological interventions—early mobilization, effective pain management, sleep promotion, environmental optimization, nutritional and sensory support, routine delirium screening using validated tools, and coordinated multidisciplinary care—are consistently identified as essential components of successful POD prevention. In conclusion, POD in older adults with hip fracture is a common but potentially preventable complication, and early risk assessment together with evidence-based multicomponent perioperative interventions—including individualized anesthetic and pain management strategies, appropriate pharmacological therapy, routine delirium screening, and coordinated multidisciplinary care—is essential for reducing its incidence and improving clinical outcomes in this vulnerable population.

Complicated Silicosis Diagnosed 12 Years After Exposure Cessation: Lessons Learned from Gaps in Occupational Health Surveillance

Mon, 31 Aug 2026 00:00:00 +0700

Silicosis is an occupational lung disease caused by prolonged inhalation of respirable crystalline silica and remains a major global public health concern. Despite advances in occupational health practice and dust control measures, new cases continue to occur, particularly in developing countries. We report the case of a 67-year-old Thai man who had worked in a refractory brick factory for 23 years as a stone crusher operator without appropriate respiratory protection. Twelve years after cessation of occupational exposure, he was diagnosed with complicated silicosis during a routine health examination. Chest radiography demonstrated diffuse small nodular opacities throughout both lungs with bilateral upper-lung mass-like opacities. Although lung biopsy is not routinely required for the diagnosis of silicosis, it may be indicated when radiological findings are inconclusive or when alternative diagnoses, particularly pulmonary tuberculosis or lung cancer, cannot be confidently excluded. In this patient, chest computed tomography was unable to reliably differentiate complicated silicosis from pulmonary tuberculosis or lung malignancy. Consequently, bronchoscopy with transbronchial lung biopsy was performed and histopathological examination revealed silicotic nodules, confirming the diagnosis. This case highlights important deficiencies in the occupational health surveillance system, including the lack of a comprehensive and continuous surveillance program extending from pre-employment through post-employment. These gaps likely contributed to delayed diagnosis despite the patient's prolonged occupational silica exposure. This case underscores the importance of implementing systematic chest radiographic surveillance before employment, periodically during employment, at the time of employment termination, and after exposure cessation among workers with a history of silica exposure to facilitate early disease detection. In addition, interpretation of chest radiographs by physicians trained in the ILO International Classification of Radiographs of Pneumoconioses, such as certified NIOSH B Readers, should be promoted to improve diagnostic accuracy. Strengthening occupational health surveillance programs is essential for the early detection and prevention of advanced silicosis and will contribute to the national goal of eliminating silicosis in Thailand.

Rapid Progression of Silicosis in a Stone Crusher Operator: A Case Report of Retrospective Radiographic Review

Mon, 31 Aug 2026 00:00:00 +0700

Silicosis is a significant occupational lung disease and public health concern caused by the inhalation of silica dust in the workplace. This report presented a case study of a 58-year-old male stone crusher operator. His initial annual chest radiograph was reported as normal; however, one year later, he developed respiratory symptoms and was subsequently diagnosed with silicosis. The disease progressed rapidly, leading to complications, and the patient passed away five years later. A retrospective review revealed that abnormalities consistent with silicosis were already presented in the initial annual radiograph. This case highlighted the critical importance of upgrading health surveillance standards, particularly by involving certified specialists for radiographic interpretation, to ensure accurate early diagnosis. This must be coupled with the strict enforcement of immediate removal from exposure sources upon detection to slow disease progression and prevent avoidable loss.

สถานการณ์โควิด -19 ปัจจุบัน สายพันธ์ NB.1.8.1 กับการเฝ้าระวังของสถานพยาบาลในปัจจุบัน

Surachai Chokkhanchitchai — Mon, 31 Aug 2026 00:00:00 +0700

ในสถานการณ์ปัจจุบัน ตั้งแต่เดือนมิถุนายน 69 เป็นต้นมา ข้อมูลจากกรมควบคุมโรคพบว่ามีผู้ป่วย

โควิด-19 และไข้หวัดใหญ่สูงขึ้น ซึ่งเป็นการรายงาน การพบผู้ป่วยเพิ่มขึ้นตามฤดูกาล แต่จำนวนผู้ป่วยยังคงต่ำกว่าค่ามัธยฐาน 5 ปี ย้อนหลัง สำหรับข้อมูลการเฝ้าระวังสายพันธุ์จากกรมวิทยาศาสตร์การแพทย์พบว่าปัจจุบัน สายพันธุ์ NB.1.8.1 เป็นสายพันธุ์หลักที่ตรวจพบในประเทศไทย ซึ่งสายพันธุ์ NB.1.8.1. ตรวจพบและแพร่ระบาดในประเทศไทยอย่างต่อเนื่องมาตั้งแต่ช่วงกลางปี 2568 แต่อย่างไรก็ตาม สายพันธุ์ NB 1.8.1. จากข้อมูลทางระบาดวิทยาและข้อมูลทางคลินิก ยังไม่พบหลักฐานว่าก่อให้เกิดอาการรุนแรงหรือเพิ่มความเสี่ยงต่อการเสียชีวิตมากกว่าสายพันธุ์ที่เคยระบาดก่อนหน้า ดังนั้นในทางระบาดวิทยา โรงพยาบาลและสถานพยาบาลต่าง ๆ ควรเฝ้าระวังติดตาม การเกิดโรค โควิด-19 ไข้หวัดใหญ่และโรคติดเชื้อไวรัสทางเดินหายใจอื่น ๆ อย่างต่อเนื่อง และเมื่อเกิดโรคในบุคคล ควรให้การรักษา การเฝ้าระวัง การป้องกันการแพร่กระจายโดยเฉพาะในกลุ่มเสี่ยง ได้แก่ ผู้สูงอายุ เด็กเล็ก ผู้ที่มีโรคประจำตัว เมื่อป่วยควรได้รับการรักษาและพบแพทย์โดยเร็วและป้องกันการแพร่กระจายเชื้อในชุมชน ตามระบบการเฝ้าระวังโรคระบบหายใจอย่างเคร่งครัดต่อไป

Fit Abilities and Usability of Standard and Alternative Respirators for Small Face Health Workers in Thailand

Kansuda Bootsri, Phanumas Krisorn — Mon, 31 Aug 2026 00:00:00 +0700

Objective: To evaluate the fit abilities and usability of a NIOSH-approved N95, certified KN95, and KN94 respirators with a hook among Thai health workers who typically have small faces. Methods: A descriptive study was conducted involving 47 Thai health workers with small facial dimensions, as defined by the NIOSH Bivariate Panel. The study assessed the fit abilities and usability of both standard and alternative respirators, including the NIOSH-approved N95 respirator, as well as the KN95 and KF94 respirators, which are certified. Results: The mean ± standard deviation fit factor values for each type of respirator were as follows: N95 = 125.9 ± 60.8, KN95 = 18.9 ± 8.53, and KF94 = 27.9 ± 22.7. In the fit criteria assessment, 61.7% of participants rated the N95 as providing a well-fitted feeling, compared to 14.9% for the KN95 and 12.8% for the KF94. In terms of comfortability, 42.6% of participants rated the N95 as the most comfortable, followed by 29.8% for KF94 and 25.6% for KN95. For breathability, 83.0% rated KF94 as the most breathable, followed by 72.3% for KN95 and 63.8% for N95. Conclusions: Only the N95 respirator passed the fit test and demonstrated appropriate fit abilities, including the highest rate of perceived well-fit feeling. In terms of usability, the N95 was rated as the most comfortable, while the KF94 was identified as the most breathable.

Factors Related to Lung Capacity among Workers in a Rice Mill in Chai Nat Province

Mon, 31 Aug 2026 00:00:00 +0700

Objective: To study lung capacity and factors related to lung capacity among workers in a rice mill in Chai Nat Province. Methods: This cross-sectional analytical study included 66 workers (94.3% of the target population) at a rice mill in Chai Nat Province. The research instruments consisted of a validated 6-part questionnaire (IOC = 0.97, Cronbach's alpha = 0.85) covering personal factor, occupational, work environment, knowledge, attitudes and safety behavior, and a portable spirometer (Spiro pet) to measure lung capacity, which was classified based on Thai national physical fitness standards. Data were analyzed using descriptive statistics (percentages) and inferential statistics (Chi-square and Fisher's exact tests) at a 0.05 significance level. Results: The study revealed that 43.9% of the workers had poor lung capacity. Factors significantly associated with poor lung capacity (p-value < 0.05) included being (p-value = 0.044), body mass index (p-value = 0.031), smoking (p-value = 0.005), exercise (p-value = 0.015) and work experience (p-value = 0.018). Notably, safety knowledge, safety attitudes and safety behaviors did not show a statistically significant relationship with lung capacity (p-value > 0.05). These findings suggest that individual physiological factors, health behaviors and years of employment or exposure duration. Conclusion: A substantial proportion of rice mill workers suffer from diminished lung capacity, primarily driven by physiological factors, health behaviors and years of employment or exposure duration. Preventive strategies should emphasize engineering controls, such as enhanced ventilation systems, integrated with intensive personal risk factor management and health behavior modifications to mitigate long-term respiratory health impacts.

The Efficacy of Health Literacy Enhancement Program for the Elderly Patients with Chronic Diseases in Ban Chang Subdistrict, Mueang District, Pathum Thani Province

Mon, 31 Aug 2026 00:00:00 +0700

Objective: This study aimed to assess baseline health literacy levels and evaluate the effectiveness of a targeted health literacy program among elderly patients with chronic diseases in Ban Chang Subdistrict, Mueang District, Pathum Thani Province. Methods: A quasi-experimental, one-group pretest-posttest design was conducted with 30 purposively sampled elderly patients (aged 60 years) diagnosed with chronic conditions. The intervention featured a 4-week health literacy program combining group activities (weeks 1–2, 3 hours/week) and home-visit follow-ups (weeks 3–4). Research instruments included a validated 6-domain, 42-item health literacy questionnaire (IOC = 0.81, Cronbach's alpha = 0.84). Data were analyzed using descriptive statistics and paired samples t-tests after confirming normal distribution. Results: The majority of participants were female (73.30%) and aged between 60–69 years (60.00%) Prior to the intervention, baseline health literacy was moderate overall ( = 66.17, SD = 5.65), though health communication ( = 13.07, SD = 1.62) and media literacy ( = 16.57, SD = 2.37) scored significantly lower, falling into the low tier. Post-intervention, the overall health literacy mean score significantly increased to a high level ( = 106.73, SD = 6.37). Furthermore, mean scores across all individual dimensions improved significantly to high levels. Conclusion: The integrated health literacy program effectively enhances overall health literacy, self-management, and media critical skills among elderly chronic disease patients, offering a sustainable, empowering approach to geriatric self-care.

The Effects of Developing a Proactive Health Promotion Approach to Reduce Dependency among Older Adults in Bang Pahan District, Phra Nakhon Si Ayutthaya Province

Wipawee Ketwang — Mon, 31 Aug 2026 00:00:00 +0700

Objective: To investigate the effects of a proactive health promotion approach on dependency and active aging among older adults in Bang Pahan district, Phra Nakhon Si Ayutthaya province, by comparing outcomes between the intervention and control groups. Methods: This study employed a quasi-experimental, two-group pretest-posttest study included 383 older adults aged 60 years and above with mild-to-moderate dependency, selected based on inclusion criteria. Participants were allocated into an intervention group (n=191), receiving a 12-week proactive health promotion program via a Geriatric Mobile Unit, and a control group (n=192) receiving routine care. Data were collected using the Barthel Activities of Daily Living (ADL) Index and the Active Aging Index (AAI). Data were analyzed using descriptive statistics, the Wilcoxon Signed-Rank test for intra-group comparisons, and the Mann-Whitney U test for inter-group comparisons with a significance level of 0.05. Results: After the intervention, the median ADL score in the intervention group significantly increased from 13.0 to 16.0, and the median AAI score significantly increased from 12.0 to 17.0 (p < 0.05). Furthermore, when comparing between groups post-intervention, the intervention group exhibited significantly higher median scores in both ADL and AAI than the control group (p < 0.05), reflecting the effectiveness of the program in enhancing active aging and reducing dependency. Conclusion: The developed proactive health promotion approach is effective in reducing dependency and promoting active aging among older adults in Bang Pahan district. It is recommended that local health authorities apply this model to strengthen primary health care services and support the aging society.

Effectiveness of Telemedicine in the Management of Inmates with Diabetes and Hypertension in Correctional Facilities in Buriram Province

Worrayot Darasawang — Mon, 31 Aug 2026 00:00:00 +0700

Objectives: This study aimed to evaluate the effectiveness of telemedicine in the management of inmates with hypertension and diabetes mellitus in Correctional Facilities in Buriram Province. Methods: A quasi-experimental study was conducted. The intervention group consisted of incarcerated patients who received telemedicine services, while the control group received usual care. Systolic and diastolic blood pressure, and fasting capillary blood glucose levels were monitored at baseline, 2 and 4 months. The effectiveness of telemedicine was analyzed using multivariable linear and logistic regressions. A generalized estimating equation (GEE) was also utilized. Results were presented as mean differences (MD), Adjusted OR (AdjOR), 95% confidence intervals (95% CI), and p-value. Results: Of 40 incarcerated patients with hypertension and/or diabetes mellitus were enrolled and equally divided into the intervention and control groups (20 participants per group). No significant differences in baseline characteristics were observed between the two groups. Telemedicine significantly reduced systolic blood pressure at the 4-month follow-up, while a significant difference in diastolic blood pressure between the two groups was observed at the 2-month follow-up. However, there was no significant difference in fasting capillary blood glucose levels throughout the study period. Overall, telemedicine significantly reduced both systolic and diastolic blood pressure compared with usual care (MD = −12.87 [−21.77, −3.97] and MD = −9.64 [−14.55, −4.73], respectively) and introduced well blood pressure control (p-value = 0.005), Nevertheless, it demonstrated comparable effectiveness in reducing fasting capillary blood glucose levels (p-value = 0.895). Conclusion: Telemedicine was more effective than usual care in reducing blood pressure among incarcerated patients with hypertension, while providing comparable effectiveness in controlling fasting capillary blood glucose levels among those with diabetes mellitus. Telemedicine services may therefore serve as an alternative approach for managing chronic diseases in incarcerated populations, enhancing equity in access to healthcare services and improving quality of life among them.

The Effectiveness of Group-Based Multicomponent Cognitive Training compared with Individual Cognitive Training in Older Adults with Mild Neurocognitive Disorder

Saran Weerametachai — Mon, 31 Aug 2026 00:00:00 +0700

Objective: To evaluate the effectiveness of group-based multicomponent cognitive training compared with individual cognitive training in older adults with mild neurocognitive disorder at the Geriatric Clinic of Saraburi Hospital. Methods: This randomized controlled trial enrolled 154 older adults diagnosed with mild neurocognitive disorder. Participants were randomly assigned to either an intervention group receiving group-based cognitive training by a multidisciplinary team (n=76) or a control group receiving individual cognitive training by an occupational therapist (n=78). Cognitive performance was evaluated over a 12-month follow-up period using the Thai Mental State Examination (TMSE) and the Montreal Cognitive Assessment (MoCA). Results: Baseline characteristics were comparable between the intervention and control groups, including mean age (75.36 ± 6.44 vs. 74.21 ± 6.63 years), female sex (73.68% vs. 66.67%), marital status (42.11% vs. 51.28%), and no current occupation (89.47% vs. 85.90%). The most common geriatric syndromes across both groups included oral problems (81.58% vs. 74.36%), visual impairment (56.58% vs. 58.97%), and a history of falls (30.26% vs. 38.46%). At 12 months, the intervention group showed no significant within-group improvement in TMSE (mean difference 0.15; 95% CI −0.72 to 1.01; p = 0.738), with no significant between-group difference (mean difference −0.69; 95% CI −1.96 to 0.56; p = 0.279). MoCA scores increased significantly within the intervention group (mean difference 2.18; 95% CI 1.17 to 3.19; p < 0.001) and showed a trend toward greater improvement than in the control group (mean difference 1.17; 95% CI −0.41 to 2.72; p = 0.147), though the between-group difference was not statistically significant. Conclusion: Group-based cognitive training delivered by a multidisciplinary team produced cognitive outcomes that did not differ significantly from individual cognitive training delivered by an occupational therapist, for both TMSE and MoCA scores at 12 months, although the group-based arm showed a statistically significant within-group improvement in MoCA. Group-based cognitive training represents a viable option that reduces the burden on specialized personnel and can be scaled up to geriatric clinics and primary care units (subdistrict health-promoting hospitals) to improve access to care for older adults with mild neurocognitive disorder.

Quality Assessment of Investigation and Radical Treatment of Malaria Cases Report (Ep.3) Under Malaria Surveillance System in the Office of Disease Prevention and Control 3, Chonburi

Mon, 31 Aug 2026 00:00:00 +0700

Objective: This study assessed the data quality of the Case Investigation and Radical Cure Report (EP.3) under the malaria surveillance system of the Office of Disease Prevention and Control 3, Chonburi, and examined factors associated with data quality in terms of accuracy, completeness, timeliness, and overall performance. Methods: Descriptive statistics were used to evaluate the quality of EP.3 reports, while the Chi–square test was applied to determine associations between data quality and related factors. Results: The completeness, accuracy, and timeliness of EP.3 reports were 85.1%, 35.1%, and 93.0%, respectively, with overall quality rated as good. Factors significantly associated with completeness included educational level, number of staff, and duration of responsibility. Gender, age, number of staff, and years of service were significantly associated with accuracy. For timeliness, the number of staff and years of service showed statistically significant associations. The number of staff was the only factor associated with all three quality dimensions. Conclusion: The quality of of EP.3 reports was good overall, with high levels of completeness and timeliness; however, accuracy remained a major area requiring improvement. The number of personnel was consistently associated with all three dimensions of data quality. Strengthening the capacity of personnel responsible for EP.3 reporting, ensuring adequate staffing, and establishing continuous supervision and data quality assessment should be considered to improve the quality of malaria surveillance data.

Safety and Efficacy of Omitting Intrathecal Morphine Combined with Ultrasound-Guided Saphenous Nerve Block for Postoperative Analgesia in Total Knee Arthroplasty: A Prospective Comparative Study at Phra Nakhon Si Ayutthaya Hospital

Paksiree Changkittirat, Pitsamai Ruenthana, Sukanya Pinhom — Mon, 31 Aug 2026 00:00:00 +0700

Objectives: Postoperative pain following total knee arthroplasty (TKA) is commonly managed with intrathecal morphine (ITM) combined with spinal anesthesia to enhance analgesic efficacy. However, ITM is associated with opioid-related side effects such as postoperative nausea and vomiting (PONV) and pruritus. This study aimed to compare the safety and efficacy of omitting ITM combined with ultrasound-guided adductor canal block versus the use of ITM in patients undergoing TKA. Methods: This prospective controlled clinical study included 60 patients undergoing TKA. Participants were divided into a control group receiving ITM (n = 30) and an experimental group without ITM (n = 30). All patients received spinal anesthesia combined with an ultrasound-guided adductor canal block. Outcomes included the incidence of PONV, pruritus, pain scores, time to first pain, and time to ambulation. Data were analyzed using Chi-square test, Fisher’s exact test, and Mann–Whitney U test, with statistical significance set at p < 0.05. Results: The experimental group demonstrated a significantly lower incidence of PONV and pruritus compared with the control group (p < 0.05). In terms of analgesic efficacy, the control group had a longer pain-free period and lower pain scores within the first 6 hours postoperatively (p < 0.05). However, pain scores at 12 and 24 hours were comparable between the two groups. Additionally, the experimental group achieved earlier postoperative ambulation than the control group (p = 0.01). Patient satisfaction was rated at the highest level in both groups, with no significant difference. Conclusion: Omitting intrathecal morphine in combination with adductor canal block reduces opioid-related side effects and enhances postoperative recovery, while maintaining comparable analgesic efficacy in the later postoperative period. This approach may be considered a safe and effective alternative for postoperative pain management in TKA patients.

The Modified Rapid Office Strain Assessment (ROSA) for Laptop User

Sila Rojratanakiat, Parvena Meepradit, Saksith Kulwong — Mon, 31 Aug 2026 00:00:00 +0700

Objective: To develop a modified Rapid Office Strain Assessment (ROSA) suitable for laptop users and to evaluate its content validity, reliability, accuracy, and user acceptability. Methods: This developmental study modified the original ROSA to include laptop-specific ergonomic variables, including monitor angle and height, keyboard positioning, and pointing devices. Content validity was evaluated by five ergonomics and occupational medicine experts in two rounds using item-level and scale-level content validity indices (I-CVI and S-CVI/Average). Test–retest reliability was assessed in 34 participants over a two-week interval using the intraclass correlation coefficient (ICC). Accuracy was examined by comparing total scores between the original and modified ROSA using paired t-tests. User acceptability was assessed with a 5-point Likert scale questionnaire. Results: After revision, all items demonstrated high content validity. The modified ROSA showed high reliability (ICC = 0.84; 95% CI: 0.71–0.92). No significant difference was found between total scores of the original and modified ROSA (p = 0.32), indicating comparable accuracy. User acceptability ratings were high across all domains. Conclusion: The modified ROSA demonstrates strong content validity, high reliability, comparable accuracy to the original instrument, and high user acceptability, supporting its use as an ergonomic risk screening tool for laptop-based work environments.

Risk Factors Associated with Hospitalized Severe Respiratory Syncytial Virus Lower Respiratory Tract Infection in children Under 5 Years at Pranangklao Hospital

Thitiya Trisorus — Mon, 31 Aug 2026 00:00:00 +0700

Objective: To investigate risk factors associated with hospitalized severe respiratory syncytial virus lower respiratory tract infection in children under 5 years and to determine the rates of intubation with mechanical ventilation, Heated Humidified High Flow Nasal Cannula (HHFNC) use, pediatric intensive care unit (PICU) admitted, and mortality. Methods: This retrospective analytic cross-sectional study reviewed medical records and electronic databases of hospitalized children diagnosed with RSV-LRTI at Pranangklao Hospital between January 1, 2024 and December 31, 2025. A total of 356 patients were included. Factors associated with severe RSV-LRTI were analyzed using logistic regression analysis. Results: A total of 356 children under five years of age with RSV-LRTI were included. Most patients were male, with a median age of 15.9 months. RSV outbreaks occurred predominantly during the rainy season through early winter. RSV pneumonia was the most common diagnosis 84.3%. Severe RSV-LRTI was identified 21.6% of patients. Respiratory support was required in 59.0% of cases, while PICU admitted occurred in 4.8%. No in-hospital mortality. Factors associated with severe RSV-LRTI included age <3 months (OR_Adj=8.7, 95% CI: 3.3–23.1), Preterm (OR_Adj=3.0, 95%CI: 1.0–9.0), presence of ≥2 underlying diseases (OR_Adj=8.7, 95% CI: 3.1–24.2), family income <10,000 baht/month (OR_Adj=2.9, 95% CI: 1.4–6.1), infiltration in ≥2 locations (OR_Adj=25.6, 95% CI: 9.5–56.1), infiltration and atelectasis (OR_Adj=17.5, 95% CI: 2.7–43.4), and nosocomial infection (OR_Adj=35.5, 95% CI: 13.1–56.3). Clinical respiratory score (CRS) ≥ 6 tended to be a predictor for mechanical ventilation. Conclusion: age <3 months, Preterm, multiple underlying diseases, low socioeconomic status, chest radiographic infiltration in ≥2 locations, infiltration and atelectasis, and nosocomial infection were significant risk factors for severe RSV-LRTI in children under five years. Demographic data, early clinical assessment, CRS, CXR and monitoring are essential to reduce disease severity.