Journal of Bamrasnaradura Infectious Diseases Institute

Cost Analysis of Mpox Patients Service Management Activities for Outpatient with Self-Isolation at Bamrasnaradura Infectious Diseases Institute

Chanchai Ardsorn, Chumphae Somboon — Fri, 26 Dec 2025 00:00:00 +0700

Most Monkeypox patients have mild to moderate disease severity, so they can receive outpatient care and self-isolation services at their homes. This study aimed to estimate cost of outpatient and self-isolation services for monkeypox patients at Bamrasnaradura Infectious Diseases Institute. The retrospective descriptive study was conducted from July 2023 to June 2024. The data were analyzed using descriptive statistics and a bottom-up approach to analyze direct medical costs.
The results of the study found that there were 45 samples who received outpatient care and self-isolation, all of whom were male, had a mean age of 36.9 years (SD = 9.9, Min-Max = 19-58), and Thai nationality were 82.2%. Most of the patients paid for their treatment themselves for 28.9%. Patients were symptomatic but not at risk for 64.4%, had underlying diseases, including: HIV infection for 33.3%. The most common first-day symptom was a rash with pustules (57.1%) and fever (23.4%). When receiving treatment, follow-up on day 3 most of them (52%) were swollen lymph nodes throughout the body. Follow-up on day 7 found that most of the pustules were starting to dry up and scab over for 91.1%. And follow-up on day 14, up to 95.6% of the pustules were starting to dry up and scab over. Most patients (66.7%) used self-isolation for < 14 days (IQR = 1 day) and all patients recovered from the symptoms of the disease. Estimation of care and treatment, the total cost analysis results were 204,256.50 baht, mostly from material costs 135,693.75 baht (66.43%). The average material cost per person was 3,015.42 baht, mostly 95.33% from diagnosis and treatment materials 2,874.67 baht. And labor costs 68,562.75 baht (33.59 %). The average labor cost per person was 1,523.62 baht, mostly 79.18% from diagnosis and treatment activities 1,206.36 baht.
This study shows the overall cost of services for outpatient care and self-isolation for monkeypox patients. If smallpox patients have mild symptoms, low risk and severity of the disease, and are ready to take care of themselves, the hospital can provide outpatient services and self-isolation at home, which will help reduce the cost burden for both patients and the government.

Personnel Perceptions of Patient Safety Culture in Hemodialysis Units in the Bangkok Metropolis

Isaraporn Rattanawan, Charuwan Tadadej, Pratana Satitvipawee — Fri, 26 Dec 2025 00:00:00 +0700

Patient safety is a challenge issue that impacts the healthcare service system. This cross-sectional survey research aims to study the perception level of patient safety culture among personnel in hemodialysis units in the Bangkok Metropolis. The sample included 366 participants. Data were collected via questionnaires from March to July 2024 and analyzed using descriptive statistics, analysis of variance, chi-square, and binary logistic regression analysis.
The findings indicated that the overall perception level of patient safety culture among personnel in hemodialysis units was high, (a mean score of 4.17). When categorized by four types of hemodialysis unit, the results revealed that 1) The units operated by public hospitals; 2) The unit operated by outsourcing; 3) The units operated by external hospitals or stand-alone units, and 4) The units operated by private hospitals had high perception scores (mean score of 4.23,4.18, 4.17 4.11 respectively). However, there was no significant difference in the overall perception of patient safety culture scores among four hemodialysis units (F (3,360) = 1.954, p-value = 1.21). The analysis of relationships found that hemodialysis units that provided resources to support patient safety practices were 5.7 times more likely (95% CI = 1.79 - 18.28) to perceive a high level of patient safety culture compared to units that did not provide such resources.
Based on the research findings, although the overall perception of patient safety culture across all ten dimensions was rated as high, two specific dimensions— staffing and work pace, and response to error—showed relatively low average scores. Hemodialysis units should adopt proactive policies prioritizing patient safety. Patient safety policies must be implemented and translated into practical actions and provide resources to support patient safety practices. These measures will help maintain patient safety standards and foster the continuous development and promotion of patient safety in hemodialysis units.

Primary Care Guideline for Pregnant Women with Syphilis in Primary Care: An Integrated Review

Fri, 26 Dec 2025 00:00:00 +0700

Syphilis in pregnancy is a growing public health problem worldwide, including in Thailand. This integrative review aimed to synthesize evidence on primary care approaches for pregnant women with syphilis. A systematic search of studies published between 2015 and 2025 was conducted in MEDLINE, CINAHL, Springer Nature Journals, BASE, and Google Scholar. Fifteen studies met the inclusion criteria: seven quantitative studies, seven qualitative studies, and one mixed-methods study. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). The findings were synthesized using thematic analysis. This integrative review highlighted five key themes that can guide the development of primary care approaches for pregnant women with syphilis, including (1) access to antenatal care and proactive integrative screening; (2) health policy and service delivery systems; (3) stigma; (4) partner management; and (5) the role and capacity of primary care nurses. These findings can inform organizations requesting to integrate nursing care with primary health-system policies. This integration enables early identification of those at risk, systematic partner follow-up, and tangible ways to strengthen nursing capacity, reducing stigma and improving outcomes for pregnant women with syphilis and their infants.

Comparison of Whole Genome Sequencing and PCR-based Methods in Identifying Drug-Resistant Tuberculosis Outbreak Clusters

Fri, 26 Dec 2025 00:00:00 +0700

Identifying outbreak clusters of Multidrug-Resistant Tuberculosis (MDR-TB) is a significant challenge in disease control. Widely used PCR-based methods have limitations in strain resolution, which makes it difficult to confirm clonal spread and accurately identify disease hotspots. This study aimed to apply Whole Genome Sequencing (WGS) and compare it with the PCR-based method for analyzing Mycobacterium tuberculosis isolates from 188 MDR-TB patients in Tha Maka District, a high-risk area, to understand transmission dynamics at both the genetic and epidemiological levels.
Results from the PCR-based method categorized patients according to WHO definitions as MDR-TB (167 cases, 88.8%), pre-XDR-TB (8 cases, 4.3%), and XDR-TB (13 cases, 6.9%). In contrast, WGS analysis achieved a much finer differentiation, distinguishing the isolates into 10 distinct sub-lineage clusters, clearly demonstrating its superior accuracy and genetic resolution over conventional methods. The L2.2.M3 strain (Beijing lineage) was the most prevalent (77.7%) and was strongly associated with high levels of drug resistance, being detected in 100% of pre-XDR-TB samples. This highlights the critical role of this lineage in the severity and spread of drug-resistant tuberculosis. Furthermore, geospatial analysis revealed a clear clustering of the L2.2.M3 strain in the Tha Maka districts, strongly indicating clonal spread. Integrating data from WGS and geospatial analysis precisely identified hotspots and high-risk strains, enabling an accurate and reliable explanation of local MDR-TB transmission patterns.
In conclusion, WGS combined with geospatial analysis is a vital tool for monitoring, controlling, and implementing proactive measures in areas highly susceptible to drug-resistant tuberculosis.

Community Participation in Chronic Disease Management: Development of a Local Model for Hypertension, Diabetes, and Cancer Care in Hua Pa Subdistrict

Fri, 26 Dec 2025 00:00:00 +0700

Non-communicable diseases (NCDs), including hypertension, diabetes, and cancers (breast, cervical, and colorectal), remain major public health challenges in Thailand. Sustainable management of chronic diseases requires strong community participation, consistent with the Chronic Care Model (CCM), which emphasizes coordinated action among local health stakeholders. This study aimed to develop and evaluate a community participation model for managing hypertension, diabetes, and selected cancers in Hua Pa Subdistrict, Sing Buri Province. A mixed-methods design was employed within a participatory action research framework, following the PAOR cycle: Planning, Action, Observation, and Reflection. Quantitative data were collected from 700 residents using health behavior questionnaires and chronic disease screening results, while qualitative data were obtained through focus group discussions with 15 village health volunteers (VHVs) from four villages. Quantitative data were analyzed using descriptive statistics and chi-square tests, and qualitative data were analyzed using content analysis.
Findings demonstrated that the model comprised three core components: (1) coordinated mechanisms among local health partners through joint planning and review platforms; (2) empowerment of community members through enhanced health knowledge, self-care skills, and health promotion activities based on the “3E–2S” principles; and (3) a digital health monitoring system using the Smart VHV platform to support data management and follow-up of at-risk individuals. After implementation, the screening rate for hypertension increased from 70.3% to 77.2%, and for diabetes from 70.1% to 80.9% (p < 0.05). Individuals with favorable health behaviors were significantly more likely to have normal screening results. Qualitative findings indicated that continuous engagement among community stakeholders fostered a shared sense of responsibility and strengthened proactive primary care services.
In conclusion, the developed community participation model effectively improved screening coverage, reduced health-risk behaviors, and reinforced the primary health care system at the subdistrict level. Ongoing capacity-building for village health volunteers, expanded use of digital tools, and integration of the model into local government health policies are recommended to ensure sustainability and support scale-up to other communities.

Development of a Smart Hospital - Based Reception and Blood Collection Service at Bamrasnaradura Infectious Institute Diseases

Narumol Thanprayoch; Pawita Suwanvattana, Tanita Rerkchalerm — Fri, 26 Dec 2025 00:00:00 +0700

This research aims to 1) study the problems and obstacles in the blood collection and specimen receiving service system, 2) reduce waiting times for specimen collection and patient blood collection, and 3) increase patient satisfaction at Bamrasnaradura infectious diseases institute, develop a service system using the Smart Hospital process, and evaluate the impact of the new system on service efficiency and risk incidence. This descriptive study was conducted between October 2024 and November 2025. Data were collected on number of patients, risk incidence, waiting times, and operational processes before and after the system update. Supporting technologies were also implemented, including a KIOSK system for automatic queue management, an automatic blood vessel labeling machine, and a Laboratory Information System (LIS) to verify patient identity and increase accuracy in the pre-analysis process. All of these technologies align with the Smart Hospital concept, which emphasizes speed, error reduction, and enhanced patient safety.
The results revealed that prior to the system development, there were several errors in the reception process: 230 incorrect queue identifications, 245 incorrect labeling, 45 incorrect blood sample tubes collected, 95 incomplete blood draws, and 5 wrong blood draws. Furthermore, the original six-step service process resulted in delays and redundancy. After the system was developed and reduced to just three steps, the incidence of risk was significantly reduced, with most errors reduced to zero, except for incomplete blood draws, which were reduced to only two. Meanwhile, the overall waiting time for patients decreased from 70.9 minutes to 34.86 minutes, a 50.8% reduction. This reflects improved efficiency in terms of accuracy, speed, and safety.
In conclusion, the application of Smart Hospital principles and automation technology to front-line laboratory services can reduce errors, increase data accuracy, reduce congestion, and wait times, and effectively support the hospital's transformation into a Smart Hospital in accordance with the Ministry of Public Health's policy.