KKU Journal for Public Health Research

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วารสารวิจัยสาธารณสุขศาสตร์ มหาวิทยาลัยขอนแก่น — Mon, 17 Nov 2025 00:00:00 +0700

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วารสารวิจัยสาธารณสุขศาสตร์ มหาวิทยาลัยขอนแก่น — Mon, 17 Nov 2025 00:00:00 +0700

A Comparison of Survival of Oral Cancer Patients after Diagnosis in Roi-Et Hospital, Roi-Et Province

Kodchamonnakorn Champangoen, Supot Kamsa-ard, Aartitaya Aunsri — Mon, 17 Nov 2025 00:00:00 +0700

Oral cancer (OC) is the 16th most common cancer globally by both incidence and mortality rates and a significant cause of cancer-related death among men in South Asia, Southeast Asia, and the Western Pacific. This study aimed to compare survival rates of OC patients after diagnosis who received treatment at Roi Et Hospital. This analytical retrospective cohort study utilized data from the Roi Et hospital-based cancer registry. The study population comprised 433 newly diagnosed oral cancer patients who were diagnosed by physicians and received treatment at Roi Et Hospital, Roi Et Province, between January 1, 2015, and December 31, 2021. Survival rates were analyzed using the Kaplan-Meier method, and the Log-rank test was used to compare survival rates between groups. Result: Females exhibited a higher median survival than males (2.4 years vs. 0.9 years). Patients with lip cancer had the longest median survival (6.2 years). Early-stage disease (Stage 1: 7.6 years; Stage 2: 6.0 years) was associated with markedly better survival compared to advanced-stage disease (Stage 3: 1.0 year; Stage 4: 0.7 years). Well-differentiated tumors showed a higher median survival (3.1 years) compared to other pathological grades. Patients without metastasis had a longer median survival than those with metastasis (1.9: 0.4 years). In sum up, a comparison of Survival of Oral Cancer Patients after Diagnosis in Roi-Et Hospital, Roi-Et Province found that Sex, Topography, Stage, Histology grading, Metastasis were associated with oral cancer patient survival. However, there may be additional factors that influence survival outcomes and warrant further investigation.

Prevalence and Correlates of Stigma among Covid-19 Patients in Northeastern Thailand

Mon, 17 Nov 2025 00:00:00 +0700

The COVID-19 pandemic has brought about substantial psychological and social impacts, particularly stigma, among individuals who have previously contracted the virus. This cross-sectional research aimed to investigate the levels of stigma and associated factors among COVID-19 survivors in Northeastern Thailand. A total of 1,250 samples aged 18 years and above who had recovered from COVID-19 were recruited through multi-stage sampling across 12 provinces. Data were collected via an online structured questionnaire in 2023 and analyzed using descriptive statistics and Generalized Linear Mixed Models (GLMM).

The findings revealed that 77.20% of participants experienced low stigma, 13.28% moderate stigma, and 9.52% high stigma, with a mean stigma score of 27.26 (S.D.=12.36). Stigma across all four dimensions—self-stigma, workplace, family, and community—was predominantly low. Factors significantly associated with lower stigma included being a government employee (Adj.OR=2.66, 95%CI: 1.40–5.05), shorter treatment duration (<7 days) (Adj.OR=1.95, 95%CI: 1.20–3.17), good COVID-19 preventive behaviors (Adj.OR=1.73, 95%CI: 1.16–2.56), excellent health literacy (Adj.OR=1.84, 95%CI: 1.25–2.72), mild-to-moderate stress (Adj.OR=4.34, 95%CI: 2.76–6.83), and moderate post-traumatic stress (Adj.OR=5.01, 95%CI: 2.35–10.70).

This study underscores the importance of addressing psychological, behavioral, and sociodemographic factors when developing stigma-reduction interventions. Public health strategies should therefore emphasize on promoting health literacy, mental health screening, alleviating stigma in communities.

Incidence Rate and Spatial Analysis of Liver and Bile Ducts Cancer, Kalasin Province

Peeraluk Samranruen, Supot Kamsa-ard, Oraya Sahat — Mon, 17 Nov 2025 00:00:00 +0700

Background and Objectives: The incidence of liver and bile duct cancer has been steadily increasing. The application of Geographic Information Systems (GIS) to analyze spatial factors offers a promising approach for developing targeted prevention strategies. This study aimed to investigate the spatial determinants and the incidence of liver and bile duct cancer in Kalasin Province, Thailand. Methods: Analysis retrospective cohort study was conducted among patients diagnosed with liver and bile duct cancer residing in Kalasin Province. Data were collected from Kalasin Hospital, covering 1,060 patients (135 sub-district) between January 1, 2019, and December 31, 2023. Factors examined included demographic characteristics, climatic conditions, and environmental context. Spatial relationships between these factors and cancer incidence were analyzed using Getis-Ord Gi*, Global Moran’s I, and Anselin Local Moran’s I (LISA). Incidence rates were reported with 95% confidence intervals (95%CI).

Results: The overall incidence rate of liver and bile duct cancer in Kalasin Province during the study period was 16.32 per 100,000 person-years (95% CI: 15.32–17.32). Males had a significantly higher incidence (24.0 per 100,000; 95% CI: 22.24–25.74) than females (9.35 per 100,000; 95% CI: 8.29–10.40). The highest age-standardized incidence rates (ASRs) among males were observed in Tha Khantho Subdistrict (ASR = 138.44; 95% CI: 18.29–258.61), followed by Nong Saen (ASR=106.84; 95% CI: 4.63–209.04), and Yot Kaeng (ASR=97.58; 95% CI: 14.50–180.68). Among females, the highest ASRs were recorded in Yot Kaeng (ASR=58.92; 95% CI: 4.58–113.24), Um Mao (ASR=57.5; 95% CI: 24.90–90.09), and Dong Ling (ASR=43.86; 95% CI: 0.62–87.12). The Getis-Ord Gi* analysis identified significant high clustering areas of liver and bile duct cancer incidence in Kalasin Province, indicating that these subdistricts had significantly higher rates compared to their surroundings. High-risk clusters were observed in Chaotha, Namon, Lup, Lampan, Ummao, Don Sombun, Klang Muen, Najan, Nong Krungsi, Khok Khruea, Nong Waeng, Lam Huai Lua, and Dong Phayung. Moran’s I and LISA analyses indicated that distance from water sources was significantly associated with cancer incidence (p = 0.047). A positive spatial autocorrelation and clustering (Moran’s I=0.027) LISA identified High-High clusters in Kut Pla Khao, Khum Kao, and Sa-at Chaiyasi subdistricts.

Conclusion: This study found that distant from water sources was linked to higher liver and bile duct cancer incidence. The overall incidence rate is lower than the national average. This lower rate may be due to differences in how comprehensively cancer cases are reported nationwide.

These findings can help guide targeted surveillance and screening programs in high-risk areas, especially those near water sources. The study also recommends establishing mobile health services to improve access to care in remote or high-incidence communities. Such measures will support more effective proactive public health efforts.

Sleep and Factors Associated with Sleep in Patients with Alcohol Use Disorders During the Recovery Phase at Suan Prung Hospital, Chiang Mai Province

Tarunya Deekanla, Pallop Siewchaisakul, Alongkon Srilerd, Sineenart Chautrakar — Mon, 17 Nov 2025 00:00:00 +0700

Sleep is a natural physiological process in human. Patients with alcohol use disorder, especially during the recovery phase, often experience poor sleep quality. This may be due to the effects of alcohol disrupting the central nervous system and disrupting the sleep cycle, leading to imbalances in functioning. As a result, patients may experience difficulty falling a sleep, frequent awakenings during night, light sleep causing early waking, nightmares, and other sleep disturbances. Several factors have been found to affect sleep.

The purpose of this analytical cross-sectional study was to investigate sleep and sleep-related factors in patients with alcohol disorders in the recovery phase. The sample included 207 patients with alcohol disorders who had been admitted to Suan Prung Hospital and were in the recovery phase. The sample was drawn using simple random sampling. Data were collected using questionnaires such as the personal data questionnaire, the Pitts-burgh Sleep Quality Index (PSQI) in Thai, and the sleep disturbance factor assessment form. Data analysis statistics included frequency, percentage, mean, and standard deviation. The Chi-square statistic was used to analyze sleep-related factors, with a 0.05 level of statistical significance.

Results: The study's findings revealed that the sample group had an average age of 48.1 years, 91.8 percent were male. According to the sleep study findings, 76.8 percent of people experience poor sleep. Physical illness (p-value 0.017), stress (p-value 0.005), and anxiety (p-value 0.009) all had a significant effect on sleep.

According to the findings, more than half of patients with recovering alcohol disorders have poor sleep. The associated factors were physical illness, stress, and anxiety. Therefore, relevant agencies should develop programs to promote sleep quality in these patients, which would aid in their physical and mental recovery, improve their ability to perform daily activities, and enhance their overall quality of life.

Effect of the Potential Development of Peoples to Promote Health Literacy and improve the Quality of Life with Community Participation in Wang Phrao Subdistrict, Ko Kha District, Lampang Province

Chatchadaporn Pissamorn, Eakasit Chaipin — Mon, 17 Nov 2025 00:00:00 +0700

This quasi-experimental study with a one-group pretest–posttest design aimed to assess health literacy and quality of life among community members and to examine the effects of a health literacy promotion program implemented with community participation. The study was conducted from January to March 2024 in Wang Phrao Subdistrict, Ko Kha District, Lampang Province. The sample consisted of 60 working-age individuals, both male and female, aged 30–60 years. The sample size was determined using G*Power software. The intervention program included five health literacy promotion sessions, each lasting two hours. Data were collected using structured questionnaires on demographic information, health literacy, and quality of life. Data were analyzed using descriptive statistics and paired samples t-test. The results revealed that the majority of participants were female (88.33%), and 56.67% were aged between 50 and 60 years. The overall health literacy score increased by 39.30 points after the intervention (Mean difference=39.30, p-value<0.001), and the quality of life score increased by 16.90 points (Mean difference=16.90, p-value <0.001). The differences in scores before and after the intervention were statistically significant. These findings suggest that the health literacy promotion program with community participation contributed to enhancing both health literacy and quality of life among the participants.

Holistic Intelligence and Health Literacy Affecting Performance the Community Mental Health among Village Health Volunteers in Muang District Chaiyaphum Province

Mon, 17 Nov 2025 00:00:00 +0700

Thailand's mental health situation is concerning, with an increasing trend of mental health patients and individuals experiencing stress problems, depression risk, suicide risk, and burnout in communities. Consequently, proactive community mental health development policies have been established, with Village Health Volunteers (VHVs) serving as key personnel in community health development work and primary health leaders.

This research aimed to study factors influencing community mental health work performance among VHVs in Mueang District, Chaiyaphum Province. This cross-sectional study examined a sample of 731 VHVs using stratified random sampling. Data were collected using a questionnaire and found that the reliability values for overall intelligence, health literacy, and community mental health practice were 0.98, 0.98, and 0.97, respectively. and analyzed using descriptive statistics and inferential statistics including Pearson's correlation coefficient and stepwise multiple regression analysis.

The research findings revealed that VHVs had overall holistic intelligence at a moderate level (Mean=3.48, S.D.=0.88), overall health literacy at a moderate level (Mean=3.46, S.D.=0.88), and overall community mental health work performance at a moderate level (Mean=3.43, S.D.=0.86). The study found that factors significantly influencing community mental health work performance (p<0.05) included: health literacy in communication (B=0.305), health literacy in decision-making (B=0.213), health literacy in responsive questioning (B=0.171), health literacy in knowledge and understanding (B=0.114), holistic intelligence in problem-solving (B=0.077), and health literacy in behavior modification (B=0.063). These factors together could predict work performance at 93.0% (R²_adj=0.930).

Therefore, relevant health agencies should prioritize VHV capacity development by emphasizing the enhancement of communication skills, decision-making abilities, and mental health knowledge and understanding, as well as developing appropriate work support systems to increase efficiency in community mental health care.

Association between Lipid Profile and Stroke among Type 2 Diabetes Patients Treated at Public Health Facilities in Kamalasai District, Kalasin Province

Kitiporn Donrekha, Chananya Jirapornkul, Naowarat Maneenin, Nantiya Mekchim — Mon, 17 Nov 2025 00:00:00 +0700

Stroke is a major public health problem both globally and in Thailand. It is a leading cause of death and disability worldwide. Diabetes is a significant risk factor for stroke. Dyslipidemia is commonly associated with diabetes and further increases the risk of atherosclerosis, which can lead to stroke. However, studies examining the relationship between blood lipid levels and stroke in patients with type 2 diabetes, particularly in Kamalasai District, Kalasin Province, and more broadly in Thailand, remain limited. This study aims to the relationship between blood lipid levels and the incidence of stroke in patients with type 2 diabetes. A case-control study was conducted. The sample group included 216 patients with type 2 diabetes who received treatment at government health facilities in Kamalasai District, Kalasin Province. The participants were divided into two groups: the case group, which consisted of 108 type 2 diabetic patients who had cerebrovascular disease, and the control group, which consisted of 108 type 2 diabetic patients without cerebrovascular disease. Data were collected by extracting information from the medical records database of Kamalasai Hospital. The relationship was analyzed using multiple logistic regression, and the results were presented as adjusted odds ratios (Adjusted OR) with a 95% confidence interval and p-value. Low-Density Lipoprotein Cholesterol (LDL cholesterol) levels were significantly associated with stroke in patients with type 2 diabetes (p-value<0.001). After adjusting for the effects of other variables in the final model, patients with type 2 diabetes who had LDL cholesterol levels greater than 100 mg/dL were found to have a 6.14-fold higher risk of stroke compared to those with LDL cholesterol levels below 100 mg/dL (Adjusted OR=6.14; 95% CI: 2.60–14.76). In conclusion, the study indicates that LDL cholesterol levels are associated with the incidence of stroke in patients with type 2 diabetes. Therefore, healthcare and public health personnel should routinely screen for and assess cardiovascular disease risk in patients with type 2 diabetes who have elevated LDL cholesterol levels. Early intervention and effective management in this group are essential to reduce the risk of stroke.

Mortality Rate from Road Traffic Accidents in Urban Areas, Health Region 9, 2023

Mon, 17 Nov 2025 00:00:00 +0700

Background: Road traffic accidents represent a global public health crisis, particularly in urban areas where rapid urbanization, complex transportation systems, traffic congestion, and urban lifestyles increase the risk of fatal injuries. These incidents impose significant health, economic, social, and developmental burdens. This study aimed to investigate the mortality rate from road traffic accidents in the urban areas of Health Region 9.

Methods: A descriptive study was conducted using data on injured and deceased patients from road traffic accidents in urban areas covering 60 subdistricts of Health Region 9. Data were obtained from healthcare facilities reporting to the Injury Surveillance (IS) Version PHER Plus system between January 1 and December 31, 2023, totaling 5,474 cases. Mortality rates from road traffic accidents were analyzed with 95% confidence intervals (CI).

Results: In 2023, a total of 5,474 road traffic accident cases were reported in urban areas of Health Region 9, including 129 deaths, resulting in a mortality rate of 12.99 per 100,000 population (95 % CI: 10.94–15.44). Among provinces, Surin had the highest mortality rate at 23.17 per 100,000 population (95 % CI: 15.44–34.76). The case fatality rate (CFR) among injured patients was 2.36 %, with higher CFRs observed in males 3.27 % (95% CI: 2.68–3.97), the elderly aged ≥60 years 5.41 % (95% CI: 3.73–7.56), pedestrians 11.33% (95% CI: 7.20–17.40), non–protective equipment users (2.81%; 95% CI: 2.33–3.39), and those injured by collisions with vehicles, obstacles, or animals 3.71 % (95% CI: 3.09–4.46). Higher CFRs were also observed among car users 3.40 % (95% CI: 1.79–6.33), individuals injured on rural highways 6.25% (95% CI: 2.70–13.81), and during evening–night hours (18:00–23:59) 3.23% (95% CI: 2.46–4.23).

Conclusion: Urban areas in Health Region 9 exhibited a road traffic mortality rate exceeding the national target (≤12 per 100,000 population by 2027). High-risk groups included males, the elderly, pedestrians, and non-protective equipment users. Strategies to reduce fatalities should include stricter enforcement of traffic regulations, promotion of protective equipment use, enhanced surveillance during high-risk periods, and improvement of road infrastructure, particularly rural highways, to ensure safety for urban populations.

The Efficacy of Mulberry Leaf Extract in Inhibiting Gram-positive Pathogenic Bacteria During the Post-fermentation Process of Fermented Fish (Pla-ra)

Mon, 17 Nov 2025 00:00:00 +0700

Foodborne disease caused by consuming of pathogenic microorganisms contaminated food or drinking water is an important public health problem which causing of illness and death. Pathogenic microorganisms are highly contaminated from fermented foods, such as fermented fish (Pla-ra), which is popularly consumed in the northeastern region of Thailand. This study aimed to investigate the key chemical compounds of five mulberry (Morus spp.) cultivars and to evaluate the efficacy of their leaf extracts in inhibiting the growth of pathogenic bacteria during the post-fermentation process of Pla-ra. From the antioxidant activity testing and the content of phenolic compounds and flavonoids from five mulberry strains, which are Buriram 60, Khun Pai, Mon Pai, SakonNakhon 72 and SakonNakhon 85, found that, the ethanolic crude extracts from SakonNakhon 85 strain has the highest amount of these substances, 0.183±0.012 mg gallic acid equivalent /mg of crude extracts, 125.39±3.96 mg quercetin equivalent / mg of crude extracts, respectively, as well as an antioxidant activity. However, from the gram positive pathogenic bacterial growth inhibition results shown the best inhibitory effect in both water and ethanolic crude extracts from Mon Pai strain. The minimum inhibitory concentration of Staphylococcus aureus and Bacillus cereus were 12.5-25.0 mg/mL and 3.1-6.3 mg/ml, respectively, and the minimum bactericidal concentration of S. aureus and B. cereus were 25.0-50.0 mg/mL and 3.1-12.5 mg/mL, respectively. Moreover, when using crude extracts from Mon Pai strain at a concentration of 50.0 mg/ml in the process after fermentation for 28 days. It can effectively reduce the total number of bacteria and B. cereus, and moderately inhibited the growth of S. aureus compared to the control samples. From the results of this study found that the crude extract from the mulberry leaf was effective and can be used in the fermentation process of fermented fish to inhibit pathogenic bacteria which can reduce the risk of foodborne disease.

Early Childhood Well-Being: Caregivers’ Perceptions

Khunkamon Lardsena, Pulsuk Siripul — Mon, 17 Nov 2025 00:00:00 +0700

Objectives: This study aimed to explain the meaning and factors/conditions contributing to the well-being of early childhood children as perceived by their caregivers. Methods: A qualitative research approach was employed. Key informants were purposively selected based on specific inclusion criteria, comprising individuals with direct experience in caring for early childhood. There were 28 participants, consisted of 1) primary caregivers of children aged 3-5 years, and 2) two early childhood teachers. The study was conducted at two child development centers, located in two subdistricts of a province in the northeastern region of Thailand. Data were collected through focus group discussions, in-depth interviews, and non-participant observations. The data were analyzed using content analysis and thematic analysis.

Findings: According to the caregivers' perceptions, the concept of well-being among early childhood children (aged 3–5 years) encompasses four key dimensions: 1) Being loved and cherished (feeling loved by caregivers and family members),
2) Comfort and no suffering, 3) Have fun freely, and 4) Warmth and confidence. Additionally, the research also found three main factors/conditions contributing to children well-being were 1) Child-related factors, such as child nature, healthy body, cheerful mind, and so on. 2) Family-related factors, such as speaking in a loving and harmonious manner, having the whole family together, nurture the child with understanding, and so on. 3) Environment factors, such as children personal space availability, reliable neighbors, and safety. Conclusion: The findings of this study provide profound insights into early childhood well-being as perceived by caregivers. Caregivers, teachers/childcare providers, nurses, and professionals responsible for early childhood care were able to apply the discoveries to enhance well-being among young children and to utilize them in the subsequent development of assessment tools for evaluating early childhood well-being.

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วารสารวิจัยสาธารณสุขศาสตร์ มหาวิทยาลัยขอนแก่น — Mon, 17 Nov 2025 00:00:00 +0700

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วารสารวิจัยสาธารณสุขศาสตร์ มหาวิทยาลัยขอนแก่น — Mon, 17 Nov 2025 00:00:00 +0700

List of contents

วารสารวิจัยสาธารณสุขศาสตร์ มหาวิทยาลัยขอนแก่น — Mon, 17 Nov 2025 00:00:00 +0700