Currently, e-cigarettes are the most popular tobacco product among adolescents. The purpose of this study was to explore the relationship between exposure to adverse childhood experiences (ACEs) and use of cigarettes, e-cigarettes, and dual use in a sample of adolescents in Bangkok, Thailand. The sample comprises 6167 students from 48 schools (grades 9, 11, and vocational year 2) who participated in the 2019 round of the Behavior Surveillance Survey. History of 11 ACEs was used to calculate a cumulative ACE score (range 0-11). Multinomial logistic regression was used to assess the relationship between history of ACEs and smoking. In the sample, 7.0% reported using e-cigarettes only and 9.5% used e-cigarettes and cigarettes (dual use). After controlling for sociodemographic characteristics, history of ACEs was associated with increased odds of dual use. The odds of cigarette, e-cigarette, and dual use was significantly greater if the adolescent had a history of ≥4 ACEs. Special attention is needed to prevent smoking of different types among those with a history of ACEs.

Background: Postpartum depression (PPD) can have serious consequences on both the mother and infant. Despite the higher prevalence, there are limited numbers of studies on PPD in low- and middle-income countries, like Myanmar. This study aimed to explore the prevalence and associated factors of PPD in primary healthcare settings in Myanmar. Methods: This cross-sectional online study was conducted with 220 mothers under 6 months postpartum in April–May 2020 and who registered in public health centres in Kungyangone Township, Yangon, Myanmar. The postpartum depression was measured with the Edinburgh postpartum depression scale (EPDS, ≥ 13 scores). Independent variables included sociodemographic factors, obstetric and infant factors, psychosocial factors (social support and social media usage), health services utilisation and accessibility factors. Chi-square tests and multiple logistic regression were performed. Results: Overall prevalence of depressive symptoms in 220 women under 6 months postpartum was 31.8% (95% confidence interval [CI]: 25.9, 37.3). In multiple logistic regression, unplanned pregnancy (adjusted odds ratio [AOR]: 2.946), less than four times antenatal care (ANC) visits (AOR: 2.518), travel time more than 1 h to reach health centres (AOR: 3.068) and birth interval more than 5 years (AOR: 4.594) were more likely to be associated with PPD, while preterm delivery (AOR: 0.091) was inversely associated. Conclusion: This study showed the relatively high prevalence of PPD and the strong association with preterm delivery, pregnancy intention, breastfeeding status, birth interval as well as frequency of ANC received and travel time to health centre. It may suggest that maternal mental health services should be integrated with existing maternal and child health (MCH) services for early detection and prevention of depression symptoms with promotion of MCH services utilisation and improved accessibility among mothers in primary healthcare setting.

No abstract

No abstract

Background The risk of sexually transmitted infections (STI) arises when there is unsafe sexual activity. Unsafe sex often begins in the teenage years, and it will persist as long as there is the opportunity for risky sexual activity. The purpose of this study was to assess the sexual risk behaviors and related factors of sexually-active adolescents in educational institutions in Thailand. Methods This was cross-sectional survey using an Internet-based application in schools in Bangkok from November 2020 to February 2021 with a total of 6,167 high school and vocational students. The schools were selected by simple random sampling among institutions, and the students were systematically randomly selected, with an equal number of males and females. We used multivariable logistic regression to analyze associations and control confounding variables. Indicators of risky sex include: (1) Not using a condom; (2) Having more than one sex partner; (3) Having sex in exchange for cash or in-kind compensation; and (4) Having sex without consent. Results Of a total of 872 sexually-active participants, the mean age was 15.6 years, 66.9% were vocational students, 42.1% were male, 57.9% were female, and 69.5% had sex risk behavior. The multivariate logistic regression analysis identified the following statistically-significant factors related to risky sex: smokes cigarettes (AOR = 1.79; 95% CI 1.12–2.88); uses cannabis (AOR = 2.84; 95% CI 1.23–6.56); gambles (AOR = 1.81; 95% CI 1.28–2.55); has sex without contraception (AOR = 2.74; 95% CI 2.91–3.93); has a history of childhood sex abuse (AOR = 1.60; 95% CI 1.03–2.56). Conclusions Our findings suggest that, in designing and implementing sexual risk prevention programs for adolescents in educational settings, there is a need to highlight the role of substance abuse in relation to sexual risk behaviors. Programs should target both male and female students. Teenagers who use marijuana are more likely to be sexually active than those who have never used marijuana. These potential risks should be taken into account with respect to legalization of marijuana and recreational use of this drug.

The objective was to study the factors that enabled persons at risk of HIV to obtain voluntary counseling and testing (VCT) in Thailand. This research was a cross-sectional study and data were collected during May to July 2013 in 8, purposively selected provinces. The method for selecting respondents used time-location quota sampling to achieve a total sample of 751 persons. The proportion who had VCT in the year prior to the survey was 56%.The significant enabling factors associated with VCT were having someone encourage them to go for testing and receiving information about VCT In addition, other significant factors for female sex workers were self-assessed risk for HIV and having had risk behavior, and for men who have sex with men the factors were awareness of eligibility for VCT. Thus, in order to achieve the VCT target for higher risk populations by 2016, there should be special mechanisms to inform the different groups, along with improvements in outreach services to make VCT more convenient for key affected populations.

A clinical audit of hospitals in Thailand was conducted to assess compliance with the national hypertension treatment guidelines and determine hypertension control rates across facilities of different sizes. Stratified random sampling was used to select sixteen hospitals of different sizes from four provinces. These included community (<90 beds), large (90–120 beds), and provincial (>120 beds) hospitals. Among new cases, the audit determined whether (i) the recommended baseline laboratory assessment was completed, (ii) the initial choice of medication was appropriate based on the patient's cardiovascular risk, and (iii) patients received medication adjustments when indicated. The hypertension control rates at six months and at the last visit were recorded. Among the 1406 patients, about 75% had their baseline glucose and kidney function assessed. Nearly 30% (n = 425/1406) of patients were indicated for dual therapy but only 43% of them (n = 182/425) received this. During treatment, 28% (198/1406) required adjustments in medication but this was not done. The control of hypertension at six months after treatment initiation was 53% varying between 51% in community and 56% in large hospitals (p < .01). The hypertension control rate at last visit was 64% but varied between 59% in community hospitals and 71% in large hospitals (p < .01). Failure to adjust medication when required was associated with 30% decrease in the odds of hypertension control (OR 0.69, 95% CI 0. 50 to 0.90). Failure to comply with the treatment guidelines regarding adjustment of medication and lost to follow‐up are possible target areas to improve hypertension control in Thailand.

The association of adverse childhood experiences (ACEs) on health outcomes has garnered attention as a public health concern. The present study aimed to examine the prevalence and associations between ACEs and adverse health outcomes among adolescents. In 2017, a cross-sectional study was conducted to identify the retrospective prevalence of ACEs and their association with adverse health conditions. A total of 2,058 adolescents completed the on-line questionnaire. Exposures included psychological, physical, and sexual forms of abuse, neglect and violence as well as household dysfunction. Main outcome measures included sexual behavior, drinking, illegal drug use, smoking, depression, and anxiety. Multiple logistic regression assessed the independent relationship between individual ACEs, ACE score categories, and adverse health conditions in adolescents, while controlling for covariates. A total of 51.4 % of respondents reported at least one ACE and 12.2% reported three or more ACEs. A score of >3 ACEs was associated with increased odds of experiencing high anxiety (AOR = 3.91, 95%CI = 2.92,5.25), high depression (AOR = 4.02, 95%CI = 3.00,5.38), sexual experience (AOR = 3.12, 95% CI = 2.23,4.37), binge drinking (AOR = 3.32, 95%CI = 1.74,3.08), smoking (AOR = 3.14, 95%CI = 2.31,4.28), and illegal drug use (AOR = 2.59, 95%CI = 1.80,3.67). The study ABOUT THE AUTHORS Bang-on Thepthien, completed her Ph.D in behavioral science, is an assistant professor in ASEAN institute for health development, Mahidol University and current position is the program director of masters of arts in addiction studies. Her research focuses on addictive behavior and mental health among adolescent in the education system.Min Htike is a clinical manager at associate at the International Rescue Committee. Htike's research focuses on mental health in adolescents and minority population.