Objectives The objectives of the research were to determine the prevalence and factors associated of uncontrolled blood pressure among Thai hypertensive patients in a nationwide survey. Results A total of 65,667 patients with hypertension were included in this study. The greater proportion of participants, 40,834 (62.2%), were females. The average age of participants was 63.9 ± 11.1 years. Uncontrolled hypertension was detected among 16,122 patients (24.6%; 95% CI 24.2–24.9). Among males and females, uncontrolled hypertension was 25.6% (95% CI 25.1–26.2) and 23.9% (95% CI 23.5–24.3) respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with being male, age, regions, hospital levels, diabetes comorbidity, higher body mass index, low density lipoprotein cholesterol level and the number of antihypertensive medications.
Introduction Hypertension is a common cardiovascular disease at present. Uncontrolled blood pressure leads to further complications including heart attack, stroke and chronic kidney disease. In Thailand, most of the information related to this issue is collected by hospitals or hospital-based organizations rather than at the community level. The objectives of this study were to determine the prevalence of uncontrolled hypertension and to assess the relationship between patient characteristics (socio-behavioral and clinical) and uncontrolled blood pressure among hypertensive patients in the rural communities in the central areas in Thailand. Materials and methods This was a cross-sectional study conducted in Na-Yao and Phra-Pleong rural communities of Thailand in 2018 using the total design method. In all, 406 individuals aged ≥18 years were interviewed using structured questionnaires related to demographic information, higher risk behavior, comorbidities and arthrometric measurement. Blood pressure was assessed for all participants. Uncontrolled hypertension was defined as BP ≥140/90 mmHg. Results The prevalence of uncontrolled hypertension was 54.4% (males: 59.8%; females: 52.4%). Uncontrolled blood pressure was associated with neck circumference more than 35.75 cm for males and 32.75 cm. for females (adjusted odds ratio; 1.66, 95% confidence interval; 1.03–2.68), sedentary behavior more than 5 hours a day (adjusted odds ratio; 2.03, 95% confidence interval; 1.28–3.23) and missed doctor appointments (adjusted odds ratio; 3.29, 95% confidence interval; 1.09–9.94). Conclusion Approximately one half of hypertensive patients in these rural communities had uncontrolled blood pressure. The Ministry of Public Health and health care providers should provide further strategies to prevent uncontrolled blood pressure’s complications.
BackgroundIschemic Heart Disease (IHD) is the first ranked among most common causes of death involving cardiovascular and other diseases. The information on the prevalence of IHD in Thailand is lacking especially among patients with diabetes mellitus. The objectives of this study were to determine the prevalence of IHD among patients with diabetes mellitus and to determine factors associated with IHD in a nation-wide survey.MethodsA cross-sectional study to assess national outcomes among patients with diabetes who visited 831 public hospitals in Thailand was conducted in 2013 to evaluate status of care among patients with diabetes aged at least 18 years who received medical treatment in the target hospital for the last 12 months.ResultsA total of 25,902 patients with diabetes were included in this study. IHD was detected among 918 patients (3.54%; 95%CI 3.32–3.77). Multivariate analysis was conducted to determine which factors were most associated with IHD, and the results showed age (AORs 1.05; 95%CI 1.04–1.05), being male (AORs 1.78; 95%CI 1.53–2.07), hypertensive comorbidity (AORs 2.10; 95%CI 1.68–2.62), being in Health Region 4 (AORs 1.93; 95%CI 1.54–2.35), presenting hyperglycemic crisis (AORs 1.53; 95%CI 1.14–2.06) and insulin therapy (AORs 1.40; 95%CI 1.17–1.66) were the highest associated factors for IHD in this population.ConclusionOur data emphasized that IHD was a problem among patients with diabetes. Diabetic patients should be regularly assessed for IHD and their risk factors should be better controlled. Moreover, the Ministry of Public Health managers and clinicians should provide further preventative strategies to attenuate cardiovascular disease.Electronic supplementary materialThe online version of this article (10.1186/s12872-018-0887-0) contains supplementary material, which is available to authorized users.
Introduction Diabetic retinopathy (DR) is one of the most common and serious ocular complications in both developed and developing countries. To date, epidemiological data of DR and their associated factors in Southeast Asian countries especially in Thailand are scarce. We aimed to use the information from the Thailand Diabetes Mellitus/Hypertension (DM/HT) study to determine trends in DR prevalence and also risk factors among Thai patients with type 2 diabetes (T2D). Methods A series of cross-sectional surveys of clinical outcomes was conducted annually in 2014, 2015 and 2018 among patients with T2D aged >18 years receiving medical care for at least 12 months. A stratified single stage cluster sampling method that was proportional to the size sampling technique was used to select a nationally and provincially representative sample of patients with T2D in Thailand. A standardized case report form was used to obtain the required information from medical records. Results A total of 104,472 Thai patients with T2D were included in the study from 2014 to 2018. The dominant proportion of participants, 70,756 (67.7%), were females. The overall prevalence of DR declined from 6.9% in 2014 to 6.3% in 2015 and 5.0% in 2018 (p for trend <0.001). The independent associated factors with DR included survey year, greater duration of DM, geographic region, hospital level, social security scheme, dyslipidemia, insulin therapy, high HbA1c level and elevated pulse pressure. Conclusion We reported a decreasing in trend in the prevalence of DR among Thai patients with T2D over one half decade. Patients with T2D should be encouraged to control their underlying diseases and engage in other effective interventions. When these modifiable risk factors can be inhibited, DR and other cardiovascular complications will be alleviated.
Introduction Understanding the current epidemiology of human immunodeficiency virus (HIV) infection in Thailand will facilitate more effective national HIV prevention programs. This study aimed to determine the prevalence and risk factors for HIV infection among young Thai men. Methods A total survey was conducted of Royal Thai Army new conscripts, participating in the national HIV surveillance in November 2010 and May 2011. Behavioral risk factors for HIV infection were determined using a standardized survey questionnaire in the total study population and men who have sex with men (MSM) subgroup. Results A total of 301 (0.5%) HIV infected young Thai men were identified from the total study population (63,667). Independent risk factors associated with HIV infection among the total study population included being single (adjusted Odds Ratio [AOR] 1.6, 95% Confidence Interval [CI] 1.1–2.2), having no formal education (AOR 6.5, 95% CI 2.3–18.4) or a bachelor’s degree (AOR 1. 8, 95% CI 1.0–3.0), engaging in bisexual (AOR 3.7, 95% CI 2.4–5. 6) or exclusively homosexual activity (AOR 14.4, 95% CI 10.4–19.8), having a history of Sexually Transmitted Infection (STI) (AOR 2.3, 95% CI 1.6–3.3) and having sex in exchange for gifts/money (AOR 2.0, 95% CI 1. 5–2.8). A total of 4,594 (7.9%) MSM were identified, of which 121 (2.6%) were HIV infected. The prevalence of HIV infection among MSM in urban (2.8%) and rural (2.4%) areas were relatively comparable ( p -value = 0.44). Of the identified MSM, 82.5% reported having sexual desire with females only. Risk factors associated with HIV infection in the MSM subgroup included living in the western region (AOR 3.5, 95% CI 1.2–10.4), having a bachelor’s degree (AOR 2.7, 95% CI 1.2–5.7), having a history of exclusive receptive (AOR 3.6, 95% CI 1.6–7.7) or versatile anal sex (AOR 4.7, 95% CI 3.0–7.5) and history of having sex in exchange for gifts/money (AOR 2.3, 95% CI 1.5–3.5). Conclusion The prevalence of HIV infection among young Thai men has continued to be below 0.5% in 2010 and 2011. High risk sexual activity, including MSM, played a major role in the HIV epidemic among this population. Effective HIV prevention programs should cover MSM who have heterosexual desire as well as having sex in exchange for gifts/money and be implemented in both urban and rural areas.
Background: Obesity is one principle risk factor increasing the risk of noncommunicable diseases including diabetes, hypertension and atherosclerosis. In Thailand, a 2014 study reported obesity (BMI ≥25 kg/m 2) in a Thai population aged ≥15 years was 37.5, 32.9 and 41.8% overall and among males and females, respectively. The study aimed to determine trends in the prevalence of obesity among adults residing in a Thai rural community between 2012 and 2018 and investigate the associations between obesity and behavioral factors. Methods: Serial cross-sectional studies were conducted in 2012 and 2018 among adults in Na-Ngam rural community. In 2012 and 2018, all 635 and 627 individuals, respectively, were interviewed using structured questionnaires related to demographics, risk behaviors, comorbidities and arthrometric measurement. Spot urine was collected by participants and obesity was defined as BMI ≥25 kg/m 2. The risk factors for obesity were analyzed in the 2018 survey. Results: A total of 1262 adults in Na-Ngam rural community were included in the study. The prevalence of obesity was 33.9% in 2012 and 44.8% in 2018 (P < 0.001). The average BMI increased from 23.9 ± 4.2 kg/m 2 in 2012 to 25.0 ± 4.52 kg/m 2 in 2018 (P < 0.001). Obesity was associated with higher age (AOR 0.99; 95%CI 0.97-0.99), smoking (AOR 0.52; 95%CI 0.28-0.94), instant coffee-mix consumption > 1 cup/week (AOR 1.44; 95%CI 1.02-2.04), higher number of chronic diseases (≥1 disease AOR 1.82; 95%CI 1.01-2.68, > 2 diseases AOR 2.15; 95%CI 1.32-3.50), and higher spot urine sodium level (AOR 1.002; 95%CI 0.99-1.01).
Background The prevalence of obesity has been increasing in both males and females worldwide. In Thailand, the National Health Examination Surveys reported that the prevalence of obesity (body mass index (BMI) ≥30 kg/m 2 ) among Thai male adults aged 20–59 years increased from 1.7% in 1991 to 6.8% in 2009. Obesity has been confirmed to lead to health problems, including noncommunicable diseases. In the present study, we report trends in the prevalence of obesity among new conscripts from 2009 to 2016. We also investigated the associated factors of obesity. Methods Serial cross-sectional studies were conducted from 2009 to 2016 among male Royal Thai Army (RTA) conscripts whose weight and height had been measured to determine BMI after being inducted. Each subject completed a detailed risk factor questionnaire. Obesity was defined as BMI ≥ 30 kg/m 2 . Results A total of 26,540 young Thai males conscripted into the RTA were included in this study. The prevalence of obesity was 2.2% in 2009, 3.4% in 2010, 2.5% in 2011, 2.9% in 2012, 3.4% in 2013, 4.4% in 2014, 5.0% in 2015, and 4.8% in 2016 ( P for trend < 0.0001). The independent risk factors for obesity were coming from the north central and south regions compared with the northeast, higher education level, indoor occupation and no regular exercise. Conclusions Our data emphasized that obesity constitutes a serious problem among young Thai men. We could apply these findings in military units to other groups at any age. Regular exercise should be provided to young adults and other age groups to slow the process of obesity, so that associated complications, especially noncommunicable diseases, will cease.
The prevalence of HIV among young Thai men stabilized at 0.5% from 2005 to 2011. A cross-sectional study was conducted among the male army conscripts in 2018 at 36 military training units nationwide. All new conscripts in each selected unit were invited to participate in the study. Questionnaires were used to determine risk factors to HIV infection that had been developed from related risk factors studies among young Thai men. Among 4629 participants, 44 (1.0%) HIV positive individuals were identified. The proportion subject reporting a history of sex with another man was 10.1%. The prevalence of HIV infection among men who have sex with men (MSM) was 4.0%. The proportion of consistent condom use with a male partner was 39.7%. The risk factors of HIV infection included having sex with another man, history of sexually transmitted infection and history of sex in exchange for gifts/money. Only 1.4% of MSM used pre-exposure prophylaxis (PrEP). HIV prevention programs including PrEP in Thailand should be emphasized among MSM in both rural and urban settings.
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