Objectives To evaluate the effectiveness of the Pap smear screening programme in Thailand in the prevention of invasive cervical cancer. Setting Four tertiary hospitals, in two provinces of north-east Thailand. Methods A hospital-based case-control study of women aged 30-64, who were resident in north-east Thailand. A total of 130 women with a diagnosis of invasive cervical cancer were compared with two groups of controls: a) hospital controls, b) hospital patient companions. Information on risk factors for cervical cancer and history of screening by cytology (Pap smear) were collected using a structured interview. Results Eighty percent of control subjects reported having had a Pap test in the past, and some twothirds within the three years before interview. There was a significant protective effect for multiple (6þ) previous screening tests as reported by 20% of controls. When women who had tests less than six months prior to the study were excluded, there was a strong, significant protective effect of the number of tests (for 1-5 tests: OR ¼ 0.45 95% CI ¼ 0.25 to 0.84, and for 6þ tests: OR ¼ 0.29 95% CI ¼ 0.11 to 0.82). Tests carried out 1-2 years and 3þ years before diagnosis were associated with an OR of 0.27 (95% CI ¼ 0.13-0.56) and 0.42 (95% CI ¼ 0.20-0.88), respectively. Conclusions The cervical screening programme in north-east Thailand has achieved excellent coverage and is preventing cervical cancer. Women who have been screened multiple times are at substantially lower risk than those only screened a few times suggesting that the quality of the screening could be improved.

Cervical cancer continues to be an important public health problem in Thailand. While the high risk human papillomavirus (HPV) types have been established as the principle causative agent of both malignancies and the precursor lesions, cervical intraepithelial neoplasia (CIN), other factors may also be involved like other sexually transmitted diseases, as well as smoking. Chlamydia trachomatis is an obligate intracellular Gramnegative bacterium which has a tendency to cause chronic infection featuring inflammation and therefore might be expected to increase the risk of cervical cancer. In the present nested case-control study, 61 cases of cervical cancer and 288 matched controls with original serum samples were identified from the Khon Kaen Cohort, established in the North-East of Thailand, by linkage to the Khon Kaen population based cancer registry. C. trachomatis specific IgG antibodies at recruitment were measured by microimmunofluorescence and assessed for association with cervical cancer using STATA release10. No significant link was noted either with all cancers or after removal of adenocarcinomas. The results suggest no association between Chlamydia infection and cervical cancer development in North-East Thailand, but possible influencing factors must be considered in any future research on this topic.

This was a survey research conducted in Northestern Thailand during 2009-2010 and designed to evaluate the success of a health education program by comparing levels of health knowledge in the community before and after the launching of a Multi-professional Intervention and Training for Ongoing Volunteer-based Community Health Programme. The survey questionnaire included items about demographic characteristics and health knowledge. The participants were 1,015 members of various communities, who were randomly selected to be included in the survey before launching the intervention, and 1,030 members of the same communities randomly selected to be included in the survey after the intervention was completed. The demographic characteristics of both groups were similar. Overall knowledge and knowledge of all the diseases, except lung and cervical cancer, were significantly higher after the intervention. In conclusion, a Volunteer-based Community Health Programme has advantages for areas where the numbers of health personnel are limited. The use of trained community health volunteers may be one of the best sustainable alternative means for the transfer of health knowledge.

Stroke is a chronic disease requiring patients to be treated for a long period of time. Patients need to been given close and attentive care, and this has an impacton the health and daily lives of caregivers. The aim of this cross-sectional descriptive study was to investigate the quality of life of stroke patient caregivers at Srinagarind Hospital, Khon Kaen Province, Thailand. The subjects were 166 caregivers of all stroke patients who received treatment at Srinagarind Hospital during the period 1 July 10 September, 2011. The research tool was a questionnaire which was intwo parts: Part 1 was designed to collect baseline data about the patients and their caregivers, and Part 2 was the Thai version of the brief WHO quality of life assessment instrument (WHOQOL-BREF-THAI). Data were collected from the patients medical histories and from interviews conducted by the researchers and were analyzed using descriptive statistics. The results showed that the overall quality of life of caregivers was at a moderate level with a mean score of92.5. In terms of each component domain of the quality of lifeinstrument, the mean scores for physical health, mental health, social relationships, and the environment were24.1, 21.3, 10.7, and 29.3 points, respectively.Even though the quality of life of caregivers was moderatelyhigh, medical professionals who provide care for stroke patients should assist and support caregivers in various ways by, for example, giving advice on sources of information which are useful to the caregivers themselves and for the physical and mental health care of the patients in. They should also provide assistance to families when they require help in continuing to care for the patients in their own homes.