BackgroundA low-intensity armed conflict has been occurring for nearly a decade in southernmost region of Thailand. However, its impact on child health has not yet been investigated. This study aimed to estimate the prevalence of delayed child growth and development in the affected areas and to determine the association between the violence and health among children aged 1–5 years.MethodsA total of 498 children aged 1–5 years were recruited. Intensity of conflict for each sub-district was calculated as the 6-year average number of incidents per 100,000 population per year and classified into quartiles. Growth indices were weight-for-age, height-for-age, and weight-for-height, while development was measured by the Denver Development Screening Test II (Thai version). Food insecurity, child-rearing practice, health service accessibility, household sanitation, and depression among the caregivers were assessed using screening scales and questionnaires. Contextual information such as average income and numbers of violent events in each sub-district was obtained from external sources.ResultsGrowth retardation was highly prevalent in the area as reported by rates of underweight, stunting, and wasting at 19.3%, 27.6% and 7.4%, respectively. The prevalence of developmental delay was also substantially high (37.1%). Multi-level analysis found no evidence of association between insurgency and health outcomes. However, children in areas with higher intensity of violence had a lower risk of delay in personal-social development (OR = 0.4; 95% CI = 0.2 - 0.9; p-value = 0.05).ConclusionUnlike war refugees and internally-displaced persons in camp-like settings, the relationship between level of armed conflict and growth and developmental delay among children aged 1–5 years could not be demonstrated in the community setting of this study where food supply had been minimally perturbed.

BackgroundChild abuse appears to be on the increase during the COVID-19 pandemic, but the extent that lockdown measures modified the association between stress and abuses has not been systematically assessed.ObjectivesTo assess: 1) the association between caregiver’s stress and self-reported verbal abuse and corporal punishment of a child in the household, and; 2) modification of the stated association by experienced COVID-19 lockdown measures.Participants and settingsCaregivers residing in villages on lockdown in the Deep South of Thailand (n=466 participants)MethodsWe randomly sampled 12 villages in the study area, and 40 households per village. Trained enumerators who were residents of the sampled villages collected the data using phone-based interview. We measured stress level using the standard ST-5 questionnaire. We developed and pilot-tested questions for measurement of child abuse and lockdown experiences specifically for this study.ResultsCaregivers with moderate and higher levels of stress were more likely than caregivers with low level of stress to report verbal abuse (48% vs. 23%, respectively; Adj. OR = 3.12, 95% CI = 1.89, 5.15) and corporal punishment (28% vs. 8%, respectively; Adj. OR = 2.76, 95% CI = 1.41, 5.42). We found that COVID-19 lockdown experiences modified the associations between stress and verbal abuse and corporal punishment.ConclusionThere were associations between stress and abuses, which were modified by lockdown experiences. However, social desirability, lack of details in the answers, and potential confounding by mental illness co-morbidities were notable limitations of the study. Caveat is advised in the interpretation of the study findings.

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MDMA (3, 4-methylenedioxymethamphetamine) is a psychoactive substance that is associated with neurotoxicity. MDMA exposure to human results in the degeneration of neuronal cells in the hippocampus. Hence, the purpose of this study was to examine the potential of a natural compound known as thymoquinone (TQ) to protect against neuronal damage and memory impairment in rats stimulated by MDMA. The administration of TQ into MDMA-induced neuronal damage rats was carried out in male Sprague Dawley via a 1-week treatment dividing into four groups (n=36, 7-9 per group). The studied groups involved with the treatments comprise i) Control (1 mL/kg saline), ii) MDMA (10 mg/kg MDMA), iii) MDMA+TQ (10 mg/kg MDMA + 40 mg/kg TQ) and iv) TQ control (40 mg/kg TQ). A novel object recognition test (NORT) was carried out to evaluate the memory performance of the rats, followed by a histopathological assessment of the hippocampal dentate gyrus. The histopathology analysis revealed a significant increase in numbers of positive cells by Fluoro-Jade C following the effect of MDMA on neuronal damage (MDMA induced group) compared to control (P<0.05). Next, the TQ treatments observed in MDMA+TQ exhibited a decline in positive cells from Fluoro-Jade C. The index of recognition memory was found to be increased in MDMA+TQ compared to the MDMA alone (P<0.05). This study suggests that the neuronal damage inflicted by MDMA in a rat model has the potential to be treated by TQ.

Adolescents in Thailand’s Deep South are growing up amid protracted instability, yet limited research has left a critical gap in understanding their strengths, stressors, and unmet support needs. This study aimed to gain understanding of daily lives and well-being of orphaned adolescents in the Deep South to inform future intervention efforts. In total, 10 orphaned adolescents and their primary caregivers were recruited for study participation. Adolescents participated in a visual ethnography study over the course of 2 days to “ show us a day in your life with photos,” with follow-up interviews to discuss their photos. Caregivers participated in a focus group discussion about the challenges of caring for orphaned adolescents and supports that would be helpful in alleviating these challenges. Qualitative transcripts were coded by five researchers from multiple disciplines to identify emergent themes using a grounded theory approach. Themes included tension related to technology use, limited caregiver-adolescent communication, social isolation, financial hardship, and future aspirations. Lacking in peer social interaction, exploration, and opportunities to take risks, the atmosphere of restricted mobility has important implications for adolescents’ social development. Caregivers and their children have little family time for recreation and leisure that would provide opportunities to connect and navigate these issues.