The high burden of CHB in Asian countries is a major challenge for the incorporation of national programs to prevent CHB complications within health care systems.

The Thai Diagnostic Autism Scale (TDAS) was developed for use as a diagnostic tool for the early diagnosis of Autism Spectrum Disorder (ASD) in Thai children aged 12–48 months old. TDAS consists of 23 items (13 and 17 items in the observational and interview sections, respectively) classified into seven domains (A1–A3 and B1–B4) according to the criteria in the Diagnostic and Statistical Manual of Mental Disorder, fifth edition (DSM‐5). Children with a single score in the A1–A3 domains and at least two of the B1–B4 domains were classified with ASD. The item‐objective congruence (IOC) index, confirmatory factor analysis, and Kappa coefficient were used to evaluate the content, constructs, and inter‐rater validity levels between the evaluators and concurrent validity between TDAS and physicians' diagnoses, respectively. TDAS showed good overall content validity (IOC range 0.71–1.00), suitable construct validity (root‐mean‐squared errors of approximation of 0.076 and 0.067, comparative fit indexes of 0.902 and 0.858, and Tucker‐Lewis indexes of 0.882 and 0.837 for the observation and interview sections, respectively), and excellent diagnostic agreement between TDAS and the evaluators (Kappa = 1.000) as well as between TDAS and the physicians' diagnoses (Kappa = 0.871). The sensitivity and specificity of TDAS were 100% and 82.4%, respectively. In conclusion, TDAS yielded a high level of content validity, concurrent validity, and inter‐rater reliability for the early diagnosis of ASD in Thai children. A large‐scale study using TDAS is needed to determine an appropriate cut‐off point as well as its efficacy. Lay Summary The Thai Diagnostic Autism Scale was developed for use as a diagnostic tool for the early diagnosis of Autism Spectrum Disorder (ASD) among Thai children. It contains 23 items in seven domains for the screening via observations and interviews. The psychometric properties of this diagnostic tool provide its reliability and suitability for the early diagnosis of ASD. A large‐scale study using it is needed to determine an appropriate cut‐off point as well as its efficacy.

The Thai Diagnostic Autism Scale (TDAS) was developed to diagnose autism spectrum disorder (ASD) under the context and characteristics of the Thai population. Although the tool has an excellent agreement, the interpretation of diagnostic results needs to rely on the optimal cut-off point to maximize efficiency and clarity. This study aims to find an optimal cut-off point for TDAS in the diagnosis of ASD and to compare its agreement with the DSM-5 ASD criteria. This study was conducted on 156 children aged 12–48 months old who were suspected of having ASD and had enrolled from hospitals in the four regions of Thailand in 2017–2018. The optimal cut-off point for TDAS was considered by using receiver operating characteristic (ROC) curves according to the DSM-5 ASD criteria. The areas under the curve (AUCs) for TDAS and ADOS-2 were also compared. Multivariable logistic regression was performed to create a predictive model for the probability of ASD. The AUC of TDAS was significantly higher than that of ADOS-2 (0.8748 vs. 0.7993; p = 0.033). The optimal cut-off point for TDAS was ≥20 points (accuracy = 82.05%, sensitivity = 82.86%, and specificity = 80.93%). Our findings show that TDAS with a cut-off point can yield higher diagnostic accuracy than ADOS-2 and TDAS domain. Diagnosis by using this cut-off point could be useful in practical assessments.

IntroductionThe success of antiretroviral treatment (ART) programs can be compromised by high rates of patient loss to follow-up (LTFU). We assessed the incidence and risk factors of LTFU in a large cohort of HIV-infected children receiving ART in Thailand.MethodsAll children participating in a multicenter cohort (NCT00433030) between 1999 and 2014 were included. The date of LTFU was 9 months after the last contact date. ART interruption was defined as ART discontinuation for more than 7 days followed by resumption of treatment. Baseline and time-dependent risk factors associated with LTFU were identified using Fine and Gray competing risk regression models with death or referral to another hospital as competing events.ResultsOf 873 children who were followed during a median of 8.6 years (interquartile range 4.5–10.6), 196 were LTFU, 73 died, and 195 referred. The cumulative incidence of LTFU was 2.9% at 1 year, 7.3% at 5 years and 22.2% at 10 years. Children aged 13 years and more had a 3-fold higher risk (95% confidence interval 2.06–4.78) of LTFU than those younger. Children who had interrupted ART within the previous year had a 2.5-fold higher risk (1.12–5.91) than those who had not. The risk of LTFU was lower in children stunted (height-for-age Z-scores <-2 SD) (0.42–0.96) or underweight (weight-for-age Z-scores <-2 SD) (0.24–0.97).ConclusionAdolescence, ART interruption and absence of growth deficit were associated with LTFU. These may be warnings that should draw clinicians’ attention and possibly trigger specific interventions. Children with no significant growth retardation may also be at risk of LTFU.