We evaluated effectiveness of personal protective measures against severe acute respiratory disease coronavirus 2 (SARS-CoV-2) infection. Our case-control study included 211 cases of coronavirus disease (COVID-19) and 839 controls in Thailand. Cases were defined as asymptomatic contacts of COVID-19 patients who later tested positive for SARS-CoV-2; controls were asymptomatic contacts who never tested positive. Wearing masks all the time during contact was independently associated with lower risk for SARS-CoV-2 infection compared with not wearing masks; wearing a mask sometimes during contact did not lower infection risk. We found the type of mask worn was not independently associated with infection and that contacts who always wore masks were more likely to practice social distancing. Maintaining > 1 m distance from a person with COVID-19, having close contact for < 15 minutes, and frequent handwashing were independently associated with lower risk for infection. Our findings support consistent wearing of masks, handwashing, and social distancing to protect against COVID-19.
Background. Effectiveness of personal protective measure against COVID-19 infection is largely unknown. Methods. We conducted a retrospective case-control study, using a cohort of contact tracing records in Thailand. A total of 1,050 asymptomatic contacts of COVID-19 patients between 1 and 31 March 2020 were retrospectively interviewed by phone about their protective measures against COVID-19 infection. Cases were defined as asymptomatic contacts who were diagnosed with COVID-19 by 21 April 2020. Multilevel mixed-effect logistic regression models were used Findings. Overall, 211 (20%) were diagnosed with COVID-19 by 21 Apr 2020 (case group) while 839 (80%) were not (control group). Fourteen percent of cases (29/210) and 24% of controls (198/823) reported wearing either non-medical or medical masks all the time during the contact period. Wearing masks all the time (adjusted odds ratio [aOR] 0.23; 95%CI 0.09-0.60) was independently associated with lower risk of COVID-19 infection compared to not wearing masks, while wearing masks sometimes (aOR 0.87; 95%CI 0.41-1.84) was not. Shortest distance of contact >1 meter (aOR 0.15; 95%CI 0.04-0.63), duration of close contact ≤15 minutes (aOR 0.24; 95%CI 0.07-0.90) and washing hands often (aOR 0.33; 95%CI 0.13-0.87) were significantly associated with lower risk of infection. Sharing a cigarette (aOR 3.47; 95%CI 1.09-11.02) was associated with higher risk of infection. Those who wore masks all the time were more likely to wash hands and practice social distancing. We estimated that if everyone wore a mask all the time, washed hands often, did not share a dish, cup or cigarette, maintained distances >1 meter and spent ≤15 minutes with close contacts, cases would have been reduced by 84%. Interpretation. Our findings support consistently wearing masks, washing hands, and social distancing in public to protect against COVID-19 infections. Combining measures could substantially reduce infections in Thailand.
Objectives: The objective of this study was to evaluate and injury surveillance (IS) system's ability to monitor road traffic deaths and the coverage of road traffic injury and death surveillance in Phuket, Thailand. Methods: U.S. Centers for Disease Control and Prevention guidelines on surveillance system evaluation were used to qualitatively and quantitatively evaluate IS. Interviews with key stakeholders focused on IS's usefulness, simplicity, flexibility, acceptability, and stability. Active case finding of 2014 road traffic deaths in all paper and electronic hospital record systems was used to assess system sensitivity, positive predictive value, and data quality. Electronic data matching software was used to determine the implications of combining IS data with other provincial-level data sources (e.g., death certificates, electronic vehicle insurance claim system). Results: Evaluation results indicated that IS was useful, flexible, acceptable, and stable, with a high positive predictive value (99%). Simplicity was limited due to the burden of collecting data on all injuries and use of paper-based data collection forms. Sensitivity was low, with IS only identifying 55% of hospital road traffic death cases identified during active case finding; however, IS cases were representative of cases identified. Data accuracy and completeness varied across data fields. Combining IS with active case finding, death certificates, and the electronic vehicle insurance claim system more than doubled the number of road traffic death cases identified in Phuket.
Thailand lacks occupational injury and illness (OII) surveillance for its agricultural sector, a sector that comprises 34% of the total Thai workforce but is not covered by the workers compensation system. This study used data from Thailand’s Universal Health Care System to estimate the medical costs of OIIs from agricultural work in Thailand. In 2017, OII medical costs totaled $47 million (USD), about ~ 0.2% of the gross domestic product produced by the Thai agricultural sector. We recommend that some of the national funds currently used for medical treatment of OIIs be used instead to develop and implement prevention programs in agriculture. This would improve not only worker health and safety, but also productivity. Availability of data on working conditions, injuries and illnesses, and especially lost time, lost income and productivity, and OII-related costs for the workers and their dependents might enable better public health policy formulation.
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