The objective of this study is to predict the volume of the elderly in different health status categories in Thailand in the next ten years (2020–2030). Multistate modelling was performed. We defined four states of elderly patients (aged ≥ 60 years) according to four different levels of Activities of Daily Living (ADL): social group; home group; bedridden group; and dead group. The volume of newcomers was projected by trend extrapolation methods with exponential growth. The transition probabilities from one state to another was obtained by literature review and model optimization. The mortality rate was obtained by literature review. Sensitivity analysis was conducted. By 2030, the number of social, home, and bedridden groups was 15,593,054, 321,511, and 152,749, respectively. The model prediction error was 1.75%. Sensitivity analysis with the change of transition probabilities by 20% caused the number of bedridden patients to vary from between 150,249 and 155,596. In conclusion, the number of bedridden elders will reach 153,000 in the next decade (3 times larger than the status quo). Policy makers may consider using this finding as an input for future resource planning and allocation. Further studies should be conducted to identify the parameters that better reflect the transition of people from one health state to another.
On 28 April 2021, the investigation team of the Department of Disease Control, Ministry of Public Health, was notified of a cluster of people developing neurological symptoms following COVID-19 vaccination in a province in eastern Thailand. We conducted an investigation from 29 April to 20 May 2021 to confirm the outbreak, describe the epidemiological characteristics and identify possible risk factors. A matched case-control study was conducted. Matching factors were gender and vaccination site. A confirmed case was a person receiving COVID-19 vaccination in the province and developed at least one neurological symptom between 21 April and 20 May 2021. The rapid assessment of the vaccination cold chain system was carried out. We found a total of 36 cases out of 3920 vaccinees (attack rate = 0.92%), all cases were recovered and classified as an immunization stress-related reaction (ISRR) by the National AEFI Expert Committee. An analytic study found that menstruation was significantly associated with ISRR (AOR = 6.84 [95%CI = 1.09–42.91]). The environmental survey suggested that the cold chain system was properly managed. Further studies on other precipitating causes of ISRR should be performed. In terms of recommendation, health providers should pay greater attention to women menstruating during and after COVID-19 immunization.
Introduction Necrotizing fasciitis (NF) is a rare skin and soft-tissue bacterial infection with high morbidity and mortality. Knowledge about the prevalence and incidence of NF in Thailand is quite sparse. The objective of this study was to determine the prevalence of NF in Thailand and factors that may be potentially associated with NF morbidity and mortality. Methods A cross-sectional study using secondary data from Thailand’s national health databases between 2014 and 2018 was conducted. Descriptive statistics using median and percentage formats were used. This was complemented by multivariable logistic regression to determine the association between various factors (such as age and underlying diseases) with NF morbidity and mortality. Univariate spatial data analysis was exercised to identify the geographical hot spots in which the disease appeared. Results During 2014–2018, we found 90,683 NF cases. About 4.86% of the cases died. The median age for all cases was 59.39 years old. The annual incidence of NF demonstrated an upward trend (from 26.08 per 100,000 population in 2014 to 32.64 per 100,000 population in 2018). The monthly incidence was highest between May and August. A high incidence cluster (as indicated by local Moran’s I) was found in the north-eastern region of Thailand. The most infected sites were on the ankles and feet (43.18%) with an amputation rate of 7.99% in all cases. Multivariable logistic regression indicated that the significant risk factor for amputation was a presence of underlying diseases, namely diabetes (OR 7.94, 95% CI 7.34–8.61). Risk factors for mortality included being elderly (OR 1.82, 95% CI 1.68–1.98) and a presence of underlying hypertension (OR 1.16, 95% CI 1.07–1.27), cirrhosis (OR 4.67, 95% CI 4.17–5.21), and malignancy (OR 1.88, 95% CI 1.55–2.26). Discussion and Conclusion As the elderly and those with chronic underlying diseases are likely to face non-preferable health outcomes from NF, healthcare providers should pay great attention to these groups of patients. Early and intensive treatment might be considered in these groups of patients. Further studies that aim to validate the volume of actual NF cases and reported NF cases are recommended.
Objective: On 1 December 2020, the Department of Disease Control of Thailand was notified of a cluster of food poisoning cases among participants at a church festival in Mae Ai district, Chiang Mai province. We conducted an outbreak investigation to confirm diagnosis, describe the epidemiological characteristics of the outbreak, identify possible sources of the outbreak and provide appropriate control measures. Methods:We reviewed medical records of the food poisoning cases from the health care centres. Active case finding was conducted among participants who had consumed food and water at the festival. An environmental survey was done in the village where the festival was held. A case-control study was conducted to identify the source of the outbreak. Samples for laboratory analysis included rectal swabs and fresh stool specimens from the cases and food handlers, surface swabs of cooking equipment, food, water and ice samples.Results: Among 436 participants surveyed, 368 (84.4%) cases of food poisoning were identified. The most common clinical manifestation was abdominal pain (89.7%), followed by watery diarrhoea (45.7%), nausea (43.5%), vomiting (38.9%), fever (18.5%) and bloody diarrhoea (4.6%). None died in this outbreak. The case-control study showed that mixed spicy seafood salad served in the festival was significantly associated with the disease by both univariable and multivariable analyses. However, the causative agent could not be identified. The environmental investigation suggested this seafood might have been undercooked. Conclusion:Clinical manifestations of the cases, incubation period and the suspected seafood salad suggested seafood-related food poisoning. Grimontia hollisae, the organism causing illness similar to Vibrio parahaemolyticus and commonly undetectable in the laboratory with routine testing, might be the pathogen that caused this outbreak.G. hollisae should be in differential diagnosis and identified in seafood-associated outbreaks.
On 4 Sep 2017, the Bureau of Epidemiology received a notification from Tak Provincial Health Office on an outbreak of hand, foot and mouth disease (HFMD) at a nursery following one death at the provincial hospital. An investigation was carried out to confirm the diagnosis and identify source of infection. Active case finding was performed in the nursery, index case’s house and community. Medical records were reviewed, and children, teachers and household members of the index case were interviewed. Confirmed cases were defined as children or teachers in the nursery, household members and neighbors of the index case who was found to have enterovirus from fresh stool or nasopharyngeal/throat swab by polymerase chain reaction. Total 30 cases were identified, including nine confirmed, one probable (index case) and 20 suspected cases. The overall attack rate was 51.7% and case fatality proportion was 3.3%. There were 26% of enterovirus 71, 13% of coxsackie B4 identified from fresh stool samples of symptomatic cases. Neither samples from asymptomatic close contact or nasopharyngeal/throat swab was positive. No residual chlorine in the supplied water at the nursery was detected. We recommended hand washing with soap, wash the toys more than once a week, chlorinate the water to more than 0.5 ppm and increase awareness of enterovirus infection to early detect the outbreak.
Thailand is classified by the World Health Organization as one of a few countries in the world with the highest tuberculosis (TB) burden. The Thai Ministry of Public Health has implemented the ‘Tuberculosis Case Management’ (TBCM) as the main database for the national TB surveillance. TBCM is designed for case registration and management as well as case reporting and notification. This study thus aimed to evaluate TBCM for its surveillance function. A cross-sectional descriptive study was conducted to review the surveillance function of TBCM during 1 Jan to 30 Jun 2017 at Mae Sot Hospital, Thailand. The study team reviewed the protocols and guidelines of TBCM. The practice of health personnel at the TB clinic was observed to determine the data flow of TBCM. Qualitative and quantitative study methods were employed in accordance with the Center for Disease Control and Prevention’s Guidelines for Evaluating Surveillance Systems. We found that TBCM reporting system at Mae Sot Hospital was acceptable, stable and useful in achieving the objectives of TB control program. Sensitivity and positive predictive value of TBCM accounted for 80.8% and 99.4% respectively. The most common reason of miss-reporting was a loss to follow-up after admission or after health exam, particularly amongst non-Thai patients. Timeliness and data quality were concerned attributes that required improvement. TBCM and the in-house medical recording system should be harmonized to mitigate the risk of erroneous coding.
Objectives Personal protective equipment (PPE) use is associated with reduced risk of SARS-CoV-2 infection among healthcare personnel (HCP). There are limited data on the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on the PPE use of HCP. We describe the changes in PPE use from just before the widespread of community outbreaks (‘pre-pandemic’) to intra-pandemic time points, and examine factors associated with not changing in PPE use behavior among HCP in four Thai hospitals. Methods We performed a retrospective cohort evaluation using two-time points: (i) February-March 2020 (pre-pandemic period); and (ii) January–March 2021 (intra-pandemic period). Self-reported frequency of appropriate PPE use was measured by a Likert scale. We used multivariable logistic regression to identify factors associated with no increase in self-reported PPE use. Results Of 343 HCP, the proportion of participants reporting ‘always’ using PPE rose from 66% during the pre-pandemic period to 80% during the pandemic. Factors associated with HCP who did not increase in PPE use included having high baseline reported PPE, being a non-registered HCP (e.g. nurse assistants, dental assistants, porters), being male, and having a low perceived risk of becoming infected with any respiratory virus while working in the hospital. Conclusion PPE education, training, and risk communication content should target all cadres of HCP, regardless of registered/non-registered status, with a focus on behavior change for improved prevention and control of SARS-CoV-2 and other respiratory viruses in healthcare settings.
Evaluation of the malaria surveillance system was conducted in Sai Yok District, Kanchanaburi Province, Thailand. The objective of the study was to describe the surveillance system and assess the system performance in reporting malaria cases. The study applied cross-sectional approach. Key qualitative and quantitative attributes were assessed. Document review on malaria cases treated in Sai Yok Hospital and data collection at Vector Borne Disease Control Unit (VBDU) in 2015 were performed. In-depth interviews with policy makers and health care workers were exercised. Findings showed that sustainability of the surveillance system might be undermined if the Global Fund support would curtail after 2017. There were some discrepancies between number of cases reported by VBDU and those by health facility via the R506 national reporting system. Sensitivity of VBDU reports was slightly higher than the reports by the hospital though the overall sensitivity of the whole district was of acceptable quality. Concerning policy recommendations, a substantial shift of budgetary support from the Global Fund to domestic resources was suggested. Health personnel at the hospital should be more emphasized on the utilization of R506 reporting system. In addition, the R506 reporting system and the VBDU system should be harmonized.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.