District Program Research Articles

Self-reported prevalence of tuberculosis: unveiling spatial representation in the districts of Tamil Nadu.

The objective of the current study was to estimate the self-reported individual-level crude prevalence and cluster-level adjusted prevalence of TB for the districts of Tamil Nadu and to understand the spatial distribution of TB cases through spatial autocorrelation and hotspot analysis. National Family Health Survey (NFHS) data, gathered during 2014-2015 (NFHS-4) and 2019-2021 (NFHS-5), were used in the current study to estimate district-wise, individual-level crude and cluster-level adjusted TB prevalence per 100 000 population in Tamil Nadu. This was illustrated with the help of spatial geographic representation for various districts of Tamil Nadu using SPSS and QGIS software. The spatial autocorrelation and hotspot analysis were performed using Geoda software. The overall self-reported individual-level crude prevalence of TB was 337 (95% CI 302 to 375) and 169 (95% CI 144 to 197) per 100 000 population, whereas the cluster-level adjusted prevalence of TB was 356 (95% CI 311 to 405) and 184 (95% CI 154 to 219) per 100 000 population in NFHS-4 and NFHS-5, respectively. This study highlights those geographical areas with high rates of TB prevalence. This information would be useful for the state and district programme managers to identify areas of high TB prevalence where interventions can be focused.

Evaluating the Impact of Fair Price Shops on Food Security: A Comprehensive Study within the Aspirational District Programme in Hazaribagh, Jharkhand

Abstract The Aspirational District Programme, initiated by Prime Minister Narendra Modi in January 2018, aims to promote equitable development across 115 identified districts in India, including 19 in Jharkhand, with Hazaribagh situated in the North Chotanagpur division. This program operates under 49 indicators spread across five key sectors: Health and Nutrition, Education, Agriculture and Water Resources, Financial Inclusion and Skill Development, and Basic Infrastructure. A critical aspect of this initiative is the Health and Nutrition sector, which emphasizes the provision of nutritious food to ensure that no one faces hunger. Food security is vital in assessing whether individuals have consistent access to food, particularly through the Public Distribution System (PDS). This system includes numerous Fair Price Shops, or ration shops, tasked with delivering essential goods to individuals categorized as Below Poverty Line (BPL), Priority House Holds (PHH), and those under the Antyodaya Anna Yojana (AAY) in Jharkhand, aimed at supporting the most impoverished families with subsidized rates set by the central government. My research focuses on several Fair Price Shops in Hazaribagh district, employing survey methods to gather primary data. The objective is to gain insights into the actual conditions of these ration shops and to evaluate the extent of benefits received by the local population.

Structural inequality modifies midlife outcomes of a multisystemic early childhood program.

The role of structural inequalities in the long-term benefits of early childhood programs has not been assessed. Previous findings in the Chicago Longitudinal Study, an early childhood cohort investigation with low-income families, indicate that Child-Parent Center (CPC) participation beginning in preschool was associated with a variety of positive health behaviors. In this secondary analysis, we assessed if structural inequalities (neighborhood poverty, history of discrimination) modified the magnitude of associations between CPC and health and education outcomes (cardiovascular health, body mass index, educational attainment) 30 years later. The Chicago Longitudinal Study cohort of 1,539 children (93% Black, 7% Hispanic) grew up in high-poverty neighborhoods and attended CPCs or the usual district programs. At midlife (ages 32-37, M = 34.9 years, 2012-2017), 1,073 participants completed telephone interviews on structural inequalities, health, and education. Regression analyses were conducted with inverse propensity score weighting. After accounting for structural inequality, CPC participation was significantly associated with outcomes. Mean differences on Framingham risk scores, for example, were significant for CPC preschool at ages 3 and 4 (coefficient = -2.15, p = .004, standardized difference = -0.20). Neighborhood poverty moderated (reduced) the association between CPC and cardiovascular health. Neighborhood poverty and perceived discrimination had independent contributions with outcomes. Findings show that structural inequalities, especially poverty, directly influence and/or moderate long-term effects of CPC participation. Increasing neighborhood resources and socioeconomic status may help comprehensive programs sustain their impacts. Early childhood and sociostructural influences reflect the increasing importance of community contexts to health promotion. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Routine community-based vitamin A supplementation compared to the Mass campaign among 6-59-months old’s children in two health districts, Far North Cameroon

Introduction: Vitamin A supplementation (VAS) is one of the most cost-effective interventions with the greatest impact in reducing child mortality. Mass campaigns are costly, donor-driven, and heavily dependent on funding for mass immunization campaigns. We analyzed routine community-based VAS (rVAS) coverage using the pilot approach of strengthening community participation versus the mass campaign strategy during the “Mother and Child Health and Nutrition Action Week” (MCHNAW). Methods: This was a descriptive study among from children under five prospectively followed up in a VAS program in Kaele and Guidiguis health districts. We performed a descriptive analysis of data from routine VAS program after capacity building of Community Health Workers (CHW) and compared them with data from the MCHNAW in the period October 2019 and May 2020. Data were collected in the health facilities from the registers to ODK Kobocollect and analyzed by Microsoft Excel 2010. Results: rVAS showed 95.29% (92.49% Kaele; 98.49% Guidiguis) coverage for children aged 6-11 months (first dose). And 98.29% (97.71% Kaele & 98.77% Guidiguis) coverage for children aged 12-59 months (2nd dose). In comparison, VAS coverage in the mass campaign was lower with 68.46% (61.80% Kaele 72.42% Guidiguis) for 6-11 months and 62.57% (61.27% Kaele & 63.28% Guidiguis) for 12-59 months. These coverages are also lower, compared to the national target coverage (80%). rVAS showed high coverage (>92%) compared to Mass campaign and national target among 6–59-months age children in both health district in the far North Cameroon. However, this study has not analyzed the cost of both strategies of VAS. Conclusion: Reinforce the routine community-based VAS showed the best coverage to reach children under-five compared to the mass campaign VAS. However, there is need more cost-effectiveness studies to confirm whether strengthening community-based VAS could be a better practice versus mass campaign.

Healthcare workers’ views on decentralized primary health care management in Lesotho: a qualitative study

BackgroundLesotho experienced high rates of maternal (566/100,000 live births) and under-five mortality (72.9/1000 live births). A 2013 national assessment found centralized healthcare management in Ministry of Health led to fragmented, ineffective district health team management. Launched in 2014 through collaboration between the Ministry of Health and Partners In Health, Lesotho’s Primary Health Care Reform (LPHCR) aimed to improve service quality and quantity by decentralizing healthcare management to the district level. We conducted a qualitative study to explore health workers’ perceptions regarding the effectiveness of LPHCR in enhancing the primary health care system.MethodsWe conducted 21 semi-structured key informant interviews (KII) with healthcare workers and Ministry of Health officials purposively sampled from various levels of Lesotho’s health system, including the central Ministry of Health, district health management teams, health centers, and community health worker programs in four pilot districts of the LPHCR initiative. The World Health Organization’s health systems building blocks framework was used to guide data collection and analysis. Interviews assessed health care workers’ perspectives on the impact of the LPHCR initiative on the six-health system building blocks: service delivery, health information systems, access to essential medicines, health workforce, financing, and leadership/governance. Data were analyzed using directed content analysis.ResultsParticipants described benefits of decentralization, including improved efficiency in service delivery, enhanced accountability and responsiveness, increased community participation, improved data availability, and better resource allocation. Participants highlighted how the reform resulted in more efficient procurement and distribution processes and increased recognition and status in part due to the empowerment of district health management teams. However, participants also identified limited decentralization of financial decision-making and encountered barriers to successful implementation, such as staff shortages, inadequate management of the village health worker program, and a lack of clear communication regarding autonomy in utilizing and mobilizing donor funds.ConclusionOur study findings indicate that the implementation of decentralized primary health care management in Lesotho was associated a positive impact on health system building blocks related to primary health care. However, it is crucial to address the implementation challenges identified by healthcare workers to optimize the benefits of decentralized healthcare management.

Health impact evaluation of Aspirational Districts Program in India: Evidence from National Family Health Survey

The Aspirational District Program (ADP) is a unique initiative of Government of India launched in 2018 that aims to reduce inter-district multidimensional inequality. ADP aims to bring the least developed districts to catch up with the rest of the other districts in the country. The program is comprehensive in its scope as it targets improvement of several key development indicators spanning health and nutrition, education, agriculture and water resources, financial inclusion and skill development and basic infrastructure indicators. Aspirational districts (ADs) are eligible for enhanced funding and priority allocation of various initiatives undertaken by the central and the state governments. Our research estimates the causal impact of ADP on the targeted health and nutrition indicators using a combination of propensity score matching and difference-in-differences (PSM-DID). We use the fourth and fifth rounds of National Family Health Survey (NFHS) data collected in 2015–16 and 2019–21 respectively which serve as the pre and post-treatment data for our analysis. Moreover, we take advantage of the transparent mechanism outlined for the identification of ADs under ADP, which we use for propensity score matching for our PSM-DID. While we observe negative impact of ADP on early initiation of breastfeeding, we believe that the impact is confounded with the effects of Covid-19 since part of NFHS-5 data was collected during the pandemic. However, the negative impact of ADP on early initiation of breastfeeding disappears when we only use pre-covid data (i.e. data for districts from states surveyed before the pandemic). Additionally, using pre-covid data we find a reduction in the prevalence of underweight children younger than 5 years to an extent of 2 to 4 percentage points in ADs as an impact of ADP, which is robust across multiple specification. We do not find evidence of a positive or a negative impact of ADP on any other health and nutrition indicators. Future research efforts should be made towards impact evaluation of all the targeted indicators in order to get a comprehensive unbiased evaluation of ADP.

Systemic Success in Physical Education: A PLC Before Its Time

Drawing from a variety of conceptual and theoretical frameworks, this article provides a summary of decades of research into a university–district partnership that in multiple ways could be considered a systemic success. It describes the practices and processes of how two sectors of the broader physical education system (i.e., in-school physical education and teacher education) have complemented each other in the pursuit of the ongoing workforce development of physical education professionals. Physical education professionals belonging to the participating school district and teacher preparation program have sustained a working partnership based on sound professional learning community (PLC) principles (e.g., ongoing professional development, collaborative teaming, common vision, mission, and language, strong support from the central office) long before PLCs became fixtures in districts and schools. Indeed, this partnership could, in many respects, be described as a PLC before its time. This article highlights the partnership’s early days and several features that have supported its success and longevity. It also offers supporting evidence from the perspectives of the students, parents, and teachers who have been associated with this partnership.

Ecotourism: Another Benefit of Agro-Silvo-Fishery and Trigona Apiculture in Peatland Ecosystem of Baru Village, Banyuasin, South Sumatra

Agro-silvo-fishery and Trigona apiculture are two business models developed in the peatland ecosystem in Baru Village, Banyuasin District, South Sumatra. Since the beginning of 2022, two demo plots have been built in the same village landscape as part of the business model implementation. The system‘s agro-silvo-fishery was established by constructing a pond around a paddy field and planting betelnut, vegetables, and fruit trees. Local fish that had acclimated to the acidic peatland habitat were captured during the flooding and raised in the ponds. In the constrained biophysical and chemical conditions of swampy terrain, this method is thought to be the greatest way to provide a variety of revenue. Individual farmers cannot afford the costs associated with setting up this system, especially when it comes to constructing the pond and dykes. Individual farmers cannot afford the costs associated with establishing this system, especially when it comes to constructing the pond and dykes. Hence, support from the district and village government and program partners is valuable. The farmer group harvested corn and vegetables from the dykes and rice from the paddy fields in the first year, and fish were not ready for harvest. However, the local BUMDes saved the day by creating weekly regular fishing activities and competition events, generating revenue from tickets. Moreover, the Trigona apiculture became a popular place for those outside the village to learn free of charge. Based on profitability analysis, the NPV of establishing agro-silvo-fishery is Rp103.036.769 per 0.8 ha for 30 years, with additional income from ecotourism is estimated to reach Rp21.600.000 per year. The established demonstration plot has the potential to become an ecotourism destination, and the key is to maintain the surrounding flowers and plants as the source of food for bees and the water condition for the fish.

Key performance indicators-based monitoring, measuring progress and ranking of Aspirational Districts

The Aspirational District Program (ADP) is an effort to transform those districts which are lacking in development. It focuses on each district's strengths, identifies areas for quick development, and tracks advancement by rating districts regularly. By competing with and learning from others in the spirit of competitive & cooperative federalism, districts are pushed and encouraged to first catch up with the best district within their state, and then aim to become one of the best in the nation. The government's "Sabka Saath Sabka Vikas aur Sabka Vishwas" initiative aims to improve residents' quality of life while promoting inclusive growth. The ADP fundamentally aims to localise the Sustainable Development Goals, resulting in national advancement. In this paper we have described the delta rankings, Key performance Indicators (KPI) and the effects on development of aspirational districts. The delta ranking of the Aspirational Districts combines the innovative use of data with pragmatic administration, keeping the district at the locus of inclusive development.

Epidemiological, Serological, and Entomological Investigation of New Visceral Leishmaniasis Foci in Nepal.

The aim of this study was to explore epidemiological, serological, entomological, and social aspects of visceral leishmaniasis (VL) in new foci in Nepal. The study was conducted in 11 villages of five districts that had been previously free of VL but that reported new cases between 2019 and 2021. We screened 1,288 inhabitants using rK39 tests and investigated the epidemiological and clinical characteristics of 12 recent VL cases. A total of 182 community members were interviewed about knowledge, attitude, and practices regarding VL. They then underwent an awareness training; 40 of them had a second interview at 6 months to assess the training impact. Vector surveys were conducted in six houses per village to assess sandfly density and infection rates. The prevalence of VL infection was 0.5% and 3.2% among screened populations in Dolpa and Kavre districts, respectively, while the other districts had no rK39-positive cases. No association between travel history and VL infection was found. Phlebotomus argentipes sandflies were collected in three districts at high altitudes (from 1,084 to 4,450 m). None of the sandflies captured had Leishmania donovani DNA. People in new foci were not aware of VL symptoms, vectors, or preventive measures. The training significantly improved their knowledge and practice in seeking medical care in case of illness. The epidemiological, serological, and entomological investigations suggest indigenous focal transmission of VL. An integrated package of strategic interventions should be implemented by the national VL elimination program in districts with new VL foci.

The Aspirational District Program in India and the Emergence of Innovative Practices for Local Governance

The Aspirational District Program in India and the Emergence of Innovative Practices for Local Governance

The Aspirational District Program in India and the Emergence of Innovative Practices for Local Governance

The Aspirational District Program in India and the Emergence of Innovative Practices for Local Governance

Показатели и направления оптимизации первичной медико-санитарной помощи в Южном федеральном округе.

The study of indicators and directions for optimizing primary health care in the regions of the Russian Federation allows us to assess the effectiveness of the functioning of the first and basic level of contact of patients with the health care system. The purpose of the work is to study indicators and directions for optimizing primary health care in the Southern Federal District. Materials and methods: A theoretical analysis of literature, statistical information and documents related to indicators and optimization of primary health care in the Southern Federal District was performed. For a comparative assessment of the dynamics of indicators, the growth (%) was calculated. Results. The supply of local therapists in the Southern Federal District is lower than the national average. It was revealed that the Republic of Kalmykia, Astrakhan region and Rostov region have a negative increase in the provision of local therapists for 2016 and 2021: –6.1; –20.9 and –22.2% respectively. In terms of the number of local pediatricians, a negative increase (9.0%) is observed only for the Rostov region. An analysis of directions for optimizing primary health care showed that in the regions of the Southern Federal District programs are being implemented to improve the infrastructural organization and equipment of primary health care, as well as to eliminate the personnel shortage of medical personnel. However, the reports indicate only indicators of the number of doctors per 10 thousand population without highlighting primary health care workers. Conclusion. The key problem of the Southern Federal District is the shortage of doctors in the field of primary health care. The dynamics of the health care situation in the Southern Federal District have not been sufficiently studied. It is necessary to continue: improving the material and technical equipment of the industry, including in hard-to-reach areas, carrying out preparatory work with students in medical institutions, improving working conditions and offering attractive labor financing for workers and organizing social assistance.

The Influence of The Child-Friendly District Program on The Fulfillment of Children's Rights in Banyumas District

Children play an important role in the future of a country, therefore the state has an obligation to protect their rights. Various child protection efforts through the issuance of legislation and concrete programs based on child protection have been carried out by the government. One of the child protection-based government policies implemented in the regions is the child-friendly district program. In 2021, the Banyumas Regency Government was successfully confirmed as a Child Friendly Regency. The objectives of the research are to determine the indicators that must be met by Banyumas Regency in order to be designated as a Child Friendly Regency, to find out how to create a child-friendly village regulation and to analyze the effect of the Child Friendly Regency Program on the fulfillment of children's rights in Banyumas Regency. The output of this research is an article in the national journal Sinta 6, namely Idea Law, Faculty of Law, Universitas Jenderal Soedirman Purwokerto, articles in proceedings with ISBN and copyright of scientific articles.

Building And Sustaining Capacities of Health Officials in use of Data for Decision-Making: Evidence from Rajasthan, India

Purpose: This paper critically explores the initiatives that were implemented in Rajasthan during the period of 2018-19 by UNFPA, in collaboration with the Department of Health and Family Welfare, the Government of Rajasthan, and IIHMR University, Jaipur, Rajasthan, India. The main objective of these initiatives was to strengthen the capabilities of health officials and data managers at different levels within the state, enabling them to make evidence-based decisions using data effectively.
 
 Theoretical framework: The capacity-building program was designed to reinforce the system for evidence-based planning, monitoring, and data utilization through a comprehensive training approach and continuous support. This study thoroughly investigates the entire process, assesses its effectiveness, and draws policy recommendations based on the outcomes of the capacity-building interventions. An essential aspect underscored by the study is the importance of providing ongoing support and guidance post-training to ensure sustainable development and successful implementation of the acquired knowledge.
 
 Methodology: The methodology described in this paragraph involves capacity building approaches for government officials in the health sector. Specifically, the methodology includes the following elements: capacity building approaches; Inhouse Training programme technique; Digital technology enabled process; Training of State, District, and Block Level Health Programme Officials and Data Managers; Mentoring and Hand-Holding Support; Web-Based Learning Method using 'Google Classroom.
 
 Findings: The findings of this study emphasize two crucial factors that contributed to the success of the capacity-building initiatives. Firstly, the provision of on-site assistance proved to be highly effective in reinforcing the newly acquired knowledge and skills. Secondly, the utilization of the web-based Google Class platform was found to be instrumental in promoting knowledge retention and enhancing the effective utilization of data.
 
 Value: In conclusion, this research sheds light on the significance of capacity-building initiatives in the realm of health and data management. It highlights the positive impact of on-site support and the role of technology, particularly the Google Class platform, in ensuring the lasting benefits of such programs. The paper concludes by underlining the importance of continued support and sustained efforts in maximizing the potential of data-driven decision-making in the healthcare sector in Rajasthan.

Evaluation of the Ministry of Health's pilot program - A personal pregnancy follow-up service

Abstract Background The Israeli Ministry of Health has developed a unique pregnancy follow-up (PF) service in the Haifa District Infant-Parent Centers, including a fixed nurse attending the necessary examinations and services, supporting and guiding the woman throughout her pregnancy. Aim To examine the differences between the participants who received PF within the pilot program (research group) and those who received standard PF (control group) regarding health behaviors, receiving information and attitudes regarding health behaviors, professional support, and satisfaction with the service. Methods Questionnaires were filled in by 293 mothers to infants- 38% of which belonged to the research group and 62% to the control group. There were no significant differences between the two groups’ characteristics. Findings Significant differences were found between the groups regarding receiving information and support, and some of the attitudes and behaviors, as well as a difference in satisfaction, in favor of the research group; e.g., 95% of the participants in the research group were vaccinated against Pertussis, as compared to 85% of the control group (z = 2.47, p<.001). Process model for parallel mediation revealed that receiving PF in the research group was associated with (1) More positive attitudes (Effect=0.06, SE = 0.04 CI=0.01,0.15) and receiving information (Effect=0.18, SE = 0.08 CI=0.02,0.33), which in turn were associated with more reported health behaviors (Total indirect effect=0.30, SE = 0.09 CI=0.14,0.49); (2) Receiving more support (Effect=0.16, SE = 0.04 CI=0.09,0.26), as well as more information (Effect=0.10, SE = 0.05 CI=0.01, 0.19), which in turn were associated with higher satisfaction with the PF (Total indirect effect=0.25, SE = 0.05 CI=0.16,0.36). Conclusions The findings indicate the pilot program's success in promoting pregnant women's health, among other things, due to the guidance and support provided by a fixed dedicated nurse. Key messages • Personal pregnancy follow-up is efficient for supporting and guiding women during a sensitive period for their fetus’ and their own health, and encourages compliance with health behaviors. • It is recommended to implement the program in additional districts, and to examine the findings among a wider and more diverse sample.

A Model of Community Empowerment in Increasing Welfare in the Border Area through the District Program

This study analyzes the Community Empowerment Model in improving the community's welfare in the border area through the district's regional program. Welfare conditions in border areas are quite apprehensive, especially about social welfare; it is necessary to accelerate the development of underdeveloped regions. This research method is included in descriptive research with a qualitative approach. This research tries to describe the Community Empowerment Model in improving the welfare of people in border areas through regional programs. The results of the study of the Community Empowerment Model in enhancing the interest of the community in the border area through the district regional program show that the district government's strategy in dealing with underdeveloped villages in the border area is only limited to designing local economic development such as development in the field of SMEs and infrastructure development, empowering village communities in its implementation developing independence and community welfare by utilizing resources through the establishment of Village development policies and programs. In addition, the provision of village facilities and infrastructure. Increasing the institutional capacity of the business world government, such as MSMEs and village cooperatives. The design that has been formed has yet to be implemented effectively by the government, so i t has not impacted increasing economic resilience in society.

PROGRAM POLICY IMPLEMENTATION CHILD FRIENDLY DISTRICT

<em>This study aims to analyze the extent to which the implementation of the child-friendly district program is carried out in accordance with the statements in regional regulations, especially in Gorontalo Regency. The research method used is qualitative descriptive. Data sources are derived from primary and secondary data. Data collection techniques are obtained through observation, interviews, and documentation. Protection of children is an obligation of parents without discrimination because children need to live better wherever they are and must be guaranteed by all families and social environments, especially their parents. Children are vulnerable to violence, both from their age and from adult disorders. Violence against children, both women and men can occur in various environments, both in families, schools, and outside the home. Therefore, attention to child safety must be a priority carried out by parents, families and also the government, where it has been regulated or has official regulations in the form of law number 35 of 2014 so that no one can avoid criminal threats if there is violence against a child, it must be punished in accordance with applicable regulations. The results showed that the implementation of the Child decent District program policy in Gorontalo Regency has not been optimal due to low socialization carried out by the local government, lack of coordination between related agencies, and supervision of officers by agencies has not been effective, and efficient due to the lack of officers (HR), as well as inadequate facilities and infrastructure</em>.

Ryan White HIV/AIDS Part B and AIDS Drug Assistance Programs during COVID-19: safety net public health programs' challenges and innovations.

We characterized the challenges and innovations of states' Ryan White HIV/AIDS Program (RWHAP) Part B programs, including AIDS Drug Assistance Programs (ADAPs), during the COVID-19 pandemic. In the United States, these are important safety net programs for HIV healthcare, providing essential medical and support services, and medications, to people with HIV with low incomes who are uninsured/underinsured. Data were collected via the 2021-2022 NASTAD National RWHAP Part B and ADAP Monitoring Project Report, a cross-sectional survey of state, district, and territorial programs through a mixed method study design. For quantitative data, we used descriptive statistics. Qualitative responses were coded and analyzed using content analysis. Forty-seven RWHAP Part B and ADAPs responded (92% response rate). The majority of respondents reported that maintaining client eligibility (78%) and working remotely (70%) were the most challenging aspects of the pandemic, particularly in regards to implementing new telehealth and e-certification platforms. In response to COVID-19, programs introduced enrollment "grace periods" (19%), bolstered client outreach (11%), allowed more than a 30 day supply of medications (79%), and supported medication home delivery for clients (80%). Despite the challenges of the COVID-19 pandemic, RWHAP Part B and ADAPs implemented several operational innovations in order to continue providing essential medicines and services. Other public health programs may adopt similar innovations, including digital innovations, for greater public health benefit. Future studies should assess the retention of policy innovations over time, their impact on the individual client level satisfaction or health outcomes, and what factors may improve the acceptability of telehealth and e-certification platforms.

Presence of Candida and its associated factors in participants attending oral cancer screening in the lower northeastern area of Thailand

BackgroundCertain evidence indicated high prevalence of Candida in oral potentially malignant disorders (OPMDs) and oral cancer (OC). This study was aimed to investigate the presence of Candida and its associated factors in participants who attended the oral cancer screening program in the lower northeastern districts of Thailand.MethodsConvenient participants residing in the lower northeastern districts of Thailand who attended the oral cancer screening were enrolled. A questionnaire retrieving demographic characteristics, risk factors of oral cancer, and risk of having Candida was completed. Oral examination was performed by oral medicine specialists or oral surgeons. The participants were categorized into 4 groups according to their clinical diagnosis, namely normal oral mucosa (NOM), OPMDs/OC, non-OPMDs/OC and clinically suspected oral candidiasis (CSOC). Stimulated saliva flow rate was measured. Dip-slide test was performed in each participant to evaluate the presence of Candida. The levels of Candida were categorized into high and low levels according to the score received from the dip-slide test. Factors associated with high levels of Candida were identified using multivariate logistic regression analysis.ResultsA total of 577 participants were recruited. High levels of Candida were found in 31.3%, 24.7%, 25.9% and 18.1% in the OPMDs/OC, the non-OPMDs/OC, the CSOC and the NOM groups, respectively. According to multivariate logistic regression analysis, age above 60 years, female gender, betel quid chewing habit, use of denture, hyposalivation, and being in the CSOC group were found to be significantly associated with high levels of Candida.ConclusionHigher number of participants in the OPMDs/OC group was found to have high levels of Candida. Increasing age, female gender, betel quid chewing habit, use of denture, hyposalivation and having CSOC lesions were associated with high levels of Candida.