Mortality In Thailand Research Articles

Prediction of HIV Mortality in Thailand using Three Data Sets from the National AIDS Program Database

HIV continues to hinder the growth and development of a country and identifying the mortality rate will help to address this problem. Therefore, we sought to examine HIV mortality in Thailand in the years 2014 and 2015. A retrospective study was conducted to investigate HIV mortality in all regions of Thailand. For the reliability of this study, the data were drawn from two main sources, Bureau of Registration and Administration (BORA) and the National Health Security Office (NHSO) of Thailand. A total of 23,243 deaths were recorded in years 2014 and 2015. Negative binomial regression was used to predict and compare HIV mortality rates by year, age group and gender. The overall HIV mortality accounted for 2.6% of all reported deaths, representing 18.3 deaths per 100,000 populations. Among HIV deaths, 91% of them participated in the National AIDS Program (NAP) and 56% of them received Antiretroviral Therapy (ART). There was statistically significant effect, with males having a higher death rates than females. Despite the relevance of reduction of HIV mortality in Thailand, our study clearly shows that HIV mortality in Thailand is much dependent on age and gender. Thus, we suggest continued effort is needed to address gender and age difference.

Impact of regular Breast Self-Examination on breast cancer size, stage, and mortality in Thailand.

Impact of regular Breast Self-Examination on breast cancer size, stage, and mortality in Thailand.

PRS27 ECONOMIC BURDEN OF INFLUENZA IN THAILAND: A SYSTEMATIC REVIEW

Influenza is one of the global health threats. The incidence of influenza and mortality in Thailand are relatively high compared with other countries. Little is known about economic burden of influenza in Thailand. This study summarized evidence of economic burden of influenza in Thailand from published literature. A systematic search was conducted in electronic databases for studies estimating the economic burden of influenza in Thai settings, up to 15th December 2018. Exclusion criteria were studies evaluating other diseases and not reporting costs of influenza illness. All costs were extracted and adjusted to 2018 value. Out of 578 records, 12 articles were met inclusion criteria and included in this review. These studies were conducted with different approaches (6 from societal perspective, 5 from healthcare provider perspective, and 1 with macroeconomic analysis) and focused on different populations (4 in children, 3 in adults, 2 in elderly, 2 in all ages, and 1 in healthcare workers). The average cost per episode of all ages for influenza-like-illness was estimated to be US$21.5. However, the cost could be as high as US$233.2 in elderly and $643.1 in children less than 5 years who had severe influenza. Amongst patients with acute coronary syndrome who had influenza-like illness or pneumonia, the hospitalization cost and other non-medical costs were calculated to be US$964.4 and US$19.3, respectively. From societal perspective, the overall burden of influenza was estimated to be between US$31.1 and US$83.6 million per year in Thailand and about 50% of these estimates referred to indirect costs. Variations of costs depend upon several factors such as patients’ age, co-existing conditions, and disease severity. Economic burden of influenza in Thailand was substantial and our findings will aid policy makers on identifying the appropriate strategies to minimize the burden.

Death in Transitional Asia: 11-Year All-Cause Mortality in the Thai Cohort Study

OBJECTIVE: Thailand is experiencing a substantial reduction in overall mortality, an ageing society and increasing prevalence of non-communicable diseases. There is an urgent need to understand locally important risk factors for this new disease burden and their distribution. We investigated risk factors for mortality in a large cohort of Thai adults and report on key trends.
 
 PARTICIPANTS: A nationwide cohort of 87,151 Thai adults followed up since 2005 with their data records linked to the Thai civil registration system to monitor mortality up to the end of 2016. 
 
 METHODS: We used logistic regression models to measure associations between a large range of socio-demographic, health behaviour and health status variables and all-cause mortality. 
 
 RESULTS: 1402 cohort members died between 2005 and 2016. In fully-adjusted models higher income, female sex, and higher education had the strongest protective effects against mortality. Normal body weight also protected (AOR 0.71 [0.52-0.96] with Obese as reference). Heavy smoking (AOR 1.48 [1.29-1.70]), and regular alcohol consumption (AOR 1.37 [1.12-1.68]) were associated with the highest mortality. Experiencing injury in the year proceeding the baseline survey also associated with increased mortality, while urbanising since childhood had a protective effect. 
 
 CONCLUSION: This study adds to evidence regarding risks for all-cause mortality in Thailand. Results indicate the need for Thailand to maintain successful tobacco control programs and to address the effects of increased alcohol consumption. The protective effect of higher education is particularly important in Thailand given the growing proportion of the population who are finishing high school and moving to higher education.

Risk patterns of lung cancer mortality in northern Thailand

BackgroundOver the past decade, lung cancers have exhibited a disproportionately high mortality and increasing mortality trend in Thailand, especially in the northern region, and prevention strategies have consequently become more important in this region. Spatial analysis studies may be helpful in guiding any strategy put in place to respond to the risk of lung cancer mortality in specific areas. The aim of our study was to identify risk patterns for lung cancer mortality within the northern region of Thailand.MethodsIn the spatial analysis, the relative risk (RR) was used as a measure of the risk of lung cancer mortality in 81 districts of northern Thailand between 2008 and 2017. The RR was estimated according to the Besag-York-Mollié autoregressive spatial model performed using the OpenBUGS routine in the R statistical software package. We presented the overall and gender specific lung cancer mortality risk patterns of the region using the Quantum Geographic Information System.ResultsThe overall risk of lung cancer mortality was the highest in the west of northern Thailand, especially in the Hang Dong, Doi Lo, and San Pa Tong districts. For both genders, the risk patterns of lung cancer mortality indicated a high risk in the west of northern Thailand, with females being at a higher risk than males.ConclusionsThere was distinct geographical variation in risk patterns of lung cancer mortality in Thailand. Differences could be related to differences in risk factors such as ground-based radon and air pollution. This study provides a starting point for estimating the spatial pattern of the risk of lung cancer mortality and for examining associations between geographic risk factors and lung mortality for further studies.

Mortality burden attributable to heatwaves in Thailand: A systematic assessment incorporating evidence-based lag structure

BackgroundAvailable information on the acute and cumulative effects of heatwaves on cause-specific mortality in Thailand is scarce. ObjectivesTo quantify the acute and cumulative effects of heatwaves on mortality in Thailand, and assess heatwave-related mortality burden. MethodsThirty heatwave definitions were used and categorized into three groups: low intensity heatwaves (HWlow), middle intensity heatwaves (HWmiddle), and high intensity heatwaves (HWhigh). Time-series analyses were conducted to examine the acute and cumulative effects of HWlow, HWmiddle, and HWhigh on total and cause-specific mortality in 60 provinces of Thailand, incorporating an optimal lag for each cause and each province. Random-effects meta-analyses were performed to pool provincial estimates to national estimates for both acute and cumulative effects. Meta-regressions were conducted to identify the possible factors contributing to the spatial heterogeneity of heatwave vulnerability. ResultsThe cumulative effects of HWlow and HWmiddle on total and cause-specific mortality were greater than HWhigh. Both acute and cumulative effects of HWlow, HWmiddle and HWhigh on neoplasms and certain infectious and parasitic diseases were among the highest across all death causes. Effects of heatwaves on deaths from endocrine, nutritional and metabolic diseases appeared to be longer-lasting, and effects of heatwaves on deaths from ischaemic heart diseases and pneumonia occurred more rapidly. Northern and Central Thailand were the regions vulnerable to heatwaves, and proportion of elderly population was the major driver behind the spatial heterogeneity of heatwave vulnerability. ConclusionsMore attention needs to be paid to mild heatwaves. Future heatwave-related mortality burden due to neoplasms and infectious diseases in Thailand may increase as climate change continues.

Co-occurrence of opisthorchiasis and diabetes exacerbates morbidity of the hepatobiliary tract disease.

Complications arising from infection with the carcinogenic liver fluke Opisthorchis viverrini cause substantial morbidity and mortality in Thailand and adjacent lower Mekong countries. In parallel, the incidence rate of diabetes mellitus (DM) is increasing in this same region, and indeed worldwide. Many residents in opisthorchiasis-endemic regions also exhibit DM, but the hepatobiliary disease arising during the co-occurrence of these two conditions remains to be characterized. Here, the histopathological profile during co-occurrence of opisthorchiasis and DM was investigated in a rodent model of human opisthorchiasis in which diabetes was induced with streptozotocin. The effects of excretory/secretory products from the liver fluke, O. viverrini (OVES) on hepatocyte and cholangiocyte responses during hyperglycemic conditions also were monitored. Both the liver fluke-infected hamsters (OV group) and hamsters with DM lost weight compared to control hamsters. Weight loss was even more marked in the hamsters with both opisthorchiasis and DM (OD group). Hypertrophy of hepatocytes, altered biliary canaliculi, and biliary hyperplasia were more prominent in the OD group, compared with OV and DM groups. Profound oxidative DNA damage, evidenced by 8-oxo-2'-deoxyguanosine, proliferating cell nuclear antigen, and periductal fibrosis characterized the OD compared to OV and DM hamsters. Upregulation of expression of cytokines in response to infection and impairment of the pathway for insulin receptor substrate (IRS)/phosphatidylinositol-3-kinases (PI3K)/protein kinase B (AKT) signaling attended these changes. In vitro, OVES and glucose provoked time- and dose-dependent effects on the proliferation of both hepatocytes and cholangiocytes. In overview, the co-occurrence of opisthorchiasis and diabetes exacerbated pathophysiological damage to the hepatobiliary tract. We speculate that opisthorchiasis and diabetes together aggravate hepatobiliary pathogenesis through an IRS/PI3K/AKT-independent pathway.

Short-term effects of particulate matter exposure on daily mortality in Thailand: a case-crossover study

Several studies have shown seasonal variations between particulate matter (PM) exposure and daily mortality. However, few studies have focused on age differences on the risk of mortality from PM10, in addition to seasonal effects. Therefore, we attempted to estimate the association between PM10 and daily mortality in Thailand, while accounting for seasonal variations and age differences. A time-stratified case-crossover design was used in this study. Environmental, meteorological, and mortality data of 12 provinces in Thailand between 2011 and 2014 were analyzed to estimate the association between PM10 and daily mortality attributed to non-accidental, cardiovascular, respiratory causes and age differences. The conditional logistic regression was employed to determine whether the risk of mortality differed by seasons and age groups. We found an association between cumulative exposure to PM10 and increased risk of mortality attributed to non-accidental causes, cardiovascular diseases, and respiratory diseases. During the study period, cold months (November to February) [1.75% (95% CI 1.20, 2.31)] had a stronger effect of increased 10 μg/m3 in PM10 with 1 ppb in O3 on non-accidental mortality than hot (March to June) [0.67% (95% CI 0.15, 1.20)] and wet (July to October) [− 1.00% (95% CI − 1.99, − 0.01)] months. However, increasing of age did not modify any associations between PM10 and mortality. An association between PM10 exposure and daily mortality was observed. Age difference was not significantly associated with the risk of mortality.

Cancer incidence in northern Thailand: Results from six population-based cancer registries 1993-2012.

Rapid changes in social and economic development have led to cancer becoming a major cause of national morbidity and mortality in Thailand. Cancer registries have been critical in documenting subnational cancer patterns and transitions in the country; with the establishment of six registries in northern Thailand, a comprehensive assessment of the scale and profile of cancer is now possible in the region. Cancers of the liver, lung, colorectum, breast and cervix were the major cancers 2008-2012, although variations in the profiles of cancer were observed, with a very high incidence of liver cancer seen among males in Phrae, corresponding to one in 11 men developing the disease in a lifetime. Based on data from Lampang and Chiang Mai 1993-2012, rates of lung and cervical cancer incidence have declined, while liver, colorectal and breast cancer incidence have been increasing up to 2012. A more detailed investigation of the incidence trends for specific cancer sites and subtypes at the local level are crucial to the monitoring and evaluation of the cancer control interventions implemented within the Thai national cancer control programme (NCCP). Priority should be given to extend the capacity of the new registries in northern Thailand, ensuring improvement in quality and utilization of the data to drive epidemiologic research and cancer control.

Correcting Misreported Multinomial Outcome Data Based on Logistic Regression Model with Application to Stroke Mortality in Thailand

Causes of death in Thailand are misreported; about 40 % of deaths have been recorded as “ill-defined”. This study aims to describe statistical methods to correct misreported multinomial outcome by using verbal autopsy (VA) data. Since the outcome is a nominal variable, with 21 levels, the appropriate model for systematic analysis of death by ICD-10 code is multinomial regression. Moreover, it is simpler and more informative to separately fit logistic regression models to the 21 outcome cause groups, and then rescale the results to ensure that the total number of estimated deaths for each group match those reported in the corresponding populations. This method also gives confidence intervals for percentages of deaths in cause groups for levels of each risk factor, adjusted for other risk factors. These confidence intervals are compared with bar charts of sample percentages, to assess evidence of confounding bias. The methods were illustrated using stroke deaths. Area plots are used to show results by gender, age group, and year. The most misclassified stroke deaths were ill-defined, other cardio vascular disease, mental and nerve (outside-hospital), septicemia, and respiratory disease (in-hospital).

Molecular mechanisms of cholangiocarcinoma cell inhibition by medicinal plants.

Cholangiocarcinoma (CCA) is one of the most common causes of cancer-associated mortality in Thailand. Certain phytochemicals have been demonstrated to modulate apoptotic signaling pathways, which may be targeted for the prevention and treatment of cancer. Therefore, the aim of the present study was to investigate the effect of specific medicinal plants on the inhibition of CCA cell proliferation, and to identify the molecular mechanisms underlying this. A WST-1 cell proliferation assay was performed using an RMCCA1 cell line, and apoptotic signaling pathways were also investigated using a PathScan Stress and Apoptosis Signaling Antibody Array Kit. The cell proliferation assay indicated that extracts from the Phyllanthus emblica fruit pulp (PEf), Phyllanthus emblica seed (PEs), Terminalia chebula fruit pulp (TCf), Terminalia chebula seed (TCs), Areca catechu seed (ACs), Curcuma longa (CL) and Moringa oleifera seed (MOs) exerted anti-proliferative activity in RMCCA1 cells. In addition, the PathScan assay revealed that certain pro-apoptotic molecules, including caspase-3, poly (ADP-ribose) polymerase, checkpoint kinase 2 and tumor protein 53, exhibited increased activity in RMCCA1 cells treated with the aforementioned selected plant extracts, with the exception of PEf. The mitogen-activated protein kinase (MAPK) pathways (including ERK1/2 and p38 MAPK) expression level was significantly increased in RMCCA1 cells pre-treated with extracts of PEs, TCf, CL and MOs. The activation of protein kinase B (Akt) was significantly demonstrated in RMCCA1 cells pre-treated with extracts of TCf, ACs and MOs. In summary, the present study demonstrated that extracts of PEs, TCf, TCs, ACs, CL and MOs exhibited anti-proliferative effects in CCA cells by inducing pro-apoptotic signals and modulating signal transduction molecules. Further studies in vivo are required to demonstrate the potential applications of specific plant extracts for the treatment of human cancer.

Post universal health coverage trend and geographical inequalities of mortality in Thailand.

BackgroundThailand has achieved remarkable improvement in health status since the achievement of universal health coverage in 2002. Health equity has improved significantly. However, challenges on health inequity still remain.This study aimed to determine the trends of geographical inequalities in disease specific mortality in Thailand after the country achieved universal health coverage.MethodsNational vital registration data from 2001 to 2014 were used to calculate age-adjusted mortality rate and standardized mortality ratio (SMR). To minimize large variations in mortality across administrative districts, the adjacent districts were systematically grouped into “super-districts” by taking into account the population size and proximity. Geographical mortality inequality among super-districts was measured by the coefficient of variation. Mixed effects modeling was used to test the difference in trends between super-districts.ResultsThe overall SMR steadily declined from 1.2 in 2001 to 0.9 in 2014. The upper north and upper northeast regions had higher SMR whereas Greater Bangkok achieved the lowest SMR. Decreases in SMR were mostly seen in Greater Bangkok and the upper northern region. Coefficient of variation of SMR rapidly decreased from 20.0 in 2001 to 12.5 in 2007 and remained close to this value until 2014. The mixed effects modelling revealed significant differences in trends of SMR across super-districts. Inequality in mortality declined among adults (≥15 years old) but increased in children (0–14 years old). A declining trend in inequality of mortality was seen in almost all regions except Greater Bangkok where the inequality in SMR remained high throughout the study period.ConclusionsA decline in the adult mortality inequality across almost all regions of Thailand followed universal health coverage. Inequalities in child mortality rates and among residents of Greater Bangkok need further exploration.

Estimating the Impact of Expanding Treatment Coverage and Allocation Strategies for Chronic Hepatitis C in a Direct Antiviral Agent Era.

Hepatitis C virus (HCV) infection is an important worldwide public health problem, and most of the global HCV burden is in low- to middle-income countries. This study aimed to estimate the future burden of chronic hepatitis C (CHC) and the impact of public health policies using novel antiviral agents in Thailand. A mathematical model of CHC transmission dynamics was constructed to examine the disease burden over the next 20 years using different treatment strategies. We compared and evaluated the current treatment (PEGylated interferon and ribavirin) with new treatments using novel direct-acting antiviral agents among various treatment policies. Thailand’s CHC prevalence was estimated to decrease 1.09%–0.19% in 2015–2035. Expanding treatment coverage (i.e., a five-fold increment in treatment accessibility) was estimated to decrease cumulative deaths (33,007 deaths avoided, 25.5% reduction) from CHC-related decompensated cirrhosis and hepatocellular carcinoma (HCC). The yearly incidence of HCC-associated HCV was estimated to decrease from 2,305 to 1,877 cases yearly with expanding treatment coverage. A generalized treatment scenario (i.e., an equal proportional distribution of available treatment to individuals at all disease stages according to the number of cases at each stage) was predicted to further reduce death from HCC (9,170 deaths avoided, 11.3% reduction) and the annual incidence of HCC (i.e., a further decrease from 1,877 to 1,168 cases yearly, 37.7% reduction), but cumulative deaths were predicted to increase (by 3,626 deaths, 3.7% increase). Based on the extensive coverage scenario and the generalized treatment scenario, we estimated near-zero death from decompensated cirrhosis in 2031. In conclusion, CHC-related morbidity and mortality in Thailand are estimated to decrease dramatically over the next 20 years. Treatment coverage and allocation strategies are important factors that affect the future burden of CHC in resource-limited countries like Thailand.

Improving the measurement of maternal mortality in Thailand using multiple data sources.

BackgroundThailand uses cause of death records in civil registration to summarize maternal mortality statistics. A report by the Department of Health using the Reproductive Age Mortality Studies (RAMOS) reported that the maternal mortality ratio (MMR) in 1997 was approximately three to four times higher than MMR based on the civil registration cause of death records. Here, we used multiple data sources to systematically measure maternal mortality in Thailand and showed a disparity between age groups and regions.MethodsWe calculated the number of maternal deaths using a two-stage method. In the first stage, we counted the number of deceased mothers who successfully gave live births. In the second stage, we counted the number of women who died during the pregnancy, delivery, or the postpartum period without a live birth.ResultsThe number of maternal deaths dropped from 268 in 2007 to 226 in 2014. Nearly 50 % of the deaths occurred in Stage 1. The maternal mortality ratio in 2007 was 33.6 per 100,000 live births; the rate fell to 31.8 in 2014. The age ranges of women observed were 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, and 45-49, and the MMR averages were 21.5, 23.8, 27.0, 42.1, 67.7, 115.4, and 423.4 per 100,000 live births, respectively. The Southern region consistently exhibited the highest MMR compared to other regions for every year analyzed, except 2012. Women in Bangkok had a lower risk of dying during pregnancy, delivery, and the postpartum period than women from other regions.ConclusionsWe demonstrated that using multiple administrative data sources in the two-stage method was an efficient method that provided systematic measurement and timely reporting on the maternal mortality ratio. An additional benefit of the method was that information provided from the combined data sources, (e.g., the number of maternal deaths by age group and region) was relevant to the safe motherhood policy.

Assessment of potential public health impact of a quadrivalent inactivated influenza vaccine in Thailand.

BackgroundEach year, an influenza B strain representing only one influenza B lineage is included in the trivalent inactivated influenza vaccine (IIV3); a mismatch between the selected lineage and circulating viruses can result in suboptimal vaccine effectiveness. We modeled the added potential public health impact of a quadrivalent inactivated influenza vaccine (IIV4) that includes strains from both influenza B lineages compared to IIV3 on influenza‐associated morbidity and mortality in Thailand.MethodsUsing data on the incidence of influenza‐associated hospitalizations and deaths, vaccine effectiveness, and vaccine coverage from the 2007–2012 influenza seasons in Thailand, we estimated rates of influenza‐associated outcomes that might be averted using IIV4 instead of IIV3. We then applied these rates to national population estimates to calculate averted illnesses, hospitalizations, and deaths for each season. We assumed that the influenza B lineage included in IIV3 would provide a relative vaccine effectiveness of 75% against the other B lineage.ResultsCompared to use of IIV3, use of IIV4 might have led to an additional reduction ranging from 0·4 to 14·3 influenza‐associated illnesses per 100 000 population/year, <0·1 to 0·5 hospitalizations per 100 000/year, and <0·1 to 0·4 deaths per 1000/year. Based on extrapolation to national population estimates, replacement of IIV3 with IIV4 might have averted an additional 267–9784 influenza‐associated illnesses, 9–320 hospitalizations, and 0–3 deaths.ConclusionCompared to use of IIV3, IIV4 has the potential to further reduce the burden of influenza‐associated morbidity and mortality in Thailand.

Smoking, smoking cessation, and 7-year mortality in a cohort of Thai adults.

BackgroundSmoking is a strong risk factor for mortality in both the developed and the developing world. However, there is still limited research to examine the impact of smoking cessation and mortality in middle-income Southeast Asian populations.MethodsWe use longitudinal data from a large Thai cohort of adult Open University students residing nationwide, linked with official death records to assess the association of smoking status and mortality risks during a 7-year follow-up. The log-rank test was used to evaluate the statistical probability of differential survival according to baseline smoking status. Multivariate hazard ratios (HR) were reported for smoking status and all-cause and cause-specific mortality.ResultsFrom 2005 baseline to 2012, current smokers were more likely to die than cohort members who ceased smoking and never smokers (1.9 vs 1.3 vs 0.6 %, p < 0.05). The hazard of all-cause mortality increased with the daily amount of cigarette consumption among both current and former smokers. Cause of death analyses showed that current male smokers had a significantly increased risk of cardiovascular disease related mortality (HR 3.9 [95 % CI 1.8–8.1]). Former male smokers had a moderate increase in risk of dying from cardiovascular diseases compared to never smokers (HR 1.6 [95 % CI 0.7–3.4]). Current male smokers between 2005 and 2009 experienced highest subsequent mortality hazards during the period 2009–2012 compared to never smokers (HR 2.1 [95 % CI 1.4–3.4]). The higher risk of dying reduced if people quit smoking during the 2005–2009 follow-up period (HR 1.5 [95 % CI 0.7–3.3]). Risk for mortality fell even further among long-term quitters (HR 1.4 [95 % CI 0.9–2.2]).ConclusionAmong a large nationwide cohort of Thai adults, current smokers were at a significantly and substantially higher risk of all-cause mortality, especially cardiovascular-related mortality. The higher risk of dying fell if people quit smoking and the risk for mortality was even lower among long-term quitters. Promotion of smoking cessation will contribute substantially to the reduction in avoidable mortality in Thailand.

Abundance, composition and growth rate of coral recruits on dead corals following the 2010 bleaching event at Mu Ko Surin, the Andaman Sea

Elevated seawater temperatures in the summer months of 2010 were associated with widespread coral mortality in Thailand. A large number of corals at Mu Ko Surin died following the bleaching event. Understanding of the recruitment of corals would improve our ability to predict the potential for coral recovery from the impacts of bleaching events, as well as the interpretation of spatio-temporal variability in coral community structure. This study aims to examine the composition, abundance and growth rate of juvenile corals and the potential of reef recovery at Mu Ko Surin in order to help to understand how reefs react to major disturbances. We found that the densities of coral recruits varied among years and study sites. In the year 2011, coral recruitments ranged between 0.18 ± 0.02 to 1.67 ± 0.07 recruits per m2 for 10 study sites. While in 2012, the monitoring revealed a range between 0.96 ± 0.16 and 2.19 ± 0.21 recruits per m2 from 5 study sites. Fungia, Acropora, Porites and Favites were the dominant groups of coral recruits. In terms substrate forms, they were significant differences between sampling years but the preferential dominant substrate forms did not differ. The Acropora recruits at Ko Torinla showed normal distributions of size class during the two periods. Their ranges in 2011 and 2012 were 4–30 and 13–54 mm, respectively. Six species of Acropora recruits, i.e. Acropora intermedia, A. nasuta, A. cerealis, A. subulata, A. muricata and A. latistella were found. They showed diverse growth rates due to the spatial distribution of 2.11 ± 0.59 to 7.47 ± 1.37 cm per year. This study provides useful data in terms of coral recruitment and recovery from degradation and disturbance, especially from temperature changes induced by coral bleaching. The findings suggest that there is the possibility for coral recovery around Mu Ko Surin following the 2010 bleaching event.

Mortality attributable to seasonal influenza A and B infections in Thailand, 2005-2009: a longitudinal study.

Influenza epidemiology differs substantially in tropical and temperate zones, but estimates of seasonal influenza mortality in developing countries in the tropics are lacking. We aimed to quantify mortality due to seasonal influenza in Thailand, a tropical middle-income country. Time series of polymerase chain reaction–confirmed influenza infections between 2005 and 2009 were constructed from a sentinel surveillance network. These were combined with influenza-like illness data to derive measures of influenza activity and relationships to mortality by using a Bayesian regression framework. We estimated 6.1 (95% credible interval: 0.5, 12.4) annual deaths per 100,000 population attributable to influenza A and B, predominantly in those aged ≥60 years, with the largest contribution from influenza A(H1N1) in 3 out of 4 years. For A(H3N2), the relationship between influenza activity and mortality varied over time. Influenza was associated with increases in deaths classified as resulting from respiratory disease (posterior probability of positive association, 99.8%), cancer (98.6%), renal disease (98.0%), and liver disease (99.2%). No association with circulatory disease mortality was found. Seasonal influenza infections are associated with substantial mortality in Thailand, but evidence for the strong relationship between influenza activity and circulatory disease mortality reported in temperate countries is lacking.

Correcting and estimating HIV mortality in Thailand based on 2005 verbal autopsy data focusing on demographic factors, 1996-2009

Background: It is known that death registry (DR) underestimates HIV deaths. The objectives of this study were to examine under-reporting/misclassification and to estimate HIV mortality in Thailand during 1996-2009 from a model based on 2005 verbal autopsy (VA) data. Methods: Logistic regression was used to predict HIV deaths from the VA dataset with and without demographic covariates. This full model was then used to predict individual HIV deaths from the DR dataset of provinces in which VA was conducted. The proportions in the remaining provinces were predicted from spatial interpolation based on coefficients of the VA provinces. Results: Area under Receiver Operating Characteristic curve of the full model was 0.969 compared to 0.879 of the simple cross-referencing model when demographic covariates were not included. DR-reported HIV deaths accounted for only one-third of all VA-estimated HIV deaths. The most misclassified HIV deaths were those registered as tuberculosis and mental and nervous system. Under-reporting was most common among females and people aged 20-39 years, and effect of province was highest in the upper north and upper south regions. Conclusions: For approximately two-thirds of all HIV deaths estimated by the full model, the causes were reported under other categories, not HIV. Demographic variables are essential for accurately correcting causes of death from death registries.

Self-reported health and subsequent mortality: an analysis of 767 deaths from a large Thai cohort study.

BackgroundFew studies have examined the link between self-reported health (SRH) and subsequent mortality in developing countries, and very few considered mortality effects of changes in SRH. We examined the relationship between SRH and subsequent all cause or cause-specific mortality in Thailand. We also noted if mortality varied after people changed their SRH.MethodsWe used longitudinal data including SRH from a nationwide Thai Cohort Study (baseline 2005 - follow-up 2009) and linked to official death records (2005–2012). Cox regression examined the association between SRH in 2005 and subsequent all-cause mortality or cause-specific mortality, with results given as confounder-adjusted hazard ratios (HR). We further assessed association between changes in SRH during 2005–2009 and mortality from 2009 to 2012.ResultsPoor SRH at baseline independently relates strongly with subsequent cardiovascular disease (CVD) mortality (HR = 2.8, CI: 1.3-5.9) and “other” causes of death (HR = 1.9, CI: 1.1-3.3) but moderately with cancer mortality (HR = 1.4, CI: 0.7-3.0). SRH did not exhibit a relationship with injury mortality (HR = 1.0, CI: 0.5-2.1). Worsening SRH from 2005 to 2009 associated with increased mortality in 2009–2012 for females but not for males.ConclusionsIn Thailand, SRH is a good predictor of population mortality due to internal causes (e.g. CVD). SRH is holistic, simple to measure and low cost; when repeated it measures dynamic health status. In many developing countries chronic diseases are emerging and morbidity information is limited. SRH could help monitor such transitions in burdens and trends of population health.