Provinces In Southern Thailand Research Articles

Prevalence of congenital limb defects: Data from birth defects registries in three provinces in Southern Thailand.

This is the first population-based study in Thailand on the prevalence of congenital limb defects (CLD). Data were obtained from recently established birth defects registries in three southern Thailand provinces during 2009-2013. Entries in the birth defects registries included live births, stillbirths after 24 weeks gestational age, and terminations of pregnancy following a prenatal diagnosis of fetal anomaly. The total of 186 393 births recorded included 424 CLD cases, giving an average prevalence of 2.27 per 1000 births (95% CI, 2.05-2.49). The most common CLD was talipes equinovarus (44.1%), followed by polydactyly (13.9%) and syndactyly (9.4%). The prevalence significantly increased with maternal age from 1.81 in mothers aged <30 years to 2.75 in mothers 30 to < 35 years, and to 2.94 in mothers ≥35 years (P = 0.004). Overall 9.4% of the CLDs were syndromic CLD, again with significantly greater percentages in pregnant women aged ≥35 years than the non-syndromic CLD (32.5% vs 17.5% respectively, P = 0.03). In conclusion, the overall prevalence of CLD in the 3 southern Thailand provinces examined was 2.27 per 1000 births, and syndromic CLD was significantly higher in pregnant women aged ≥35 years than younger pregnant women.

Population-Based Study of Prevalence of Cleft Lip/Palate in Southern Thailand.

Oral cleft is a common craniofacial birth defect that leads to long-lasting adverse outcomes. In Thailand, there have been two studies of the prevalence of oral clefts using data from university hospitals during 1969 through 1978 and 1988 through 1999, which found prevalence rates of 1.23 and 1.22 per 1000 live births, respectively. The primary outcome was to assess the prevalence of oral clefts from the birth defects registry during 2009 through 2013 in three provinces in southern Thailand. The secondary outcomes were to correlate the risk of oral cleft and maternal age. Population-based study. Four hundred sixty-seven hospitals in three provinces in southern Thailand. Oral cleft cases and maternal data-including live births, stillbirths, and termination of pregnancy following a prenatal diagnosis-were collected from the birth defects registry. Of the total 186,393 births, there were 269 oral cleft cases, giving an average prevalence of 1.44 per 1000 births (95% CI, 1.22-1.63). The most common cleft type was cleft lip and palate (45.0%), followed by cleft palate (29.0%), with 15.6% syndromic cleft. The mean maternal age was 28.0 ± 6.4 years. There were no differences in prevalence of oral clefts among the different maternal age groups. However, advanced maternal age 35+ years was associated with syndromic cleft children. The prevalence of oral clefts was 1.44 per 1000 live births, with 15% of cases having an associated congenital anomaly or a recognized syndrome. Increased maternal age was associated with a higher prevalence of syndromic cleft.

Water scarcity footprint of products from cooperative and large rubber sheet factories in southern Thailand

The water scarcity footprints (WSF) of ribbed smoked sheet (RSS) from 14 cooperative rubber sheet factories (CRSF) in nine provinces in southern Thailand were evaluated. The WSF of ribbed smoked sheet bales (RSSB) was determined in two large rubber sheet factories (LRSF) in two provinces. Average values of consumptive water use (CWU) for RSS and RSSB were 549 and 592 m3/tonne, respectively. The CWU for both CRSF and LRSF was found to be very small in comparison to that for producing inputs from the rubber plantation. The CWU used for producing RSS arose from acquisition of fresh latex. Acquisition of unsmoked sheet and RSS had a major contribution for the RSSB production. WSFs of RSS and RSSB in terms of water deprivation ranged from 0.12 to 72.8 and 5.12 to 52.4 m3 water-equivalent/tonne, respectively. The major difference of CWU in the rubber plantations caused the difference of WSF for RSS and RSSB. The results of this study revealed that the policy makers should focus on the rubber plantation as the first priority. CWU and WSF values should be included as indicators for determining suitable areas of rubber plantation and for getting government support. In the factories, technologies or processes that used less water must be employed in the washing process to reduce CWU.

PO-0978 Population-based Study Of Down Syndrome Prevalence In Southern Thailand

Introduction Down syndrome (DS) is the most common chromosomal disorder that causes mental retardation. In Thailand, studies on DS from 1969–1978 and 1988–1999, both hospital-based, found prevalences of DS of 0.89 and 1.07 per 1,000 live births. Objective To determine the prevalence of DS in the population-based birth defect registries in 3 provinces in southern Thailand (Songkhla, Trang, Phatthalung), and the proportion of termination of pregnancy (ToP) of DS fetuses detected by prenatal screening. Method Data were obtained from a population-based surveillance study undertaken during 2009–2012. Entries in the birth defects registry included all live births, all stillbirths, and all ToPs following a prenatal diagnosis. Infants with clinical characteristics of DS had a chromosomal study to make a definite diagnosis. Results Of the total 148,795 births recorded during the study period, 180 DS cases were listed, giving an average prevalence of 1.21 per 1,000 births. The median maternal age was 36.4 years with percentage of maternal age ≥35 years of 52.2% (94/180). Fifty-three cases (29.4%) diagnosed prenatally resulted in termination of pregnancy.

The Current Status and Future Trends of Farm Production and Marketing of Para-Rubber in the Upper East Coast Provinces of Southern Thailand

The research aimed to: 1) describe the current status and future trends of para-rubber production and marketing in the study area; 2) identify the marketing costs of farmers; and 3) study the marketing system of para-rubber. Data were collected from 462 farmers, 108 middlemen, and 17 processors. The study area was 4 provinces in the Upper East Coast of Southern Thailand: Chumpon, Suratthani, Nakhonsrithammarat, and Patthalung. The surveys were conducted by using structured questionnaires, in-depth interviews, and workshops. The data were analyzed by descriptive statistics, cost analysis, and marketing channel analysis. From 2005 to 2010, planting areas increased but total yields declined, due to heavy rains and floods. The rubber prices fluctuated but had an increasing trend. On an average, the planting area was 2.7 ha and had been cultivated for 17 years. The major variety was RRIM 600. The majority of farmers (63%) sold most of their para-rubber in latex form, while rubber sheets (31%) or cup lumps (18%) dominated less often. Hired help was often paid by a split of sales revenue. The product price, relationship, and shipping distance affected selecting the sales channel. Most preferred self-transportation to middlemen (81%), who usually set the price lower than the central market price. The marketing costs were from sheet making, transportation, and deductions for low quality. Sheet making at 3.65 THB per kg was mainly labor costs (72%). The transportation cost of cup lumps, latex and, sheets were on average 1.04, 0.86, 0.48 THB per kg, respectively. The cup lumps had quality deductions of 11% average from full price, and cup lump wetness and contamination had affected 65% of farmers, while 46% had sold sheets with deductions averaging 2%. Fluctuating prices and lack of knowledge about market channels and prices were the major problem for 45% of the farmers. Farm producers mainly sold latex or dry rubber (sheets, cutting scraps, and cup lumps). The latex marketing channel was through collectors for processing plants, that could both be local or larger scale. The dry rubber marketing channels included also collectors, central market, and processing plants. Rubber processed to primary products (smoked sheets, block, and compound rubber) was mainly exported. The latex marketing channels are gaining importance because farmers prefer to sell in latex form. They are likely to sell to a local village collector close to the farm. The demand for local processing plants that transform latex to rubber sheets or block rubber as well as the latex processing plants will likely increase.

High resolution wind atlas for Nakhon Si Thammarat and Songkhla provinces, Thailand

In this work, a high resolution wind atlas for Nakhon Si Thammarat and Songkhla provinces in southern Thailand was developed using combined mesoscale, MC2, and microscale, MsMicro, modeling techniques. The model inputs consist of long-term statistical climate data, i.e. the NCEP/NCAR database, high resolution topography and land cover data. The 200 m resolution wind resource maps were validated with observed mean wind speeds from 10 met stations located along the coastlines of the territory studied. These comparisons have shown that the wind atlas provides a good representation of the wind resource throughout the territory of Nakhon Si Thammarat and Songkhla provinces, Thailand. The technical power potential and potential annual energy production are then identified. Results from the technical power potential at 80 m above ground level show that a total of 1374 MW of wind farms, generating annually 3.6 TWh of electricity, could be installed; while 407 MW of small wind turbines (50 kW), generating annually 1.0 TWh of electricity, could be installed.

A phylogeny and taxonomy of the Thai-Malay Peninsula Bent-toed Geckos of the Cyrtodactylus pulchellus complex (Squamata: Gekkonidae): combined morphological and molecular analyses with descriptions of seven new species

An integrative taxonomic analysis using color pattern, morphology and 1497 base pairs of the ND2 mitochondrial geneand its five flanking tRNAs demonstrated that nine monophyletic species-level lineages occur within the Cyrtodactyluspulchellus complex (Cyrtodactylus pulchellus sensu strictu and C. macrotuberculatus) of the Thai-Malay Peninsula thathave a sequence divergence between them ranging from 5.9–16.8%. Additionally, each lineage is discretely diagnosablefrom one another based on morphology and color pattern and most occur in specific geographic regions (upland areas orislands) that prevent or greatly restrict interpopulation gene flow. Six of these lineages were masquerading under thenomen C. pulchellus and are described as the following: Cyrtodactylus astrum sp. nov. from northwestern PeninsularMalaysia and southwestern Thailand; C. langkawiensis sp. nov., at this point endemic to Langkawi Island, Malaysia; C.bintangrendah sp. nov., a lowland species surrounding the Banjaran (=mountain range) Bintang of northwesternPeninsular Malaysia; C. bintangtinggi sp. nov., endemic to the upland regions of the Banjaran Bintang of northwesternPeninsular Malaysia; C. trilatofasciatus sp. nov., endemic to upland regions of Cameron Highlands in the central portionof the Banjaran Titiwangsa in Peninsular Malaysia; and C. australotitiwangsaensis sp. nov. from the more southerlyupland regions of the Banjaran Titiwangsa. An additional species, Cyrtodactylus lekaguli sp. nov. from Satun, Trang, SuratThani, and Phang-nga provinces in southern Thailand, was identified on the basis of morphology and color pattern and is hypothesized to be part of a clade containing C. astrum sp. nov. and C. langkawiensis sp. nov.

A survey of sandflies in the affected areas of leishmaniasis, southern Thailand

Leishmania siamensis was firstly described as a causative agent of autochthonous visceral leishmaniasis in southern provinces of Thailand since 2008. The spread of leishmaniasis depends on the distribution of the vectors and reservoir hosts. Unfortunately, little is known about these vital factors. The objective of this study was to identify the distribution of sandfly species, their density, and their habitats in the affected areas of leishmaniasis, southern Thailand. A cross-sectional survey of sandflies was conducted in three provinces of southern Thailand where leishmaniasis cases were previously reported. The collection of sandflies was performed using CDC light traps for four consecutive months, from March to June 2009. A total of 2,698 sandflies were collected in the affected areas. Among 1,451 female sandflies, six species of genus Sergentomyia were identified, i.e., Sergentomyia gemmea, Sergentomyia iyengari, Sergentomyia barraudi, Sergentomyia indica, Sergentomyia silvatica, and Sergentomyia perturbans. S. gemmea (81.4%) was the most predominant species in all areas. In addition, one species of the genus Phlebotomus, Phlebotomus argentipes, a known vector of leishmaniasis was also detected. The distribution of sandfly species in these leishmaniasis-affected areas was different from the previous studies in other areas of Thailand. Further studies are needed to proof whether these sandflies can be the natural vectors of leishmaniasis.

A cohort study on anti-filarial IgG4 and its assessment in good and uncertain MDA-compliant subjects in brugian filariasis endemic areas in southern Thailand

The prevalence of Brugia malayi was surveyed in three highly endemic provinces in southern Thailand as part of an ongoing evaluation of the effectiveness of two rounds of mass drug administration (MDA). Prior to MDA IV, and thereafter every 6 months up to 18 months, including MDA V at 12 months, nocturnal blood sampling was assayed for microfilaria (mf) and IgG4 antibodies in 200 subjects from Nakorn Srithammarat and Surathani provinces. From an additional 300 subjects from Narathiwatt province, daytime blood was also examined for IgG4 antibodies for 1 year. Subjects who tested positive, with reciprocal IgG4 titres above 100, were dichotomized in the 'good compliant' or 'uncertain compliant' groups. Stool samples were examined for intestinal parasites from all 500 subjects simultaneously. Only two subjects (1%) tested positive for mf, while 98 subjects (19.6% of 500) tested positive for IgG4. In general, the good drug-compliant subjects were less likely to exhibit the IgG4 response than subjects in the uncertain compliant group. Only six subjects (1.2%) exhibited lymphoedema while 68 subjects (13.6%) had a total of 105 parasitic infections, with female instances of protozoan infections exceeding male instances of helminth infections. It was concluded that the two MDA rounds were highly successful in not only in reducing mf to negligible levels but also in lowering antifilarial IgG4 titres in the good compliant subjects. The IgG4 assay is a sensitive and cost-effective surveillance tool for the early detection of brugian infections that is not contingent on nocturnal blood collections.

Multilevel factors affecting tuberculosis diagnosis and initial treatment

The study aims to assess provider adherence to national tuberculosis programme guidelines on diagnosis, initial regimens and dosages, and to examine independent effects of factors at patient, staff and hospital levels influencing adherence. A review of 383 medical records of new tuberculosis (TB) patients and interviews with related staff were carried out. The study was conducted in 16 public hospitals of seven provinces of southern Thailand. The outcome variables were provider adherence to the guidelines on diagnostic procedure, initial regimen and dosage. Independent variables consisted of patient, staff and hospital factors. Multilevel logistic regression was used to identify factors associated with adherence. The proportions of adherence to the diagnostic procedure, initial regimen and initial dosage prescribed were 70.0%, 100.0% and 57.1%, respectively. Most of diagnosis non-adherence was anti-TB drugs being prescribed for smear-negative patients without prior antibiotic trial (12.5%). The anti-TB drug with the highest percentages of patients receiving non-adhered dosage was ethambutol (33.6%). In contrast to single-level analysis, which showed significant influence of up to five factors, multilevel analysis confirmed only strong effect of male patients receiving better adhered diagnosis and of non-doctors and TB clinics providing better dosage adherence. Adherence to TB diagnostic procedures was not good, and adherence to initial dosage, especially for ethambutol, was poor. TB clinics, the key factor of adherence, should be expanded. Female patients should be reviewed more carefully because they tend to receive poorer diagnosis adherence.

Little Bear Sells CDs and Ai Theng Drinks Coke: Sacred Clowning and the Politics of Regionalism in South Thailand 1

Images of stock clowns from the traditional Thai shadow play (nang talung) are found throughout the villages and towns of the Thai Buddhist majority provinces of southern Thailand. These extremely popular funny men appear not only in shadow play performances but also in commercials, story books, logos, and billboards. Clowns also appear as tourist souvenirs, sacred amulets, crafted into statues, and the like as indigenous reflections of southern Thai identity. In this article, I discuss the complex and often ambiguous relationship between the clown's traditional sacred power and his forays into southern Thailand's political and economic landscape. By so doing, I focus my attention on the clown as being both a subversive and conservative agent. On the one hand, he represents a Turnerian-like anti-structure, which allows him to test the limits of social and political acceptability and on which his ritual personality as a sacred being rests. On the other hand however, shadow play clowns are celebrated by puppeteers, local audiences and state officials as being embodiments of modernity and Thailand's national quest for regional distinctiveness.

Symptoms of Posttraumatic Stress Disorder and Depression Among Children in Tsunami-Affected Areas in Southern Thailand

On December 26, 2004, an undersea earthquake occurred off the northwestern coast of Sumatra, Indonesia. The tsunami that followed severely impacted all 6 southwestern provinces of Thailand, where approximately 20,000 children were directly affected. To assess trauma experiences and the prevalence of symptoms of posttraumatic stress disorder (PTSD) and depression among children in tsunami-affected provinces in southern Thailand. Population-based mental health surveys were conducted among children aged 7 to 14 years in Phang Nga, Phuket, and Krabi provinces from February 15-22, 2005 (2 months posttsunami), and September 7-12, 2005 (9 months posttsunami). Trauma experiences and symptoms of PTSD and depression as measured by a tsunami-modified version of the PsySTART Rapid Triage System, the UCLA PTSD Reaction Index, and the Birleson Depression Self-Rating Scale. A total of 371 children (167 displaced and living in camps, 99 not displaced from villages affected by the tsunami, and 105 not displaced from unaffected villages) participated in the first survey. The prevalence rates of PTSD symptoms were 13% among children living in camps, 11% among children from affected villages, and 6% among children from unaffected villages (camps vs unaffected villages, P = .25); for depression symptoms, the prevalence rates were 11%, 5%, and 8%, respectively (P = .39). In multivariate analysis of the first assessment, having had a delayed evacuation, having felt one's own or a family member's life to have been in danger, and having felt extreme panic or fear were significantly associated with PTSD symptoms. Older age and having felt that their own or a family member's life had been in danger were significantly associated with depression symptoms. In the follow-up survey, 72% (151/210) of children from Phang Nga participated. Prevalence rates of symptoms of PTSD and depression among these children did not decrease significantly over time. This assessment documents the prevalence of mental health problems among children in tsunami-affected provinces in southern Thailand at 2 and 9 months posttsunami. Traumatic events experienced during the tsunami were significantly associated with symptoms of PTSD and depression. These data may be useful to target mental health services for children and may inform the design of these interventions.

Substance use among high-school students in southern Thailand: Trends over 3 years (2002–2004)

Purpose To examine the trends of substance use and correlated variables in high-school students in Southern Thailand. Methods Surveys of high-school years 7, 9 and 11 and vocational school year 2 students in four provinces in Southern Thailand were conducted in 2002–2004 to examine lifetime substance use, use within 1 year and 30 days before the interview, using a self-completed questionnaire. Results The prevalence of lifetime use of any illicit substance was 5–7% overall (about 7%, 9% and 13% in boys and 2%, 1% and 3% in girls in 2002, 2003 and 2004, respectively). Krathom, a local addictive plant, and cannabis were the most commonly used illicit substances on a lifetime basis with prevalences of 2.3%, 2.8%, 4.9% ( p < 0.01) and 2.6%, 2.3%, 3.4% ( p > 0.05) in the surveyed years. The rates of alcohol consumption in the past 30 days were 19.3%, 17.3% and 15.2% ( p > 0.05) while smoking rates were 14.6%, 8.8% and 10.8% ( p < 0.05). The significant correlates of current illicit substance use were surveyed year, male, vocational school, school level, and school performance. Conclusion The problem of substance abuse is increasing among Thai adolescents. School-based interventions seem desirable, especially in boys, vocational and public school students.

Conventional Tourism and Ecotourism in Phuket, Thailand: Conflicting Paradigms or Symbiotic Partners?

This paper examines the ways in which conventional tourism and ecotourism are conceptually, operationally, and spatially linked in Phuket and surrounding provinces in southern Thailand. Phuket's two oldest and most prominent ecotourism companies are used as case studies to illustrate how the principles of ecotourism are implemented in practice even as structural connections to the existing conventional tourism industry are maintained. The collective number of ecotourism customers, the packaged nature of ecotourists' holidays, the marketing strategies employed by Phuket's ecotourism companies, the close proximity of ecotourism activities to conventional tourism areas, and the nature and structure of daily ecotourism operations all bind ecotourism in southern Thailand to more conventional tourism in the region. However, despite such strong connections to conventional tourism, Phuket's ecotourism companies nevertheless continue to promote the most prominent principles found in definitions of ecotourism: nature-based activity; conservation; sustainability; ethical management; local-orientation in terms of control, benefits, and scale; and environmental education.

Health of dentists in southern Thailand

The aims of this study were to investigate the prevalence and nature of some health and lifestyle problems of dentists in southern Thailand. The design was a cross-sectional study using a self-report questionnaire distributed to all 220 dentists working in 14 provinces in southern Thailand in 1997. One hundred and seventy-eight 178 (80.9%) dentists aged 22-54 years responded. Only about one third of dentists 65 (36.7%) reported exercising on a regular basis. Almost one fifth of dentists 35 (19.1%) reported that they consumed alcohol on a weekly basis. Few dentists 4 (2.4%) reported regular smoking. Almost all dentists reported that their practice of dentistry has increased stress or stress-related problems 171 (96.1%). More than two thirds of respondents had had some known or unknown systemic health problem since graduation 112 (71.8%), although most dentists reported having no systemic disease at present 104 (59.1%). The present study has indicated that dentists in southern Thailand report a high career prevalence of stress, a moderate career prevalence of work-related problems which may be related to job satisfaction, and moderate career prevalence of systemic disease. Further continuing education and investigation of appropriate interventions to improve rates of exercise amongst dentists in southern Thailand is needed.

Occupational hygiene practices of dentists in southern Thailand

The aims of this study were to investigate the prevalence and nature of infection control, radiation control and handling of mercury, reported by dentists in southern Thailand. A cross-sectional study with self-report questionnaire to all 220 dentists working in 14 provinces in southern Thailand in 1997. 178 dentists (80.9%) aged 22-54 years responded. All reported wearing personal protective measures, at least sometimes and using high level disinfection (formerly sterilisation) procedures for handpieces. Most (93.8%) reported changing sterilised handpieces for each patient. The most commonly reported method of high level disinfection was alcohol (37.1%). Just over two-thirds (68.0%) reported having HBV vaccination. Most (94.3%) reportedly took precautions when radiographs were taken and (89.9%) reported protecting their eyes with a UV/blue light shield or filter while using these units. About half of dentists (51.7%) reported storing excess amalgam under water compared with 20.1% that they stored it in a closed box. 77.7% reported using sealed mercury amalgam capsule systems, at least sometimes. Nearly half (47.1%) reported disposing of used capsules in the bin. The present study has indicated that occupational hygiene practices of dentists in southern Thailand are generally consistent with published guidelines for infection control and also with other populations of dentists studied in the areas of infection control and radiation protection. Further continuing education and investigation of appropriate interventions to promote good occupational hygiene standards may also be needed.

Occupational health problems of dentists in southern Thailand

To investigate the prevalence and nature of some occupationally related health problems in dentists in southern Thailand. A cross-sectional study using a self-report questionnaire distributed to all 220 dentists working in 14 provinces in southern Thailand in 1997. One hundred and seventy-eight dentists aged between 22 to 54 years responded. The most common occupational health problems were musculoskeletal pain (78 per cent) and percutaneous injury (50 per cent). Associated factors were analysed using multivariate analysis. About 22 per cent of these dentists had a history of contact dermatitis mostly caused by allergy to latex gloves, 15 per cent had eye problems, and 3 per cent had hearing problems. Continuing education in the avoidance of percutaneous injuries would be beneficial, as exposure to potential infectious agents is of concern. Further studies are needed to identify causes of musculoskeletal pain and to identify appropriate interventions to reduce its prevalence, as would similar measures to reduce exposure to agents which may be producing contact dermatitis.

Obesity among school children in a province of southern Thailand and its association with socioeconomic status

The association of nutrition status of children aged 7-12 years (n=663) with socioeconomic factors in a province of southern Thailand in 1995 was investigated. Three type of schools were surveyed: a school with a higher educational standard (elite school) in the municipality of the province, a school with many children from low-income families (low-income school) in the same municipality, and five ordinary schools in rural areas of the province (district schools). The proportions of obese children were 22.1%, 5.8% and 2.7%, respectively for the three type of schools, when obesity was defined as weight to height of over 120% of the median of children in Bangkok. The risk ratios and 95% confidence intervals for obesity in the elite and the low-income schools were 5.0 (3.5-7.2) and 1.9 (0.8-4.8), respectively, taking the district schools as a reference. Our research suggested that the high prevalence of obesity among elite-school children could be related to the comparatively high socioeconomic status of the children's families. It also shows that the children in the province studied were as a whole considerably leaner than children in the big cities of Thailand. These results imply a need for appropriate interventions which cannot only prevent obesity, but also improve the malnutrition of school children in the rural provinces of southern Thailand.