Rural Northeastern Thailand Research Articles

Behavior to Prevent Coronavirus Disease 2019 (COVID-19) among the Elderly with Non-Communicable Disease in Rural Northeastern Thailand

Objective: This study aimed to investigate the preventive behaviors against coronavirus disease 2019 (COVID-19) and to identify factors influencing these behaviors. Material and Methods: We conducted a cross-sectional study from September 2021 to January 2022 during the COVID-19 outbreak. The study population comprised 320 early-onset elderly individuals with non-communicable diseases residing in rural northeastern Thailand. A simple random sampling technique was utilized to select participants. Data collection was facilitated through a self-administered questionnaire. Results: The analysis indicated that 69.1% of participants were female, with a mean age of 63.7 years. Diabetes mellitus represented 43.1% of the underlying conditions. A significant majority (54.4%) exhibited a high level of preventive behavior against COVID-19. Notably, 76.3% of the participants consistently engaged in hand hygiene with alcohol gel in public settings. Age and educational background were significant personal factors correlated with preventive behaviors (p-value<0.05). Participants with very high preventive behaviors were predominantly in the 60-65 age bracket (62.3% vs. 37.7%, p-value=0.027) and had completed late elementary education (46.0% vs. 30.1%, p-value=0.018). Conclusion: Elderly individuals with underlying diseases in rural areas of northeastern Thailand displayed commendable preventive behaviors against COVID-19. These findings suggest a heightened awareness and proactive engagement in mitigating the transmission of this infectious disease.

Current prevalence and geographic distribution of helminth infections in the parasitic endemic areas of rural Northeastern Thailand

BackgroundHelminth infection is a global health issue that not only causes acute helminthiasis but long-term infection may lead to complicated symptoms as well as severe complications. The World Health Organization cooperated with the Ministry of Public Health in many countries, particularly where high prevalence, spending a lot of resources for limiting the infection. In Thailand, the incidence of parasitic helminth infections was continuously declined in the last few decades according to several campaigns for parasitic elimination. However, the rural community in the northeast of Thailand where the highest prevalence of the country still needs to be monitored. This present study aims to report the current prevalence of parasitic helminth infections in Nakhon Ratchasima and Chaiyaphum provinces where sharing a huge area of the northeastern region of Thailand but only a few studies have been published.MethodsThe stool specimens were collected from 11,196 volunteers and processed by modified Kato-Katz thick smear, PBS-ethyl acetate concentration techniques, and PCR. The epidemiological data were collected, analyzed, and used for generating of parasitic hotspots.ResultsThe results indicated that O. viverrini remains the major parasite in this area with a total prevalence of 5.05% followed by Taenia spp., Hookworms, T. trichiura, and Echinostoma spp., respectively. Mueang district of Chaiyaphum province has the highest prevalence especially O. viverrini with a prevalence of 7.15% that higher than the latest national surveillance. Interestingly, the prevalence of O. viverrini was hugely reported (more than 10%) in five subdistricts. The geographic localization of O. viverrini infections revealed that a lot of water reservoirs such as the lakes or branches of the river in the two-most prevalent subdistricts. Our finding indicated that gender and age were insignificantly different.ConclusionThis finding suggested that the parasitic helminth infection in the rural areas of northeast of Thailand remains high and the housing location is a major contributing factor for the parasitic infection.

High prevalence of chronic kidney disease and its related risk factors in rural areas of Northeast Thailand

In Thailand, chronic kidney disease (CKD) screening was reported in 2009 with an overall prevalence of 17.5% and the highest at 22.2% in the northeastern region. This study aimed to find out CKD prevalence of the Kidney Disease Improving Global Outcomes criteria and their related risk factors in the rural community. A population-based study was conducted in the rural sub-districts of northeastern Thailand. Data of socio-demographic status, lifestyle, underlying diseases, blood pressure, and body mass index were recorded. Blood and urine analysis was conducted along with ultrasonography of kidneys. Specimen collection and analyses were repeated after 3 months, and the factors associated with CKD were studied by logistic regression analysis. A total of 2205 participants with a mean age of 57.8 ± 11.7 years and female predominance (66.7%) completed the study. The prevalence of CKD was 26.8%, i.e., stages 1 (7.3%); stage 2 (9.0%); stage 3a (6.0%); stage 3b (2.8%); stage 4 (1.4%); and stage 5 (0.3%). Hypertension, diabetes mellitus, and renal stones were the major underlying diseases. Only 3.5% of the participants were aware of having CKD. An increase in age, male, unemployment, current smoking, diabetes, hypertension, underweight, anemia, hyperuricemia, and leukocytosis were significantly associated factors with the disease. The study revealed that CKD has developed as a significant public health problem in rural northeastern Thailand and one out of every four people has CKD. Therefore, early interventions are essential for the proper management and prevention of CKD.

A blind passenger: a rare case of documented seroconversion in an Angiostrongylus cantonensis induced eosinophilic meningitis in a traveler visiting friends and relatives

BackgroundEosinophilic meningitis (EOM) is a rare condition that is caused by various communicable and non-communicable factors. The rat-lungworm Angiostrongylus cantonensis, which is associated with consumption of raw or undercooked paratenic or intermediate hosts, is the most common cause of parasitic eosinophilic meningitis worldwide. While the majority of A. cantonensis cases are reported from endemic regions, cases in travelers pose a challenge to clinicians in non-endemic countries. Here we report a rare case of eosinophilic meningitis caused by A. cantonensis in a Swiss traveler who was diagnosed after returning from Thailand.Case presentationA 33-year old woman with a travel history to rural north-eastern Thailand presented to an emergency department in Switzerland with severe headache and vomiting. Eosinophilic meningitis was confirmed as the cause of the symptoms; however, serologic investigations failed to confirm an A. cantonensis infection on the first evaluation. Nevertheless, empirical treatment with an anthelminthic and steroid regimen led to a rapid alleviation of symptoms. Repeated serology confirmed seroconversion 2 weeks after treatment initiation.DiscussionParasitic etiology must be considered in returning travelers who present with symptoms compatible with a central nervous system infection. A thorough medical history, including types of food consumed, is paramount and can often suggest differential diagnosis. Neuroangiostrongyliasis is rare and might be missed if serology does not cover possible seroconversion.

Skipped-Generation Families: Economic Happiness in Rural North-Eastern Thailand

This paper investigates economic happiness of skipped-generation families in rural north-eastern Thailand. The qualitative methodological approach was implemented in the study. Data collection was conducted in April - May 2018 and in-depth interview was used as a research instrument to collect data from two groups of key informants, including 1) community leaders, community seniors, and community commitees, In total eight persons, and 2) skipped-generation families living in a rural north-eastern region of Thailand, in total twenty families. Data analysis was done by the content analysis method. The study indicated that skipped-generation families are the familes with grandparents and grandchildren living together. Most families have an agricultural occupation, because they have a lot of land by inheritance and divided into two parts: housing and farming. Mostly agricultural income by sugar canes and farming can earn 2,400 USD per year. Moreover, remittances from international migrant only 450 USD per month is spent on family expenses and education of grandchildren. Some families do not have enoughmoney to invest in farming in the next year, and they have a lot more debt than 3,000 USD from a migrant who goes to work abroad. However, skipped-generation families have a perception of economic happiness "An empty hand is no lure for a hawk, no man is happy who does not think himself so" So, skipped-generation families must take this view to manage the economic situation of the family, even though the incomes are insuf-ficient to cover their living and lack of labor due to migrant workers going to work abroad. This affects the economic happiness of skipped-generation families to sustain their living in a rural society.SKIPPED-GENERATION FAMILIES:Economic Happiness in Rural North-Eastern Thailand

The Sufficiency Economy and Community Sustainability in Rural Northeastern Thailand

Thailand is promoting a sufficiency economy (SE) emphasizing community solidarity, mixed farming and sustainable agriculture. We analyze to what extent the SE philosophy is part of the daily lives of communities in Isan, NE Thailand. We interviewed rural household representatives and community leaders on education, employment, community dynamics, aspirations, concerns and social-sufficiency. The majority observed that community values and interaction were essential and were satisfied with living standards and community. However, most want their children to proceed to university meaning many may not return to agriculture limiting the ability of SE values to be transferred to the next generation.

Organic Farmers’ Connectedness with Nature: Exploring Thailand’s Alternative Agriculture Network

Only recently has research begun to explore how individuals translate their values into actions towards the natural world. As Buddhist scriptures have been associated with environmental stewardship, Thailand’s rural agrarian communities provide a useful site to test farmers’ perceptions of nature. Studies have shown that the Thai alternative agriculture movement has advocated a closer connection to nature through organic extension programs. This paper explores the ways organic rice farmers work with each other and nature to sustain rice farms in rural Northeastern Thailand. In depth interviews with organic farmers shed light on why they form collectives and what holds these groups together. Subsequent analysis revealed the salience of organic fertilizer collectives as a medium of associations between farmers and nature. A final round of structured interviews with seventy-five organic farmers’ examined connectedness with nature through a study of fertilizer practices. Findings suggest that organic farmers perceived bountiful rice and good health as externalities of nurturing the soil. Organic farmers developed a physical association with nature that led to a collective ecological worldview. Although, this study points to the social and spiritual attributes of a close connection with nature, organic farmers also depend on access to capital, technology, and strong local leadership.

Why Thai parents do not discuss sex with their children: a qualitative study

This qualitative article explores the attitudes of Thai adolescents and parents concerning the barriers that prevent parents providing sex education to their adolescent children. Focus groups were conducted with 30 parents and 36 adolescents in rural north-eastern Thailand and were analyzed by using thematic analysis. The results showed that most Thai parents have not taught their children about sex education issues. Five themes emerged in relation to the limitations in providing sex education in Thai families. These were: restrictions imposed by traditional Thai culture; sex education is not a parental duty; parental limitations; the generation gap; and better not bring it up. We conclude that the core values in Thai society restrict the discussion of sex, resulting in youth missing the opportunity to acquire the knowledge that is needed about sexual issues from their family. This article provides evidence of how parents' knowledge and perceptions are linked to their ability and willingness to discuss sexual matters with their teenagers. Therefore, future sex education policies could be greatly enhanced by empowering parents to take part in the sex education of their teenage children.

Attitudes of adolescents and parents towards premarital sex in rural Thailand: A qualitative exploration

Objective This qualitative study aimed to explore attitudes of Thai parents and adolescents towards premarital sex. Study design Data were collected from 11 focus groups with 30 Thai parents and 36 adolescents aged 15–19 years old in rural areas of Udon Thani province, Thailand and examined using thematic analysis. Results Four themes were identified from the data: the social judgement of girls; boys have nothing to lose; considering risks and parents as problem solvers. All themes relate to the continuing existence of double standards concerning the social norm for premarital sex as applied to young women on one side and young men on the other. Conclusions The influence of traditional values is still very strong in rural north-eastern Thailand. The findings highlight teenagers’ need for more support from their parents. The promotion of open, honest communication between parents and teens is important to overcome difficulties of social judgements and align thinking between old and new social values.

Melioidosis in children from Kuala Lumpur, Malaysia

There are few data on paediatric melioidosis in endemic areas outside rural north-eastern Thailand and northern Australia. This study reports 16 culture-confirmed cases of melioidosis in children aged < or = 15 years seen between 1976 and 2005 at an urban teaching hospital in Kuala Lumpur, Malaysia. Seven (43.8%) patients had septicaemic melioidosis (with three known deaths) and nine (56.2%) had localised disease (one death). Eleven (68.8%) patients had underlying diseases, including five with haematological malignancies. Skin, soft tissue and lymph nodes were most commonly affected. There were no cases of parotitis or pharyngocervical disease (seen in Thailand), or encephalomyelitis (seen in Australia). The differences in disease seen in this study compared with the mostly rural patients described in previous studies might be owing to a different patient population in an urban environment. Septicaemic melioidosis has a high mortality, but localised disease has a good prognosis, and selected cases may be cured without the full recommended treatment regimen.

&lt;i&gt;Molam Phifa&lt;/i&gt; in Northeast Thailand

The purpose of this article is to describe in concrete terms, the Molam Phifa as a practitioner of khong haksa, or the spiritual power to avoid affliction, an indigenous notion that has not been studied before, and thus to it approach the reality of practical religion in rural northeastern Thailand. The data collection was conducted in the region where one of the Molam Phifas lived, using mainly questionaries and in-depth interviews for 5 months in 1994.Literally, Molam Phifa is a specialist in singing songs for Phifa (the Supreme Being) which is part of Thai-Lao peasant culture. Among the villagers, Molam Phifa is known as a ritual specialist, especially performing healing rituals by singing and dancing and Phifa possession of her body. It is reported that most of Molam Phifa are females and each has her own group of believers, gaining recruits who are cured in the healing rituals. Moreover, there are collective rituals held twice a year, when many believers gather at the Molam Phifa's house to make offerings to Phifa.For the villagers, khong haksa is a notion of spiritual power against the evil or calamity which causes illness, and it subsumes the concepts of Buddhism and spirit belief, including various kind of things perceived as spiritual power, such as Phifa, tham, etc. In relation to Buddhism, there are not only many discourses from Buddhism, but believing and making offerings to khong haksa is also perceived as merit-making behavior.Since the indigenous knowledge of Molam Phifa has innumerable diversity, it is necessary to consider the historical perspective of the area where it has developed. After examination the historical process of the village formation, it was found that when the villagers were faced the socio-cultural changes caused from “modernization, ” many had to change their occupations, which required them to go out of the village sphere. In this case, Molam Phifas served them, unfettered by village boundaries and kinship structure, by using their spiritual power different from the power of village guardian spirits or ancestral spirits which have their own spheres of protective power. In other words, this case study shows the process of becoming the center of the religious practice by reorganizing various religious factors in a local way, though lived in a village where the Buddhist temple was not the center of religious practice. This case also shows that khong haksa, or the indigenous notion of power, has been developed and succeeded, especially in Northeast Thailand, by high mobility of the population and a flexible kinship network, and recognized by the people as the supernatural power to protect kinship and social networks beyond village society or kinship groups. Consequently, the indigenous notion of power, like khong haksa, could be the key factor of dynamic construction and integration of Buddhism and spirit cults at the practice level.

Kayaioka Schools and Expansion of Secondary Education in Rural Northeastern Thailand:

Kayaioka Schools and Expansion of Secondary Education in Rural Northeastern Thailand:

Gender, Values, and Intentions to Move in Rural Thailand

This article explores gender differences in the intentions to move among a sample of young adults in rural northeastern Thailand. Based on the value-expectancy framework of migration decisionmaking, an explanatory model is tested which includes migration-related value measures along with individual, household and community-level determinants of both intentions to move and change in intentions to move. Multinomial logistic regression results based on data from the 1992 Thailand National Migration Survey provide some support for the hypothesis of gender-specific determinants of both intentions to move and the reconsideration of migration intentions. For men, value measures of affiliation and comfort, social networks, the presence of young children in the family, and land holdings are significant determinants of migration decisionmaking; for women income and comfort values, the presence of elderly persons in the household, community size, and crop losses are the salient factors. The results are discussed in light of traditional and current cultural expectations for men and women in rural Thailand.

Gender, Values, and Intentions to Move in Rural Thailand

"This article explores gender differences in the intentions to move among a sample of young adults in rural northeastern Thailand. Based on the value-expectancy framework of migration decisionmaking, an explanatory model is tested which includes migration-related value measures along with individual, household and community-level determinants of both intentions to move and change in intentions to move. Multinomial logistic regression results based on data from the 1992 Thailand National Migration Survey provide some support for the hypothesis of gender-specific determinants of both intentions to move and the reconsideration of migration intentions. For men, value measures of affiliation and comfort, social networks, the presence of young children in the family, and land holdings are significant determinants of migration decisionmaking; for women income and comfort values, the presence of elderly persons in the household, community size, and crop losses are the salient factors."

Sudden and Unexplained Deaths in Sleep (Laitai) of Young Men in Rural Northeastern Thailand

Sudden and unexplained death in sleep (SUDS) is a significant cause of death of young adults in several Asian populations, but its distribution and incidence are not well known. We conducted a survey by mail of SUDS (known as 'laitai' in the local dialect) that occurred in adults during 1988-1989 in 3867 villages in northeastern Thailand with a total population of 5.42 million. Headmen of 2651 villages (68.6%) returned the questionnaire and sudden deaths of adults 20-49 years old were reported in 396 of these villages. The validity of reports was assessed by interviewing next of kin and witnesses in a sample of 92 villages reporting sudden deaths; 60 of 127 reports of SUDS from these villages were verified (47.2%). Officials and villagers in seven villages that did not respond to the questionnaire were also interviewed and no cases of sudden death were found. The verified SUDS victims were all men wth a mean age of 35.9 years (SD 7.8). A family history of SUDS was reported in 40.3% of index cases and 18.3% had brothers who had died similarly; no such deaths were reported among sisters. The estimated annual rate of death from SUDS among men 20-49 years was 25.9 per 100,000 person years (95% confidence interval (CI): 21.0-30.7). The sudden deaths were seasonal with 38% occurring during March-May and 10% during September-October (chi 2 = 9.45, P = 0.02). Sudden death in sleep is a leading cause of death of young men in rural northeastern Thailand and the characteristics of Thai victims are similar to those of other Asian victims of this unexplained syndrome.