Rural Thai Research Articles

Rural income dynamics and poverty reduction in Thai villages from 1987 to 2004

AbstractThis article aims to examine the factors contributing to the increase in household income and the corresponding reduction in poverty in rural Thai villages from 1987 to 2004 by employing household panel data. It is found that there has been a significant structural shift of household income away from farm to nonfarm income sources, as well as a reduction in the income gap and the difference in poverty incidence between favorable and unfavorable regions. Such decreases in poverty and its regional gap have been associated with the declining importance of income accrued to farm land, measured by farm size and the availability of irrigation, and with the increasing importance of human capital, measured by the proportion of working members who have graduated from post lower secondary schools. Such findings indicate that the success in rural poverty reduction in Thailand has resulted from the development of the rural nonfarm sector coupled with the improvement of the schooling levels of the rural population.

Factors affecting tooth loss among rural Khon Kaen adults: Analysis of two data sets

Tooth loss is an oral health problem affecting Thai people and people of other nations as well. Not much of epidemiologic evidence concerning factors affecting tooth loss among Thai people has been reported although severity of tooth loss among Thai people has never been decreased. This study employed two existing data sets to evaluate the role of health behaviors such as tobacco smoking and betel quid chewing (a common habit prevalent among rural Thai females), together with other factors in relation to tooth loss among rural Thai people. The study population in the first (phase I) and second (phase II) data sets included 1484 and 3471 male and female adults residing in rural areas of Khon Kaen province, Thailand during 1990-1991 and 1992-1994, respectively. The data were obtained through oral examination and interview. Employing descriptive, bivariate, and multivariable Poisson regression, key risk indicators of tooth loss were identified for both data sets. The findings from final multivariable Poisson regression models were consistent in that tobacco smoking, betel quid chewing, age, dental caries (defined as decayed plus filled teeth) and periodontitis were significantly related to tooth loss among these rural populations. Therefore, preventive programs aiming at discouraging Thai people from smoking tobacco and/or chewing betel quid should be established so that healthy natural teeth can be maintained.

Walking a new path of life: learning tours, ‘agro‐forestry’ and the transformation of the village of Bann Na Isarn, Thailand

Rural areas in both developed and developing countries are being increasingly marginalized through structural changes. Furthermore, the disinvestment in state‐provided supports and services means that rural people are left to their own devices to cope with these changes. Numerous authors argue that the most effective way of dealing with these challenges and changes is through informal learning and local knowledge construction. One way of facilitating this type of local informal learning is through learning tours, which can be best understood as organized conversations. This study asked the question: what impact does participation in a learning tour have on the participants in the learning tour, the non‐participants and the community in general? We begin by developing a theoretical framework that integrates community capitals with the principles of working knowledge. Using this theoretical framework, we then employ a case study design, looking at how one person's learning in the rural Thai village of Bann Na Isarn changes his life, the lives of those around him, his community and other communities in the surrounding area. The study concludes that it is the tension between the individual and the structural that fosters social and community change, that local learning can be an effective strategy for mitigating the impact of capitalist ideology and development while at the same time improving the quality of local life, and that local informal learning is a rich complex process that must be understood as being embedded within a specific context.

Using of osmotic fragility (OF) and dichlorophenol-indolephenol (DCIP) tests screening for antenatal clinic: appraisal of usefulness of the program in rural Thai communities

RRH: Rural and Remote Health. Published article number: 587 - Using of osmotic fragility (OF) and dichlorophenol-indolephenol (DCIP) tests screening for antenatal clinic: appraisal of usefulness of the program in rural Thai communities

Prediction of Percentage Body Fat in Rural Thai Population Using Simple Anthropometric Measurements

To develop and validate sex-specific equations for predicting percentage body fat (%BF) in rural Thai population, based on BMI and anthropometric measurements. %BF (DXA; GE Lunar Corp., Madison, WI) was measured in 181 men and 255 women who were healthy and between 20 and 84 years old. Anthropometric measures such as weight (kilograms), height (centimeters), BMI (kilograms per meter squared), waist circumference (centimeters), hip circumference (centimeters), thickness at triceps skinfold (millimeters), biceps skinfold (millimeters), subscapular skinfold (millimeters), and suprailiac skinfold (millimeters) were also measured. The sample was randomly divided into a development group (98 men and 125 women) and a validation group (83 men and 130 women). Regression equations of %BF derived from the development group were then evaluated for accuracy in the validation group. The equation for estimating %BF in men was: %BF(men) = 0.42 x subscapular skinfold + 0.62 x BMI - 0.28 x biceps skinfold + 0.17 x waist circumference - 18.47, and in women: %BF(women) = 0.42 x hip circumference + 0.17 x suprailiac skinfold + 0.46 x BMI - 23.75. The coefficient of determination (R2) for both equations was 0.68. Without anthropometric variables, the predictive equation using BMI, age, and sex was: %BF = 1.65 x BMI + 0.06 x age - 15.3 x sex - 10.67 (where sex = 1 for men and sex = 0 for women), with R2 = 0.83. When these equations were applied to the validation sample, the difference between measured and predicted %BF ranged between +/-9%, and the positive predictive values were above 0.9. These results suggest that simple, noninvasive, and inexpensive anthropometric variables may provide an accurate estimate of %BF and could potentially aid the diagnosis of obesity in rural Thais.

Effect of urbanization on bone mineral density: A Thai epidemiological study

BackgroundThe incidence of fractures in rural populations is lower than in urban populations, although the reason for this difference is unclear. This cross-sectional study was designed to examine the difference in bone mineral density (BMD), a primary predictor of fracture risk, between urban and rural Thai populations.MethodsFemoral neck and lumbar spine BMD was measured by dual-energy X-ray absorptiometry (GE Lunar, Madison, WI) in 411 urban and 436 rural subjects (340 men and 507 women), aged between 20 and 84 years. Body mass index (BMI) was calculated from weight and height.ResultsAfter adjusting for age and body weight in an analysis of covariance model, femoral neck BMD in rural men and women was significantly higher than those in urban men and women (P < 0.001), but the difference was not observed at the lumbar spine. After stratifying by sex, age group, and BMI category, the urban-rural difference in femoral neck BMD became more pronounced in men and women aged <50 years and with BMI ≥ 25 kg/m2.ConclusionsThese data suggest that femoral neck BMD in rural men and women was higher than their counterparts in urban areas. This difference could potentially explain part of the urban-rural difference in fracture incidence.

Effects of physical activity and dietary calcium intake on bone mineral density and osteoporosis risk in a rural Thai population.

The objective of the study was to determine the effects of modifiable risk factors on bone mineral density in postmenopausal Thai women. Dietary calcium intake (g/day), energy expenditure (kcal/day), and sunlight exposure (h/day) were assessed in 129 rural Thai women aged 63 years (range 50 to 84 years). Bone mineral density (BMD) at the femoral neck, lumbar spine, and distal radius were measured by dual-energy X-ray absorptiometry (DXA). The average dietary calcium intake was 236 +/- 188 g/day (mean +/- SD), while the energy expenditure was 2,118 +/- 656 kcal/day with 1.1 +/- 1.7 h of sunlight exposure. In multiple linear regression analysis, dietary calcium intake, energy expenditure, and years since menopause were significant and independent predictors of BMD at various sites. The three factors together accounted for between 35% and 45% of the variance of BMD. The prevalence of osteoporosis (defined as BMD T-scores < or =-2.5) was 33% at the femoral neck, 42% at the lumbar spine, and 35% at the distal radius. The risk of osteoporosis was higher in women with lower dietary calcium intake (< or =138 mg/day; prevalence rate ratio [PRR], 1.4; 95% confidence interval [CI], 1.0 to 1.9), lower energy expenditure (< or =1,682 kcal; PRR, 1.7; 95% CI, 1.2 to 2.3), and greater years since menopause (> or =6 years; PRR, 2.6; 95% CI, 1.2 to 5.8). The population attributable risk fraction of osteoporosis risk due to the three factors was 70%. These results suggest that in the Thai population, low dietary calcium intake and low physical activity together with advancing years since menopause were independent risk factors for low BMD.

A note on the anti-HIV seroprevalence of the mothers in the labor room at a rural Thai hospital.

A note on the anti-HIV seroprevalence of the mothers in the labor room at a rural Thai hospital.

Distribution of dengue and Japanese encephalitis among children in rural and suburban Thai villages.

In the rainy season of 1989, IgG and IgM antibodies against dengue and Japanese encephalitis viruses (measured by enzyme-linked immunoassay [ELISA]) in serum from all primary-school children in two areas of central Thailand were sampled in order to choose a study site for more detailed epidemiological and entomological analysis. Students in three schools in the largely non-agricultural, suburban community of Bang Bua Thong, Nontaburi Province were sampled in late June and July. Of 1,477 children, 33/1,000 had recent dengue infection and 7/1,000 had recent JE infection. The rate of dengue infection in each village influenced the rate in schools, in that the rate of the school could be predicted from the proportion of students coming from each village. This result suggested that most transmission occurred in the residential environment; otherwise, the rate in each village going to a single school would be identical. Serum samples were taken in late August in the agricultural community of Hua Samrong, Chachoengsao Province. Of 748 students in two schools, 95/1,000 had signs of recent dengue infection and 32/1,000 had signs of recent JE infection. Two of 12 villages had significantly less flavivirus infection than some other villages and three villages had significantly more flavivirus infection. The children from one village had a dengue infection rate of 256 per 1,000, which was higher than the national average for the worst year (1987) previously recorded in Thailand. Within Hua Samrong, there was evidence for significant dengue transmission in one of the schools and concentrated transmission in small areas of two of the villages. The younger age group (3-8 years old) had significantly higher risk of infection by either flavivirus than older children. Elevated homes with wooden floors had significantly higher risk of dengue in the largest village. The observations from 1989 describe the epidemiological situation in rapidly developing, rural villages. This stage of development is probably being repeated throughout Southeast Asia as formerly isolated, rural villages become connected by transportation and economy to urban centers. What appears to be a single dengue outbreak based on passive surveillance conducted on a regional basis may actually be a variety of epidemiological situations. The practical implication of this conclusion is that application of a combination of vaccination and vector control should be targeted to higher risk areas in order to increase the likelihood of regional dengue virus eradication.

Teaching Writing in Rural Thailand: Considering New Perspectives

This article reports on a practical writing workshop for Thai teachers of English in a rural Thai setting. The teachers were participants in a Certificate in TEFL course sponsored by the Canadian International Development Agency (CIDA and taught by the Southeast Asian Ministers of Education Organization, Regional Language Centre (SEAMEO RELC). The genre approach to teaching writing is proposed as a way of helping teachers look beyond structural elements like vocabulary, punctuation, and spelling. The social functions and language choices of three important genres of writing, Description, Anecdote, and News Item, are examined in the article. The principles and practices may be generalizable to similar situations, that is, places where English is taught as a foreign language.

The essential elements of spirituality among rural Thai elders

The essential elements of spirituality among rural Thai elders

Longitudinal studies of Aedes aegypti (Diptera: Culicidae) in Thailand and Puerto Rico: population dynamics.

Aspiration collections of adult Aedes aegypti (L.) were made weekly from inside and outside of houses for 3 yr in a rural Thai village (n = 9,637 females and n = 11,988 males) and for 2 yr in a residential section of San Juan, Puerto Rico (n = 5,941 females and n = 6,739 males). In Thailand, temperature and rainfall fell into distinct seasonal categories, but only temperature was correlated with fluctuations in female abundance. Average weekly temperature 6 wk before mosquitoes were collected and minimum weekly temperature during the week of collection provided the highest correlations with female abundance. Accounting for annual variation significantly improved Thai models of temperature and mosquito abundance. In Puerto Rico, temperature, but not rainfall, could be categorized into seasonal patterns. Neither was correlated with changes in female abundance. At both sites the vast majority of females were collected inside houses and most contained a blood meal. Most teneral females were collected outside. Wing length--an indicator of female size--and parity, egg development or engorgement status were not correlated, indicating that feeding success and survival were not influenced by female size. At both sites, females fed almost exclusively on human hosts (> or = 96%), a pattern that did not change seasonally. In Puerto Rico more nonhuman blood meals were detected in mosquitoes collected outside than inside houses; no such difference was detected in Thailand. Gut contents of dissected females indicated that females in the Thai population had a younger age distribution and fed more frequently on blood than did Ae. aegypti in Puerto Rico. Our results indicated that aspects of this species' biology can vary significantly from one location to another and 1 yr to the next.

The essential elements of spirituality among rural Thai elders.

The purpose of the study reported here was to understand and describe the essential elements of spirituality among rural Thai elders. The research question that guided the study was: How do rural Thai elders experience and describe spirituality in their daily lives? This question was explored through in-depth, audio-taped, face-to-face interviews with 12 rural Thai elders living in the Nakhorn Prathom Province in the central part of Thailand during the period from January to March 1998. Prior to implementing the study, approval to conduct this study was granted from the Institutional Review Broad of the University of Alabama at Birmingham. Through the process of hermeneutic phenomenological data analysis, three categories and nine themes emerged. The findings of the study provide a knowledge base for Thai nurses to explore and explain spirituality to enhance nursing science and provide holistic nursing care. Further research should be conducted throughout the health and illness continuum with all age groups and with individuals of different cultures and belief systems.

Physical Signs of Malnutrition Observed in Rural Villages of Thailand

Three Army dietitians deployed to Thailand in May 1997 in support of Cobra Gold, an annual military training exercise. Hie dietitians were members of military medical teams with the goal of promoting long-term public health improvements in rural Thai villages, Practicing in the absence of laboratory data made it necessary for dietitians to rely on their physical nutrition assessment skills. The physical signs of nutrient deficiency observed were grouped into three categories; 1) iron deficiency indicators such as spoon shaped, brittle, ridged nails, pale, slick appearing tongues, and pale conjunctival eye membranes, 2) protein-calorie malnutrition indicators such as temporal wasting, hollowing under eyes, easily pluckable hair, pronounced clavicle in males, and wasted dorsal interosseous, and 3) B Complex vitamin deficiency with magenta colored tongues, sore, burning mouths and tongues, and pallor complexions. Recognizing and interpreting physical signs of nutrient deficiencies lead dietitians to investigate social issues such as living conditions and food availability. Based on their findings the dietitians provided dietary treatment and education to individuals and worked closely with community leaders to outline long-range nutrition goals. This experience illustrated the need for Army dietitians to strengthen their physical nutrition assessment skills. As a result, training on recognizing and interpreting physical signs of malnutrition has increased in Army courses designed to prepare dietitians for deployment.

U.S. Army Dietitians Deploy in Support of Cobra Gold: A Humanitarian Mission

Dietitians are multifunctional and play an important role in humanitarian missions as educators, planners, and consultants. Three dietitians deployed to Thailand in support of the 16th Annual Joint and Combined Exercise, Cobra Gold 1997. The goal of the Medical Civic Assistance Program (MEDCAP) was to promote long-term public health improvements in rural Thai villages. The dietitians counseled 140 patients and taught an additional 5,300 individuals during nutrition classes. The primary nutrition-related clinical diagnoses included malnutrition, anemia, diabetes, hypertension, goiter, and poor appetite. The dietitian who deployed as the medical planner and MEDCAP executive officer facilitated coordination and planning for all phases of the MEDCAP operation. The teams were made up of U.S. and Thai military forces and Thai civilian medical personnel. The mission requirements were established with the Royal Thai Supreme Command, Thai governors, Ministry of Public Health officers, military and medical officers, and veterinarians of the three provinces.

Health and rural‐to‐urban migration in Thailand: The Population and Community Development Association's experience in rural development

The Population and Community Development Association (PDA), a non-governmental organisation, has designed and implemented a new model of rural economic development in which health is considered to be the cornerstone of all development strategies. By attacking migration as the root cause of current threats to the population's health, PDA's Thai Business Initiative in Rural Development program provides economic opportunities to villagers in the poorest areas of the country. This structural approach to health enhancement includes specific components to address primary health care, family planning, and HIV/AIDS prevention, education and care.

Glucose tolerance in rural diabetic Thais, first-degree relatives and non-diabetic controls

To determine whether non-insulin-dependent diabetes mellitus (NIDDM) in a rural Thai population is characterised by insulin resistance and hyperinsulinaemia, 17 unselected diabetic outpatients from a regional hospital, five first-degree relatives and 10 healthy controls were studied. Subjects in these groups were matched as closely as possible for age and sex, and mean body mass indices were similar (mean ± S.D.; 21.8 ± 5.5, 20.6 ± 1.4 and 21.8 ± 2.3 kg/m 2, respectively, P > 0.5). Beta-cell function (%B) and insulin sensitivity (%S), expressed relative to values for non-diabetic Caucasians, were assessed mathematically using the ‘CIGMA’ model and plasma glucose and insulin achieved after a standard 1-h glucose infusion. The diabetic patients had higher fasting plasma glucose concentrations than the controls (8.6 ± 4.0 vs. 4.6 ± 0.4 mmol/l, P < 0.01) but plasma insulin levels were comparable (geometric mean [−S.D.–+S.D.]; 4.0 [1.7–9.4] vs. 4.0 [1.7–9.2] mU/l, P > 0.1). %B in the diabetic group (21% [10–41]) was lower than in the controls (128% [88–187], P < 0.001) while %S tended to be higher (185% [86–400] vs. 111% [49–251], 0.1 > P > 0.05). Relatives had intermediate values of both variables. %S and %B correlated poorly in the diabetic group ( P > 0.1) but together accounted for 90% of the variation in basal plasma glucose (multiple r = 0.95, n = 17, P < 0.0001). Beta-cell dysfunction appears the primary defect in diabetic patients from a Thai subsistence farming population. Insulin resistance may not always characterise NIDDM in geographical areas where a ‘thrifty genotype’ would be expected; other factors associated with diabetes in developing countries (such increased susceptibility to serious infections) may also influence diabetes prevalence.

Forest management in Northern Thailand: a rural Thai perspective

Deforestation is considered to be one of Thailand's most pressing natural resource management problems. Critics of past management practices argue that protection policies have been ineffective because of inadequate attention to the needs and concerns of local people. This study compares the responses of men and women. The results show that men are quite involved, and that the genders do not differ in their perceptions of deforestation.

Female Aedes aegypti (Diptera: Culicidae) in Thailand rarely feed on sugar.

Female Aedes aegypti (L.) of two different body sizes and provided with different diets (20% sucrose, water only, or 20% sucrose + human blood) were marked and released together in a rural Thai village. Recaptured marked and unmarked (wild) adults were tested for fructose by the cold-anthrone reaction. Both released and wild females showed a low frequency of sugar feeding in nature; both small-bodied and large-bodied individuals failed to sugar feed significantly. Marked females released with sugar in their crop utilized this energy source over the following 2-3 d but failed to replenish it. In contrast, about one-third of wild, resting males showed evidence of recent sugar feeding. This indicated that the absence of plant sugar in females was not caused by a shortage of nectar sources in this rural domestic environment. Presumably, the nonutilization of plant sugar as an energy source increases the frequency of blood feeding and, therefore, the vectorial capacity of Ae. aegypti.

Influence of malaria infection on peroxyl-radical trapping capacity in plasma from rural and urban Thai adults

Measurement of peroxyl-radical trapping capacity (TRAP) were made in plasma from patients with malaria from a rural and an urban Thai community. The results were compared with those from control subjects living in the same areas and chosen to match the patients closely. Measurements were also made of various antioxidants including nutritional indices vitamin C and alpha-tocopherol and the non-nutritional indices urate and protein-sulphydryl. Parasite counts, temperature on examination and the duration of illness were recorded together with measurements of plasma caeruloplasmin (EC 1.16.3.1), retinol and malondialdehyde (MDA). In general, most measurements made in the villagers were lower than those in the comparable urban groups. The exceptions were caeruloplasmin and MDA when the latter was expressed as MDA:cholesterol ratio. TRAP values were extremely low in 50% of the villagers and 25% of the urban patients with malaria and these results correlated with retinol and vitamin C and inversely with malonaldehyde. The results suggested that low TRAP values are associated with lipid peroxidation and that vitamin C and possibly retinol may be destroyed by the oxidative conditions present in the plasma in this disease.