Songkhla Province Research Articles

Increased active pulmonary tuberculosis risk from sharing bong of cannabis: a case–control study from Thailand

IntroductionTuberculosis (TB) is a chronic lung disease caused by Mycobacterium tuberculosis. Tobacco smoking and sharing of instruments have been reported to increase TB risk. In 2022, cannabis was legalized in Thailand. To address for the potential increase in cannabis use after legalization and the reported increased TB risk associated with cannabis usage, we aimed to estimate the odds ratio and population-attributable fraction (PAF) of different types of cannabis use.Materials and methodsA matched case–control study was conducted in the Songkhla Province of Southern Thailand in 2023. Face-to-face interviews were conducted to collect information on cannabis consumption. Multivariate logistic regression was performed to estimate the odds ratios representing TB risk from the independent variables. PAF was also calculated to compare the public health impacts of the variables.ResultsAmong the 148 TB cases and 117 healthy controls, we observed lower socioeconomic status and higher proportions of tobacco and alcohol use in these cases. Eleven percent of the controls were current cannabis users, while nearly 19% had ever experienced cannabis use. The proportions of ever-used, smoked, and shared cannabis use were significantly higher in these cases. After adjusting for covariates, the best-fit model showed an odds ratio of 4.22 (95% confidence interval: 1.47–12.07) for smoking and sharing a bong of cannabis. No statistical significance was found for the other types of consumption. PAF of smoked and shared bongs of cannabis was 12.16, which was slightly lower than that found in smoking tobacco (12.62).ConclusionIncreased numbers of cannabis users, especially shared smokers, may have an impact on TB risk in lower-middle-income countries, where TB is already highly prevalent.

USING PREDICTIVE ANALYTICS TO IMPROVE SURVEILLANCE OF HEAT-RELATED ILLNESS DURING MILITARY TRAINING

Background: Heat-related illnesses are a critical concern for military personnel, especially those unfamiliar with hot climate regions. The Royal Thai Army (RTA) implements a 10-week military training program encompassing four phases: (1) Heat acclimatization training, (2) Combat fundamentals and unarmed combat training, (3) Armed combat training and tactical training, and (4) Field training exercise and evaluations. Objective: This study aimed to conduct a predictive analysis of heat-related illnesses to enhance prevention programs. Methods: The study utilized secondary data from the RTA Medical Department, incorporating variables such as age, occupation, education, underlying diseases, smoking and alcohol consumption, sleep duration, exercise, medication history, body mass index (BMI), weight loss, body temperature, dark urine, heat rash, and environmental humidity. Multiple machine learning algorithms were employed to develop predictive models. Results: The samples comprised 809 male recruits (103,051 encounters) with an average age of 22. Approximately 12% of the recruits had a BMI ≥30 kg/m2, while nearly 70% and 90% reported tobacco use and alcohol consumption in the past 12 months, respectively. Among the recruits, 16% reported substance use within the preceding 30 days. The eXtreme Gradient Boosting (XGB) model achieved 91% accuracy in predicting heat-related illnesses before Phase 2. The top five predictive variables were Lopburi Province (central region), Songkhla Province (southern region), and Bangkok (capital city), sleep duration before joining military training (hours), and age (years). Conclusion: This study, which applied machine learning techniques to predict heat-related illnesses among Thai recruits, can potentially impact the health and training of military personnel. The comparative analysis of various algorithms identified the XGB model as the optimal performer in predicting heat-related illnesses during the combat fundamentals and unarmed combat training phase. However, it is essential to note that further study is needed to enhance the applicability of our predictive model, which includes expanding its use to new cohorts of Thai conscripts, underscoring our research’s ongoing nature.

Unveiling Post-COVID-19 syndrome: incidence, biomarkers, and clinical phenotypes in a Thai population

BackgroundPost-COVID- 19 syndrome (PCS) significantly impacts the quality of life of survivors. There is, however, a lack of a standardized approach to PCS diagnosis and management. Our bidirectional cohort study aimed to estimate PCS incidence, identify risk factors and biomarkers, and classify clinical phenotypes for enhanced management to improve patient outcomes.MethodsA bidirectional prospective cohort study was conducted at five medical sites in Hatyai district in Songkhla Province, Thailand. Participants were randomly selected from among the survivors of COVID-19 aged≥18 years between May 15, 2022, and January 31, 2023. The selected participants underwent a scheduled outpatient visit for symptom and health assessments 12 to 16 weeks after the acute onset of infection, during which PCS was diagnosed and blood samples were collected for hematological, inflammatory, and serological tests. PCS was defined according to the World Health Organization criteria. Univariate and multiple logistic regression analyses were used to identify biomarkers associated with PCS. Moreover, three clustering methods (agglomerative hierarchical, divisive hierarchical, and K-means clustering) were applied, and internal validation metrics were used to determine clustering and similarities in phenotypes.FindingsA total of 300 survivors were enrolled in the study, 47% of whom developed PCS according to the World Health Organization (WHO) definition. In the sampled cohort, 66.3% were females, and 79.4% of them developed PCS (as compared to 54.7% of males, p-value <0.001). Comorbidities were present in 19% (57/300) of all patients, with 11% (18/159) in the group without PCS and 27.7% (39/141) in the group with PCS. The incidence of PCS varied depending on the criteria used and reached 13% when a quality of life indicator was added to the WHO definition. Common PCS symptoms were hair loss (22%) and fatigue (21%), while mental health symptoms were less frequent (insomnia 3%, depression 3%, anxiety 2%). According to our univariate analysis, we found significantly lower hematocrit and IgG levels and greater ALP levels in PCS patients than in patients who did not develop PCS (p-value< 0.05). According to our multivariable analysis, adjusted ALP levels remained a significant predictor of PCS (OR 1.02, p-value= 0.005). Clustering analysis revealed four groups characterized by severe clinical symptoms and mental health concerns (Cluster 1, 4%), moderate physical symptoms with predominant mental health issues (Cluster 2, 9%), moderate mental health issues with predominant physical symptoms (Cluster 3, 14%), and mild to no PCS (Cluster 4, 77%). The quality of life and ALP levels varied across the clusters.InterpretationThis study challenges the prevailing diagnostic criteria for PCS, emphasizing the need for a holistic approach that considers quality of life. The identification of ALP as a biomarker associated with PCS suggests that its monitoring could be used for early detection of the onset of PCS. Cluster analysis revealed four distinct clinical phenotypes characterized by different clinical symptoms and mental health concerns that 'exhibited varying impacts on quality of life. This finding suggested that accounting for the reduced quality of life in the definition of PCS could enhance its diagnosis and management and that moving toward personalized interventions could both improve patient outcomes and help reduce medicalization and optimally target the available resources.FundingThe research publication received funding support from Medical Council of Thailand (Police General Dr. Jongjate Aojanepong Foundation), Hatyai Hospital Charity and Wellcome Trust.

Assessing antimicrobial resistance profiles of Salmonella enterica in the pork production system.

Introduction. Salmonella enterica is a significant enteric pathogen affecting human and livestock health. Pork production is a common source of Salmonella contamination, with emerging multidrug resistance (MDR) posing a global health threat.Gap statement. Salmonella contamination and antimicrobial resistance (AMR) profiles in the pig production chain are underreported.Aim. To investigate the prevalence of S. enterica in the pig production chain and characterise their AMR profiles.Methodology. We collected 485 samples from pig farms, a standard pig abattoir and retail markets in Patthalung and Songkhla provinces in southern Thailand. Antimicrobial susceptibility testing was performed on these samples, and AMR profiles were determined.Results. S. enterica was detected in 68.67% of farm samples, 45.95% of abattoir samples and 50.67% of retail market samples. Analysis of 264 isolates, representing 18 serotypes, identified S. enterica serotype Rissen as the most prevalent. The predominant resistance phenotypes included ampicillin (AMP, 91.29%), tetracycline (TET, 88.26%) and streptomycin (STR, 84.47%). Over 80% of isolates showed resistance to three or more antimicrobial classes, indicating MDR. The AMP-STR-TET resistance pattern was found in nearly 70% of all MDR isolates across the production chain.Conclusions. The high prevalence of MDR is consistent with extensive antimicrobial use in the livestock sector. The presence of extensively resistant S. enterica highlights the urgent need for antimicrobial stewardship. Strengthening preventive strategies and control measures is crucial to mitigate the risk of MDR Salmonella spreading from farm to fork.

An Investigation of a Community Chickenpox Outbreak with a Fatal Case, Songkhla Province, Thailand, October 2022

In October 2022, a suspected chickenpox death was notified. A field investigation was done to verify the diagnosis and cause of death, describe the epidemiological characteristics, identify risk factors, and control the outbreak. We conducted a descriptive study and a matched case-control study. A case was defined as a person with multiple stages of skin lesions on at least two body areas in Subdistrict from 1 Aug 2022 to 24 Oct 2022. We reviewed medical records and searched for cases house-to-house. For the matched case-control study, cases were chickenpox cases residing in Bo Tru Subdistrict, from 1 Aug 2022 to 14 Oct 2022. Controls were neighbors without symptoms or chickenpox history, matched by age. Samples were tested using the reverse transcription polymerase chain reaction technique. Environmental surveys were performed. We identified 30 cases including the deceased, who was 49 years old. The median (interquartile range) age of the cases was 11 (7–38) years. Seventeen were elementary-school students. None of the cases received chickenpox vaccination or had a history of chickenpox. The secondary attack rate among household contacts was 41.2% (14/34). Reverse transcriptase polymerase chain reaction tests from three cases were all positive. Being a close contact with a case and sharing personal utensils were risk factors. We strengthened the surveillance system for early detection and treatment and provided risk communication in the community. Chickenpox cases should be isolated from susceptible persons. Standard treatment guidelines for complicated cases should be distributed among healthcare services.

Habits of Highly Effective Schools Administrators in the Era of Changing World Schools Under the Primary Education Service Area Office, Songkhla Province

Objectives: 1)to study the Degree of Success and Important of habits of highly effective school administrators in the era of a changing world, and 2)to investigate the necessary traits of effective school administrators in the changing world era. Theoretical Framework: By the concept of the 7 Habits of Highly Effective People (Covey (2004) which include: 1) Be Proactive 2) Begin with the End in Mind 3) Put First Things First 4) Think Win-Win 5) Seek First to Understand, then to be Understood 6) Synergize and 7) Sharpen the Saw. Methodology: It is a descriptive research. Data analysis included frequency, percentage, and the Modified Priority Needs Index (PNI modified). Findings: The findings revealed that the Degree of Success and Important Habits of Highly Effective School Administrators in the Era of a Changing World at a high level (x ̅= 4.46, SD= .58, x ̅=4.53, SD=.56). The overall necessity of traits of effective school administrators had a PNI modified value of 0.015. Specific traits in descending order of necessity included: Synergize (PNI modified = 0.047) Think Win-Win (PNI modified = 0.020) Seek First to Understand, then to be Understood (PNI modified = 0.018, Begin with the End in Mind (PNI modified = 0.017), Put First Things First (PNI modified = 0.015), Sharpen the Saw (PNI modified = 0.013) and Be Proactive (PNI modified = 0.004) Implications: Therefore, developing effective school administrators to cultivate all 7 habits necessitates studying essential data, which is perceptual information, to effectively develop habits. Given the importance and research findings, researchers recognize the significance of developing effective habits in school administrators in this ever-changing world to serve as a guideline for development and driving force in.

A molecular epidemiological analysis of Burkholderia pseudomallei in southern Thailand.

Melioidosis, a severe bacterial illness caused by Burkholderia pseudomallei, is prevalent in most parts of Thailand, including its southern region situated within the Malay Peninsula. Despite a lower reported incidence rate of melioidosis in the South compared to the Northeast, the mortality rate remains persistently high. This study aimed to better understand the epidemiology and investigate the presence of B. pseudomallei in the natural environment of southern Thailand. Using multi-locus sequence typing (MLST), we characterized B. pseudomallei isolates derived from human cases and compared them with previously reported sequence types (STs) from the same region. A total of 263 clinical isolates retrieved from 156 melioidosis patients between 2014 and 2020 were analyzed, revealing 72 distinct STs, with 25 (35%) matching STs from Finkelstein's environmental isolates collected in southern Thailand during 1964-1967. Notably, strains bearing STs 288, 84, 54, 289, and 46 were frequently found among patients. Additionally, we observed strain diversity with multiple STs in 13 of 59 patients, indicating exposure to various B. pseudomallei genotypes in the environmental sources of the infection. Environmental surveys were conducted in Songkhla Province to detect B. pseudomallei in soil and water samples where local patients lived. Of the 2737 soil samples from 208 locations and 244 water samples from diverse sources, 52 (25%) soil sampling locations and 63 (26%) water sources were cultured positive for B. pseudomallei. Positive soil samples were predominantly found in animal farming area and non-agricultural zones like mountains and grasslands, while water samples were frequently positive in waterfalls, streams, and surface runoffs, with only 9% of rice paddies testing positive. Collectively, a significant proportion of recent melioidosis cases in Songkhla Province can be attributed to known B. pseudomallei STs persisting in the environment for at least the past six decades. Further characterization of B. pseudomallei isolates from recent environment surveys is warranted. These findings illuminate the contemporary landscape of B. pseudomallei infections and their environmental prevalence in southern Thailand, contributing to the regional threat assessment in Thailand and Southeast Asia.

Unveiling Student Segments: Leveraging Clustering Analysis of Registration Data for Enhanced Recruitment Strategies

Recruiting the right students is crucial for higher education institutions to achieve their goals of attracting talented individuals and fostering academic success. This study aims to investigate the effectiveness of data-driven recruitment strategies in identifying target student populations and tailoring recruitment efforts accordingly. By utilizing K-means clustering analysis on a dataset of student profiles, this research identifies distinct clusters based on factors such as province of residence, parent occupation, and parent revenue. The findings reveal valuable insights into the characteristics and preferences of different student clusters, enabling the development of targeted recruiting strategies. The results indicate that a significant number of students in specific clusters are from Songkhla Province, have parents predominantly engaged in the private sector, agriculture, and fishery occupations, and come from families with moderate income levels. Building upon these findings, several recommendations for recruiting strategies are proposed. These include focusing marketing efforts in the identified regions, forging partnerships with local businesses, offering financial aid programs, and establishing connections with agricultural and fishing communities. This can involve targeted online advertisements, promotional campaigns in local schools, and active participation in career fairs or educational expos held in Songkhla Province. This study contributes to the field of higher education recruitment by leveraging data-driven approaches to identify target student populations and develop tailored strategies.

Risk Factors Associated with an Influenza B Outbreak due to Inefficient Screening in a Prison in Thailand

On 3 Oct 2019, the Office of Disease Prevention and Control Region 12 Songkhla received notification of a suspected influenzacluster in a prison in Songkhla Province, Thailand. In cooperation with the local public health teams, we investigated the event to confirm the diagnosis, identify the source of infection, and implement control measures. A suspected influenza case was defined as an individual with fever and at least one of the following symptoms: cough, sore throat, runny nose, or dyspnea. Aconfirmed case was a suspected case who tested positive to influenza by the reverse transcription polymerase chain reaction technique. An environmental survey was conducted to assess risk behaviors and determine the occupancy rate. A case-control study was performed to identify associated factors of developing influenza. We identified 128 suspected cases, of which seven were confirmed to have type B influenza. All were male and their median (interquartile range) age was 29 years (24–35). The overall attack rate was5.2%. The first case developed symptoms in the new prisoner zone and moved to another zone without undergoing respiratory screening. The analytical study revealed that sleeping within one meter of a confirmed case (adjusted odds ratio (AOR) 1.77, 1.07–2.92), and sharing drinking glasses with others (AOR 1.83, 1.18–2.82)were significant risk factors. The overcrowded prison (165% occupancy) led to limited availability of vaccines, causing 83.5% of prisoners to be unvaccinated. Strict screening of new prisoners before moving to another area and early isolation of symptomatic prisoners are recommended.

Wind Potential Assessment for Songkhla, Thailand

The analysis and evaluation of wind energy projects are important to understand their economic and environmental suitability for installation and operation. Using wind data from the Meteorological Department, Used WAsP software for calculating, simulating, and analyzing the Annual Energy Production (AEP) and then applied it to calculate the Levelized Cost of Electricity (LCOE) of wind turbines installed in the Songkhla province area. The selected areas are suitable for all three models of wind turbines in the simulation. From the wind data analysis, wind direct was found that in the east sector (sector 4), there is the highest wind frequency at the wind station. The simulation results from Laem son-on area and Hua khao area show suitable mean wind speeds for wind farm installations. In the wind turbine simulation, three models were compared: Bonus 300 kW MkIII, Bonus 1.3 MW, and PowerWind 56 900 kW. At the Songkhla cape area, the positions with the highest AEP were 132.485 MWh, 344.419 MWh, and 332.597 MWh, respectively. Hua Khao area, the positions with the highest AEP were 225.284 MWh, 586.303 MWh, and 540.045 MWh, respectively. In the LCOE calculations for all model of wind turbines, at both Laem Son- On and Hua Khao locations, the most cost-effective wind turbine is the Bonus 300 kW. It has an LCOE of $142.43/MWh and $83.76/MWh, respectively. Therefore, the most cost-effective location is Hua Khao.

Plant Growth Promotion and Biological Control against Rhizoctonia solani in Thai Local Rice Variety "Chor Khing" Using Trichoderma breve Z2-03.

Several strains of Trichoderma are applied in the field to control plant diseases due to their capacity to suppress fungal pathogens and control plant diseases. Some Trichoderma strains also are able to promote plant growth through the production of indole-3-acetic acid (IAA). In southern Thailand, the local rice variety "Chor Khing" is mainly cultivated in the Songkhla province; it is characterized by slow growth and is susceptible to sheath blight caused by Rhizoctonia solani. Therefore, this research aimed to screen Trichoderma species with the ability to promote plant growth in this rice variety and enact biological control against R. solani. A total of 21 Trichoderma isolates were screened for indole compound production using the Salkowski reagent. The Z2-03 isolate reacted positively to the Salkowski reagent, indicating the production of the indole compound. High-performance liquid chromatography (HPCL) confirmed that Z2-03 produced IAA at 35.58 ± 7.60 μg/mL. The cell-free culture filtrate of the potato dextrose broth (CF) of Z2-03 induced rice germination in rice seeds, yielding root and shoot lengths in cell-free CF-treated rice that were significantly higher than those of the control (distilled water and culture broth alone). Furthermore, inoculation with Trichoderma conidia promoted rice growth and induced a defense response against R. solani during the seedling stage. Trichoderma Z2-03 displayed an antifungal capacity against R. solani, achieving 74.17% inhibition (as measured through dual culture assay) and the production of siderophores on the CAS medium. The pot experiment revealed that inoculation with the Trichoderma sp. Z2-03 conidial suspension increased the number of tillers and the plant height in the "Chor Khing" rice variety, and suppressed the percentage of disease incidence (PDI). The Trichoderma isolate Z2-03 was identified, based on the morphology and molecular properties of ITS, translation elongation factor 1-alpha (tef1-α), and RNA polymerase 2 (rpb2), as Trichoderma breve Z2-03. Our results reveal the ability of T. breve Z2-03 to act as a plant growth promoter, enhancing growth and development in the "Chor Khing" rice variety, as well as a biological control agent through its competition and defense induction mechanism in this rice variety.

Factors Affecting Depression among First-year Undergraduate Students at A University in Songkhla Province, Thailand

Objective: The purpose of this research was to study factors affecting depression among first-year undergraduate students at a university in Songkhla Province. Theoretical Framework: Psychological factors consist of Self-Esteem (X1), Life satisfaction (X2), Rumination (X3), Problem-solving (X4). Obligation factors consist of Study stress (X5), Taking responsibility for financial obligations (X6). Relationship factors consist of Relationships with friends (X7) and Relationships with family (X8). Methods: Data was collected by surveying 180 students. The research method was a questionnaire consisting of 1) general information about the respondents 2) the Patient Health Questionnaire for Adolescents (PHQ-A) to measure levels of depression, and 3) a questionnaire on factors influencing depression, including psychological factors, obligation factors, and relationship factors. The study identified Cronbach's alpha coefficients, which are equal to 0.76 - 0.93 to analyze the average, standard deviation, Pearson correlation coefficient, and stepwise multiple regression analysis. Results and Discussions: The results found that three factors significantly affect student depression: rumination, self-esteem, and relationship with family. Rumination and self-esteem affect student depression with statistical significance at p&lt;.001 and the relationship with family has a significant effect on student depression at p&lt;.01. These factors can predict 54.70% of the depression of first-year undergraduate students at a university in Songkhla Province (R2 = .547, p &lt; .01). Research Implications: Factors affecting depression among first-year undergraduate students at a university in Songkhla Province included self-esteem, rumination, and relationships with family. Originality/Value: Therefore, the organizations or institutions involved in caring for students should use this as a basis for planning and monitoring depression, paying particular attention to promoting students' self-esteem, management of rumination, and building relationships with families to reduce factors affecting depression for first-year undergraduate students effectively.

The development process of urban agricultural networks to ensure urban food security in Hat Yai City, Songkhla Province, Thailand

ABSTRACT The purpose study was to examine the process, results, factors affecting the development process of the Hat Yai urban agricultural network for food security, Hat Yai District, Songkhla Province, Thailand, using qualitative research. Participant observation, in-depth interviews, group discussions, and inductive data analysis were conducted. Data were collected from thirty-one participants. The study found that the process of agricultural network development consists of three stages: network formation, seeking cooperation, learning and integration. The results are reflected at the individual, group, and network levels, linking them to the sustainable development dimension. The positive factors affecting the development process are the urban context, common goals, organisational culture, management, and building trust. The negative factors include the nature of Hat Yai urban residents in the context of developing countries, resource inadequacy, and public policy. The recommendations involve having holistic and targeted local public policy regarding urban agriculture to establish sustainable urban food security.

Coastal Evolution of Satingpra Peninsula, Songkhla Province: Implications for Understanding Songkla Lagoon Formation

Songkhla Lagoon has been studied for decades, but there is no clear evidence of its origin. As a barrier to the lagoon, the Satingpra Peninsula plays a crucial role in understanding its formation. Eleven sediment samples from sand ridges and tidal flats on the Satingpra Peninsular were collected and analysed for granulometry and geochronology. Both coarse-grained and fine-grained quartz-rich fractions were utilised to prepare samples of aliquots. The optically stimulated luminescence (OSL) dating was performed using the single-aliquot regenerative dose method for a determined (deposited) age. In addition, previous research, geological surveys and geochronological data were combined to explain their formation in this region. The OSL ages in the present study indicated that the late Holocene regression occurred between 0.36 and 3.27 ka (ka stands for 1,000 years). Integrated with previous studies, recorded ages dating back to the mid-Holocene sea level rise (ca. 6.5 ka) and the subsequent late-Holocene decline, indicate that both the old lagoon and middle beach ridge exhibit a sand ridge formation that runs parallel to the shoreline, extending from the south to the north. The middle sand, in this study, formed from about 3.02 to 1.5 ka ago resulting in the lagoon being isolated from the sea during that time. The lagoonal tide led the deposition as the present tidal flat from 3.3 to 1.7 ka. About 2.19 ka ago, the inner and middle ridges formed due to wind-driven processes influenced by a dry climate. This was followed by a continued sea level regression, leading to the formation of the outer ridge around 1.5 ka ago when the sea level was 1.4 m below the present sea level. However, it’s essential to consider this sea level data in relation to the tectonic and human-induced land motions in the surrounding area. HIGHLIGHTS OSL ages, based on average dose model at the Northern Satingpra Peninsula were 1.04 - 3.27 ka. The old sand ridges of the Satingpra Peninsula prograde northward after mid Holocene sea level highstand. Paleo sea level based on wind-wave sediments contact was 1.4 m lower than present day at 1.46 ka. GRAPHICAL ABSTRACT

Mechanical Wave Concepts of Thai High School Students: Comparing Learned and Unlearned Groups

Mechanical waves are one of the basic topics of physics; they are also the basis of various fields such as physical optics, geophysics, engineering, and medical physics. This study aims to investigate the mechanical wave concepts of Thai high school students. Participants were 150 grade 11 – 12 students from a high school in Songkhla Province, Thailand. They were divided into two groups. The first group consisted of 77 students – grade 12 who had already learned about mechanical waves, and the second group consisted of 73 students – grade 11 who had not yet learned about the topic. The main instrument was the Mechanical Wave Conceptual Survey (Tongchai, Sharma, Johnston, Arayathanitkul &amp; Soankwan, 2009) which consisted of 22 multiple-choice questions. The researchers also asked students to provide their reasoning for choosing their answers for each multiple-choice question. The survey was administered to students and they were given 50 minutes to complete it. Students’ answers and their reasoning were analyzed quantitatively and qualitatively. As a result, students’ responses were categorized into four main topics: 1) propagation; 2) superposition; 3) reflection; and 4) standing waves. Responses from both groups of students indicated the same misconceptions.

Examining the models of social entrepreneurs in Nam Noi community, Hat Yai district, Songkhla province

Examining the models of social entrepreneurs in Nam Noi community, Hat Yai district, Songkhla province

Factors Associated with Influenza-like Illness among Inmates in an All-male Prison, Songkhla Province, Thailand, 2023

On 9 Feb 2023, the Office of Disease Prevention and Control Region 12Songkhlawas informed of an influenza-like illness (ILI) cluster in an all-male prison in Songkhla Province. We investigated to identify the causative agent, possible sources and risk factors, and provide control measures. We conducted an active case finding by interviewing inmates and officers. Prison facilities and hygiene behaviors of inmates and officers were inspected. A retrospective cohort study was performed. Basic and effective reproductive numbers were estimated. The overall attack rate was 12.6% (474/3,648). Most cases were inmates from Wing C (80.4%). There were no severe cases or deaths. Of ten specimens tested, all were positive for influenza B/Victoria lineage, V1a.3a.2. Fifty-four percent of inmates had received influenza vaccine within the last 12 months. A mismatch between the viral strain in the vaccine and the one causing this outbreak likely contributed to the outbreak as the vaccine provided to the inmates was manufactured during the previous year's influenza season. Vaccine effectiveness was 36.2% against ILI. Having high-risk conditions (adjusted odds ratios (AOR) 2.83, 95% confidence interval (CI) 1.27–6.32) and sharing drinking glasses (AOR 2.02, 95% CI 1.21–3.36) were significant risk factors. The basic reproductive number for ILI in this outbreak was 1.36. The effective reproductive number ranged from 0.18–3.69. For effective management of ILI outbreaks in prisons, a continuous program of influenza vaccination following updated World Health Organization recommendations and a comprehensive surveillance system with rigorous respiratory illness management practices are suggested.

Self-protective behaviors of Thai village health volunteers in community engagement during a COVID-19 outbreak: interpretation using the health belief model

BackgroundVillage health volunteers (VHVs) engaging in community-based COVID-19 prevention and control measures played a key role in mitigating effects of the COVID-19 pandemic in Thailand. We conducted a cross-sectional questionnaire survey study to investigate factors affecting VHVs’ COVID-19 self-protective behaviors and social distancing in Songkhla Province during the first COVID-19 outbreak. Such information may help to understand how to support VHVs in future pandemics.MethodsA total of 152 VHVs from 13 sub-districts participated in the study, completing a 54-item questionnaire based on the Health Belief Model (HBM). The questionnaire included items assessing susceptibility, severity, benefits, barriers, self-efficacy, social distancing, and self-protective behavior. Stepwise multiple regression analysis determined which aspects of the HBM could explain VHVs’ self-protective behavior.ResultsThe VHV population sampled broadly reflected the main demographic characteristics of the local population, although VHVs were predominantly female. Self-protective behavior was significantly associated with VHVs’ role (higher perceived compliance for village leaders than non-leaders) but not with other demographic characteristics. Most VHVs reported high levels of self-efficacy (80.5%), adherence to social distancing measures (70.9%), and engagement in self-protective behavior (72.8%) against COVID-19. However, compliance with hand hygiene appeared to be suboptimal, suggesting room for improvement. Self-efficacy and perceived social distancing showed strong and moderate correlations with self-protective behavior against COVID-19 (r = 0.917, β = 0.819; and r = 0.561, β = 0.173 respectively; p < 0.001). The final HBM-based regression model accounted for 87.2% of the variance in VHVs’ self-protective behavior.ConclusionsThis study highlights the importance of VHVs’ self-efficacy for achieving self-protective behavior during a COVID-19 outbreak, and suggests that self-efficacy may help to overcome barriers that might otherwise hinder behaviors to mitigate against COVID-19. Policies that support self-efficacy should be implemented in any future pandemic, and steps to support VHVs with hand hygiene compliance and empower non-leaders to increase their self-protective behavior may also be helpful. Whilst the HBM provided a useful framework for interpretation, the final model was driven mainly by self-efficacy.

Uptake of COVID-19 vaccine among high-risk urban populations in Southern Thailand using the COM-B model.

The COVID-19 pandemic has imposed unprecedented suffering on social and individual levels worldwide. Vaccines against COVID-19 have been prioritized as a crucial strategy for ending the pandemic as well as minimizing its consequences. This study aimed to determine the uptake of COVID-19 vaccine among high-risk urban populations in Southern Thailand using the Capability, Opportunity, Motivation, and Behavior (COM-B) model. We conducted a web-based cross-sectional study in the Hat Yai district, Songkhla province in Southern Thailand, in September and October 2021. The questionnaire was composed of sections on sociodemographic characteristics, COVID-19 vaccination status, and COM-B constructs. We employed a multivariable logistic regression analysis to determine factors associated with the uptake of the COVID-19 vaccine. We set statistical significance at p < 0.05. In this study, females constituted 54.7% of the total participants (n = 358), and nearly half of the participants (45.8%) were in the younger age group (18-29). Of all the participants, 59.5% (95%CI: 54.2%-64.6%) received at least one dose of the COVID-19 vaccine. Factors associated with the uptake of COVID-19 vaccine and their adjusted OR (95% CI) were being married: 3.59 (2.06-6.24), having a graduate degree: 2.34 (1.38-3.96), gainfully employed: 3.30 (1.91-5.67), having a high level of opportunity: 2.90 (1.48-5.66), and having a high level of motivation: 2.87 (1.17-17.08). The uptake of COVID-19 vaccines was moderate in this population. Moreover, the results showed that the COM-B model is useful in predicting COVID-19 vaccine uptake. The findings of this study could be used to aid future public health interventions in any event of outbreaks similar to COVID-19 disease in Thailand and beyond.

Risk of circulatory diseases associated with proton-pump inhibitors: a retrospective cohort study using electronic medical records in Thailand.

Proton-pump inhibitors (PPIs) are prescribed to treat gastric acid-related diseases, while they may also have potential risks to population health. Recent studies suggested that a potential mechanism explaining the association between PPIs and cardiovascular diseases (CVD) includes the inhibition of the nitrate-nitrite-nitric oxide (NO) pathway. However, previous observational studies showed controversial results of the association. In addition, the inhibition of the NO pathway due to PPIs use may lead to peripheral vascular diseases (PVD); however, none of the studies explore the PPI-PVD association. Therefore, this study aimed to evaluate the association of PPIs with circulatory diseases (CVD, ischemic strokes or IS, and PVD). We conducted a retrospective hospital-based cohort study from Oct 2010 to Sep 2017 in Songkhla province, Thailand. PPIs and histamine 2-receptor antagonists (H2RAs) prescriptions were collected from electronic pharmacy records, while diagnostic outcomes were retrieved from electronic medical records at Songklanagarind hospital. Patients were followed up with an on-treatment approach. Cox proportional hazard models were applied to measure the association comparing PPIs vs H2RAs after 1:1 propensity-score-matching. Sub-group analysis, multi-bias E-values, and array-based sensitivity analysis for some covariates were used to assess the robustness of associations. A total of 3,928 new PPIs and 3,928 H2RAs users were included in the 1:1 propensity score-matched cohort. As compared with H2RAs, the association of PPIs with CVD, IS, and PVD, the hazard ratios were 1.76 95% CI = [1.40-2.20] for CVD, 3.53 95% CI = [2.21-5.64] for ischemic strokes, and 17.07 95% CI = [13.82-76.25] for PVD. The association between PPIs and each outcome was significant with medication persistent ratio of over 50%. In addition, the association between PPIs and circulatory diseases was robust to unmeasured confounders (i.e., smoking and alcohol). PPIs were associated with circulatory diseases, particularly ischemic strokes in this hospital-based cohort study, whereas, the strength of associations was robust to unmeasured confounders.