Showing papers in "Southeast Asian Journal of Tropical Medicine and Public Health in 2016"

Leptospirosis incidence and mortality in malaysia.

Abstract: Leptospirosis is endemic in Southeast Asia, Central and South America, the Caribbean, and Oceania. Malaysia was categorized as a probable endemic country without any available data. Thus, this study was conducted to determine incidence, case fatality rate and mortality rate of leptospirosis. Leptospirosis is a notifiable disease in Malaysia since 2010 whereby probable or confirmed cases must be notified to relevant health district office. There were 3,665 and 4,457 probable and laboratory confirmed leptospirosis cases notified in 2012 and 2013, respectively. In the 2-year period, the most common age group of patients was 19 years old or less (23.3%) with male:female ratio of 2.61:1. Students consisted about 16.9% of patients, followed by agriculture-based or plantation workers (14.7%). Overall age-standardized incidence rate of leptospirosis in Malaysia for 2012 and 2013 was 29.02 per 100,000. Overall case fatality rate was 1.47% for 2-year period and overall age-standardized mortality rate was 0.45 per 100,000. Leptospirosis is an emerging public health concern in Malaysia and may pose a significant health impact and burden to the nation in the coming years if not well controlled.

Health literacy, medication adherence, and blood pressure level among hypertensive older adults treated at primary health care centers.

Abstract: We conducted this study to explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving health care services at Primary Health Care Centers in Sa Kaeo Province, Thailand. Six hundred hypertensive older adults had their blood pressure level recorded and were interviewed using questionnaires. Structural Equation Modeling (SEM) was used to determine the effect size, both direct and indirect, among factors. Almost half (48.7%) of studied subjects had inadequate health literacy, 98.3% had good medication adherence, and 80% had good blood pressure levels. The highest effect size on health literacy was literacy, followed by cognitive ability, and culture and society. Medication adherence was affected directly and indirectly by cognitive ability, literacy, and culture and society. Health literacy had not only a direct effect on medication adherence but was also the mediator. Finally, the highest effect size on blood pressure level was critical and communicative health literacy. These findings suggest that health literacy should be considered in the Health Literacy Program of the National Public Health Policy and Plan, Ministry of Public Health.

Nasopharyngeal carriage of streptococcus pneumoniae in healthy children under five years old in central lombok regency, indonesia.

Abstract: Colonization with Streptococcus pneumoniae is mostly symptomless, but can progress to respiratory or even systemic disease. We investigated nasopharyngeal carriage of Streptococcus pneumoniae in healthy children under five years of age in Central Lombok Regency, Indonesia. This cross sectional study was carried out in 2012 among 1,200 healthy children aged 2 to 60 months. A multiplex sequential PCR was employed to determine serotype of cultured S. pneumoniae and a disk diffusion method to assess susceptibility to antimicrobial drugs. S. pneumoniae was cultured from 554 children and the most frequent serotypes found were 6A/B (22% of pneumococcal strains), 19F (11%), 23F (10%), 15B/C (8%), and 19A and 14 (4% each). The majority of strains were still susceptible to clindamycin (97%), erythromycin (87%), chloramphenicol (81%), and penicillin (72%), with only 41% and 38% susceptible to tetracycline and sulfamethoxazole/trimethoprim, respectively. Continuous surveillance of S. pneumoniae carriage is important for future pneumococcal vaccination programs in Indonesia.

Overweight, obesity and associated factors among 13-15 years old students in the association of southeast asian nations member countries, 2007-2014.

Abstract: The aim of this study was to assess overweight or obesity and associated factors in school-going adolescents in the Association of Southeast Asian Nations (ASEAN) member countries. The analysis included 30,284 school children 13-15 years of age from seven ASEAN members participating in the Global School-based Student Health Survey (GSHS) between 2007 and 2013. The overall prevalence of overweight or obesity across seven ASEAN countries (excluding Brunei) was 9.9%, significantly higher in boys (11.5%) than in girls (8.3%). Among eight ASEAN countries, the highest prevalence of overweight or obesity was in Brunei Darus-salam (36.1%), followed by Malaysia (23.7%), and the lowest was in Myanmar (3.4%) and Cambodia (3.7%). Multivariate logistic regression analysis found that younger age, coming from an upper middle country, never been hungry, and not walking or biking to school were associated with overweight or obesity. In addition, among boys, having three or more servings of vegetables per day and having no close friends, and among girls, having fast foods two or more times per week, been victims of bullying and having peer support were additional factors associated with overweight or obesity. Increased strategies utilizing a number of the risk factors identified are needed to prevent and treat overweight or obesity in adolescents in ASEAN member countries.

Depression and its associated factors among secondary school students in malaysia.

Abstract: Research in the field of factors associated with depression among adolescents is lacking in Malaysia. The aims of the present study were to assess the current prevalence of depression and its related factors among secondary school students in Pasir Gudang, South Malaysia. In this cross sectional study, 2,927 secondary school students (13-17 years old) from urban areas were screened for symptoms of mental disorder as well as demographic and risk behaviors using a validated Depression, Anxiety and Stress Scale (DASS) 12 questionnaire. The majority of the respondents (53.8%) were Malay, of which 53.1% were female. Symptoms of mild depression were found in 33.2% of the respondents, while the prevalence of the symptoms of moderate, severe, and extremely severe depression was 21.5%, 18.1%, and 3.0%, respectively. Logistic regression suggested that participants who were Chinese or had a lower average grade were three times more likely to have depression, while those who came from a single-parent family were twice as likely to have this condition. This study indicated that academic performance and risk behaviors along with the demographic characteristics are important contributors to adolescent depression.

Prevalence of methicillin resistant staphylococcus aureus from nose and throat of patients on admission to medical wards of dr soetomo hospital, surabaya, indonesia.

Abstract: Epidemiological data of methicillin resistant Staphylococcus aureus (MRSA) carriage in Indonesian hospitals are still scarce. These data are required for health management of infectious diseases in order to control hospital MRSA. The carriage rate of MRSA in nose and throat of patients on admission to Dr Soetomo Hospital Surabaya, Indonesia was 8.1% of 643 patients, 5.4% from throat, 3.9% from nose and 1.2% from both sites. Prevalence of MRSA among patients admitted to surgical and non-surgical ward was not different (8.2% and 8.0%, respectively). Although MRSA prevalence in Indonesian hospitals is low compared to many other countries worldwide, appropriate health strategies will be needed to be implemented if this infection is to be controlled.

Physical activity, self-esteem, and quality of life among people with physical disability.

Abstract: Physical activity (PA) can improve health and quality of life (QOL) of healthy people. However, the association between PA and QOL among people with physical disability (PWPD) is inconclusive. This study was conducted to determine the relationships between factors including intensity of PA, activitiy in daily living (ADL), stress, and self-esteem that influences self-reported QOL among PWPD. The relationships were further explored using the in-depth interview method to find out whether the intensity of PA, stress, and self-esteem are related to QOL perception in PWPD. One hundred sixty PWPD aged 18-48 years who studied at a vocational school were enrolled. A mixed method case study was conducted: cross-sectional survey and in-depth interview. Five questionnaires, including the Barthel Index, Perceived Stress Scale (PSS), Rosenberg Self-Esteem Scale (RSES), and Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) were distributed. QOL was measured using the WHOQOL_BREF. Multiple linear regression was used to determine factors for QOL prediction. For in-depth interview, ten persons from each group (poor-to-fair and good QOL) volunteered to explore further about life satisfaction related to physical disability. One hundred forty-six (91%) subjects completed all questionnaires. One hundred fourteen (77%) reported poor-to-fair QOL. QOL was explained by self-esteem and ADL (adjusted R² 34.7%, p < 0.001) after adjusted for age, stress, and PA. Although PA could not explain QOL in PWPD, good QOL reported high activities (28.40 ± 30.20 MET hour/day) compared to poor and fair QOL (17.94 ± 22.06 and 21.70 ± 17.75 MET hour/day). Those who had good QOL reported that they were proud to be independent and did not feel inferior. PA participation among people with disabilities should therefore be encouraged.

Serotypes and antimicrobial resistance of salmonella enterica isolated from pork, chicken meat and lettuce, bangkok and central thailand.

Abstract: Food of animal origins, particularly pork and chicken meat, has long been recognized as major sources of human salmonellosis. There have been recent reports of human salmonellosis outbreaks due to consumption of leafy green vegetables such as lettuce. In this study, 120 (40 pork, 40 chicken meat and 40 lettuce) samples were randomly collected from retail markets in Bangkok and central Thailand during June to August 2015 for Salmonella serotype identification and antimicrobial susceptibility testing. Salmonella was found in 82%, 62% and 20% of pork, chicken meat and lettuce samples, respectively. The top 5 most common Salmonella serotypes were Panama (15%), Schwarzengrund (12%), Rissen, Anatum, and Stanley (11% each), Albany (9%), and Indiana (8%). A high percentage of Salmonella isolated from food of animal origin were resistant to multiple antimicrobial drugs, including ampicillin, chloramphenicol, nalidixic acid, sulfamethoxazole-trimethoprim, and tetracycline. From antibiogram pattern analysis, the most common serotypes constituted isolates that were multidrug resistant. The study indicates that Salmonella was still present in various kinds of food and that certain serotypes have become predominant, a phenomenon not previously reported in Thailand.

Phylogeny of angiostrongylus cantonensis in thailand based on cytochrome c oxidase subunit i gene sequence.

Abstract: Angiostrongylus cantonensis is an emerging infectious agent causing eosinophilic meningitis or meningoencephalitis in humans with clinical manifestation of severe headache. Molecular genetic studies on classification and phylogeny of A. cantonensis in Thailand are limited. This study surveyed A. cantonensis larvae prevalence in natural intermediate hosts across Thailand and analyzed their phylogenetic relationships. A total of 14,032 freshwater and land snails were collected from 19 provinces of Thailand. None of Filopaludina sp, Pomacea sp, and Cyclophorus sp were infected with Angiostrongylus larvae, whereas Achatina fulica, Cryptozona siamensis, and Megaustenia siamensis collected from Kalasin, Kamphaeng Phet, Phetchabun, Phitsanulok, and Tak Provinces were infected, with C. siamensis being the common intermediate host. Based on morphology, larvae isolated from 11 samples of these naturally infected snails preliminarily were identified as A. cantonensis. Comparison of partial nucleotide sequences of cytochrome c oxidase subunit I gene revealed that four sequences are identical to A. cantonensis haplotype ac4 from Bangkok and the other seven to that of A. cantonensis isolate AC Thai, indicating two independent lineages of A. cantonensis in Thailand.

Diagnostic test of sputum genexpert mtb/rif for smear negative pulmonary tuberculosis.

Abstract: The objective of this study was to evaluate the performance of the Gene-Xpert MTB/RIF sputum test for diagnosing pulmonary tuberculosis (TB) among patients sputum acid-fast bacillus (AFB) smear negative results in Thailand, a country with a high prevalence of pulmonary tuberculosis. We studied 151 patients who presented to Srinagarind Hospital, Khon Kaen, Thailand with a 2 week or more history of fever and/or cough and an abnormal chest radiograph between 2010 and 2014; these patients had at least 2 negative sputum AFB smear results. Of these, 76 were diagnosed as having either confirmed or probable pulmonary TB: the 32 confirmed cases were those with a positive sputum culture for Mycobacterium tuberculosis (MTB) and the 44 probable case were those with clinical and radiographic findings consistent with TB and who had a response to anti-TB therapy. Seventy-five cases were diagnosed as not having pulmonary TB. Of the 32 patients with a positive sputum culture for MTB, 26 had a positive GeneXpert MTB/RIF sputum test. Compared to sputum culture for MTB the GeneXpert MTB/ RIF test gave a sensitivity of 83.9% (95% CI: 66.3-94.5) and a specificity of 92.1% (95% CI: 83.6-97), a positive predictive value (PPV) of 81.3% (95% CI: 63.6-92.8) and a negative predictive value (NPV) of 93.3% (95% CI: 85.1-97.8). The GeneXpert MTB/RIF test had a fair sensitivity and specificity for diagnosing smear negative pulmonary TB. It may be useful for diagnosing pulmonary TB in patients with a negative sputum AFB smear. The assay is faster than culture and can detect rifampicin resistant strains of MTB.

Prevalence and factors influencing betel nut chewing among adults in west insein township, yangon, myanmar.

Abstract: Betel nut chewing can cause precancerous oral lesions and is common in Myanmar. We conducted a cross sectional study aimed to estimate prevalence and factors influencing betel nut chewing among 420 subjects aged ≥18 years in West Insein Township, Yangon, Myanmar in order to inform preventive health programs. The mean age of the study subjects was 45(±15) years. The overall prevalence of current betel nut chewing among study subjects was 55.2%. The mean age starting betel nut chewing was 29(±13) years, and the mean duration of chewing was 15(±13) years. The reasons given by study subjects for chewing betel nut included the addictive effect to betel nut, to release tension, to get rid of boredom and to stop smoking. Sixty-two point three percent of current betel nut chewers also chewed tobacco and 24.2% also smoked cigarettes. Factors significantly associated with betel nut chewing were male gender, current alcohol consumer, having no education or finishing primary or secondary school, having a low score regarding their attitude about the health effects of betel nut chewing, and having high score on interpersonal factors by family and peer pressure. Our results show a need to better educate the public about the health effects of betel nut chewing among the study population.

Assessing associations between caries prevalence and body mass index and nutritional data among children aged 6-12 years.

Abstract: The purpose of this cross sectional study was to examine associations between dental caries and body mass index (BMI) and diet in 6 to 12 year old children One hundred subjects were included in the study The number of decayed, missing and filled teeth (DMFT), height and weight were examined in each subject The primary caregiver for each subject completed a diet questionnaire The data were analyzed using a chi-square test, a Fisher's exact test, a Kruskal-Wallis test and an independent sample t-test Associations between variables and caries were examined using a Spearman's correlation with significance set at a p-value < 005 The mean age, BMI and number of DMFT were 921 ± 21 years old, 1852 ± 48 kg/m2, and 403 ± 436, respectively Sixty-seven percent of subjects had a normal BMI, 24% were overweight, and 9% were underweight Twenty-three percent of subjects had no dental caries (DMFT score = 0), 23% had moderate to many caries (DMFT scores = 31-69), 22% had very many caries (DMFT scores ≥ 7), 17% had few caries (DMFT scores < 3) Overweight and underweight children did not have a significantly different number of DMFT than normal weight children The number of DMFT did not correlate with reported sugar (R = -0128) or carbohydrate (R = -0174) consumption There was no significant association between BMI and dental caries and amount of sugar and carbohydrate consumption and dental caries

Evaluation of a commercial stool concentrator kit compared to direct smear and formalin-ethyl acetate concentration methods for diagnosis of parasitic infection with special reference to opisthorchis viverrini sensu lato in thailand.

Abstract: Opisthorchiasis and cholangiocarcinoma (CCA) are major public health problems in Thailand and countries in the lower Mekong Subregion. Elimination of opisthorchiasis will be an important step toward the prevention, control and reduction of CCA. In order to achieve this goal, a sensitive and robust diagnostic method is required to identify people with current Opisthorchis viverrini sensu lato infection as the parasite is a group 1 carcinogen believed to be an etiology of CCA. To date, sensitive parasitological methods, such as formalin-ethyl acetate concentration technique (FECT) is preferred, but it is not practical in a remote primary care setting. In this study, we evaluated the diagnostic accuracy of a commercial stool concentrator kit with that of a direct simple smear method and a modified FECT. In diagnosing parasite infection and opisthorchiasis, the commercial kit had greater sensitivity (43.8-58.5%) than direct smear method (12.5-31.7%), but was less sensitive than FECT (73.2-75%). In a separate sample population, similar results were obtained when comparing the diagnostic accuracy of the commercial kit and FECT. However, the commercial kit was more effective in a field setting than FECT, and had better accuracy than direct smear method, which suggests that the kit could have potential utility in epidemiological studies and control programs of opisthorchiasis, as well as other parasitic infections. The design of the self-contained one-tube kit plus its long storage time after sample preparation provides a considerable advantage over other methods, such as direct or Kato thick smear method, under similar field conditions.

Children’s eating behavior questionnaire: factorial validation and differences in sex and educational level in thai school-age children.

Abstract: The purposes of this study were to test the validity of the Thai version Children’s Eating Behavior Questionnaire (CEBQ) and to describe the variation in eating style among school-age children. This school-based, cross sectional study was conducted in five primary public schools selected from Bangkok and the three regions of Thailand (North, Northeast, South). Six hundred and eighty students from the first and fourth grade classes were included in our study. The CEBQ was used to assess the eating styles among these children. Factor analysis revealed an eight-factor solution accounted for 57.1% of the total variance. Most of the scale items loaded as expected and their factor loadings were comparable to those obtained from the original study in England. The reliability coefficients are all within acceptable ranges (more than 0.7), with the exceptions of the subscales of ‘slowness in eating’ and ‘emotional under eating’ with the coefficients of 0.64 and 0.69, respectively. There were some significant differences in eating behaviors between sex and educational level. Boys scored higher on ‘enjoyment of food’ compared with girls (p<0.05), as well as on ‘desire to drink’ (p<0.05). Children in Grade 1 scored higher on ‘satiety responsiveness’ (p<0.001) and ‘slowness in eating’ (p<0.001) compared with those in Grade 4. This study supported the use of CEBQ as an appropriate tool for measuring the eating behaviors among Thai school-age children.

Antibiotic resistance and mortality in children with nosocomial bloodstream infection in a teaching hospital in indonesia

Abstract: Nosocomial infection is a major problem in hospitals worldwide. Understanding patterns of bacterial etiology and antibiotic susceptibility are important factors to combating nosocomial infection. Among children with nosocomial bloodstream infection (BSI), we identified pathogens and determined antibiotics resistance patterns and mortality rates for antibiotic-susceptible and multidrugresistant (MDR) infection in patients with nosocomial BSI in pediatric wards and PICU at Dr Sardjito Hospital, Indonesia during December 2010 to February 2013. Of 174 isolates from 170 patients, 168 pathogens were bacteria, of which 148 were gram-negative. Pseudomonas aeruginosa, Klebsiella spp, Enterobacteriaceae, Acinetobacter baumanii, and Escherichia coli was found in 55%, 6%, 4%, 1%, and <1%, respectively of the isolates. Imipenem, amikacin, ciprofloxacin, and ceftazadime had the highest sensitivity to nosocomial pathogens at 86%, 84%, 84%, and 75%, respectively. Eleven patients had MDR-infections, 7 of whom died. Among 153 patients infected with bacteria resistant to <3 classes of antibiotics (non-MDR), mortality was 40%, and among 4 patients with fully drug-susceptible sepsis only one died. Thus, substantial mortality was observed in children with nosocomial-BSI, particularly with MDR pathogens. Given the further high risk of resistance with wider use of carbapenems, third generation cephalosporins and flouroquinolones, prevention should be given highest priority in combating hospital-acquired infection.

Risk factors for latent tuberculosis infection among health-care workers in northeastern thailand.

Abstract: Health-care workers (HCWs) are a high-risk population for acquiring Mycobacterium tuberculosis infection. Understanding the risk factors for latent tuberculosis infection (LTBI) could provide information to facilitate an appropriate tuberculosis (TB) control program. We aimed to determine the prevalence of, and risk factors for LTBI among HCWs in northeastern Thailand. Between 1 November 2013 and 30 September 2015, we examined 112 HCWs at Srinagarind Hospital, Khon Kaen Province in northeastern Thailand using the QuantiFERON®-TB Gold In-Tube (QFT) assay. Twenty-one [18.8%; 95% confidence interval (CI): 11.5- 26.0%] HCWs had a positive QFT result — all of whom were determined to have LTBI. The exposure risks and demographic data obtained from a questionnaire were compared between the 21 subjects who had a positive QFT assay and the 91 subjects who had a negative QFT assay. Multivariate analysis showed factors significantly associated with a positive QFT assay were: age ≥30 years (OR=18.88; 95%CI: 1.52-234.36), having worked as a nurse (OR=2.78; 95%CI: 1.19-6.49), having been employed at that job for ≥10 years (OR=8.78; 95%CI: 1.26-61.29) and having been exposed to known TB patients (OR=13.32: 95%CI: 1.61-110.04). Appropriate guidelines need to be developed, especially for these at-risk workers to prevent LTBI. These high-risk workers should also be considered for regular TB screening.

Prevalence of hypertension, anemia, asymptomatic urinary tract infection, syphilis, hiv and hepatitis b virus infectionamong pregnant women attending an antenatal clinic at a rural hospital in southern ethiopia.

Abstract: Antenatal care (ANC) is provided to prevent, diagnose early and treat pregnant women for a variety of diseases The objective of this study was to determine the seroprevalences of syphilis, human immunodeficiency virus (HIV) and hepatitis B virus (HVB) and asymptomatic urinary tract infections and the prevalence of hypertension and anemia among pregnant women attending the antenatal clinic at Gambo Rural Hospital in southern Ethiopia The following tests were conducted among study subjects: hemoglobin (Hgb) level, rapid plasma reagin (RPR) for syphilis, anti-HIV antibodies, hepatitis B surface antigen (HBsAg) and urine analysis A total of 574 pregnant women were included in this study The mean age of the participants was 257 (SD: 48) years old; 882% were living in urban areas and 118% in rural areas Sixty-seven point two percent of participants began their attended care during the second trimester of their pregnancy Overall, anemia (Hgb < 11 mg/dl) was present in 89% (95% CI: 69-116): severe anemia (Hgb < 7 mg/dl), moderate anemia (Hgb 7-89 mg/dl) and mild anemia (Hgb 9-109 mg/dl) were found in 05% (95% CI: 02-15), 02% (95% CI: 003-09) and 82% (95% CI: 62-108) The overall prevalence of hypertension was 12% (95% CI: 006-26) This was significantly higher (p=001) in the third trimester (32%) than in the second (05%) and first (0%) trimesters The prevalence of preeclampsia, defined by have hypertension and proteinuria, was 07% (95% CI: 03-18) Asymptomatic urinary tract infection (having ≥10 white blood cells /high power field in the urine) was present in 127% of participants (95% CI: 100-155) The RPR test was positive in two patients (03%; 95% CI: 01-13) The prevalences of positive test for HBsAg and HIV-1 were 23% (95% CI: 13-38) and 02% (95% CI: 003-09), respectively No HIV-2 cases were detected Our data show relatively low prevalences of anemia, hypertension, urinary tract infection, syphilis, HIV, and hepatitis B virus infections among study subjects at a rural antenatal clinic in southern Ethiopia

FACTORS ASSOCIATED WITH EXTENDED SPECTRUM β-LACTAMASE PRODUCING ESCHERICHIA COLI IN COMMUNITY-ACQUIRED URINARY TRACT INFECTION AT HOSPITAL EMERGENCY DEPARTMENT, BANGKOK, THAILAND.

Abstract: Urinary tract infection or UTI is most commonly caused by Escherichia coli. This study investigated the prevalence of and risk factors for extended spectrum β-lactamase-producing (ESBL) E. coli in community-acquired UTI presenting at the Emergency Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. A retrospective review was conducted over a one-year period (2014) of case histories of patients over 15 years of age diagnosed with (n = 159) and without culture-positive (n = 249) ESBL E. coli. Backward stepwise multivariate logistic regression analysis revealed four independent risk factors for UTI caused by ESBL E. coli, namely, urinary catheter use, previous UTI in which ESBL E. coli was present, and previous use of antibiotics cephalosporin and penicillin. This information should be useful in devising future public health prevention and control programs for ESBL E. coli-associated community-acquired UTI.

Prevalence of trematode larvae in intermediate hosts: snails and fish in ko ae sub-district of khueang nai, ubon ratchathani province, thailand.

Abstract: Ko Ae Sub-district of Khueang Nai, Ubon Ratchathani Province, Thailand is located in an endemic area for Opisthorchis viverrini and other fish-borne zoonotic trematodes (FZT) infection. This study shows the status in Ko Ae Sub-district of FZT infection based on availability of intermediate hosts and necessary requirements for the transmission of FZT. A cross-sectional survey of intermediate hosts of FZT, including Bithynia siamensis goniomphalos and cyprinoid fish, was conducted from April 2013 to December 2014. Examination of 1,000 snails revealed 3.4% were infected with trematode cercariae, with a density of infection greater than 100 cercariae per infected snail. Six groups of morphologically-distinguishable trematode cercariae were identified, namely, cystophorous, echinostome, furcocercous, mutabile, parapleurolophocercous, and xiphidio, the latter being the most predominant type. Among 250 cyprinoid fish samples with metacercariae present at their caudal fins and examined for FZT by pepsin digestion, metacer- cariae of Haplorchis taichui, H. pumilio, and Centrocestus formosanus were found. Unidentified metacercariae collected from fish caudal fins were subsequently shown using a PCR-based assay to be C. formosanus. No infection by O. viverrini in the intermediate hosts, Bithynia siamensis goniomphalos and cyprinoid fish was evident. The study provides new information regarding trematode larvae infection in the primary and secondary intermediate hosts of FZT in this area of Thailand.

Burnout and occupational participationamong turkish dental students.

Abstract: The aim of the present study was to investigate the prevalence of burnout and occupational participation limitation among dental students in a dental school in Turkey. Four hundred fifty-eight dental students (females=153; males=305) were included in the study. The age range varied from 17-to-38 years. Maslach Burnout Inventory-Student Version (MBI-SV) and Canadian Occupational Performance Measure (COPM) were used to gather data. Descriptive analyses, t-test, and Kruskall-Wallis test for independent groups were used for data analyses. The results indicated that 26% of all the students have burnout in terms of emotional exhaustion (25%), cynicism (18%), and academic efficacy (14%). The results showed that burnout is statistically significant in relation to demographics (p<0.05). Twenty-four percent of the students showed considerably decreased occupational performance and satisfaction scores, which suggested occupational participation limitations. Occupational performance and satisfaction scores were inversely correlated with emotional exhaustion and cynicism, while directly correlated with reduced academic efficacy (p<0.05). The results of the present study indicates that burnout and occupational participation limitation can be seen among dental students. Students with burnout may also have occupational participation limitation. Enriching dental education programs with different psychological strategies may be useful for education of healthy dentists and improve the quality of oral and dental health services.

Prevalence of intestinal protozoan infections among children in thailand: a large-scale screening and comparative study of three standard detection methods.

Abstract: A significant impact of intestinal parasitic infections on public health has mostly been neglected. Parasitic infections are one of risk factors for malnutrition in children. In this study, a large-scale screening of intestinal parasitic infections among children in 16 schools in 6 regions of Thailand was performed. In addition, we compared sensitivity of methods currently employed for detection of intestinal parasitic infection. Fecal samples collected from 1,909 students were examined for intestinal parasites by simple smear, formalin-ethyl acetate concentration (FECT), and Locke-egg-serum (LES) medium culture methods. Seven hundred and thirteen samples were infected with at least one intestinal parasite. The highest prevalence (82.8%) was found in Kanchanaburi Province, western Thailand. Blastocystis spp was the most common (32.8%) parasite, followed by Giardia duodenalis (4.2%), Ascaris lumbricoides (3.6%), hookworms (1.6%), Entamoeba histolytica (0.7%), Trichuris trichiura (0.5%), Enterobius vermicularis (0.5%), Strongyloides stercoralis (0.4%), minute intestinal flukes (0.2%), and Taenia spp (0.1%). Mixed parasitic infections were found in 121 students. In a comparative study, we found that FECT was more sensitive (74.0%) than simple smear (55.0%) method for detecting helminths. However, sensitivity of these two methods is not significantly different for protozoan detection (31.2% by simple smear and 33.5% by FECT). LES culture technique was the most sensitive method (77.5%) for detecting Blastocystis spp. Our results indicate a high prevalence of intestinal parasite infection among Thai students. More sensitive methods should be developed for a large-scale screening of intestinal protozoan infection.

Schistosomicidal activity of the crude extract of artocarpus lakoocha.

Abstract: Puag-Haad is a traditional anthelmintic drug used to treat taeniasis in Thailand and Lao PDR. It is derived from the aqueous extract of the plant Artocarpus lakoocha. We investigated the in vitro anthelmintic properties of Puag-Haad against Schistosoma mansoni. Adult worms were incubated in M-199 medium containing 250, 500 and 750 μg/ml of Puag-Haad or praziquantel (PZQ) at a concentration of 175 μg/ml for 3, 6, 12 and 24 hours. The relative motility (RM value), survival index (SI) and tegument alterations seen under scanning electron microscope were assessed at each incubation time. The results showed the crude extract of A. lakoocha at a concentration of 250 μg/ml was more effective in causing damage than PZQ at a concentration of 175 μg/ml using RM and SI values. The major target organ affected by Puag-Haad was the tegument. The damage was greater at higher concentrations of the crude extract. It is likely tetrahydroxystilbene (THS), the main compound in Puag-Haad, caused the damage. THS could be a future candidate as a schistosomal drug. Further studies are needed to explore its mechanism, efficiency and safety in vivo.

Rate of adherence to and factors associated with methadone maintenance treatment program (mmtp) compliance among injecting drug use patients in nepal.

Abstract: We conducted a survey to determine the rate of adherence to and factors associated with compliance with a methadone maintenance treatment program (MMTP) among injecting drug users in Nepal. We conducted face-to-face structured interviews with 165 methadone treatment patients aged 20-54 years during 5-20 April 2015. Data analysis included percentages, means, standard deviations, chi-square tests and multiple logistic regression analysis. Seventy-two point one percent of respondents had good adherence to a MMTP. Multiple logistic regression with 81.8% prediction showed respondents without a previous history of relapse were 2.7 times more likely to adhere to the MMTP than those with a history of relapse [Adjusted OR = 2.772; 95% Confidence interval (CI): 1.163-6.605]. Respondents with a good knowledge of the MMTP 9.4 times more likely to be adherent to the MMTP than those with a poor to fair knowledge of the MMTP (Adjusted OR = 9.464; 95% CI: 3.873-23.126). The likelihood of MMTP adherence was 4.5 times more likely when methadone treatment services were available than those where the availability of methadone treatment services were low to moderate (Adjusted OR = 4.553; 95% CI: 1.883-11.008). Knowledge and availability of MMTP need to be improved in the study area in Nepal.

Comparison of medical costs and care of appendectomy patients between fee-for-service and set fee for diagnosis-related group systems in 20 chinese hospitals.

Abstract: The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

A study of the association between selenium and cardiovascular disease in lampung, indonesia.

Abstract: Selenium deficient areas have been associated with a higher prevalence of cardiovascular disease in some countries. In this study, we investigated the correlation between cardiovascular disease prevalence and selenium concentration in paddy soil and rice grains, the main staple food in Lampung, Indonesia. Paddy soil and rice samples (n(s) = 35) from eight regencies (n(d) = 8) in Lampung were analyzed for selenium content. The prevalences of heart disease, stroke, and hypertension in those regencies were obtained from the Ministry of Health of Indonesia. The Shapiro-Wilk's test was used to examine the data distribution. The Pearson's correlation was used to examine the correlation between cardiovascular disease prevalence and selenium concentration in the paddy soil and rice grains. Heart disease prevalence was negatively correlated with the selenium concentration in the paddy soil (r = -0.77, p = 0.02) and rice grain (r = -0.71, p = 0.05). A negative correlation was seen for stroke prevalence and selenium concentration in paddy soil (r = -0.76, p = 0.02). Hypertension prevalence was negatively correlated with the selenium concentration in the rice grains (r = -0.83, p = 0.01). These findings suggest that the selenium concentration in paddy soil and rice grains in the Lampung area may play a role in the fact the area has the lowest cardiovascular disease prevalence in Indonesia. Keywords: selenium, cardiovascular diseases, paddy soil, rice grain, Indonesia

Nocardia beijingensis brain abscess in an hiv infected patient: a first case report and literature review.

Abstract: We report here brain abscesses caused by Nocardia beijingensis in a 59-year-old-Thai male with human immunodeficiency virus (HIV) infection presenting with progressive right sided hemiparesis. A computed tomography scan of the brain showed multiple brain abscesses. A stereotactic brain biopsy and 16S rRNA sequencing showed Nocardia beijingensis. The patient was treated with trimethoprim-sulfamethoxazole and recovered completely. As far as we are aware, this is the first reported case of a brain abscess in an HIV infected patient due to Nocardia beijingensis.

Prevalence and risk factors for cardiac iron overload and cardiovascular complications among patients with thalassemia in northern thailand.

Abstract: Cardiovascular complications are the most common cause of death among thalassemia patients in Thailand. In this study, we evaluated the prevalence of cardiac iron overload, cardiovascular complications and the associated risk factors. The information obtained will serve as a guidance for surveillance, prevention and early treatment of the complications. We conducted a cross sectional study of Thai patients with thalassemia attending Chiang Mai University Hospital, Thailand. Cardiac T2* magnetic resonance imaging (CMR T2*) was used to evaluate the myocardial iron deposition and echocardiography was used to evaluate the cardiac function and to identify pulmonary hypertension. Ninety-one patients were included in the study; 64% females with a median age of 31 (16-75) years. Of the total study subjects, 49% had homozygous β thalassemia, 32% had β thalassemia/Hb E disease, and 19% had Hb H disease. Half the participants were transfusion-dependent and 84% had received iron chelation. The CMR T2* showed cardiac iron overload in 10 patients (11%). The maximum ferritin level in the previous 3 years was higher among the patients with cardiac iron overload (6,310 ng/ml) than among the patients without cardiac iron overload (3,352 ng/ml) (p=0.001). Twenty-one patients (23%) had cardiovascular complications. Cardiomyopathy was seen in 8% of patients [17% in patients with transfusion-dependent thalassemia (TDT) and none in patients with non-transfusion-dependent thalassemia (NTDT)] and pulmonary hypertension in 15% of patients (14% in patients with TDT and 16% in patients with NTDT). TDT and cardiac iron overload were significantly associated with cardiomyopathy. No risk factors were found to be significantly associated with pulmonary hypertension. In summary, cardiac iron overload and cardiomyopathy are important complications in TDT while pulmonary hypertension is seen in both TDT and NTDT. Iron chelation and monitoring of serum ferritin level will prevent cardiac iron overload and cardiomyopathy. Interval monitoring with echocardiography will help with early identification of the cardiac complications.

Ambient pm₁₀ and pm₂.₅ concentrations at different high traffic-related street configurations in bangkok, thailand.

Abstract: This study investigated the potential exposure levels of PM₁₀ and PM₂.₅ at two different road configuration sites in Bangkok, Thailand: covered and open roadside areas. One hundred samples were collected together with the meteorological data: temperature, relative humidity, wind speeds, and solar radiation. Spearman rank correlation was used to analyze the relationships between these factors, and PM₁₀ and PM₂.₅ levels at different roadside areas. The PM₁₀ and PM₂.₅ levels at the covered area were 1.72 and 1.60 times more than those levels at open area were. The mean levels were found to be 154.59 and 94.42 µg/m³ at the covered areas, and 89.43 and 58.69 µg/m³ at the open areas. These results suggested that a higher potential risk for workers, such as street vendors, was the exposure to particulate matters at the covered areas compared to open areas. Wind speeds and relative humidity were significantly negative-related influencing factors on PM₁₀ and PM₂.₅ levels at the open area, but not significantly related for the covered areas.

Survey of house rat intestinal parasites from surabaya district, east java, indonesia that can cause opportunistic infections in humans.

Abstract: The purpose of this study was to investigate the prevalence of house rat zoonotic intestinal parasites from Surabaya District, East Java, Indonesia that have the potential to cause opportunistic infection in humans. House rat fecal samples were collected from an area of Surabaya District with a dense rat population during May 2015. Intestinal parasites were detected microscopically using direct smear of feces stained with Lugol's iodine and modified Ziehl-Neelsen stains. The fecal samples were also cultured for Strongyloides stercoralis. Ninety-eight house rat fecal samples were examined. The potential opportunistic infection parasite densities found in those samples were Strongyloides stercoralis in 53%, Hymenolepis nana in 42%, Cryptosporidium spp in 33%, and Blastocystis spp in 6%. This is the first report of this kind in Surabaya District. Measures need to be taken to control the house rat population in the study area to reduce the risk of the public health problem. Keywords: zoonotic intestinal parasites, opportunistic infection, house rat, densely populated area, Indonesia

Comparison of growth, infections and feeding habits among formula-fed infants starting complementary feeding at 4 to 6 months old with those starting at 6 months old.

Abstract: The World Health Organization recommends starting complementary feeding among infants beginning at 6 months old, as opposed to 4 to 6 months old. We prospectively studied 21 formula-fed infants beginning complementary feeding at 4 to 6 months old and compared them with 20 formula-fed infants starting feeding at 6 months old to determine difference in growth, number of infections and feeding habits. The studied infants were each enrolled at age 4 months. The decision as to which group the infants were classified into was based on the parental decision as to when to start complementary feeding. Initial demographic data were obtained for each subject. Growth, infections, and feeding habit data were recorded. No significant differences in growth were detected between the 2 groups. Respiratory infections at age 10 to 12 months were more common among children who began complementary feeding later. By age 12 months, the percentages of subjects who were bottle feeding and night feeding, and new food acceptance were not different from each other, but those who began complementary feeding at age 6 months were less picky eaters. By 15 months old, those who began complementary feeding at age 6 months had less bottle feeding and better food acceptance. In conclusion, for formula-fed infants, age of onset of complementary feeding was not associated with infant growth or infection rates. However, some feeding habits differed between the two groups. It is unclear if the age of introducing complementary feeding caused these differences or was merely associated with these differences.