School-based helminthiases control: I. A baseline study of soil-transmitted helminthiases in Nakhon Si Thammarat Province,Thailand

A baseline study of soil-transmitted helminthiases was carried out in Nakhon Si Thammarat Province, southern Thailand. The study sites were Wat Krou Chou Primary School and nearby villages in Sichon district, and Wat Thang Phoon Primary School and nearby villages in Chalerm Phrakiat District. Surveys of the schoolchildren's stools were conducted by the Kato-Katz technique. The results showed that 23.7% of schoolchildren in Wat Krou Chou and 24.7% of those in Wat Thang Phoon were infected with soil-transmitted helminths, with a 24.1% overall infection rate. The major infection was hookworm (22.2% and 19.6%) and the minor one was trichuriasis, (2.9% and 8.7% respectively). The intensity of infection was similar in both schools, 85.7% and 90.2% respectively for light intensity hookworm. Schoolchildren with hookworm infection were not anemic. The hemoglobin value of children with hookworm infection was not significantly different from that of uninfected children. Data regarding the health behavior of children's parents in both schools were reported.     

Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case-control study

Objective To assess the protective effect of depot-medroxyprogesterone acetate (DMPA) on uterine leiomyomas. DMPA has been widely used in Thailand for many years; uterine leiomyomas is the most common female tumour.
Design A multicentre hospital-based case-control study.
Setting University and regional hospitals.
Patients Cases were all newly diagnosed patients with pathologically proven diagnosis of uterine leiomyomas, who were admitted to eight hospitals in three regions of Thailand from January 1991; to June 1993;. Three controls matched with cases by sex, age within five years and date of admission within three months were recruited.
Main outcome measures Information on socio-demographic factors, personal and family history, current disease, reproductive and contraceptive history was collected from cases and controls by interview.
Results There were 910 cases and 2709; controls. After univariate and unconditional multiple logistic regression analysis, risk factors associated positively with uterine leiomyomas are tubal ligation, family history of uterine leiomyomas, higher education, obesity and abortion. In contrast, DMPA, use of oral contraceptives, higher parity and smoking are associated with a lower relative risk suggesting that they have a protective effect against uterine leiomyomas. This causative relation is further strengthened by the strong duration-response relation between DMPA and uterine leiomyomas. This protection may persist for more than 10 years after the last dose.
Conclusion We have demonstrated a strong, duration dependent protective effect of DMPA against uterine leiomyomas.     

Prediction of percentage body fat in rural thai population using simple anthropometric measurements

OBJECTIVE: To develop and validate sex-specific equations for predicting percentage body fat (%BF) in rural Thai population, based on BMI and anthropometric measurements. RESEARCH METHODS AND PROCEDURES: %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. RESULTS: 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. DISCUSSION: 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.     

A comparative study of monophasic oral contraceptives containing either drospirenone 3 mg or levonorgestrel 150 microg on premenstrual symptoms

This open-label randomized study compared the effects of two combined oral contraceptives (OCs) containing 3 mg drospirenone (DRSP)/30 microg ethinyl estradiol (EE) with 150 microg levonorgestrel (LNG)/30 microg EE on the prevalence and changes from baseline of premenstrual symptoms after six cycles. The symptoms were measured using the Women's Health Assessment Questionnaire. Subjects receiving DRSP/EE had fewer prevalence of premenstrual symptoms than those receiving LNG/EE after six cycles. A significantly lower score of negative affect category in the premenstrual phase was demonstrated in those receiving DRSP/EE more than LNG/EE. The DRSP/EE group showed a greater improvement of mean scores from baseline in the premenstrual phase compared with those who received LNG/EE on negative affect as seen in the items on anxiety, irritability, feeling sad or blue and weight gain in the category of water retention. In conclusion, OCs containing DRSP have beneficial effects in reducing the prevalence of premenstrual symptoms especially the symptoms of negative affect and weight gain, particularly when compared to LNG/EE. Hence, it should be recommended for women who are susceptible to these adverse symptoms.     

Atypical avian influenza (H5N1)

We report the first case of avian influenza in a patient with fever and diarrhea but no respiratory symptoms. Avian influenza should be included in the differential diagnosis for patients with predominantly gastrointestinal symptoms, particularly if they have a history of exposure to poultry.     

Antinociceptive activity of the methanolic extract of Kaempferia galanga Linn. in experimental animals

Kaempferia galanga Linn. (Zingiberaceae) presents many chemical constituents of the volatile oil extracted from the rhizome. The rhizome of Kaempferia galanga is used by people in many regions for relieving toothache, abdominal pain, muscular swelling and rheumatism. In this study we investigated the antinociceptive activity in mice and rats using acetic acid-induced writhing, formalin, hot plate and tail-flick tests. The extract at test doses of 50, 100 and 200 mg/kg, p.o. clearly demonstrated antinociceptive activity in all tests. This activity was dose- and time-dependent. The extract administered at 200 mg/kg, p.o. had a stronger antinociceptive effect than aspirin (100 mg/kg, p.o.) but less than morphine (5 mg/kg, s.c.). Naloxone (2 mg/kg, i.p.) abolished the antinociceptive action of both morphine (5 mg/kg, s.c.) and the extract (200 mg/kg, p.o.) in a similar manner. In conclusion, the methanol extract of Kaempferia galanga markedly demonstrated the antinociceptive action in experimental animals. The antinociceptive mechanisms appear to be both peripherally and centrally mediated actions and the opioid receptors are probably involved. Therefore, our studies support the use in traditional medicine of Kaempferia galanga against pain caused by various disorders.     

Influenza viruses in Thailand: 7 years of sentinel surveillance data, 2004-2010

Please cite this paper as: Chittaganpitch et al. (2012) Influenza viruses in Thailand: 7 years of sentinel surveillance data, 2004–2010. Influenza and Other Respiratory Viruses 6(4), 276–283. Background The re‐emergence of avian influenza A (H5N1) in 2004 and the pandemic of influenza A (H1N1) in 2009 highlight the need for routine surveillance systems to monitor influenza viruses, particularly in Southeast Asia where H5N1 is endemic in poultry. In 2004, the Thai National Institute of Health, in collaboration with the US Centers for Disease Control and Prevention, established influenza sentinel surveillance throughout Thailand. Objectives To review routine epidemiologic and virologic surveillance for influenza viruses for public health action. Methods Throat swabs from persons with influenza‐like illness and severe acute respiratory illness were collected at 11 sentinel sites during 2004–2010. Influenza viruses were identified using the standard protocol for polymerase chain reaction. Viruses were cultured and identified by immunofluorescence assay; strains were identified by hemagglutination inhibition assay. Data were analyzed to describe frequency, seasonality, and distribution of circulating strains. Results Of the 19 457 throat swabs, 3967 (20%) were positive for influenza viruses: 2663 (67%) were influenza A and able to be subtyped [21% H1N1, 25% H3N2, 21% pandemic (pdm) H1N1] and 1304 (33%) were influenza B. During 2009–2010, the surveillance system detected three waves of pdm H1N1. Influenza annually presents two peaks, a major peak during the rainy season (June–August) and a minor peak in winter (October–February). Conclusions These data suggest that March–April may be the most appropriate months for seasonal influenza vaccination in Thailand. This system provides a robust profile of the epidemiology of influenza viruses in Thailand and has proven useful for public health planning.     

The cost of influenza in Thailand

The cost of influenza in less wealthy tropical countries is needed to inform national vaccine policy decisions. Between September 2003 and August 2004, we prospectively identified hospitalized pneumonia cases and outpatients with laboratory confirmed influenza in a Thai province. Disease incidence, patient interviews, medical record reviews, and data from a national health survey were used to calculate direct and indirect costs which were extrapolated to the Thai population. Influenza was identified in 80 (11%) of 761 hospitalized pneumonia inpatients with projected annual incidence of 18-111/100,000 population. Influenza was confirmed in 23% of 1092 outpatients with an estimated annual incidence of 1420/100,000 population. Influenza was estimated to cause between US dollar 23.4 and US dollar 62.9 million in economic losses with lost productivity accounting for 56% of all costs. The burden of influenza in Thailand is greater than previously appreciated, particularly in young children and the elderly. The impact and cost-effectiveness of influenza vaccination for high-risk groups merits further investigation.     

Human sparganosis in Thailand: an overview

Human sparganosis is caused by cestode larvae (spargana) of the genus Spirometra, which exploit copepods as the first intermediate host. A wide range of amphibians, reptiles, birds, and mammals serve as second intermediate/paratenic hosts. Human infections occur mainly by ingesting raw intermediate/paratenic hosts. Cases are found mainly in China, Japan and Korea, and sporadically also in Thailand and other Asian countries. In the period 1943–2010, there were 52 reported cases of sparganosis in Thailand. The average patient age was 32 years (range 11–82 years). From the available patient information, the prevalence of sparganosis infection was higher among females than males, at a ratio of F:M = 2:1 (27:15). Patients have mainly been found in the northeast, north, and central regions of Thailand, with only a few in the south. Although a single subcutaneous nodular lesion was the most common feature, about one third of patients had ocular lesions. In particular, patients having ocular lesions were about half of total cases reported pre-1990, with several confirmed cases’ applying fresh frog muscle as a poultice to relieve sore eyes, according to traditional medicine. In Thailand, sparganosis is not merely a food-borne disease but is also caused by the traditional belief of applying frog muscles (contaminated with sparganum) to sore eyes.